Lesson 6 of 6 · When to stop reading and see someone
What the evidence says, including where it is thin
Two things held at once. The evidence for talking treatment here is genuinely good, and it is honest about its own limits, which we would rather show you than tidy away. And seeking a remedy sits inside the tradition rather than outside it. The Companions asked whether they should make use of medical treatment and were told to make use of it. And when a man asked whether to tie his camel and rely on Allah or leave it loose and rely on Allah, he was told to tie it and rely.
Qur’an and Sunnah
The report beside this tells a man to tie his camel and then rely. The verse is that second half on its own. Seeking the treatment and trusting Allah are being put side by side here, not set against each other.
وَيَرۡزُقۡهُ مِنۡ حَيۡثُ لَا يَحۡتَسِبُۚ وَمَن يَتَوَكَّلۡ عَلَى ٱللَّهِ فَهُوَ حَسۡبُهُۥٓۚ إِنَّ ٱللَّهَ بَٰلِغُ أَمۡرِهِۦۚ قَدۡ جَعَلَ ٱللَّهُ لِكُلِّ شَيۡءࣲ قَدۡرࣰ ا
and will provide for them from an unexpected source; God will be enough for those who put their trust in Him. God achieves His purpose; God has set a due measure for everything
Qur’an 65:3
There is no disease Allah created without also creating its treatment. That is the plainest form of the point, that a remedy exists to be looked for. The longer report here carries the same sentence inside a fuller exchange, so you can read it on its own and in its setting.
Narrated Abu Huraira:The Prophet (ﷺ) said, "There is no disease that Allah has created, except that He also has created its treatment
Sahih al-Bukhari 5678graded sound, sahihaynthe Arabic and its grading
They asked whether they should make use of medical treatment and were told to make use of it. Seeking help for this sits inside the tradition rather than outside it.
Narrated Usamah ibn Sharik: I came to the Prophet (ﷺ) and his Companions were sitting as if they had birds on their heads. I saluted and sat down. The desert Arabs then came from here and there. They asked: Messenger of Allah, should we make use of medical treatment? He replied: Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age
Sunan Abi Dawud 3855graded sound, albanithe Arabic and its grading
A man asked whether to tie his camel and rely on Allah, or leave it loose and rely. Tie it and rely. Doing the practical thing was not treated as the opposite of trust, which is the other half of the point about seeking help.
Anas bin Malik narrated that a man said:"O Messenger of Allah! Shall I tie it and rely(upon Allah), or leave it loose and rely(upon Allah)?" He said: "Tie it and rely(upon Allah)." Other chains report similar narrations
Jami' at-Tirmidhi 2517graded sound, albanithe Arabic and its grading
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Across 41 trials and 2,843 people, talking treatment moved anxiety symptoms by a moderate amount, and moved quality of life less. It works, and it works less completely than the headline number suggests, which is worth knowing before you start rather than after.
41 randomised trials against a placebo condition, 2,843 people. Symptoms of the target disorder improved by a moderate amount, Hedges g 0.56, while quality of life moved less, 0.30. The authors say plainly that therapists cannot be blinded in trials like these, and that the effects for panic and social anxiety were smaller than for generalised anxiety. Symptom scores move more than lives do, and that is worth knowing before you start.
Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JAJ, Hofmann SG (2018). Cognitive behavioral therapy for anxiety and related disorders: a meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502 to 514 doi
Improving and recovering are not the same thing, and a real share of people whose scores improve still meet the criteria afterwards. This is the honest counterweight to the numbers above, and it is here so you are not disappointed by an ordinary result.
Responding to treatment and recovering from the condition are not the same thing. A meaningful share of people whose scores improve still meet the criteria for the disorder afterwards. This is the honest counterweight to the numbers above.
Springer KS, Levy HC, Tolin DF (2018). Remission in CBT for adult anxiety disorders: a meta-analysis. Clinical Psychology Review, 61, 1 to 8 doi