Socratic Questioning in CPT

[Tinyflame]

@Justmehere I forgot, the video above said 'shaking' is actually a really good sign. (A lot ties in to Peter Levine and Bessel Van der Kolk's work).

I want to look at CFT (Compassion Focused Therapy- Dr. Paul Gilbert)- there is another option (of many things, or ways, or maybe ways to tweak it? Gentler ways? :hug: )

 

[Justmehere]

Although I know it’s probably not questions in general, but the act of being drilled down into, forced to change, forced to break, forced to be what’s necessary and the choice/no-choice of it welding right/wrong/yes/no/all-of-it together. And the consequences. The terrible unthinkable consequences if it’s gotten wrong. Even the tiniest bit wrong.

Yep. Exactly.

Come at the trigger, first, instead of the root cause.

As in, move questions to be just questions, not interrogative nonsense.

Sometimes I can do this. It doesn't really lead to any insight or change as is intended by socratic questioning...

Or it can be useful for questioning the lies abusive pricks taught us about ourselves and deconstruing them.
Or giving an agency that you CAN question things that would seem given for absolute and the freedom in that.

This is a good point.

Who suggested this approach to you?

My therapist.

Can you ask your therapist to help separate the waters first? In the sense of being a grounding ability for you not to equate therapy with torture or therapists with perpetrators.

This isn't working out in therapy for some reason but seems to be a key thing to sort out.

However I do have doubts about the idea of a valid innate inner truth. My inner truths are distorted - that is part of PTSD. Socratic questioning may be useful to reveal those distortions, but in itself can't change them.

CBT ways of challenging distorted thoughts have worked in the past, but it's more directive. I have distorted thoughts, no doubt... and Socratic questioning, for whatever reason, doesn't seem to lead to them changing. A few direct questions makes sense to me, like asking, "can you think of a less black and white viewpoint?" I don't have to believe that viewpoint. It doesn't have to be an innate thought. It can just be a hypothesis, an idea to try on.

Long strings of socratic questioning in therapy right now are not really about getting to my truth. I mean, let's be honest. If my innate truth is "I am a unicorn and that's why I was abused" my therapist isn't going to accept that. The CPT therapist is trying to get to a version of the truth, which may or may not be my own.

My experience of this process is that the questions are not direct. They are trying to question me, manipulate me, into a truth, and when I don't get it right, the questions get repeated and twisted until I do eventually get it right, sometimes by saying sh*t I don't believe, or it ends when I walk out because I don't like this game of trying to be questioned at long lengths into insight. Also, insight alone has it's limits. Sometimes, I can talk like she wants to hear, but then I'm only saying what she wants to hear and I can't stand it. When I say what I am actually thinking, I get questioned to death, and I can freaking argue the validity of my thoughts pretty damn well. Which is often what happens.

When I say, "People have hurt me because it brought them pleasure or stress relief to do so" (which yes, I know, is possibly a little too black-and-white") as my "stuck point" and getting the question back, "is that thought based on habit or fact?" just leads me to feeling really sh*tty. I don't know why. I want to yell at her, "just say to me, 'I don't think that's factual.'"

Because here's the deal: if I say back, "fact" then I'm wrong. So somehow I'm supposed to say "habit," and I only know this through the damn question game. And by the fact that the questions will get more intense if I say fact. So FINE. (Damn it, just writing about this pisses me off. UGH. What is wrong with me?!)

These two T's were gentle in their questioning and giving space to think and answer. If I felt interrogated I would walk out and slam the door behind me.

I've actually done this... sigh.

He speaks of when do we not say no when we should if we are being authentic, why we don't and the implications; the difference between intuition and our reactions with trauma; and he does SQ with people/ a person in the audience (who are willing), and it's quite shocking how it develops for the person.

It can be quite helpful for some, and maybe it could be for me, but I am too defensive.

You don't deserve self disgust. Survival is an amazing thing. Disgust belongs to the perp. Its normal to try to satisfy someone doing this.

Thanks for this reminder. It is very appreciated right now - and hard to believe.

I'm assuming normal teaching type CBT may be fine as well as talk therapy which is on the warm and less questioning spectrum.

This actually does help. I don't understand why we don't do this. But whatever, CPT is what my therapist is suggesting we do, and it will mean more of this Socratic questioning if I agree to go back and do it. (We currently have nothing scheduled until I am ready and the holidays are over.)

I think I may have too many walls up and be too defensive with therapists right now to do CPT. I don't really have a therapist with the ability to help me pull them back down. Maybe I could find some CBT worksheets, like the same type they use in CPT, and do them about the trigger of being questioned and begin to sort this out on my own, and bring them in to a session with her and see what she thinks. Maybe we could deal with the trigger first instead of just into the trauma and trigger me endlessly in how we do that. Or I move on to find a different therapy.

Questions are totally ok here for me. I've tried to figure out why. I think it's because 1.) it tends to be direct in the goal 2.) I've yet to see a post on a thread that is a long list of 57 questions back to back with zero statements 3.) this forum is not "safe," but I guess I would say that I figure my peers are on my "side" so to speak, in a way that I've lost any sense of with therapists. <-- perhaps I need to CPT or CBT this.

 

[Ronin]

Is there a chance you would pick this up as a method with another therapist?

Since sounds to me discrediting your life experiences and challenging your reality are not meant to be a part of that method, and whoever is doing it with you has not really caught onto that concept. So someone with more understanding of subtleties, that there are truths that may need a correction here and there... and then there are core truths one *should not* challenge and f*ck with, as they are a basis of sanity...?

 

[Abstract]

It sounds like the questions themselves may not be the whole problem. Its maybe the manipulation and perceived lack of safety (triggerdness) that are. Maybe it isnt that strange that questioning from her is presently an issue in context of therapy not working for either of you at present. Needing to feel OK in the therapy space isn't such an unusual thing to need to have something you find challenging be OK. Especially considering the traumatic event you are dealing with.

The perp was using questions to express violence at you, to manipulate you and attempt to humiliate you. You don't presently have the stomach for anything that seems manipulative.

I have to say as a personal side note that I can pick up when a therapist has a strong agenda with questions and I especially don't love it if there is a long string of them without any real attempt to genuinely hear and discuss what I have to say in reply. I have however experienced therapist being genuinely interested in what I have to say. Yes Im sure with an idea of what they think is best to start but still open to learning with me. I may be stuck in unhelpful thought loops, self hatred or any number of things but I also am not totally ignorant about my life and what helps me and doesn't and am the only person with direct access to my brain.

I wonder if she has fallen into a mentality where she is too stuck in an agenda for you and battle with you and not listening enough. Not giving you enough credit for being part of what can help you.

Did you tell her how triggering you found that long questioning session? That sounded very much like it was happening to fit an agenda she had. If you did then her suggesting something that centres around more questioning is an interesting choice. There really should be lots of choices for you that could potentially work. With other people, other styles of interacting or other approaches. You know a lot about you. You don't have to just go with what she says.

list of 57 questions back to back with zero statements

I don't even need to make a comment about that.

 

[Tinyflame]

Yes I guess I'm not presupposing the questions (or answers) are simply to uncover cognitive distortions, but rather for you to understand the nuances of what make you tick- for you, and to decide if you want to keep them, or not, or something in between (not black or white). In the realm of (your own) emotional experience- not on the basis of a cognitive one. (Cognitive says I understand x and y and z, emotional says does it serve me now, how?, and do I want to build on that, or replace it, or alter it?)

 

[Justmehere]

A super basic outline of Socratic questioning:

1. Is this thought realistic?
2. Am I basing my thoughts on facts or on feelings?
3. What is the evidence for this thought?
4. Could I be misinterpreting the evidence?
5. Am I viewing the situation as black and white, when it’s really more complicated?
6. Am I having this thought out of habit, or do facts support it? CBT's Cognitive Restructuring (CR) For Tackling Cognitive Distortions

One of my "stuck point" thoughts: "I will be penalized if I answer incorrectly."
1.) Yes, appears to be realistic.
2.) I am basing this thought on facts and feelings. Both.
3.) See trauma, family life, therapy, and etc, etc ....for significant evidence.
4.) I could possibly be wrong.
5.) I don't think this is a too black-and-white view.
6.) The facts do appear to support it.

Perhaps it would be more accurate to say, "I will face negative consequences for wrong answers." This thought doesn't really change anything for me though.

I can see how this process could work for something less "stuck" and more distorted, like, "the world is better off without me." There is evidence to the contrary, it is a habitual thought, etc.

This is a worksheet with more Socratic questions. All the questions assume the thought is wrong. What to do when it's not wrong? I don't see how it helps to have a therapist question the crap out of it.

 

[Tinyflame]

Wow @Justmehere , that makes sense (I guess???), but not what I'm referring to.. for example- forgetting to look for any of the above, just to 'answer' ( as good science doesn't look to prove anything specific, nor is right nor wrong):

I will be penalized; or face wrong answers, perhaps:

How would you be penalized? What would that look like?
-> What would that mean?
or, -> What makes that wrong?
-> If I am penalized, what does that affect? How does that make me feel?
-> What am I afraid to lose?
(etc etc, etc- They are your questions, that expound on your own answers).

:hug:

 

[Friday]

A super basic outline of Socratic questioning:

You know this is just running thoughts through a cognitive distortion filter... right? IE take the thought and run through the top 10 CDs to see if it’s biased or skewed, and voila.

Link Removed with more Socratic questions. All the questions assume the thought is wrong. What to do when it's not wrong? I

Why would you be working on thoughts that AREN’T wrong (or problematic), and attempting to change them?

 

[Justmehere]

You know this is just running thoughts through a cognitive distortion filter... right? IE take the thought and run through the top 10 CDs to see if it’s biased or skewed, and voila.

Right! Minus the Socratic questioning, CPT is just CBT repackaged. It works to take a thought and hold it up to that list, and see if I’m off. That works for me. Totally can do that.

Why would you be working on thoughts that AREN’T wrong (or problematic), and attempting to change them?

Well. There in lies the confusion. CPT works on “why you think the trauma happened” and “what thoughts you have now that bring up any symptoms today.” I feel anxiety when I think of “wrong answers bring negative consequences.” I know the perp did what he did because he was a horrible human. Not because of whatever answers I gave. I still think “wrong answers bring negative consequences” and I have a fight or flight response when I think that thought. Which now that I think more about it, that fight or flight reaction probably means somewhere in my convoluted brain, I’m also thinking “wrong answers = threat of terrible pain or death.” That is a distorted thought. Too black and white, all or nothing, etc.

It feels like a classically conditioned response at this point to get so anxious about this, but it might be helpful to challenge the thought “wrong answers bring negative consequences” with the addition of “but that doesn’t mean I’m going to die.”

I think I’m going to ask if we can do plain old CBT before trying CPT.

 

[hithere]

I did CPT. The socratic questioning doesn't really go like you think it does. AT ALL. Have you done it yet? You are in control of the questioning because you start with ABC sheets, and then you do the impact statement, and then with the help of your therapist in a helpful way you identify the hot spots and stuck points. It was super therapeutic. It was the best part of my therapy. The therapist does not question you, or ask questions. You ask yourself questions. There's a whole list you're given, and a structured form of problematic thinking and thought records. REally unless you therapist is stupid (many are ) it isn't scary and won't trigger you. The triggery part is the impact statement and then the written account. THATS the scary part! You do those after you practice on the abc sheets. It's really very throughtful and laid out and you feel totally in control. It is helpful to be kind of rigid with the program, too. the temptation to not be rigid with it acts against it a bit. The rigidity of the program has a purpose that s actually helpful.

 

[Justmehere]

@hithere - I’m glad you had such a positive experience! That’s great! Really good to read. The worksheets in CPT are good tools. They are almost the same as used in CBT. I’m glad your therapist did it in a way that was helpful to you.

The socratic questioning doesn't really go like you think it does. AT ALL. Have you done it yet?

I have undergone socratic questioning in therapy. I hated it, walked out, and nearly quit treatment with anyone.

I haven’t done CPT in therapy. I read the manual for therapists and the one for clients. The manual for therapists gives long examples of how to question the client in CPT sessions, which sessions to do it in, etc. I’ve done all the worksheets and written out the impact statement and written account. I’ve done enough CBT on my own and therapy generally that it was doable.

The parts I haven’t done are the parts that involve a therapist, and the one therapist suggesting this therapy has already been recently very bent towards using lots of long strings of questions in sessions as she got trained in CPT therapy.

 

[hithere]

@hithere - I’m glad you had such a positive experience! That’s great! Really good to read. The worksheets in CPT are good tools. They are almost the same as used in CBT. I’m glad your therapist did it in a way that was helpful to you.

I have undergone socratic questioning in therapy. I hated it, walked out, and nearly quit treatment with anyone.

I haven’t done CPT in therapy. I read the manual for therapists and the one for clients. The manual for therapists gives long examples of how to question the client in CPT sessions, which sessions to do it in, etc. I’ve done all the worksheets and written out the impact statement and written account. I’ve done enough CBT on my own and therapy generally that it was doable.

The parts I haven’t done are the parts that involve a therapist, and the one therapist suggesting this therapy has already been recently very bent towards using lots of long strings of questions in sessions as she got trained in CPT therapy.

I would have a serious problem with long strings of questions as it would feel like an interrogation that leads to a "trick" or a "trap" oh my god I am getting activated just thinking about how that is a big big trigger. I know where that comes from too- I would not be able to handle it. I'm glad my therapist was more collaborative- I am very negative about therapy right now though. I know I m saying two different things. But I guess I liked cpt better becaue it kind of "controlled" the therapist so they wouldn't go off into unhelpful territory. it gave them a plan to follow,