Therapist is Using CBT for Obsessive Thoughts & it’s not Helpful

[EveHarrington]

I cancelled my therapy appointment this week as I was tired of asking for help and having handouts shoved in my face. Ok, I can get those on the internet, how about, you know, you do your damn job? One of the handouts I wrote “GASLIGHTING” on because it was about challenging my thoughts. The thing is, my thoughts are DISTRESSING YET TRUE and I resent the assumption that because they are distressing that they must be not true. This is bullshit.

I’m still trying to stay busy all the time. Last night it got bad while I was driving and I almost got into an accident. Im just at the point of being LIVID because I am actively asking for help and I’m getting shit in return.

She made a horrible assumption about my parents and about a past situation. Like, I don’t need this crap. STOP MAKING ASSUMPTIONS! It was offensive and really pissed me off. (She’s an elitist damn snob who is pissed that her daughter didn’t get into med school while her daughters POC <people of color> friends got in, because a white girl just can’t compete these days. Ugh I just can’t with this kind of shit. I don’t need to know anything about her and yet I know way too much.)

So, this is the kick in the butt I need to find someone new. Almost getting into an accident, really not good. It’s getting worse, and I just need help. The meds are helping but I need more than meds.

 

[Friday]

Good on.

One of the handouts I wrote “GASLIGHTING” on because it was about challenging my thoughts. The thing is, my thoughts are DISTRESSING YET TRUE and I resent the assumption that because they are distressing that they must be not true. This is bullshit.

This is one of my baselines.

I need someone who who can actually differentiate WHAT the problem is, and help me with that. Sure there may be multiple pieces in play, but that requires even more ability to differentiate.

Helping me break shit down, requires skill.

Or they’re not helping. And I may as well be breaking shit down on my own.

 

[Friday]

Your other thread reminded me I’ve been meaning to hit up this one since having a chat with an ex boyfriend a few days ago.

We were talking about how diagnostic criteria & McHelp only seem to focus on symptoms/expressions that annoy other people. The diagnostic makes sense, as that’s what is observable to others, but the McHelp is infuriating because books 500-1,000 pages long have been written by experts on the actual ins & outs of each disorder… but instead one runs head first into “Here’s how not to annoy people!” nonsense & useless & makes shit worse “help”. As there is no real understanding of the depth, complexity, etc.

So we started talking about ritual (he’s OCD & I’m ADHD).

For me’self ritual is part of what creates exterior structure, as I have no interior sense of structure. By creating rituals around certain times of day / activity / etc. it lets me move reeeeally freely within those blocks, as well as be able to control “what” my day looks like, and removes the thinking-aspect, that nixes anything happening. ADHD people almooooost always gave to a) be taught to ritualize & b) fight against breaking those rituals out of a sense of embarrassment/wrongness/fitting-in/etc., even though there’s evidence in spades that just makes our lives fall flat on their faces.

Meanwhile he was talking about how creating ritual is something most OCD kids figure out on their own, and the ongoing challenge is not allowing a) adults to attempt to “break” them of it (that annoying factor) & b) to develop rituals that suit their lifestyles (for example? One of his needs is an up/down &/or side/side sort of ritual to calm his mind. As a kid he did the light switch thing, and door knob thing, driving everyone spare. As an adult he fishes every morning, which he says relieves about half the pressure he’d usually be under the rest of the day; and upon entering/leaving rooms, spaces, chores, etc., he either “conducts” music for a few bars, or swipes on his legs or arms, like he’s dusting them off.)

((It reminded me sooooo much of the PTSD exercise for stress management thing, as he was describing it. A big/regular blow off, every day, and then smaller as needed things throughout the day.))

His partner, meanwhile, is an architect. Whose most needed rituals involve sweeping their eyes and numbers, and their profession actually demands that; sweep in their eyes up/down/across meter long blueprints, and running simple to complex maths in & memorized numbers their head. Absolute perfect job, for them. My ex and his partner have actually set up their home to also require/indulge both of their happy places. Like a 15 foot long counter in the kitchen, catwalks across a soaring ceiling, music playing in the background, chalkboards for messages, etc.

He went on to talk about how he’s met some people in the OCD community who were abused so badly as kids (over their rituals) that they… stopped. And every single one of them spent years in and out of the hospital in psychosis, suicidal, diagnosed with everything under the sun except the OCD they’d had since they were kids… until either by chance or expert intervention, the re-learned how to ritualize. (And then he made several jokes about me, and ADHD people in general, and various kinds of brain injury :P He’s a riot).

…but it got me to thinking…

1) As it wouldn’t just be abuse around ritual behavior that could cause that, but the life-or-death aspect of PTSD level trauma, hijacks everything. The need to stay alive, stay unnoticed, be “normal” potentially blocking/more important neurologically than ritual balance. But one could expect the same result POST trauma, with no rituals to balance out the obsessive thinking; suicidal, explosive, psychosis, etc.

2) If this might be some piece of what you’ve been struggling with for so long.

Anyhow, it may not be useful, but I wanted to kick it your way in case it might be.

 

[EveHarrington]

Your other thread reminded me I’ve been meaning to hit up this one since having a chat with an ex boyfriend a few days ago.

We were talking about how diagnostic criteria & McHelp only seem to focus on symptoms/expressions that annoy other people. The diagnostic makes sense, as that’s what is observable to others, but the McHelp is infuriating because books 500-1,000 pages long have been written by experts on the actual ins & outs of each disorder… but instead one runs head first into “Here’s how not to annoy people!” nonsense & useless & makes shit worse “help”. As there is no real understanding of the depth, complexity, etc.

So we started talking about ritual (he’s OCD & I’m ADHD).

For me’self ritual is part of what creates exterior structure, as I have no interior sense of structure. By creating rituals around certain times of day / activity / etc. it lets me move reeeeally freely within those blocks, as well as be able to control “what” my day looks like, and removes the thinking-aspect, that nixes anything happening. ADHD people almooooost always gave to a) be taught to ritualize & b) fight against breaking those rituals out of a sense of embarrassment/wrongness/fitting-in/etc., even though there’s evidence in spades that just makes our lives fall flat on their faces.

Meanwhile he was talking about how creating ritual is something most OCD kids figure out on their own, and the ongoing challenge is not allowing a) adults to attempt to “break” them of it (that annoying factor) & b) to develop rituals that suit their lifestyles (for example? One of his needs is an up/down &/or side/side sort of ritual to calm his mind. As a kid he did the light switch thing, and door knob thing, driving everyone spare. As an adult he fishes every morning, which he says relieves about half the pressure he’d usually be under the rest of the day; and upon entering/leaving rooms, spaces, chores, etc., he either “conducts” music for a few bars, or swipes on his legs or arms, like he’s dusting them off.)

((It reminded me sooooo much of the PTSD exercise for stress management thing, as he was describing it. A big/regular blow off, every day, and then smaller as needed things throughout the day.))

His partner, meanwhile, is an architect. Whose most needed rituals involve sweeping their eyes and numbers, and their profession actually demands that; sweep in their eyes up/down/across meter long blueprints, and running simple to complex maths in & memorized numbers their head. Absolute perfect job, for them. My ex and his partner have actually set up their home to also require/indulge both of their happy places. Like a 15 foot long counter in the kitchen, catwalks across a soaring ceiling, music playing in the background, chalkboards for messages, etc.

He went on to talk about how he’s met some people in the OCD community who were abused so badly as kids (over their rituals) that they… stopped. And every single one of them spent years in and out of the hospital in psychosis, suicidal, diagnosed with everything under the sun except the OCD they’d had since they were kids… until either by chance or expert intervention, the re-learned how to ritualize. (And then he made several jokes about me, and ADHD people in general, and various kinds of brain injury :P He’s a riot).

…but it got me to thinking…

1) As it wouldn’t just be abuse around ritual behavior that could cause that, but the life-or-death aspect of PTSD level trauma, hijacks everything. The need to stay alive, stay unnoticed, be “normal” potentially blocking/more important neurologically than ritual balance. But one could expect the same result POST trauma, with no rituals to balance out the obsessive thinking; suicidal, explosive, psychosis, etc.

2) If this might be some piece of what you’ve been struggling with for so long.

Anyhow, it may not be useful, but I wanted to kick it your way in case it might be.

I don’t even know how to go about finding someone who could even begin to understand BOTH? Ptsd/trauma people ALL missed out on the obsessiveness of my personality. I am just deemed to be “too difficult” (by everyone). My Dr knows because he’s tried to help medicate it. The thoughts in my head have an order to them and when they get out of order that’s when chaos sets in. It’s like OCD and PTSD got together and gave birth to my brain. It’s hell living inside my head.

I have an intake appointment today and I’m just like I am so f*cking stupid. This woman only has availability once every 2 months. Why didn’t I try to find someone else? I am an idiot.

 

[Friday]

I have an intake appointment today and I’m just like I am so f*cking stupid. This woman only has availability once every 2 months. Why didn’t I try to find someone else? I am an idiot.

Alternatively? A stopgap until you can find someone better & more available. Not stupid. Proactive.

I don’t even know how to go about finding someone who could even begin to understand BOTH?

I have better luck searching for someone who specializes in ADHD, who then sub-specializes in PTSD & Trauma, than the other way around. Which is stupid, modernly. One “should” just be able to tick both boxes, and have the list compile. But noooooooo. >.< Vexing. But it’s how the algorithm nets the best results.

Probably an echo from how therapists listed themselves before the internet. Most trauma specialists, that IS their specialty, but a small section of every BIG disorder therapists loooove trauma-clients. But only trauma clients with “their” disorder (Autism, ADHD, Eating Disorders, OCD, etc.). So they don’t bill themselves as trauma therapists but ADHD/ED/OCD/ETC specialists… who have years of additional training & certifications in trauma modalities.

So my ex’s therapist would never take me as a client, and mine would never take my ex. They’re both trauma certified up the wazoo, but their specialties are OCD (his) & ADHD (mine).

So we started talking about ritual (he’s OCD & I’m ADHD).

Most of the info online on OCD rituals is how to stop them, as opposed to how to choose/incorporate them into one’s life in a healthy/useful/productive way (with the stupid little blurb attached)

“People with OCD often perform rituals to help alleviate distress or anxiety caused by obsessive thoughts.“

But that stupid little blurb begs the question… Are there any ritualized behaviors/actions you might try, or that seems inherently “right”, to see if it helps alleviate all the badness? Or at least takes the edge off?

 

[DartCree]

My therapist is trained in CBT and she’s pushing CBT on me and it’s just not helpful.

She keeps telling me to change my behavior to change my thoughts but THIS IS NOT HELPFUL! The obsessive thoughts come and go, sometimes they are really bad. I have told her I don’t want to go back on medication but she’s really doing nothing to help me.

There's a bunch of related modalities CBT, CPT, DBT, that at the core involve you looking at your beliefs, and finding exceptions to them, and turn black and white evaluations into shades of grey.

This is helpful in turning the built up patterns that trauma laid on you into something more reasonable. It does NOT work well with complex PTSD / childhood trauma/ emotional neglect. Too much of the crap is buried. But you need to deal with your shattered selves first.



Below are books that helped me. Fisher, in particular is my hero.

What follows is a boiler plate answer that I use when it might be appropriate. You will find it in very similar forums from me all over the CPTSD* subreddits.

Google reviews of the books below, and read them. Then borrow them from your library. If you can't find them, message me.


The Book "Healing the Fractured Selves of Trauma Survivors" by Janina Fisher

She also has a workbook, "Transforming the living legacy of trauma"

Fisher talks in her intro about the self hatred, the internal conflicts. The therapy sessions that get so far,then get stuck. She really gets it.

Fisher found that approaching these shattered selves with curiosity and compassion, reassuring them that the causes of their fear and anger are no longer here, and that they are safe now helps a bunch.

Where I cannot show compassion for myself, I can show compassion for a younger me. I can give Slipstick, my nerdy self of 15, the hugs he rarely got from his parents. I can sit on a bench next to Ghost and watch the chickadees play. Ghost says little, but sitting in quiet contemplation makes us both content. I can agree with Rebel's outrage, and point out the ways his plots can go awry, and he too gets a big hug.

And in showing regard for these younger selves, I show regard for myself.


Here are a few reviews:

Complex Trauma: Dissociation, Fragmentation, and Self-Understanding

Dr. Janina Fisher's book, "Healing the Fragmented Selves of Trauma Survivors," offers insight into understanding and treating complex trauma.

psychcentral.com

Healing the Fragmented Selves of Trauma Survivors: Over… Read the comments too.

An excerpt from the intro I posted on Reddit:

https://www.reddit.com/r/CPTSD/comments/thartj

* Read the intro to Janina Fisher's book "Healing the Fractured Selves of Trauma Survivors" up to where she starts describing chapters.
* Then skim read the first few paras of each chapter, the first para after each subheading, and the example cases.
* Read the appendices next.
* Read the last 2-3 chapters on actual practice.
* Go back and start at the beginning.
* Have a printout of the methods in the appendices with you. Or shoot pix with your phone. Use these a cheat sheets for yourself.


The workbook is easier to understand, but overall is not a great workbook.


There are other similar system. Pat Ogden and somatic experiencing; Pete Walker and Richard Schwartz and Internal Family Systems.

The systems/modalities in some books rub me the wrong way. I don't like the philosophy behind "No Bad Parts" Too much of it seems nonsensical to me. So if you find yourself bristling at the book, set it down, and find another. I don't think you can heal reading an author who you hate.

I also recommend Tori Olds youtube channel. She does IFS and parts work, but with a few different buzzwords.

Brené Brown's book "Daring Greatly" is a good intro to dealing with shame and vulnerability.

Jonice Webb "Running on Empty" does a good job of describing where emotional neglect comes from and how it manifests, but is deficient on treatment.

PTSD CPTSD and DID are all dissociative disorders involving part of the personality splitting off due to intolerable emotional stress. Any book or therapist should say somewhere "Structured Dissociation" and "Trauma trained" "Parts mediation" is the general term for this style of therapy. "Trauma informed" is only window dressing.

 

[DartCree]

I hate CBT. But I’m not sure if I’ve been through Cognitive Behavior Therapy or Christian Bullshit Therapy.

The Christian aspect is entirely your therapist. Bullshit may or may not be your therapist.

I found Fisher (scan my other replies in this thread) to be a better approach.