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Wednesday 26th June 2019

Can the psychiatrist's couch be put out of business?

15th March 2011

The Economist looks at therapist-free therapy and asks if cognitive-bias modification may put the psychiatrist’s couch out of business.


Psychoanalysis, which can be traced back to the 1880s, can be an expensive form of therapy.

Today, a typical course of modern talk therapy can consist of 12-16 hour-long sessions, though is a reasonably efficient way of treating conditions like depression and anxiety.

However, a new kind of treatment – cognitive-bias modification (CBM) – has appeared, and does not even need a therapist.

All it requires is sitting in front of a computer and using a program that subtly alters harmful thought patterns.

It seems to work for anxiety and addictions, and is being extended for alcohol abuse, post-traumatic-stress disorder and other disturbances of the mind.

CBM works on the idea that many psychological problems are caused by automatic, unconscious biases in thinking. It aims to alter such biases with some success.

Emily Holmes of Oxford University, who studies the use of CBM for depression, describes the process as "like administering a cognitive vaccine".

In a recent study of social anxiety at Florida State University, which involved 36 volunteers who had been diagnosed with anxiety, half underwent eight short sessions of CBM and the rest were put in a control group and had no treatment. At the end of the study, a majority of the CBM volunteers no longer seemed anxious, whereas in the control group only 11% had shed their anxiety.

Research on CBM with alcohol addiction is shortly to be published and many other researchers are now exploring CBM.


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