Interesting Girl3, very interesting. I think it's very healthily debatable as to whether or not all thought processes and autonomic reactions are amenable to cognitive change, and I personally don't have a definitive view either way yet, though have been very much grappling with this issue of late.
My long time view has been the same as yours and it's why as much as I respect the cognitive-based interventions for their practicality, robustness and general good solid effectiveness, I have always felt some frustration with them at the extreme, because I've always carried the view that some of those instinctive, hard-wired, amigdala-based survival mechanisms are far too spontaneous and ingrained to be, as you say, amenable to cognitive intervention. And I think I do still believe this. But I also believe that long term, successful cognitive interventions can strengthen to the point at which they can kick in very very quickly to defuse and redirect a lot of the instinctual, fight/flight/freeze reactions that are so symptomatic of PTSD, so that while we may always experience those feelings and spontaneous reactions briefly, they can be interupted and overwhelmed quickly enough to permit a very high degree of improved functionality over time.
I'm well aware that I'm using terms very generically, not explaining myself well and being rather simplistic in general, but my point is that I do think that all thought processes are, to some degree, amenable to cognitive interventions, it's just that some are more easily managed than others, and some will always remain a challenge to cognitive domination while others may be completely reversed with time, patience and therapy.
Very interesting though, and a concept I reserve the right to change my mind about any old time!!!
Totally agree re the importance of trust and the time factor associated with schema therapy. I personally find it outstandingly beneficial when used in conjunction with a range of other strategies and tools, but it's true... it hurts like hell and can set you back multiple times and send you in all sorts of different directions that neither you nor your T saw coming. I imagine it's particularly challenging and demanding for the T too - asks a lot of them in terms of personal investment, boundary management and self awareness. I reckon it's worth the journey though.
Maddog
My long time view has been the same as yours and it's why as much as I respect the cognitive-based interventions for their practicality, robustness and general good solid effectiveness, I have always felt some frustration with them at the extreme, because I've always carried the view that some of those instinctive, hard-wired, amigdala-based survival mechanisms are far too spontaneous and ingrained to be, as you say, amenable to cognitive intervention. And I think I do still believe this. But I also believe that long term, successful cognitive interventions can strengthen to the point at which they can kick in very very quickly to defuse and redirect a lot of the instinctual, fight/flight/freeze reactions that are so symptomatic of PTSD, so that while we may always experience those feelings and spontaneous reactions briefly, they can be interupted and overwhelmed quickly enough to permit a very high degree of improved functionality over time.
I'm well aware that I'm using terms very generically, not explaining myself well and being rather simplistic in general, but my point is that I do think that all thought processes are, to some degree, amenable to cognitive interventions, it's just that some are more easily managed than others, and some will always remain a challenge to cognitive domination while others may be completely reversed with time, patience and therapy.
Very interesting though, and a concept I reserve the right to change my mind about any old time!!!
Totally agree re the importance of trust and the time factor associated with schema therapy. I personally find it outstandingly beneficial when used in conjunction with a range of other strategies and tools, but it's true... it hurts like hell and can set you back multiple times and send you in all sorts of different directions that neither you nor your T saw coming. I imagine it's particularly challenging and demanding for the T too - asks a lot of them in terms of personal investment, boundary management and self awareness. I reckon it's worth the journey though.
Maddog