Cognitive Behavioral Therapy (CBT) is, as it’s name suggests, is a form of talk therapy which combines elements of thinking (cognitive) and behavioral disciplines.  It grew out of behavioral theories as developed by John Watson and B.F. Skinner, and the cognitive theory of behavior as formulated  chiefly by Aaron Beck back in the 60’s.   So it’s a relatively new type of  psychological, non-pharmacological treatment.  Lately I’ve noticed that it’s being applied to everything – not just depression.  You could probably fix your leaky pipes with it, but we’re only going to modestly attempt to use the technique in our  two case studies.  We’re going to make better ping pong players (and better citizens) of our maladaptive (dysfunctional?) protagonists.  (And we’re going to do it in 2 or 3 paragraphs!-  we don’t need no PhD’s!)

      The wall puncher first.  Let’s assume that he’s  willing to proceed with this kind of therapy, although maybe a little reluctantly, because his instinct is to resist change and because he’s not exactly open minded. (Remember, he’s outta his mind.)  But maybe he’s amenable because his wife is vowing to throw him out of the house unless he can control his  reptilian brain and his violent temper. (He also happens to be a menace behind the wheel, threatening anyone on the highway who “doesn’t know how to drive” = road rage).   We can also try a behavioral motivational approach with a reward – by suggesting that he will not be expelled from his home or the club if he stops putting his fists through the sheetrock.  And we can also instill the idea that the players who have shunned him (i.e., won’t play with him) will be better disposed toward him and more willing to play with him if he behaves himself like a “normal” human being. (Don’t insist that you are right about these things.  Ask him if he thinks these ideas make sense.  The lecturing technique is usually self-defeating.) 

      Next, we have to rid him of the faulty cognitions – his thinking, for example, that he was born the way he is and that’s it’s an inborn biological thing that makes him hurl rackets and punch stuff.  Teach the guy to challenge these erroneous ideas.  He wasn’t really born that way and he doesn’t always punch the wall (e.g., when he wins).  Remind him about this and ask him if that’s true.  And, teach him to identify the times he’s about to go off so that he can utilize relaxing techniques (he can take deep breaths; he can count to 10 … make that 100; he can call a time-out).  If he’s not intellectually impaired, appeal to whatever shred of rationality he retains by reminding the guy that ping pong is only a game. (Ask him if he agrees with that.  Ask him if people at the club are evaluated on  criteria other than their winning at ping pong.)  Okay, enough of this guy.  We’ve cured him.  Let’s go to nutcase #2, our self-deprecating booby. 

     The overriding issue with the Numbah 2 crazy man, is his talking to himself all the time with all of those derogatory comments. He’s got to shup up.  He’s got to put a lid on it. No…. make that a muzzle. He has to be muzzled.  (In cognitive therapy, you’re not supposed to say that the guy is dysfunctional, only that his thoughts are.)  In his case, with all of the faulty cognitions (e.g., saying that he’s a  turkey or a dope), they have become self-fulfilling prophecies.  So, if we can make him mute, he won’t be talking himself into a blue funk.  We can even let the guy practice losing, so that he can attempt to find grace and graciousness when he experiences defeat. He might find it rewarding to be seen as a ‘nice’ considerate type of guy. It might even lower his blood pressure and heart rate.  And try to get him to see the game as a game – and not as a measure of his manhood if he wins or loses.  “Dispute” all of his negative thoughts (as they say).  

      Alright, we can discharge these two patients.  Two cures.  But, just in case none of this stuff works, better put these  guys into a nursing home – one where they have no ping pong tables.  Don’t forget to throw away the key.   We’re done with them.

      Okay, okay, so this isn’t exactly classical Cognitive Behavioral Therapy.   Real CBT costs 150 bucks an hour.  Lao Du