Problems Understanding Cbt - Questions Therapy Can Never Answer

[Sunset]

This is one thing I've never been able to understand about the idea of cognitive distortions. It's not that I don't get what they are, but I don't get how you're supposed to tell what is and isn't a distortion. And I'm just left in a place where I feel like cognitive distortions seem to depend more on the personal viewpoint of whoever you're talking to and what they find "believable", rather than having any sort of discernible objective standard that I can learn. I've asked therapists before and never gotten an answer. (In fact that's one of my big issues with therapy, that I ended up feeling it was more about imposing the therapist's view than working with mine. And before someone says try another one, I've tried 13 and that was my impression of every single one. I think it's just baked into the mindset.)

My life hasn't been rational or believable. The only reason I'm still standing here today is that I found the strength to stand against situations that everything I'd been taught and every single person around me told me were normal and natural, and to say the were wrong. And I heard all the lines - not in so many words, but still. You're seeing things too black and white, you always expect the worst, etc...and everyone around me, therapists included, would keep saying that right up until the situation turned really nasty and I got hurt badly. Even looking back, if I relate the situations without going into excruciating detail I always get told I'm catastrophizing or or something, that it can't be as bad as I say. Until I invite someone to go over the details of the situation, including the expert advice I've gotten (e.g. legal), and they can't come up with anything either.

And that's my frustration. I've been in so many situations where I was the only one saying this is really bad until too late. Or where I don't get help because people are so stupidly busy trying to get me over my distortions that they won't trust me when I need it. But how do you know? The supposed cognitive distortions look exactly like the times it really was that bad and people just didn't want to see it.

 

[radicalgratitude]

You sound like you might be a good candidate for a different kind of therapy called IFS: Internal Family Systems Therapy. http://www.selfleadership.org/
CBT only took me so far, also. I have found that for the first time, after a decade, I am recovering from my eating disorder, not to mention my traumatized parts are being healed.

 

[Intrepid]

Most of my approximately 15 therapists were well meaning and kind (1 was a real jerk), but non really got me very far. With my current therapist I took charge, and basically had to reinvent the wheel. She let me do that, which was a good thing, since by that time I didn't trust anyone. After 4 years I'm able to see that what I've done is similar to several therapies, but not exactly like any one.
My current therapist uses a version of Family Systems Therapy.

 

[Deleted member 1860]

I think CBT works best for opinion based things, not interpretations on things that are actually happening. Does this make sense? I have never used CBT for interpreting life events, as that just seems like a losing battle, and not what CBT was intended for. I mean, CBT is a way of changing our negative thoughts about ourselves and of the world in order to feel better about ourselves. We can change things like "I hate myself" or "I am ugly" or "everyone hates me" and the like. I don't see how CBT fits into changing the meaning of negative things around you, and if it attempts to do that, then I can see this as one BIG mind f*ck, somewhere in the realm of gaslighting.

 

[Chava]

Have you tried something other than CBT or are you just finding parts of it are very helpful/useful? For a while parts of it were useful for me. But my life isn't all rationale either, especially the trauma bits. CBT approach feels sort of insulting, at least if not done with good trauma sensitivity. My thoughts DON'T make sense sometimes, but I'm finding it's more body based (but then thoughts get tangled in too) and it's more because I'm stressed and tangled in past and present. I need help sorting that out. It helps to be aware of present reality. But working with trauma energy and stuff is a lot different than working with thoughts. I get into some really all-or-nothing thinking when stuff is spiraling out of control, but I like that my therapist doesn't treat it as wrong thoughts or try to correct the thinking, more just the awareness and helping me separate past and present. Personally it just helps lessen the shame to not think I'm too far F#cked in the head. I'm recovering from trauma, not wrong thoughts (all this being said, I never had a purely trauma-focused CBT therapist, though some with some trauma or EMDR training...total CBT trauma focus might be something I just know nothing about). My cognitive and rationale brain actually works really well. My trauma brain (animal brain, midbrain, whatever)...not so much. It can color my thoughts, but I've found my thoughts aren't the primary issue, which just makes this all less confusing for me.

So, just a thought (hmm). Not sure if you have reasons for sticking with CBT or, I know in some areas it's just what is most accessible. And none of this is to say it isn't helpful, so sorry if I'm not really answering your question. My CBT therapists were helpful for some stuff but I ultimately just found that form of therapy less helpful for my stuff. Lots of times there IS a very good reason for my behavior, or it makes good sense in some context, but the context itself is misplaced or I'm gluing my past and present together. In those cases, feeling like my thoughts are distorted is like an invalidation of what really made sense (at some other time). I just need to sort out "time", not so much thoughts.

 

[joeylittle]

Identifying cognitive distortions is a very precise and limited kind of thing. It's really not for labeling a person, only labeling a style to their thinking of a particular thought. It's why there are about 18 different types.

I've heard many therapists and group leaders end up throwing them around everywhere, and using them globally - it's not the purpose.

So, I have a recurring thought pattern: when I practice piano, there is only doing it wrong or doing it right. I literally do not perceive anything in-between. But that is factually untrue; there are shades of wrong and shades of right. You can mess up 20 times, or you can mess up 5 times. In my mind, those are both just called "failure".

So I am using black-and-white (polarized) thinking.

This does not mean I am a black and white thinker. That would actually be a different cognitive distortion, which is generalization. As in: because I have one example of black-and-white thinking in my life, ALL my thinking is black and white. Nope.

This link has a really awesome definition of cognitive distortion: http://psychcentral.com/lib/15-common-cognitive-distortions/0002153

Sometimes they are very, very hard to accept - because to us they appear to be so factual; and that's the point. A deeper cognitive distortion for myself is that I truly believe that because I have not ever had a functional relationship - and now I'm over forty - I will never have a partner. I can give you reasons up, down, and sideways why this thought is actually reasonable. My mental health, my lack of beauty, my introversion, the general pattern of everyone in my age group that I know, there are probably some more reasons.

But none of those reasons are factual or unchangeable. I am catastrophizing. Distorted thought.

Anyway, I think it's a useful tool if you like to or need to challenge your own thinking in a way that is very pointed and specific.

It is not useful as a way to generalize a persons' behavior. It's all about facts. Very specific facts. And how your mind teaches itself to see something as a fact when it's actually an interpretation.

 

[Intrepid]

The one who was the biggest source of trauma often told me that if I changed my thinking I would change my life. Well, it didn't work for her, or for me, I rejected that philosophy, considering the source. But now I consider it an over-intellectualization of the problem. As a person there are so many dimensions beyond the merely factual.

The "cognitive distortions" were for me defensive. Just taking them away left me vulnerable, horribly so.

Assuming that "cognitive distortions" are mal-adaptive assumes that I am doing it on purpose, as if I planned to have them, maybe just to get under the skin of my therapist. Well, that wasn't the case. I used those to protect myself when there wasn't anything else. Nothing.

 

[scout86]

Assuming that "cognitive distortions" are mal-adaptive assumes that I am doing it on purpose

I'm not sure that's true. My T has said, concerning this sort of thing, "Well, how were you SUPPOSED to know that? It's something you should have learned when you were little and your didn't get the chance to learn it then. What makes you think you should know it without learning it?"
Aren't cognitive distortions things that you learn, or adapt? They just happen to not be very accurate? (Now I'm off to read the article that I probably should have read first.)

 

[Sunset]

I've found some sort of CBT-esque approach has been pretty common to pretty much every therapist I've seen, even ones that didn't advertise as such.

I think a lot of it comes down to what I've mentioned - that I've been told my thinking is distorted, that I'm seeing things as true when the're not so many times, that I've just stopped believing it unless someone can give me a decent explanation. I'm going into therapy and being told to expect the future to be radically different from the past with no real explanation of why changing things that never had any effect on the problem in the first place

Catastrophizing stuff is particularly bad for me. If you went back 8 years and talked to me and someone at that time had mentioned it being even a remote possibility that the number of unrelated traumatic incidents that have happened to me would happen to me, a therapist would say they were incredibly paranoid and catastrophizing and all that.

And that's often the heart of the problem for me. I see how the world has been so far, I see what I could and could not have done. I see that in many cases there really wasn't much I could have done - not that I didn't have choices, but that all the choices I could make involved some serious injury to me. And I feel like with no explanation for why that happens or how I should go about handling or preventing things in the future, I just feel like I'm being blamed by being told all these things about my thinking when it has been to this point an accurate predictor of what actually happens, and the ways of thinking I'm hearing in therapy would have failed to predict or handle the situations I've actually run into.

 

[radicalgratitude]

I think what you are talking about, @Sunset, makes a lot of sense, and that is probably why CBT hasn't healed you, me, or many others who have survived trauma. It is helpful to have background knowledge in cognitive distortions, that's for sure. However, CBT is intended primarily for present-day thoughts. When you have PTSD, a lot of you is still living in the past, whether you like it or not. So you can reasonably conclude that in the present moment, you are safe (I hope), but the parts of you that are in the past feel terrified. It is hard to get to the root of the issue when you just focus on the present.

 

[Sunset]

Not entirely, @radicalgratitude. I don't really think of what I said as living in the past. It feels more to me, by analogy, like the way therapists see the present and the way I see the present are too different. To use an analogy, it's like a rich person telling a poor person he's too stressed and he should really take a vacation and not worry so much about money. It may be nice advice but it's just so far off the reality that the poor person actually lives in. That's sort of my experience. I feel like I'm being told that somehow, magically, my life will be like theirs in the future and not like my life has been, without any real attempt to address the problems in my life or even understand why it's been different so far. After all that's what they said before all this mess too, that these things that have happened weren't going to happen and I shouldn't be thinking about them.

It's not about living in the past as much as wondering why you should suddenly trust advice that hasn't been reliable before. Why should I believe it this time around when nothing's changed?

 

[joeylittle]

And I feel like with no explanation for why that happens or how I should go about handling or preventing things in the future, I just feel like I'm being blamed by being told all these things about my thinking

I'm not saying anyone is right or wrong. Without being a neutral outside observer being able to actually hear what is being said to you (and how) - it's really possible that the feeling of blame you experience is, in fact, the result of a cognitive distortion. I'm not saying that to be annoying, it's just a possible thing - and explains also why a lot of people don't benefit from that particular style of thought-challenging.

I think you don't have to believe advice if you don't want to. Sometimes it takes a lot of energy to go back to the mat. My only way of understanding this is that I've been fighting depression for a number of years, trying all sorts of different things, and nothing has actually worked, even though every time (of course) people are optimistic about things working. It's really frustrating, and I get to feeling like why should I try this or that other dangerous procedure if nothing yet has worked? And the answer is, I don't have to do it if I don't want. I can accept where I'm at, and suffer, and deal with it, or I can go back to the mat and try something new - even though my odds of success are probably very low.

There's not really a cognitive distortion in there. it's just fear. And sometimes I can handle it and sometimes I can't. At the end of the day, it's all up to you, not the people telling you things.