Good information, sabby. Thank you. I borrowed this from Alexandra_k's response on the CBT thread. It describes very well the exact nature of my reservations:

CBT might not be well suited to people with trauma disorders and personality disorders (including borderline personality disorder). Some reasons for this (and also reasons that other people may struggle) include:

- The focus on cognitions, as they maintain that faulty cognitions are the typical cause of distressing emotions. The direction of causation is much disputed as there is evidence that emotions can occur in response to unconscious stimuli and when people are required to justify their emotion after some time in CBT they confabulate faulty cognitions even though their cognitions weren't playing a causal role in their emotional experience. This is more likely to be true for people with a history of trauma.
- There is also evidence that emotion can be encapsulated from cognition so that one can believe one thing and feel another. This can occur when people know the spider can't hurt them but they still feel terrified in response, for example. The person says they don't believe the spider can hurt them so cognitive restructuring is fairly pointless with respect to changing the fear response. Behaviourist techniques are likely responsible for the progress made in the case of phobia / anxiety.

A downside of CBT is that the focus on faulty cognition can be experienced as invalidating of emotion. The focus on changing faulty cognition can reinforce the belief that certain emotions are unacceptable and must be changed.