Wow, you do have a lot to say on this. Which is fine by me, because it's a topic I've brooded about a lot, myself. So I'm going to add to the volume of text (if others don't like it they don't have to read it!).
Trying CBT myself (and knowing people with diagnosed psychiatric conditions who have had many different types of treatment) has caused me to develop some strong opinions about it.
I honestly just feel it's based on an unrealistic view of how humans work. To me, it seems it's more like psychotherapy for robots, for entities of pure reason that are driven by explicitly formulated logical prepositions (maybe a Prolog program?). I don't feel people work that way. We are biological entities, we have bodies, a physical form in which our responses and behaviours are embodied in very complex ways - we aren't computers or systems of pure abstract reason, who can be debugged, with our logical tenets amended. There's just something a bit 'off' for me about CBT's philosophical underpinnings as it relates to the mind/body distinction (or the thought/emotion relationship).
And it never tells you what to do when your 'negative beliefs' turn out not to be irrational, but are supported by the evidence. And in any case with a large variety of issues it's not really possible to definitively compile 'the evidence', as that would require an extensive, well-funded, reseach program and the writing of a thesis! In practice we all form reactions based on evidence we haven't made explicit and comprehensive, because life would be impossible otherwise (that's why P&N forum exists! If one could rationally come to a verdict about everything there'd be no politics)
I found it useless for dealing with chronic physical pain - the issue never involved conscious 'thoughts' that I could challenge. Pain precludes thought. But it did occur to me, maybe it would have helped me decades ago, when I undeniably suffered from some of those 'unhelpful beliefs', particularly that all-or-nothing-thinking. At school I was absolutely of the view that I had to do everything perfectly and get 100% on every exam or it was a disaster. That was undeniably a problem for a long time.
But then I remember the wider context, all the stressful things that were going on in my life then both at school and outside and then I think how inadequate CBT's approach would have been in the context of that real-world situation at that time. Even though I certainly had some of those unhelpful beliefs, and was fully aware that I had them, the thought of trying to apply that CBT approach in that context to me just again highlights the problem with the way it neglects the 'real world'.
The more I think about it the more inadequate CBT seems to me to be for the scale of the real problems real people wrestle with. Outside, perhaps, of fairly simple problems addressed in otherwise healthy circumstances (like a generally functioning person in reasonable economic and social circumstances who just happens to have an irrational fear of dogs, say - I can imagine it might work for that).
And the other point is, I was always entirely aware of those 'unhelpful beliefs', I used to think about them quite explicitly ("why do I find it impossible to do something without doing it obsessively or getting perfectionist about it?"), I didn't need someone to point it out to me. I was constantly trying to find a solution. The problem was more the way that tendency was deeply hard-wired into my nature, into my psychic and biological pain-and-reward system, and that it existed in a context of chaos and stress in the social environment around me.
I find that part of CBT rather patronising, in its assumption that you aren't already aware of the problems. What made change difficult was not a lack of awareness of the problem, but that real-world context I was in (being surrounded by crazy, even sociopathic and violent, adults and a general atmosphere of chaos and crisis both at school and at home). When that improved I found my own workarounds.
CBT seems to have two flaws, it seems to me. It ignores or neglects our nature as biological, physical entities (instead treating us as creatures of pure abstract reason), and also neglects the fact we do not exist in a vacuum, we are embedded in a wider social system that determines much of our life and constrains what we can do and how we feel. It almost seems to demand people be superheros, magically unconstrained by the real world. It hence comes across as patronising, even insulting, at times. Though I'm sure that is very dependent on the specific practitioner.
I gather that behaviourism is very much out-of-fashion, as the idea that we are simple stimulus-response machines was rightly derided as absurd. But I don't think that just adding a 'C' to the 'B' gets us to a complete picture of what it is to be human. It's still a massively incomplete model.
Oh, and your point 5 takes us into politics. I have a strong feeling that CBT appeals particularly to those of a certain political outlook, but I'd like to avoid this turning into P&N because I think this is an interesting topic in itself, and so far it's been a perfectly amicable discussion.
I think it's important to understand that CBT is only one puzzle piece in a spectrum of solutions. It deals specifically with thoughts, which create emotions, and identifying your thinking & changing it for better outcomes through improved behaviors & emotions, which changes what you do & how you experience your situations.
And it never tells you what to do when your 'negative beliefs' turn out not to be irrational, but are supported by the evidence.
I think this is a personal choice: the way we feel emotionally is a direct result of what we think, and we can
choose what to think. This leads into the quote of "your perception determines your reality". Reality is reality, but we all experience it a little bit differently, depending on our own personal worldviews. And we all have the choice to choose how to think, which defines the emotion we feel about a situation. Lots of people have evidence-based beliefs, lots of people have irrational beliefs, etc. Everyone is free to choose to think however they want to, especially in independent issues, despite what other people think.
I found it useless for dealing with chronic physical pain - the issue never involved conscious 'thoughts' that I could challenge.
I also think it's important to realize that feelings (like pain) are different from emotions (generated by thoughts). You
have feelings; you
create emotions. In the case of chronic pain (sorry to hear that, btw), CBT would apply to how you feel emotionally about the pain, not the feeling of pain itself. A personal example: my friend was involved in a bad car accident & lost the use of his legs. He was confined to a wheelchair for the rest of his life as a result. That's a really difficult situation to be in, but what made it worse was that he was angry about it & took it out on his wife. After a few years, his wife left him. All of his friends thought she was a real jerk for dumping him after he lost the use of his legs, but we eventually came to see that he had developed a rotten attitude about it, and was driving all of us off as well. It took him a long time to accept not only his situation, but his personal responsibility about how how felt about it & how he treated people...his wife didn't leave him because he had become crippled; his wife left him because he had become a jerk. She waited on him hand & foot & could only take so many years of verbal abuse before she got fed up with his behavior. Zooming out, this is why CBT is a one tool in a set, not a magic "master key" that applies to each & every situation - it's specifically for identifying patterns of thinking & learning how to alter them in order to solve personal problems involving things like emotional regulation.
I find that part of CBT rather patronising, in its assumption that you aren't already aware of the problems.
So I think that's a misconception: CBT exists to help you identify the problem, identify how you feel about it, reverse-engineer it & identify how you think about it, decide how you want to think & feel about it, and adjust accordingly. I think most people are already aware of their problems, at least to some extent. In my art classes, for example, I knew it was horribly dumb to not turn in my artwork & fail, because I felt like it had to be awesome & finished completely to my liking per my all-or-nothing drive, but I had never really sat down & mapped it out & allowed myself to see my distorted thinking on it...I just kept it in my head, never bothered to change how I thought about it, and thus never changed how I felt about it, so it really wasn't until I was in college & got acquainted with CBT that I really started to do some self-examination & not only clearly admit my issues to myself but also discover that I was capable of changing that internal mental script.
What made change difficult was not a lack of awareness of the problem, but that real-world context I was in (being surrounded by crazy, even sociopathic and violent, adults and a general atmosphere of chaos and crisis both at school and at home). When that improved I found my own workarounds.
I think this is hugely important to realize, because this is a
different part of the puzzle: if you're in a bad place in different situations like school & at home, no amount of positive thinking is going to fix that for you. To use a commonly-used metaphor, if you're on a bus, headed downhill, with no brakes, and are going to crash - then no amount of changing how you think or feel about the situation is going to fix that - you're going to have to take action to remove yourself from that situation. I suppose CBT could technically be used in this situation to identify the situation & change your behaviors, but CBT is really used to change your thinking, which turns into emotion, so it's more feel-based than action or behavior-based.
If you grew up with a difficult family & went to a difficult school, it's the same type thing - CBT isn't about telling you to smile in hard circumstances, it's about helping you see the situation clearly instead of through inaccurate mental distortions. If the reality of the situation is that the situation is crappy, then that's the reality of the situation. Going home to a violent-adult family is not related to CBT, in terms of realizing that no amount of better thinking is going to change that, aside from perhaps prompting you to find a way of dealing with it, like getting yourself removed from the home or moving out on your own or whatever the best option may be.
I had a friend who was in a similar situation - work & school were fine, but he lived in an intensely verbally-abusive home. As a result of growing up in that situation, he had really low self-esteem & a lot of negative thoughts. Unfortunately, he also had a fixed mindset about it & refused to take any action because he felt like he was stuck & "that was just his life". Fortunately, he met a girl that he started dating who actually treated him nice, and in his mid-20's, he finally moved out on his own & started to work on himself. Extracting himself from a horribly negative situation was technically not related to CBT, because CBT is designed to target specific situations and specifically change how you specifically think & thus specifically feel about that specific situation. CBT is a targeted tool to manage your own internal emotions, not feelings or situations, and I think it's important to separate (1) feelings from emotions, and (2) separate situations that require physical change, apart from changing your emotions (via how you think).
I think CBT can certainly be used to help you identify crappy situations & prompt you to change or remove yourself from those situations, but that's really a separate toolset from what CBT is designed to do:
1. Your thoughts create your emotions, and emotions (a result of what you think) are separate from feelings (ex. pain)
2. CBT is basically designed to help you feel better, emotionally, which results in a variety of effects, such as helping you identify roadblocks to personal success (like turning in your art assignments, lol) or feeling bad about things you shouldn't (there are a variety of effects)
3. We are all responsible for our own thoughts, and thus, our own emotions (
separate from feelings)
4. CBT is a specific tool to help solve specific problems involving emotional regulation
There are many therapies available to help us solve different problems...CBT, EDMR, medicine, personal productivity systems, etc. CBT is not a catch-all for
all issues, such as pain (feeling) or actually living in really difficult situations (re: the bus analogy - changing how you think about those situations can only take you so far), but it is one option available for solving specific problems that involve thinking & emotions, which can open the door to better behaviors, for sure!