Cbt

[Silver.]

-I don't like my mom pooch (I've worked on it, but it's still there, I don't beat myself up about it, I just buy bigger shirts)
It's like when my dermatologist reminds me I will have a scar from the cysts I have to have removed. I just think, well it can join the others, I am not fussed
-since weaning off klonopin, I often feel like I am not explaining myself well (an I am not clear belief?)
and often ask, does this make sense?

 

[Friday]

<chuckling> Actually Redfield used tons of CBT in that book. Reframing thoughts, scripts&schemas & how to alter them, perceptive & emotional shifts, grounding & centering, mindfulness/awareness, rational emotive, dialectal, stress inoculation, acceptance & commitment... If you've been following the principles outlined in that book, you've done essentially 76-82% (made up number, that just feels right in my gut) of the CBT therapies out there. Agreed. It's a great book. Been a millenia since I've read it, though.

 

[Silver.]

^^
that's my point heh, I am already doing (and have done for years), what they are meant to help you learn/achieve
could my thought processes be improved upon? I am sure of it. If I could find a therapist really skilled with this, it certainly wouldn't hurt

 

[joeylittle]

I won't write this very well - but here's an attempt...

CBT isn't only useful for what I'd call 'overt' thought processes - it's also applicable to the more hard-to-pin-down emotional reasonings, and even purely physical events that appear to have no thought behind them at all.

A common one is the belief that certain things (about one's health) cannot be helped. It's difficult to be certain that acceptance is always neutral...I have a belief that fundamentally, I'll be dealing with depression the rest of my life. Most of the time, I think I'm neutral about that. The fact is, sometimes, I'm not at all neutral about it. I can bully myself into accepting it, but I'm using negative tactics to do so. It's subtle, but it's real, and it's one piece of a bigger puzzle that constructs a core belief that I'm broken.

None of this happens with much surface emotional response. But, it's cognition, and it benefits from CBT techniques.

I don't know if this is the case with you, @Silver. - I'm just sharing it as a way that CBT can go farther, as a tool. It's not only for defusing thoughts that are tied to immediate, present-day issues. It can also be applied to the more subtle, almost subconscious thoughts that we have. Part of CBT is the act of teasing those out, finding what is activated under the surface, even if we can say 'it's OK'.

 

[Abstract]

Hi Silver,

I wanted to answer when you wrote this but didn't have the time.

Explanation of my reply: Ignoring the use of CBT as the wide blanket of behavioural therapy and rather using it to describe formal CBT (in the way that it is commonly identified). Not talking about trauma focused CBT or DBT either. To me the additions totally change the essence of the therapy and in truth other behavioural therapies often target different core issues. Such as emotion regulation.

I have been a bit obsessed about figuring out why it isn't useful for some and yet is for others. I'm still not sure of the answer to that. I am a little bit clearer or have a few theories. I need to continue but am presently in an unusual for me lacking in forward movement phase,

I was actively harmed by CBT and only started making progress after I had the first lot of therapy that didn't actively use it. I had to undo some of the harm caused as well as deal with my other issues. It sounds like it isn't harmful to you but that the issues it addresses are not the most important or fundamental to your healing at this point.

To my mind there is no doubt that all human beings do the common cognitive distortions to some extent or other. That is only one small part of the story though. What else are they dealing with. What potential vulnerabilities do they have that could stand in the way, Do cognitive distortions cause enough issues in their life to cause significant harm. Could something else be more targeted to their main concerns. Could it be approaching the issue in a way that doesn't just not understand the core concern but rather actively detract from dealing with it,


The very tendency to try to make you accept that you need CBT is to me quite symbolic of CBT in a sense.

I should probably add an additional comment here as usually if I say anything against CBT then people seem to think I hate it, I don;t hate CBT. I just don't think it helps all, I think it can potentially harm some, and I have hated it for me. I totally accept and love that it helps many. Just not me. Not in the past.

To me one of the added ironies of CBT is that it inevitably communicates some of the things it is said to avoid, There is a big metaphorical "should" hanging over it. It is a little black and white in what it expects people to benefit from. Or rather it's probably some of the people using it in a whole hearted way that are sometimes this way inclined. CBT doesn't protest to be the solution for all.

CBT distanced me from my emotions and self more than before (which was a lot), I reacted to it with increased shame and self hated. It distanced me from dealing with the real issues I was dealing with in my life. Denial, dissociation, repeated patterns of negative interactions with others. Sometimes ones thinking is far from the most problematic part of the equation.

Also - some people are way more inclined to cognitive distortions than others. And some are way more oblivious or aware of them when they do do them.

It sounds like you don't do them a lot and feel that other things are the main cause of distress in your life. Have you tried other types of therapy and is there some other approach that would better suit your needs at present? You sound pretty self aware and sensible so trust your instincts.

Unfortunately schemas etc are not used in therapy as often. The more in depth aspects of CBT. What is much more common is the standard 3, 6 or 8 sessions of working on cognitive distortions.

 

[Abstract]

Some of the messages I have received when I have ventured to say CBT wasn't helpful for me:
You obviously haven't done it properly
It was the therapists fault it didn't help not the CBT approach itself.
You obviously didn't commit and didn't put the effort in.
You are obviously defensive which indicates cognitive distortions - you need CBT.

Sure that is sometimes true when it isn't helpful for a person. All untrue for me.

Oh and: it helped for me so it must help for you....

 

[Silver.]

@Abstract
thank you!!
I have seen people here and even in the real world who have said "CBT made things worse" or it "just didn't help" and my brain could not wrap around that idea. I just couldn't "get it" no matter how many different ways I was looking at it
I can completely see how it would distance you from your emotions and in that aspect, and that makes total sense as to why it wouldn't work for you (and possibly make things worse). It actually sounds like it could have been pretty scary.

I am grateful that you took the time to write why it didn't work for you, because my goal in this thread was to see explanations of why it wasn't helpful or made things worse so I could understand
(and as odd as it sounds, it makes me a feel a bit better that I am not the only one thinking "hmm, why isn't this working for people") x

 

[Abstract]

Oh, I totally understand that Silver. It is really hard to feel OK about something like this when firstly most people do find something helpful and secondly statistics and other similar things say one should. The reaction from a lot of therapists is along that line too.

I suspect there could be many reasons someone doesn't find it helpful. Probably from being particularly healthy in that area to all sorts of vulnerabilities. Unhealthy areas. Certain types of ego fragility for one. Your article made good points.

It sounds like you are particularly healthy in that area and that's great. We don't all automatically have issues in all aspects of functioning. And for some a tiny bit of exposure to these concepts is enough.

Ironically my husband has no diagnosable mental health issues but lives bombarded by cognitive distortions with zero self awareness. Compared to my fairly low levels (other than self hatred issues). He would probably find a short course of CBT life changing, But he thinks other people are the problem not him. He is exactly one of the types of people that needs it in my opinion.

If you want to read more about the potential problems some people can have with the approach then look at the writings of Martha Linehan and the origins of DBT. Yes it was originally aimed at BPD but it is also relevant for many others and for many reasons. Some of them to do with which areas of functioning are not working the most. Some because of invalidation injuries. Some because of the level of real and continuing ongoing distress or suffering in their lives.

Invalidation can be a key point for some people. If you are not familiar you might want to read about what is meant by a clinically invalidating environment in childhood and the potential consequences that can occur.

I tend to be very open to hearing new things and taking on tasks. Throw myself into things. Extremely tuned into other people, their feelings etc. What I was shockingly poor at was knowing what I felt or thought (to do with myself not others), being able to express it, acknowledging the real problems in my life and toxic self hatred and shame. I needed encouragement both thinking about the past and encouragement seeing the negative in the present. Rather than any tentative steps in those directions being met with "how else can you think about this". My problem was whitewashing it all.

I didn't have the ability to tell that something was harming me in the moment or even over a period of time, often. When you don't have a self or sense of self and are chronically dissociated you can appear OK too. Forceful approaches like CBT don't leave space for someone chronically separated from themselves to connect the dots and start dealing with reality. There is then not enough information for the therapist to do it either as the client has to share the info first,

When it comes to therapists and the approaches they choose it seems to me that those who are CBT only are more likely to be black and white and rigid in the way they deal with therapy and those who just use it as an extra tool in their kit much more flexible and open to different perspectives. Ironic again if you ask me when one thinks of what CBT is supposed to be teaching but maybe not a surprise as I think those more inclined to that way of thinking are going to find it more useful. Just my opinion and as I said before - I know my thoughts on this are still incomplete. Always interested when I learn more about it and always open to new input.

Are you in therapy?

 

[Silver.]

What an extremely thought out reply, thankyou. I am glad to have a direction to take to start researching. I enjoy having something new to look into.

I am in therapy right now, though she is a 12 visit therapist, which isn't ideal for me, but she is what is available in this town (and the only person in an ever-growing radius that takes both of my insurances).

My s/o also does not have mental illness but has recently started therapy to tackle some of his cognitive distortions and insecurities, we are definitely opposites in the way we view situations/people/opportunities/setbacks and so on.

I am having serious brain scramble right now, and while I know I have more to say, I can't seem to reach it at the moment. I greatly appreciate the time and effort you have put into replying.
Thank you so much x

 

[Keming]

I have similar difficulties with CBT. My significant other frequently reminds me that CBT, like all therapies, will not work for everyone. Close reading of a dozen or so CBT workbooks/publications leads me to conclude:
a) CBT is meant for people of average intelligence; and
b) CBT is meant for people who are not self-aware.

I am glad that ordinary, normal people have something like CBT to help them with their troubles and trauma; but for myself, there's nothing in the CBT methodology that I haven't been doing since I was twelve. Every time I describe a problem to my therapist and he asks how I tried to solve it, I give him my method:
- Examine the problem
- Examine my emotional and intellectual reactions to the problem
- List at least four potential solutions
- Discard solutions that can be categorized as reactionary, aggressive or destructive
- Examine remaining solutions, and refine as necessary
- Select a solution that maximizes desirable outcomes while minimizing emotional content, conflict, and destructive fallout
- Note the results
- Record all actions in my notebook for later perusal. Take care to notice positive outcomes, and congratulate myself for the method, solution and outcome combined.

And my therapist nods, makes a note in his book, and changes the subject. Every time.