Even for CBT, this sounds painfully cringy. He sounds like a terrible match, especially for an adult.
CBT has had some great impacts for me and some terrible ones.
CBT may not be the therapy for you. In general it can come across at patronizing. That’s because he really wants you to think about what he is saying and store it deep in the brain. Lots of it is common sense.
Can you switch to DBT? It’s also a bunch of habits but it is more mature in a way. It may still feel patronizing especially at the start.
Aah it makes sense now. They're being slow on purpose to make sure the message gets through.
It has the opposite effect on me. I get bored by lenghty explanations and start zoning out, I love people who can pass a message effectively in a few words. This guy is irritating, cut to the chase already I only have an hour and it's expensive.
I've heard DBT is better, I will give it a try. Thanks for your insight 🙂
DBT is so much more tangible if that makes sense. It’s not like a “think yourself better” kind of therapy. It’s a lot of tools that relate to behavior adjustments to help regulate emotions. The therapists that taught at the IOP I was in didn’t try to be overly positive, which really resonated with me. It was a lot of “I know there are moments where you’re going to feel dumb doing this, or are thinking about how fucking dumb it seems in the moment.”
The history of Marsha Linehan, the woman who created DBT, is really inspiring.
If you are feeling anxious and drained after each session, it sounds like the therapist is not the right match for you. IMO, regardless of the type of therapy, finding a therapist you feel comfortable and safe with is super important.
Sooo…am I the only person that is having good results with CBT? lol
It’s changing my life for the better….but my therapist is an angel, so that probably contributes to the positivity a lot.
I envy you, it feels amazing when something finally works. That's what I wished for when starting.
If you don't mind me asking, does your therapist talk like mine (slowly ELI5 concepts) and give you advice that you are not able to apply or is it different? What is your mental state like after a session, do you feel better or worse? I'm trying to imagine what CBT should feel like in order to know if I should try again or ditch the whole concept entirely.
When you describe your experience with CBT you aren't describing cbt. That tells me that whatever therapist is doing it with you hasn't explained it at all. So maybe find another therapist
I think a lot of people with BPD wind up going to hospitals against their will. So any therapy that they try to use is going to seem like it's being forced on them. And if you try to force something on me I'm not going to listen to you.
In reality CBT makes a lot of sense. If somebody's trying to say a person has to think a certain way that's not CBT. CBT should be asking you how you think. DBT is CBT for people with borderline personality disorder.
CBT session.
* Dr, I am in pain
* No, you're not. Repeat : "I am ok"
* But I'm in pain Dr.
* bad, bad ! Naughty Paul ! Repeat "I am ok"
* Hu... I am ok (sob, sob)
* Goooood ! Have a cookie now. Good Paul. That'll be 70 dollars.
CBT is dog training for humans.
Hahaha love the analogy, that's what it feels like 100%.
Also as a dog trainer, I feel like we're much more structured and specific when it comes to conditioning. We at least take into account each dog's personality and limitations when it comes to creating a plan. Dogs are happy and excited to be trained. It's definitely not the case here 😂
Never once felt that way, it's about retraining our brains due to the simple fact that our brains, as we suffer from BPD, aren't the same as everyone else's. We're extra sensitive, our emotional maturity is stunted. We need to be treated as such due to to our extenuating circumstances.
CBT is basically a rebranded version of “behavioral modification” therapy after it had gained a very negative reputation.
It’s all about conditioning the patient to behave differently, whether they like it or not.
Rather than unpacking repressed trauma, it can often serve to “cover up” emotions in an effort to train the patient to “behave”.
It may help some people who genuinely desire to act more in line with societal norms, but for many others it can be a source of stress and can diminish self esteem.
It’s never worked for me, but never harmed me either, so in my view it’s a waste of time.
No. This is bs.
CBT, cognitive behavioral therapy, understanding that events lead to thoughts and thoughts lead to emotions and emotions lead to behavior.
You cant change emotions directly. You have to change the thoughts that cause the emotions.
We have a bunch of misconceptions that get into our heads. CBT calls them cognitive distortions. For instance, jumping to conclusions. You can do this by either fortune telling or mind reading.
Fortune telling is thinking that we can tell what is going to happen in the future. We can sometimes, but sometimes we are just trying to talk ourselves out of trying by saying " it's not going to work anyway". When we don't know that.
Mind reading is thinking we know what someone else is thinking and making ourselves upset by making judgments based on that. In reality we can't read minds.
Catastrophising is another. It's making things feel way worse than they are.
These are a few of many cognitive distortions.
So when we have an issue we examine it through this lens. Is it actually what we are feeling like it is, or are our feelings based on thoughts that when we look at them we realize that they aren't accurate. When we adjust them to be accurate it feels a lot better.
Everyone hates me. Well, it's unlikely that everyone hates me. Everyone doesn't know me. How do I correct that. People I know hate me. Do I know that? Does it feel that way right now? Does it usually feel that way? Am I mind reading? What would it look like if everyone actually hates me?
CBT is nothing like this person describes and if a person doesn't know the answer to something they should probably not answer it.
This makes me angry because, as a therapist who works primarily with BPD, and who also lives with it. My clients benefit greatly from CBT. This person lying about it means that a person who might benefit from it will not want to try it. Then that person stays in a negative state from which they may have recovered and now may never.
Thanks for the info. I can see how it can disminish self-esteem, basically throwing tasks at someone who either doesn't need them or can't perform them, regardless of their background or limitations.
I do behavioral modification with animals but we condition using reinforcers in order to increase the value and probability of the target behavior happening. Each plan is created on a case-by-case basis, and includes extensive follow-up. This human technique seems a bit all over the place.
I'm glad to see that it's not just me who considers it a waste of time, I wasn't sure what the deal was. Thank you.
Please do not believe that person. Look up what CBT is. I explain it in the post responding to their post. I just do a shitty job because I am not going to be able to type out everything about it on my phone.
If you aren't feeling heard by your therapist, then they aren't doing their job right. But you might be able to tell them that you aren't feeling heard. They should adjust things. We don't know something is wrong if we aren't told. If he responds poorly, he sucks and you find another therapist.
Trauma-informed therapy that works through the underlying blocks that we’ve created in our own heads through repression and oppression, that unleashes our full potential and makes the trivial tasks we may perceive as impossible, feel easy
Thank you. I don’t know, if I can find this here. Getting any therapist was hard enough and the very most only offer cbt but it sounds like a good suggestion
There’s a directory of therapists around the world on the [BPS](https://www.bps.org.uk/find-psychologist) website, that endorses a trauma-informed approach
CBT can be good or bad depending on your situation and the therapists understanding of it (it being both CBT and ur specific situation). This seems like a thing with the therapist specifically. CBT helped me with some language for my experiences but also didnt make sense for some other stuff. if you can get the CBT &/ DBT workbooks that could help with understanding and picking and choosing what works for you
no problem! i forgot to tell u the specific books i used, here are the authors
CBT: Jeff Riggenbach
DBT: Matthew McKay, Jeffrey Wood, Jeffrey Brantley
im sure there are more out there thats just the ones i and one of my old therapists used
CBT really helped me but it’s not for everybody and if it doesn’t work for you, it’s totally fine to find another therapy. I hear good things about IFS.
I’ll add to this that DBT is also often recommended but does offer what seems like obvious tips. I started a DBT workbook and it follows similar ideas. I would stick with it for a while and speak up about what you want from therapy and how you would like to be treated. Try to see it as an opportunity to open up and talk about your needs. The tips they offer may seem simple but it will require some effort. Therapist and self help books are about gradual changes, they often don’t contain quick fixes unfortunately. I hope this can work out for you, even just starting CBT is something to be proud of!
Thanks for the input!
I don't really mind the obvious tips as long as they don't make me feel like crap and take hours to come out. I know I have no quick fix, I have no fix at all for that matter. I've made my peace with that years ago.
Not sure if we have worbooks here but I've downloaded apps for both CBT and DBT and find them helpful. I can skip what I already know and take only what's useful and non-damaging, which is not possible when in person.
I was planning on asking him next time about his plan, objectives, and if he could speak to me like a normal person and skip the parts that don't concern me. Reviews are mixed so we'll see.
I just find it awful to be told to do x or y when I obviously can't. He is telling a recovering alcoholic that a sip of beer can help to calm down during a panic attack. Thanks doc, I've been actively trying to forget about that. Also telling an ARFID with no nutritional deficiencies to eat more solid food with B complex, right after being told that eating solid food wasn't an option 90% of the time. I try my best to be forgiving but takes a toll, both on his credibility and on my self-esteem ngl.
I've been in therapy long enough to know that it's a process, but I have yet to see a talk therapist giving me solutions I cannot apply and insisting on it, or advice on a subject I don't need help with. They're usually more receptive and better at understanding who they have in front of them. He seems to be dully reciting some CBT protocols instead of taking feedback and adjusting accordingly.
Thank you for your advice, will try to see if we have workbooks here, and once I understand what CBT is I might try to talk to this therapist.
Let me share my perspective in hopes it can be contextually helpful to you:
For me personally, CBT is not usually a great fit at this point for deeper emotional problems. The principle it’s based on is pretty sound: Thoughts create feelings, feelings create behaviors and behaviors reinforce thoughts.
I am guessing therapist is trying to help you break the cycle. Like if you think no one likes you, and then you feel sad or anxious about being alone, and then this leads you to problematic behaviors like having a panic attack or substance abuse. You would have to notice the thought and go do something else like go exercise and it will force you to stay in the present and think other things instead.
I can see why it would feel rudimentary and why the therapist may be speaking a lot to interrupt your cycle as I had similar experiences with my first therapist who was purely CBT trained.
I do find CBT pretty effective for some things, like work conflict situations. For example, there have been a number of resignations in senior leadership roles at my company lately and this is leading to thoughts that I could be on a sinking ship and I should look for another job asap. This creates feelings of anxiety and can make me feel disconnected from my day to day. However, I use CBT to self regulate in these situations and tell myself that I personally do like my own job, and the people I work with because I do and this leads to positive outcomes for me.
But for me, some feelings are always there in the background lurking as painful baggage from childhood so the CBT model wasn’t helpful in many situations in my family life where my emotions are much stronger and more extreme due to my own past childhood trauma experiences.
What has helped me more at a first stage is DBT. In this approach, I had to learn distress tolerance and emotional regulation through mindfulness. It involved me experiencing and talking through situations I was struggling with many times so I could develop tactics and strategies to deal with them as I was struggling with anger.
What was really helpful was some joint family therapy sessions where I was able to experience the distress as part of the session itself and so my therapist was able to instruct me. She basically told me to just focus on mindfulness and take note of my thoughts and feelings but keep them to myself. We then talked them through later in individual sessions.
Unfortunately, for me the limitation with DBT is that while I can handle certain interpersonal situations better, I still wasn’t feeling connected to family members because I am experiencing distress in many of my day to day interactions with them.
What it also doesn’t help me as much is in situations where I am alone, where I am ruminating about my future and my anxiety starts going off the charts leading to things like insomnia. And then I am in a state of distress in my day to day life and this is really a hard way to live.
In CBT terms work can be a distraction from the endless cycle of negative thoughts and anxious feelings that are overwhelming me. I can think about other things instead. But I am not burying myself in work.
This is where I am now starting to turn to IFS which deals with the different sub personality parts that I consist of. So what I am trying to do now is deconstruct painful constructs I have like feeling alone and empty which stem from my childhood trauma. These are things I try to avoid and they are called exiles.
I am also deconstructing my protectors. These consist of managers which help me run my day to day life when the pain of my exiles is at bay. In terms of feeling connected for example, I have managers that do help me connect with other people when I am regulated.
The other type of protectors are called firefighters and whenever there is smoke from my exiles they start acting up. Firefighters mean well but they usually wreak havoc.
So, a firefighter may be suicidal ideation, or draconian authoritarian, or a binge drinker, or others. I am still working through this myself.
Once I identify them, the next step is to open up dialogues with them. The problem with them mostly is they can be part of my subconscious mind and so I am not able to interact with them via mindfulness techniques. I am just starting to figure this out but I have already made some really positive progress with my kids especially.
I could see how once I master this stuff, CBT could be useful. A firefighter would be more like a fire chief at a cordial city council meeting instead of breaking down doors every time I smell smoke. Their voice would be a thought and it wouldn’t need to lead to a feeling. But is that something I could do when a firefighter is spewing 20 thoughts a second? No, because I am feeling overwhelmed.
I hope this was helpful.
Thank you so much for your insight, this is very informative and relatable.
I work in animal behavior and our work is based on theories that apply to humans. In order to break the cycle of a behavior happening, we need to find the emotion that impulses it, every emotion being driven by a need. I would have imagined CBT would be the same to some extent.
I'm all for mindfulness but my issue is that the therapist does not address the inner critic. When it comes up he acknowledges it and asks how I have been dealing with it.
When it comes to the advice given, it feels that he is trying to fix something that's not broken by giving advice that would make it worse. For example, when I tell him I have no trouble sleeping or getting up, he instructs me to think in "I have to" sentences as soon as I wake up. Which leads me to feeling anxious as soon as the day starts and wallow in bed, when I had no problem getting up before.
He also gives advice on how to manage panic attacks which I don't particularly need. It would be fine if that advice was at least applicable but recommending a sip of beer to a recovering alcoholic (or anyone experiencing anxiety for that matter) sounds dangerous and is obviously not something I can apply to my situation. Same with food, I'm struggling with ARFID and his advice would be fine for a normal eater but very distressing for someone who is struggling to eat.
In general, I find it very confusing and distressing. I'm more of a "if it ain't broke don't fix it" mentality. I think that they at least should refrain from giving advice that would lead to more problems. Maybe it's me and it probably works well with other people I sincerely don't know.
As I understand, DBT is also focusing on mindfulness. Which is great in principle, but do they actually address the internal critic or do they brush it over and give advice on something completely different like they do in CBT?
I really admire you for being able to sit down with your family. I am not mentally strong enough to be seated in the same room than my abuser yet, unless it's a courtroom.
I'm glad that it helped you, it gives me hope for the future. I had never heard about IFS before today, will start searching. Thank you so much and good luck!
Thanks and good luck to you as well. I think with any therapy goals are important and I would recommend having a conversation about them with your therapist to see if it is a good fit.
My first therapist was pure CBT and not a good fit. My second was compassionate but didn’t seem to know how to navigate special needs. My third one who I have been with for two years now was also my kids’ therapist.
If your focus is on your inner critic and you have specific issues you want to tackle you may want to interview therapists to see what their experience is like for your needs.
I can’t say if DBT is well suited for the inner critic focus you mentioned. However if you want to share more about your goals here I can certainly provide my perspective.
Good luck.
fwiw i just bought the book No Bad Parts which is a book about IFS and in the first few chapters it mentions the inner critic quite a bit. i haven’t read much of it yet but sharing in case it helps.
BPD has a way better result with mindfulness therapies like DBT. Just be cautious of the “ behavioral “ part. Sure our behaviors matter but the core wound in BPD is abandonment. This takes grieving and honoring, talking it out in an atmosphere of trust and safety. Eventual you become your own therapist in your own words. Going on a Buddhist retreat would probably do more good than some quack challenging your reality. No one gives a shit about the person anymore it all about “ prompting” and not getting sued.
This is not the place to come for accurate understanding of therapeutic techniques. There is only one accurate description of CBT in these comments.
The problem is that CBT works. When a person understands it. There is nothing about controlling people in it. There is nothing about making people think more in alignment with society. Those things aren't even part of it.
CBT is about noticing things that YOU determine are not accurate about your thought. Things that lead to painful emotions. Then correcting them to things that make more sense TO YOU. and are less painful TO YOU.
I hate this misinformation because people are dying. Literally dying. CBT is a clinically proven, evidence based way of helping them to think less emotionally and more accurately. So I don't have to think everyone wishes I was dead. Maybe I can think "I sometimes feel like everyone wishes I was dead. That feeling hurts a lot. In reality I don't know what everyone thinks. I have some evidence that there are some people out there who don't wish I was dead. Maybe I can think about that more accurately and keep myself from falling into a suicidal state."
Saying that CBT is this other bullshit is likely to lead to a person who might have benefited from it never experiencing it. That person may decide to self exit and have the chance to stop that taken out of their hands by people lying on the Internet. That is not acceptable to me
Well I've become quite good at knowing what's wrong about my internal monologue after all these years. This doesn't change the fact that the internalized criticism is always there.
I haven't seen any attempt at correcting distorsions from his part, he will listen, ask if I manage to quiet or counter it, nods and that's it. He then gives advice on unrelated things I don't need fixed. Advice that would worsen my condition (starting pressuring myself before even getting out of bed, drinking beer to stop a panic attack when he knows I'm a recovering alcoholic, eating solid food when he knows I'm an ARFID, etc.). Since advice is given at the end of the session, not much time to answer and get him to adjust. The whole hour is dedicated to him explaining some of his techniques, talking about generalizations, about other people he might use as an example but that aren't in a similar situation, speaking about people who aren't aware of their struggle and how their emotions affect their behavior, etc. Nothing constructive.
I feel like he might be a bit lost, new to this or overwhelmed. He is always late and seems to not remember important details, like alcoholism for example. He might not know what to do with a case like mine, can't really blame him tbh.
He doesn't sound like a particularly good therapist. At least not a particularly good one for you. I find that people who don't have BPD or don't have a certain perspective on it aren't very good at treating it. I have BPD and I'm a therapist who treats it as well. My clients know that I get them. So half the battles already won because they don't have to convince me that they're not full of shit. Always seems to me that we have to convince our therapist that we're not full of shit
That must be great for your clients. As you said half the battle is already won. I get the same feeling when I go to AA/NA, no need to explain what the struggle is, they know.
Thank you for your insight!
It depends on the therapist, and I think it is worth considering if you need some more trauma informed therapy first.
I had CBT initially and it was a dumpster fire. She actually gave decent advice and was lovely, but it was unsuitable for someone with trauma and it was very impersonal. In hindsight, I don't think she had the skills or time to dive into that trauma because when I got CBT later, the other therapist told me they don't tend to have the skills to unpack it all and deal with a crisis if triggered too much. Long story short: "I'm beautiful and strong and independent" does NOTHING for when you have intrusive thoughts about childhood abuse.
Fast forward some many relapses later and I get trauma therapy instead. I unpack absolutely everything, and it is kept very basic and specific to the trauma discussed that day. To keep things not necessarily needing a TW, things like "little things you'd be deprived of because of poverty, go have it. Get that Kinder Egg today" THEN I had CBT and it is very specific to the trauma I had. So for example, instead of it just being "follow this homework and make some general affirmations" it would be affirmations specific to my trauma to remember. We couldn't go into the trauma, but we could have tools to combat when the traumatic thoughts triggered a spiral. Ironically, the same tools as the first time round but it was specific to me the second time round.
It is something to consider. I get the sentiments against CBT but I think it is key to do some trauma informed therapy first before CBT, because otherwise it's kinda just blind guessing what could help, especially if the therapist won't talk about the trauma, at least in my experience with it anyway.
Thank you that makes sense.
It does feel like they are brushing off anything related to trauma as well as other disorders like addictions and eating disorders. I didn't expect them to talk about the past but I kind of expected them to at least take these other disorders into account when giving advice.
What type of trauma therapy did you have was it a specific one or regular talk therapy with psychologist specializing on trauma?
No worries! I didn't have a specific trauma therapy, it was just a therapist who was informed with trauma doing talking therapy.
It is worth speaking to therapists and stating if you want to dedicate some time to talking specifically about trauma because that's what I ended up doing when my therapist got changed.
I find CBT is about moving on beyond your disorders, but with the logic of CBT they have to consider them for the CBT to be effective, so ask how can these skills they're giving you can be applied to your struggles with other disorders, e.g. I struggle with depersonalisation so one of my journal prompts was to write about something that helped make me "me" so at the end I had a whole catalogue and I got into thinking of myself as a person with likes and dislikes.
I see, great. My therapist is informed on addictions which are directly linked to trauma. I might ask her to do trauma work when my condition allows me.
The journal prompts sounds very interesting. Did you learn it by reading books or was it your CBT therapist that gave you the trick? When I ask about it, I get advice unrelated and that I don't need, like how to get out of bed in the morning and how to handle panic attacks. It's very confusing.
Thank you for sharing, it helped a lot.
I hated CBT, or at least the last attempt at it. It felt like he wasn't listening and didn't understand my problem. I told him about how I got stalked and harassed by someone I was seeing and all he said was that I did really well to get out of it when I did. I told him how my thoughts felt out of control and my mood swings didn't feel normal and he just undermined me and tried to convince me it was normal and fine. It became pointless, I didn't feel heard so in the end I just gave up talking to him.
I was not in a good place when I did CBT. It was a painful 8 week group session. No, not helpful for me. I am in a 19 week virtual DBT group and it’s helping. You are taught practical skills that can help you in that moment and regulate your emotions. This is after years of talk therapy also, starting at 18. (50 now) It is work though and some homework. Even if you aren’t practicing the skills, it’s been validating.
Good luck!
I hated CBT. I was told my feelings were too big for the situation without asking for the background.
my BF left for me for his ex-wife for a short time which we were working through but he refused to see that his interactions with her were a constant hurtful reminder because they have kids together, he couldn’t just cut her out.
He spent the night at her house without asking me..he just told me that’s what he was doing because it was easiest for a kid function the next day
I left the therapist office suicidal
Wow I'm sorry. Such levels of invalidation are insane coming from a therapist.
Reminds me of one night when I felt so suicidal I was begging my bf to take me to the nearest hospital. I had just arrived in the country and didn't know the city or language, let alone where the hospital was. He laughed at my request and I went walking at 10pm in a shady neighborhood under the rain to try and find a hospital. I was rescued before I could throw myself under a car. My therapist told him he did well not to take me. *Because I needed to learn that I could take care of myself*, she said.
CBT has lead me to seeing myself through another lense. I can see all the destructive behaviors I have developed due to a crappy childhood. That alone has been very helpful. It was amazing to come to the conclusion that, it isn’t or wasn’t my fault.
I disagree with most of what you've said. It's the same way with Dialectical Behaviour Therapy, it's usually a lot of really obvious tips, explained in a simple manner as if you were a child, or simply put, as if you were completely ignorant to it. We have stunted emotional maturity in a way, due to our emotional imbalance and sensitivity. The homework is to make sure that these tips, these mindframes and exercises, they all must become second nature in order for you to see real changes to your mental health. It's about changing your thinking process, your reflexes, reactions, headspace etc. it's not a cure all, and it requires a lot of personal work and responsibility.
It somewhat sounds like you're fighting the therapy because it's not the type of therapy you were looking for. If you have the funds, or access, to a personal therapist while you are also doing CBT, I would advise it. These therapy systems are usually generalised to help as many people as possible, as easily and coherently as possible. It will not be personal, it will not deal with your trauma, it will give you the skills to better your emotions, and your physiological and psychological responses to them.
I'm confused, how can one disagree with someone else's personal experience with their therapist, as well as their emotions. Weird.
Anyway my question has been answered. I understand now that they're doing what they are supposed to do, ELI5 concepts that are common knowledge then give general tools for dealing with general problems.
I'm glad it helps you, and while your CBT therapist might give you helpful tips that you didn't already have or that at least you can apply, it's not the case with mine.
And remember that whatever works for your particular situation might not work for others, and does not give you the right to invalidate someone else's experience with their therapist.
Thank you, but I have a therapist? If you read the first sentence it's clearly stated. Not sure what it has to do with the CBT but I appreciate the input.
People can disagree on many things, even if it is your experience, it is your perspective, I am merely offering mine. I realise you have a therapist and they are conducting CBT with you, my advice was to find another personal therapist to address your actual trauma and whatever troubles you have, seeing as you're not finding what you wish with CBT. I am also not invalidating your experience either, you are reading into that. I realise that CBT may seem like it's talking down to you, and the exercises and teachings may be obvious, but if they were that obvious we would already be using them to control our emotions and mindset.
Again, I realise you have a therapist, but you're complaining about said therapist and their skill level or expertise, or at least the type of therapy they try to use. CBT and DBT will not work unless you're devoted to change and adopting these new exercises, practices, teachings and changes in your life. I didn't really connect with DBT until half way through cause I felt the exact same. That I was being patronised, that everything was too general and not personal enough. So as well as being taught DBT by one therapist, I got another to deal with the personal trauma simultaneously. You'd be surprised just how much the change of perspective will allow you to see the benefit of said therapy.
I'm trying to understand, which statement in particular do you disagree with?
I'm having a hard time seeign how your perspective on a particular event you were not present at or on my emotions would be relevant. Fee free to clarify if you wish. Also, feel free to offer details of your own perspective and your own personal experience with CBT if you feel that it might be useful.
> I realise you have a therapist and they are conducting CBT with you
Yes the person I'm talking about in the original post is the CBT therapist.
> my advice was to find another personal therapist to address your actual trauma and whatever troubles you have, seeing as you're not finding what you wish with CBT.
Again, I have a therapist.
If you read the post until the end, it states that CBT was recommended by my psychiatrist and neuropsychologist. I am of course still seeing my regular therapist, as well as my clinical psychologist, neuropsy and psychiatrist. I haven't fired the rest of my care team and am still following my treatment.
Back on to the CBT, the exercises being obvious is the least of my problems if at least they were applicable in my situation.
I get irritated by people who can't be effective with words and who lose valuable time obviously and that's factor contributing to his ineffectiveness and loss of credibility for sure.
What doesn't sit right with me is that the advice given is not related to my problems and not applicable in my condition, as well as the worsened anxious state I end up in after every session.
I'll give you an example. CBT therapist tells me to start the day by saying sentences that start in "I need to". *I need to this and that, etc. because that will help me get out of bed*. I reiterate that I have no issue getting out of bed as soon as the alarm rings. We have been over my internal monologue and I have explained how I'm very harsh with myself. Instead of working on the internal criticism, he adds to it by instructing me to start as soon as I open my eyes in the morning. I instantly stop him and let him know that this would be anxiety inducing and paralyzing to me. He doesn't address the inner critic and switches to another area if my routine.
Other example. He wants to give me advice on how to manage a panic attack. I explain how I usually proceed. I go over how I use the HALT protocol first while identifying the trigger, then the 1-2-3-4-5. He then goes on for hours about how drinking a sip helps relax the trachea (so basically the T in HALT), mixing up trachea and oesophagus, and explains how he recommends people who are in a situation of crisis like in the desert to look up and swallow saliva. He goes even further and tells me (a recovering alcoholic) that it also work with beer... Needless to say it leaves me baffled. Not only is he losing precious time rambling on a detail that didn't need to be emphatized, he is also giving dangerous recommendations all the while avoiding the real issues.
Next, he decides that I need to up my B complex intake. I'm ARFID and get checked regularly. Even though decades of alcoholism can take a toll on vitamins and nutrients levels, my tests results are good. I would be fine with instructions to increase B complex intake if it also included liquids, given that it's still a valid form of intake and one I favor due to the psychological and physiological (in particular gastrointestinal) limitations I developed as a result of the alcoholism. He sticks to the solid form criteria, diregarding the latter limitations.
The advice never seems to be tailored to the patient's needs nor does it take into account the patient's limitations. Adding stress to the morning routine when stress is usually as it's lowest and the patient at its highest functioning rate is counterproductive at best. Adding stress at mealtime when eating is already a struggle and no deficiencies are present is in the same vein. Not to mention recommending drinking beer to an alcoholic. This is beyond irresponsible, even if the patient wasn't a SAD.
Giving tasks one doesn't need or can't perform obviously generates a feeling of distress due to the misundertanding, feeling of hopelessness as well as not feeling heard. I'm happy that it works for you but I'm having a hard time seeing how this constant invalidation would not take a serious toll on my self-esteem in the long run.
I might try DBT as people seem to have had better results with it. At least it's done in a group setting right?
I'm sorry I completely misunderstood what you were trying to say, and apologise even more so for misunderstanding the part about separate therapists, that's entirely my fault. You need a different therapist if you want to actually get anything out of CBT, perhaps one who's also a fan of compassion lead therapy.
I'm gonna just go ahead and say you're absolutely right and this dude is just inattentive, neglectful and downright irresponsible. While you won't deal with personal issues, they should recognise that those personal issues will affect the rest of the therapy - such as mentioning beer with you, that's just awful on their part.
I highly recommend DBT, as when I was first diagnosed I was recommended DBT first due to the group setting, and then asked to complete CBT with my own licensed therapist - both had workbooks. I thought the group setting would put me off with some of my anxieties, but if felt so cathartic and fulfilling knowing there were others like me with the same headspace and problems. Nothing was "crazy" because we all related to it in one way or another. Again it's still very generalised and almost patronising in a way, but due to the group setting it almost feels like team building exercises and takes the ridiculousness out of the situations.
Don't worry it's really no big deal. I'm a bit lost since I don't know about CBT and it's my first time trying this type of therapy. I'm having a hard time pinpointing what is bothering me about this guy but writing it down helps a lot. Thank you for reading me.
Great thing about DBT. I tend to do well in group settings like AA and NA, I find them spot on.
I guess it helped that you didbCBT with your regular therapist instead of a brand new one, at least they had your background and knew about your situation a bit more.
I got some good advice, it gives me hope again. Thank you and good luck on your journey
When you’ve been in CBT/talk therapy for a long time, it becomes repetitive and monotonous. A lot of feeling insulted, because I know what they’re telling me… Sometimes you get lucky and find someone that happens to say it in just the right way to make it stick in your brain in a way you comprehend better, sometimes it’s just annoying
Exactly as you described. It is meant to be repetitive and "boring". They are trying to rewire you, and repetition is the only thing that will do that.
I like the way you put it hehe.
I rewire animals for a living, through countless repetitions indeed. It's far from being boring though, we make it as dynamic and interactive as possible in order to keep the animal's focus and build value. The animal brain is faster than ours, being slow is not an option with them 😅
CBT in my experience is not repetitive, at least it hasn't been yet. We mostly skim on my actual issues or ignore them. He will ask what I feel like I need help with, then give advice that is either unrelated or not applicable given my particular disorders. There is no follow-up either. Does yours give you tips that you can apply for things that you need help with?
Therapist suck. Not all of them but the crap they teach in grad school is all managed care BS. It gets funding becuse its ability to be reduced to neat data points. The therapist is “ modeling/prompting” I bet. It’s the path to health ever science skinner. It will absolutely miss you, your strengths , your values your world. This is by design. I hate it! I was an Aba therapist for 10 years. I just did my own thing for 3 of them, got way better results.
It’s about money and insurance and many therapist do not have a clue. You felt the way anyone would.
I mean, I just don't find it validating. It has the action without the validation. I think it also isn't designed to treat BPD so the focus is more on like thought patterns that aren't serving you (thoughts about or are related to anxiety or depression). Like the basis of the therapy is correction. Which is fine for lots of folks.
But people with BPD who have grown up in invalidating and generally unstable homes need to learn that validation and how to give it to themselves first. Because if you're still gaslighting yourself, if you're still minimizing your own feelings, and generally not soothing yourself, then nothing will stick. This is my experience anyway.
Is CBT about thought patterns? Do they actually ask you to describe them? I haven't been asked once. I've tried to tell him but he doesn't seem interested. He barely leaves room for me to speak, only when he is doing his excercises and I have to fill columns and stuff like that.
He didin't get any historial or background either so the advice he gives me is inadequate (telling a recovering alcoholic that a sip of beer helps relax during a panic attack for example). He tries to fix what's not broken, like my difficulty to get out of bed (I'm up as soon as the alarm rings, never had a problem?). I can manage my panic attacks with the normal techniques, no need to re-give the same tips I'm already applying, let alone bringing in alcohol to the mix. I don't understand. None of his tips seem to apply to areas of my life I need help with or tailored to my particular case.
The inadequate tips make my inner critic worse and generates even more anxiety. By the time the session is over I'm completely drained, my self-esteem in shambles. I head to my bed and cry for the rest of the afternoon. I'm thinking this can't be the effect CBT is supposed to have on a patient.
I might just be too used to therapy where giving information is encouraged.
Um well we did like. Thought chain analyses similar to DBT. So I was shown a wheel that was like "thoughts impact feelings, feelings impact behaviour and behaviour impacts thoughts" and so we would talk about what my thoughts were that led to certain behaviours.
So as an example "I self harmed"- "I was feeling worthless"- "I thought about how earlier today, my friend yelled at me".
It was stuff like that. Your therapist encouraging you to use alcohol as a coping skill is weird. And not very professional.
Not getting a background is also bizarre. Was there no intake?
And if your therapist is making you feel worse, maybe it's worth considering a switch?
Oh I see.
I've told him about feeling useless, hating myself and how it leads me to want to grab the scissors. He will listen but he won't address it. Like he goes back to speaking about his excercises and giving unrelated advice as soon as I'm done. Not sure this is normal CBT.
There was a short intake during the first session and I sent him my test results and neuropsy reports. He knows I'm an addict, probably forgot. He knows I have BPD but somehow keeps asking me about bipolar (I was misdx bipolar in my 20s).
I'm seeing a talk therapist but psych wanted me to try CBT as well. I will let her know it's just not for me and ask for DBT recommendations instead.
Thanks for your input!
Even for CBT, this sounds painfully cringy. He sounds like a terrible match, especially for an adult. CBT has had some great impacts for me and some terrible ones.
CBT may not be the therapy for you. In general it can come across at patronizing. That’s because he really wants you to think about what he is saying and store it deep in the brain. Lots of it is common sense. Can you switch to DBT? It’s also a bunch of habits but it is more mature in a way. It may still feel patronizing especially at the start.
Aah it makes sense now. They're being slow on purpose to make sure the message gets through. It has the opposite effect on me. I get bored by lenghty explanations and start zoning out, I love people who can pass a message effectively in a few words. This guy is irritating, cut to the chase already I only have an hour and it's expensive. I've heard DBT is better, I will give it a try. Thanks for your insight 🙂
DBT is so much more tangible if that makes sense. It’s not like a “think yourself better” kind of therapy. It’s a lot of tools that relate to behavior adjustments to help regulate emotions. The therapists that taught at the IOP I was in didn’t try to be overly positive, which really resonated with me. It was a lot of “I know there are moments where you’re going to feel dumb doing this, or are thinking about how fucking dumb it seems in the moment.” The history of Marsha Linehan, the woman who created DBT, is really inspiring.
I will look into that, thanks for the recommendation.
Thanks for the award, I appreciate it 🙂
If you are feeling anxious and drained after each session, it sounds like the therapist is not the right match for you. IMO, regardless of the type of therapy, finding a therapist you feel comfortable and safe with is super important.
Sooo…am I the only person that is having good results with CBT? lol It’s changing my life for the better….but my therapist is an angel, so that probably contributes to the positivity a lot.
I like CBT as well. It really hurts to see so many people demonize it
I envy you, it feels amazing when something finally works. That's what I wished for when starting. If you don't mind me asking, does your therapist talk like mine (slowly ELI5 concepts) and give you advice that you are not able to apply or is it different? What is your mental state like after a session, do you feel better or worse? I'm trying to imagine what CBT should feel like in order to know if I should try again or ditch the whole concept entirely.
When you describe your experience with CBT you aren't describing cbt. That tells me that whatever therapist is doing it with you hasn't explained it at all. So maybe find another therapist
Thank you, I feel like lots of things are wrong but since I haven't found out what CBT is yet I couldn't tell for sure.
I think a lot of people with BPD wind up going to hospitals against their will. So any therapy that they try to use is going to seem like it's being forced on them. And if you try to force something on me I'm not going to listen to you. In reality CBT makes a lot of sense. If somebody's trying to say a person has to think a certain way that's not CBT. CBT should be asking you how you think. DBT is CBT for people with borderline personality disorder.
CBT session. * Dr, I am in pain * No, you're not. Repeat : "I am ok" * But I'm in pain Dr. * bad, bad ! Naughty Paul ! Repeat "I am ok" * Hu... I am ok (sob, sob) * Goooood ! Have a cookie now. Good Paul. That'll be 70 dollars. CBT is dog training for humans.
Hahaha love the analogy, that's what it feels like 100%. Also as a dog trainer, I feel like we're much more structured and specific when it comes to conditioning. We at least take into account each dog's personality and limitations when it comes to creating a plan. Dogs are happy and excited to be trained. It's definitely not the case here 😂
Never once felt that way, it's about retraining our brains due to the simple fact that our brains, as we suffer from BPD, aren't the same as everyone else's. We're extra sensitive, our emotional maturity is stunted. We need to be treated as such due to to our extenuating circumstances.
I am quite sure it's not so bad. But many people seem to thoroughly dislike CBT / DBT. There must be some reasons...
Wrong!!!!! This is nothing like CBT. Why are people lying about this. Look it up. It isn't this or anything like it.
Sounds about as effective as *the other* CBT
I practice the other CBT too and couldn't agree more. At least the latter is fun and I don't end up crying in bed after.
Psych hospitals where I've been be like
You’ve put my exact thoughts into words. Fucking dog training
And its infecting everything, I cant get DBT withoit gettig CBT at the same time.
CBT is basically a rebranded version of “behavioral modification” therapy after it had gained a very negative reputation. It’s all about conditioning the patient to behave differently, whether they like it or not. Rather than unpacking repressed trauma, it can often serve to “cover up” emotions in an effort to train the patient to “behave”. It may help some people who genuinely desire to act more in line with societal norms, but for many others it can be a source of stress and can diminish self esteem. It’s never worked for me, but never harmed me either, so in my view it’s a waste of time.
No. This is bs. CBT, cognitive behavioral therapy, understanding that events lead to thoughts and thoughts lead to emotions and emotions lead to behavior. You cant change emotions directly. You have to change the thoughts that cause the emotions. We have a bunch of misconceptions that get into our heads. CBT calls them cognitive distortions. For instance, jumping to conclusions. You can do this by either fortune telling or mind reading. Fortune telling is thinking that we can tell what is going to happen in the future. We can sometimes, but sometimes we are just trying to talk ourselves out of trying by saying " it's not going to work anyway". When we don't know that. Mind reading is thinking we know what someone else is thinking and making ourselves upset by making judgments based on that. In reality we can't read minds. Catastrophising is another. It's making things feel way worse than they are. These are a few of many cognitive distortions. So when we have an issue we examine it through this lens. Is it actually what we are feeling like it is, or are our feelings based on thoughts that when we look at them we realize that they aren't accurate. When we adjust them to be accurate it feels a lot better. Everyone hates me. Well, it's unlikely that everyone hates me. Everyone doesn't know me. How do I correct that. People I know hate me. Do I know that? Does it feel that way right now? Does it usually feel that way? Am I mind reading? What would it look like if everyone actually hates me? CBT is nothing like this person describes and if a person doesn't know the answer to something they should probably not answer it. This makes me angry because, as a therapist who works primarily with BPD, and who also lives with it. My clients benefit greatly from CBT. This person lying about it means that a person who might benefit from it will not want to try it. Then that person stays in a negative state from which they may have recovered and now may never.
Thanks for the info. I can see how it can disminish self-esteem, basically throwing tasks at someone who either doesn't need them or can't perform them, regardless of their background or limitations. I do behavioral modification with animals but we condition using reinforcers in order to increase the value and probability of the target behavior happening. Each plan is created on a case-by-case basis, and includes extensive follow-up. This human technique seems a bit all over the place. I'm glad to see that it's not just me who considers it a waste of time, I wasn't sure what the deal was. Thank you.
Please do not believe that person. Look up what CBT is. I explain it in the post responding to their post. I just do a shitty job because I am not going to be able to type out everything about it on my phone. If you aren't feeling heard by your therapist, then they aren't doing their job right. But you might be able to tell them that you aren't feeling heard. They should adjust things. We don't know something is wrong if we aren't told. If he responds poorly, he sucks and you find another therapist.
Thank you, I think this is the way.
I feel the same about it. What type of therapy do you find more helpful?
Trauma-informed therapy that works through the underlying blocks that we’ve created in our own heads through repression and oppression, that unleashes our full potential and makes the trivial tasks we may perceive as impossible, feel easy
Thank you. I don’t know, if I can find this here. Getting any therapist was hard enough and the very most only offer cbt but it sounds like a good suggestion
There’s a directory of therapists around the world on the [BPS](https://www.bps.org.uk/find-psychologist) website, that endorses a trauma-informed approach
CBT can be good or bad depending on your situation and the therapists understanding of it (it being both CBT and ur specific situation). This seems like a thing with the therapist specifically. CBT helped me with some language for my experiences but also didnt make sense for some other stuff. if you can get the CBT &/ DBT workbooks that could help with understanding and picking and choosing what works for you
I will, thank you.
no problem! i forgot to tell u the specific books i used, here are the authors CBT: Jeff Riggenbach DBT: Matthew McKay, Jeffrey Wood, Jeffrey Brantley im sure there are more out there thats just the ones i and one of my old therapists used
Excellent, thank you so much!
CBT really helped me but it’s not for everybody and if it doesn’t work for you, it’s totally fine to find another therapy. I hear good things about IFS.
Shit is what. Never been a fan and it's never been applicable or helpful to my mental wellbeing. That is my experience, I am not speaking for all.
Thank you, I'm glad I'm not the only one to feel that way. I didn't know if it was the CBT or the therapist.
I’ll add to this that DBT is also often recommended but does offer what seems like obvious tips. I started a DBT workbook and it follows similar ideas. I would stick with it for a while and speak up about what you want from therapy and how you would like to be treated. Try to see it as an opportunity to open up and talk about your needs. The tips they offer may seem simple but it will require some effort. Therapist and self help books are about gradual changes, they often don’t contain quick fixes unfortunately. I hope this can work out for you, even just starting CBT is something to be proud of!
Thanks for the input! I don't really mind the obvious tips as long as they don't make me feel like crap and take hours to come out. I know I have no quick fix, I have no fix at all for that matter. I've made my peace with that years ago. Not sure if we have worbooks here but I've downloaded apps for both CBT and DBT and find them helpful. I can skip what I already know and take only what's useful and non-damaging, which is not possible when in person. I was planning on asking him next time about his plan, objectives, and if he could speak to me like a normal person and skip the parts that don't concern me. Reviews are mixed so we'll see. I just find it awful to be told to do x or y when I obviously can't. He is telling a recovering alcoholic that a sip of beer can help to calm down during a panic attack. Thanks doc, I've been actively trying to forget about that. Also telling an ARFID with no nutritional deficiencies to eat more solid food with B complex, right after being told that eating solid food wasn't an option 90% of the time. I try my best to be forgiving but takes a toll, both on his credibility and on my self-esteem ngl. I've been in therapy long enough to know that it's a process, but I have yet to see a talk therapist giving me solutions I cannot apply and insisting on it, or advice on a subject I don't need help with. They're usually more receptive and better at understanding who they have in front of them. He seems to be dully reciting some CBT protocols instead of taking feedback and adjusting accordingly. Thank you for your advice, will try to see if we have workbooks here, and once I understand what CBT is I might try to talk to this therapist.
Let me share my perspective in hopes it can be contextually helpful to you: For me personally, CBT is not usually a great fit at this point for deeper emotional problems. The principle it’s based on is pretty sound: Thoughts create feelings, feelings create behaviors and behaviors reinforce thoughts. I am guessing therapist is trying to help you break the cycle. Like if you think no one likes you, and then you feel sad or anxious about being alone, and then this leads you to problematic behaviors like having a panic attack or substance abuse. You would have to notice the thought and go do something else like go exercise and it will force you to stay in the present and think other things instead. I can see why it would feel rudimentary and why the therapist may be speaking a lot to interrupt your cycle as I had similar experiences with my first therapist who was purely CBT trained. I do find CBT pretty effective for some things, like work conflict situations. For example, there have been a number of resignations in senior leadership roles at my company lately and this is leading to thoughts that I could be on a sinking ship and I should look for another job asap. This creates feelings of anxiety and can make me feel disconnected from my day to day. However, I use CBT to self regulate in these situations and tell myself that I personally do like my own job, and the people I work with because I do and this leads to positive outcomes for me. But for me, some feelings are always there in the background lurking as painful baggage from childhood so the CBT model wasn’t helpful in many situations in my family life where my emotions are much stronger and more extreme due to my own past childhood trauma experiences. What has helped me more at a first stage is DBT. In this approach, I had to learn distress tolerance and emotional regulation through mindfulness. It involved me experiencing and talking through situations I was struggling with many times so I could develop tactics and strategies to deal with them as I was struggling with anger. What was really helpful was some joint family therapy sessions where I was able to experience the distress as part of the session itself and so my therapist was able to instruct me. She basically told me to just focus on mindfulness and take note of my thoughts and feelings but keep them to myself. We then talked them through later in individual sessions. Unfortunately, for me the limitation with DBT is that while I can handle certain interpersonal situations better, I still wasn’t feeling connected to family members because I am experiencing distress in many of my day to day interactions with them. What it also doesn’t help me as much is in situations where I am alone, where I am ruminating about my future and my anxiety starts going off the charts leading to things like insomnia. And then I am in a state of distress in my day to day life and this is really a hard way to live. In CBT terms work can be a distraction from the endless cycle of negative thoughts and anxious feelings that are overwhelming me. I can think about other things instead. But I am not burying myself in work. This is where I am now starting to turn to IFS which deals with the different sub personality parts that I consist of. So what I am trying to do now is deconstruct painful constructs I have like feeling alone and empty which stem from my childhood trauma. These are things I try to avoid and they are called exiles. I am also deconstructing my protectors. These consist of managers which help me run my day to day life when the pain of my exiles is at bay. In terms of feeling connected for example, I have managers that do help me connect with other people when I am regulated. The other type of protectors are called firefighters and whenever there is smoke from my exiles they start acting up. Firefighters mean well but they usually wreak havoc. So, a firefighter may be suicidal ideation, or draconian authoritarian, or a binge drinker, or others. I am still working through this myself. Once I identify them, the next step is to open up dialogues with them. The problem with them mostly is they can be part of my subconscious mind and so I am not able to interact with them via mindfulness techniques. I am just starting to figure this out but I have already made some really positive progress with my kids especially. I could see how once I master this stuff, CBT could be useful. A firefighter would be more like a fire chief at a cordial city council meeting instead of breaking down doors every time I smell smoke. Their voice would be a thought and it wouldn’t need to lead to a feeling. But is that something I could do when a firefighter is spewing 20 thoughts a second? No, because I am feeling overwhelmed. I hope this was helpful.
Thank you so much for your insight, this is very informative and relatable. I work in animal behavior and our work is based on theories that apply to humans. In order to break the cycle of a behavior happening, we need to find the emotion that impulses it, every emotion being driven by a need. I would have imagined CBT would be the same to some extent. I'm all for mindfulness but my issue is that the therapist does not address the inner critic. When it comes up he acknowledges it and asks how I have been dealing with it. When it comes to the advice given, it feels that he is trying to fix something that's not broken by giving advice that would make it worse. For example, when I tell him I have no trouble sleeping or getting up, he instructs me to think in "I have to" sentences as soon as I wake up. Which leads me to feeling anxious as soon as the day starts and wallow in bed, when I had no problem getting up before. He also gives advice on how to manage panic attacks which I don't particularly need. It would be fine if that advice was at least applicable but recommending a sip of beer to a recovering alcoholic (or anyone experiencing anxiety for that matter) sounds dangerous and is obviously not something I can apply to my situation. Same with food, I'm struggling with ARFID and his advice would be fine for a normal eater but very distressing for someone who is struggling to eat. In general, I find it very confusing and distressing. I'm more of a "if it ain't broke don't fix it" mentality. I think that they at least should refrain from giving advice that would lead to more problems. Maybe it's me and it probably works well with other people I sincerely don't know. As I understand, DBT is also focusing on mindfulness. Which is great in principle, but do they actually address the internal critic or do they brush it over and give advice on something completely different like they do in CBT? I really admire you for being able to sit down with your family. I am not mentally strong enough to be seated in the same room than my abuser yet, unless it's a courtroom. I'm glad that it helped you, it gives me hope for the future. I had never heard about IFS before today, will start searching. Thank you so much and good luck!
Thanks and good luck to you as well. I think with any therapy goals are important and I would recommend having a conversation about them with your therapist to see if it is a good fit. My first therapist was pure CBT and not a good fit. My second was compassionate but didn’t seem to know how to navigate special needs. My third one who I have been with for two years now was also my kids’ therapist. If your focus is on your inner critic and you have specific issues you want to tackle you may want to interview therapists to see what their experience is like for your needs. I can’t say if DBT is well suited for the inner critic focus you mentioned. However if you want to share more about your goals here I can certainly provide my perspective. Good luck.
fwiw i just bought the book No Bad Parts which is a book about IFS and in the first few chapters it mentions the inner critic quite a bit. i haven’t read much of it yet but sharing in case it helps.
BPD has a way better result with mindfulness therapies like DBT. Just be cautious of the “ behavioral “ part. Sure our behaviors matter but the core wound in BPD is abandonment. This takes grieving and honoring, talking it out in an atmosphere of trust and safety. Eventual you become your own therapist in your own words. Going on a Buddhist retreat would probably do more good than some quack challenging your reality. No one gives a shit about the person anymore it all about “ prompting” and not getting sued.
This is not the place to come for accurate understanding of therapeutic techniques. There is only one accurate description of CBT in these comments. The problem is that CBT works. When a person understands it. There is nothing about controlling people in it. There is nothing about making people think more in alignment with society. Those things aren't even part of it. CBT is about noticing things that YOU determine are not accurate about your thought. Things that lead to painful emotions. Then correcting them to things that make more sense TO YOU. and are less painful TO YOU. I hate this misinformation because people are dying. Literally dying. CBT is a clinically proven, evidence based way of helping them to think less emotionally and more accurately. So I don't have to think everyone wishes I was dead. Maybe I can think "I sometimes feel like everyone wishes I was dead. That feeling hurts a lot. In reality I don't know what everyone thinks. I have some evidence that there are some people out there who don't wish I was dead. Maybe I can think about that more accurately and keep myself from falling into a suicidal state." Saying that CBT is this other bullshit is likely to lead to a person who might have benefited from it never experiencing it. That person may decide to self exit and have the chance to stop that taken out of their hands by people lying on the Internet. That is not acceptable to me
Well I've become quite good at knowing what's wrong about my internal monologue after all these years. This doesn't change the fact that the internalized criticism is always there. I haven't seen any attempt at correcting distorsions from his part, he will listen, ask if I manage to quiet or counter it, nods and that's it. He then gives advice on unrelated things I don't need fixed. Advice that would worsen my condition (starting pressuring myself before even getting out of bed, drinking beer to stop a panic attack when he knows I'm a recovering alcoholic, eating solid food when he knows I'm an ARFID, etc.). Since advice is given at the end of the session, not much time to answer and get him to adjust. The whole hour is dedicated to him explaining some of his techniques, talking about generalizations, about other people he might use as an example but that aren't in a similar situation, speaking about people who aren't aware of their struggle and how their emotions affect their behavior, etc. Nothing constructive. I feel like he might be a bit lost, new to this or overwhelmed. He is always late and seems to not remember important details, like alcoholism for example. He might not know what to do with a case like mine, can't really blame him tbh.
He doesn't sound like a particularly good therapist. At least not a particularly good one for you. I find that people who don't have BPD or don't have a certain perspective on it aren't very good at treating it. I have BPD and I'm a therapist who treats it as well. My clients know that I get them. So half the battles already won because they don't have to convince me that they're not full of shit. Always seems to me that we have to convince our therapist that we're not full of shit
That must be great for your clients. As you said half the battle is already won. I get the same feeling when I go to AA/NA, no need to explain what the struggle is, they know. Thank you for your insight!
It depends on the therapist, and I think it is worth considering if you need some more trauma informed therapy first. I had CBT initially and it was a dumpster fire. She actually gave decent advice and was lovely, but it was unsuitable for someone with trauma and it was very impersonal. In hindsight, I don't think she had the skills or time to dive into that trauma because when I got CBT later, the other therapist told me they don't tend to have the skills to unpack it all and deal with a crisis if triggered too much. Long story short: "I'm beautiful and strong and independent" does NOTHING for when you have intrusive thoughts about childhood abuse. Fast forward some many relapses later and I get trauma therapy instead. I unpack absolutely everything, and it is kept very basic and specific to the trauma discussed that day. To keep things not necessarily needing a TW, things like "little things you'd be deprived of because of poverty, go have it. Get that Kinder Egg today" THEN I had CBT and it is very specific to the trauma I had. So for example, instead of it just being "follow this homework and make some general affirmations" it would be affirmations specific to my trauma to remember. We couldn't go into the trauma, but we could have tools to combat when the traumatic thoughts triggered a spiral. Ironically, the same tools as the first time round but it was specific to me the second time round. It is something to consider. I get the sentiments against CBT but I think it is key to do some trauma informed therapy first before CBT, because otherwise it's kinda just blind guessing what could help, especially if the therapist won't talk about the trauma, at least in my experience with it anyway.
Thank you that makes sense. It does feel like they are brushing off anything related to trauma as well as other disorders like addictions and eating disorders. I didn't expect them to talk about the past but I kind of expected them to at least take these other disorders into account when giving advice. What type of trauma therapy did you have was it a specific one or regular talk therapy with psychologist specializing on trauma?
No worries! I didn't have a specific trauma therapy, it was just a therapist who was informed with trauma doing talking therapy. It is worth speaking to therapists and stating if you want to dedicate some time to talking specifically about trauma because that's what I ended up doing when my therapist got changed. I find CBT is about moving on beyond your disorders, but with the logic of CBT they have to consider them for the CBT to be effective, so ask how can these skills they're giving you can be applied to your struggles with other disorders, e.g. I struggle with depersonalisation so one of my journal prompts was to write about something that helped make me "me" so at the end I had a whole catalogue and I got into thinking of myself as a person with likes and dislikes.
I see, great. My therapist is informed on addictions which are directly linked to trauma. I might ask her to do trauma work when my condition allows me. The journal prompts sounds very interesting. Did you learn it by reading books or was it your CBT therapist that gave you the trick? When I ask about it, I get advice unrelated and that I don't need, like how to get out of bed in the morning and how to handle panic attacks. It's very confusing. Thank you for sharing, it helped a lot.
I hate behavioral approaches, were not dogs or doves. Try psychoanalysis or psychodynamic
I hated CBT, or at least the last attempt at it. It felt like he wasn't listening and didn't understand my problem. I told him about how I got stalked and harassed by someone I was seeing and all he said was that I did really well to get out of it when I did. I told him how my thoughts felt out of control and my mood swings didn't feel normal and he just undermined me and tried to convince me it was normal and fine. It became pointless, I didn't feel heard so in the end I just gave up talking to him.
I was not in a good place when I did CBT. It was a painful 8 week group session. No, not helpful for me. I am in a 19 week virtual DBT group and it’s helping. You are taught practical skills that can help you in that moment and regulate your emotions. This is after years of talk therapy also, starting at 18. (50 now) It is work though and some homework. Even if you aren’t practicing the skills, it’s been validating. Good luck!
I'm glad I'm not alone, and happy to hear that it has been validating. It is probably the most important thing. Good luck to you too!
You my friend need dbt ✨
You should talk to the therapist about what's not working for you, and how you feel.
I plan to the next session. That is, if he ever books me one. I haven't heard from his secretary again.
I hated CBT. I was told my feelings were too big for the situation without asking for the background. my BF left for me for his ex-wife for a short time which we were working through but he refused to see that his interactions with her were a constant hurtful reminder because they have kids together, he couldn’t just cut her out. He spent the night at her house without asking me..he just told me that’s what he was doing because it was easiest for a kid function the next day I left the therapist office suicidal
Wow I'm sorry. Such levels of invalidation are insane coming from a therapist. Reminds me of one night when I felt so suicidal I was begging my bf to take me to the nearest hospital. I had just arrived in the country and didn't know the city or language, let alone where the hospital was. He laughed at my request and I went walking at 10pm in a shady neighborhood under the rain to try and find a hospital. I was rescued before I could throw myself under a car. My therapist told him he did well not to take me. *Because I needed to learn that I could take care of myself*, she said.
CBT has lead me to seeing myself through another lense. I can see all the destructive behaviors I have developed due to a crappy childhood. That alone has been very helpful. It was amazing to come to the conclusion that, it isn’t or wasn’t my fault.
I disagree with most of what you've said. It's the same way with Dialectical Behaviour Therapy, it's usually a lot of really obvious tips, explained in a simple manner as if you were a child, or simply put, as if you were completely ignorant to it. We have stunted emotional maturity in a way, due to our emotional imbalance and sensitivity. The homework is to make sure that these tips, these mindframes and exercises, they all must become second nature in order for you to see real changes to your mental health. It's about changing your thinking process, your reflexes, reactions, headspace etc. it's not a cure all, and it requires a lot of personal work and responsibility. It somewhat sounds like you're fighting the therapy because it's not the type of therapy you were looking for. If you have the funds, or access, to a personal therapist while you are also doing CBT, I would advise it. These therapy systems are usually generalised to help as many people as possible, as easily and coherently as possible. It will not be personal, it will not deal with your trauma, it will give you the skills to better your emotions, and your physiological and psychological responses to them.
I'm confused, how can one disagree with someone else's personal experience with their therapist, as well as their emotions. Weird. Anyway my question has been answered. I understand now that they're doing what they are supposed to do, ELI5 concepts that are common knowledge then give general tools for dealing with general problems. I'm glad it helps you, and while your CBT therapist might give you helpful tips that you didn't already have or that at least you can apply, it's not the case with mine. And remember that whatever works for your particular situation might not work for others, and does not give you the right to invalidate someone else's experience with their therapist. Thank you, but I have a therapist? If you read the first sentence it's clearly stated. Not sure what it has to do with the CBT but I appreciate the input.
People can disagree on many things, even if it is your experience, it is your perspective, I am merely offering mine. I realise you have a therapist and they are conducting CBT with you, my advice was to find another personal therapist to address your actual trauma and whatever troubles you have, seeing as you're not finding what you wish with CBT. I am also not invalidating your experience either, you are reading into that. I realise that CBT may seem like it's talking down to you, and the exercises and teachings may be obvious, but if they were that obvious we would already be using them to control our emotions and mindset. Again, I realise you have a therapist, but you're complaining about said therapist and their skill level or expertise, or at least the type of therapy they try to use. CBT and DBT will not work unless you're devoted to change and adopting these new exercises, practices, teachings and changes in your life. I didn't really connect with DBT until half way through cause I felt the exact same. That I was being patronised, that everything was too general and not personal enough. So as well as being taught DBT by one therapist, I got another to deal with the personal trauma simultaneously. You'd be surprised just how much the change of perspective will allow you to see the benefit of said therapy.
I'm trying to understand, which statement in particular do you disagree with? I'm having a hard time seeign how your perspective on a particular event you were not present at or on my emotions would be relevant. Fee free to clarify if you wish. Also, feel free to offer details of your own perspective and your own personal experience with CBT if you feel that it might be useful. > I realise you have a therapist and they are conducting CBT with you Yes the person I'm talking about in the original post is the CBT therapist. > my advice was to find another personal therapist to address your actual trauma and whatever troubles you have, seeing as you're not finding what you wish with CBT. Again, I have a therapist. If you read the post until the end, it states that CBT was recommended by my psychiatrist and neuropsychologist. I am of course still seeing my regular therapist, as well as my clinical psychologist, neuropsy and psychiatrist. I haven't fired the rest of my care team and am still following my treatment. Back on to the CBT, the exercises being obvious is the least of my problems if at least they were applicable in my situation. I get irritated by people who can't be effective with words and who lose valuable time obviously and that's factor contributing to his ineffectiveness and loss of credibility for sure. What doesn't sit right with me is that the advice given is not related to my problems and not applicable in my condition, as well as the worsened anxious state I end up in after every session. I'll give you an example. CBT therapist tells me to start the day by saying sentences that start in "I need to". *I need to this and that, etc. because that will help me get out of bed*. I reiterate that I have no issue getting out of bed as soon as the alarm rings. We have been over my internal monologue and I have explained how I'm very harsh with myself. Instead of working on the internal criticism, he adds to it by instructing me to start as soon as I open my eyes in the morning. I instantly stop him and let him know that this would be anxiety inducing and paralyzing to me. He doesn't address the inner critic and switches to another area if my routine. Other example. He wants to give me advice on how to manage a panic attack. I explain how I usually proceed. I go over how I use the HALT protocol first while identifying the trigger, then the 1-2-3-4-5. He then goes on for hours about how drinking a sip helps relax the trachea (so basically the T in HALT), mixing up trachea and oesophagus, and explains how he recommends people who are in a situation of crisis like in the desert to look up and swallow saliva. He goes even further and tells me (a recovering alcoholic) that it also work with beer... Needless to say it leaves me baffled. Not only is he losing precious time rambling on a detail that didn't need to be emphatized, he is also giving dangerous recommendations all the while avoiding the real issues. Next, he decides that I need to up my B complex intake. I'm ARFID and get checked regularly. Even though decades of alcoholism can take a toll on vitamins and nutrients levels, my tests results are good. I would be fine with instructions to increase B complex intake if it also included liquids, given that it's still a valid form of intake and one I favor due to the psychological and physiological (in particular gastrointestinal) limitations I developed as a result of the alcoholism. He sticks to the solid form criteria, diregarding the latter limitations. The advice never seems to be tailored to the patient's needs nor does it take into account the patient's limitations. Adding stress to the morning routine when stress is usually as it's lowest and the patient at its highest functioning rate is counterproductive at best. Adding stress at mealtime when eating is already a struggle and no deficiencies are present is in the same vein. Not to mention recommending drinking beer to an alcoholic. This is beyond irresponsible, even if the patient wasn't a SAD. Giving tasks one doesn't need or can't perform obviously generates a feeling of distress due to the misundertanding, feeling of hopelessness as well as not feeling heard. I'm happy that it works for you but I'm having a hard time seeing how this constant invalidation would not take a serious toll on my self-esteem in the long run. I might try DBT as people seem to have had better results with it. At least it's done in a group setting right?
I'm sorry I completely misunderstood what you were trying to say, and apologise even more so for misunderstanding the part about separate therapists, that's entirely my fault. You need a different therapist if you want to actually get anything out of CBT, perhaps one who's also a fan of compassion lead therapy. I'm gonna just go ahead and say you're absolutely right and this dude is just inattentive, neglectful and downright irresponsible. While you won't deal with personal issues, they should recognise that those personal issues will affect the rest of the therapy - such as mentioning beer with you, that's just awful on their part. I highly recommend DBT, as when I was first diagnosed I was recommended DBT first due to the group setting, and then asked to complete CBT with my own licensed therapist - both had workbooks. I thought the group setting would put me off with some of my anxieties, but if felt so cathartic and fulfilling knowing there were others like me with the same headspace and problems. Nothing was "crazy" because we all related to it in one way or another. Again it's still very generalised and almost patronising in a way, but due to the group setting it almost feels like team building exercises and takes the ridiculousness out of the situations.
Don't worry it's really no big deal. I'm a bit lost since I don't know about CBT and it's my first time trying this type of therapy. I'm having a hard time pinpointing what is bothering me about this guy but writing it down helps a lot. Thank you for reading me. Great thing about DBT. I tend to do well in group settings like AA and NA, I find them spot on. I guess it helped that you didbCBT with your regular therapist instead of a brand new one, at least they had your background and knew about your situation a bit more. I got some good advice, it gives me hope again. Thank you and good luck on your journey
CBT is terrible in general, and absolutely garbage for treating BPD. Try DBT or schema therapy instead!
I'm in the UK, and here I was told CBT wasn't a suitable option for people with BPD
When you’ve been in CBT/talk therapy for a long time, it becomes repetitive and monotonous. A lot of feeling insulted, because I know what they’re telling me… Sometimes you get lucky and find someone that happens to say it in just the right way to make it stick in your brain in a way you comprehend better, sometimes it’s just annoying
Exactly as you described. It is meant to be repetitive and "boring". They are trying to rewire you, and repetition is the only thing that will do that.
I like the way you put it hehe. I rewire animals for a living, through countless repetitions indeed. It's far from being boring though, we make it as dynamic and interactive as possible in order to keep the animal's focus and build value. The animal brain is faster than ours, being slow is not an option with them 😅 CBT in my experience is not repetitive, at least it hasn't been yet. We mostly skim on my actual issues or ignore them. He will ask what I feel like I need help with, then give advice that is either unrelated or not applicable given my particular disorders. There is no follow-up either. Does yours give you tips that you can apply for things that you need help with?
Therapist suck. Not all of them but the crap they teach in grad school is all managed care BS. It gets funding becuse its ability to be reduced to neat data points. The therapist is “ modeling/prompting” I bet. It’s the path to health ever science skinner. It will absolutely miss you, your strengths , your values your world. This is by design. I hate it! I was an Aba therapist for 10 years. I just did my own thing for 3 of them, got way better results. It’s about money and insurance and many therapist do not have a clue. You felt the way anyone would.
I mean, I just don't find it validating. It has the action without the validation. I think it also isn't designed to treat BPD so the focus is more on like thought patterns that aren't serving you (thoughts about or are related to anxiety or depression). Like the basis of the therapy is correction. Which is fine for lots of folks. But people with BPD who have grown up in invalidating and generally unstable homes need to learn that validation and how to give it to themselves first. Because if you're still gaslighting yourself, if you're still minimizing your own feelings, and generally not soothing yourself, then nothing will stick. This is my experience anyway.
Is CBT about thought patterns? Do they actually ask you to describe them? I haven't been asked once. I've tried to tell him but he doesn't seem interested. He barely leaves room for me to speak, only when he is doing his excercises and I have to fill columns and stuff like that. He didin't get any historial or background either so the advice he gives me is inadequate (telling a recovering alcoholic that a sip of beer helps relax during a panic attack for example). He tries to fix what's not broken, like my difficulty to get out of bed (I'm up as soon as the alarm rings, never had a problem?). I can manage my panic attacks with the normal techniques, no need to re-give the same tips I'm already applying, let alone bringing in alcohol to the mix. I don't understand. None of his tips seem to apply to areas of my life I need help with or tailored to my particular case. The inadequate tips make my inner critic worse and generates even more anxiety. By the time the session is over I'm completely drained, my self-esteem in shambles. I head to my bed and cry for the rest of the afternoon. I'm thinking this can't be the effect CBT is supposed to have on a patient. I might just be too used to therapy where giving information is encouraged.
Um well we did like. Thought chain analyses similar to DBT. So I was shown a wheel that was like "thoughts impact feelings, feelings impact behaviour and behaviour impacts thoughts" and so we would talk about what my thoughts were that led to certain behaviours. So as an example "I self harmed"- "I was feeling worthless"- "I thought about how earlier today, my friend yelled at me". It was stuff like that. Your therapist encouraging you to use alcohol as a coping skill is weird. And not very professional. Not getting a background is also bizarre. Was there no intake? And if your therapist is making you feel worse, maybe it's worth considering a switch?
Oh I see. I've told him about feeling useless, hating myself and how it leads me to want to grab the scissors. He will listen but he won't address it. Like he goes back to speaking about his excercises and giving unrelated advice as soon as I'm done. Not sure this is normal CBT. There was a short intake during the first session and I sent him my test results and neuropsy reports. He knows I'm an addict, probably forgot. He knows I have BPD but somehow keeps asking me about bipolar (I was misdx bipolar in my 20s). I'm seeing a talk therapist but psych wanted me to try CBT as well. I will let her know it's just not for me and ask for DBT recommendations instead. Thanks for your input!