{"id":29,"date":"2012-02-15T14:58:00","date_gmt":"2012-02-15T14:58:00","guid":{"rendered":"http:\/\/www.benkrefta.com\/transformation\/2012\/02\/15\/ending-cbt-style-therapy\/"},"modified":"2015-02-18T14:22:41","modified_gmt":"2015-02-18T14:22:41","slug":"ending-cbt-style-therapy","status":"publish","type":"post","link":"https:\/\/www.benkrefta.com\/transformation\/2012\/02\/15\/ending-cbt-style-therapy\/","title":{"rendered":"Ending CBT-style Therapy"},"content":{"rendered":"<p><a href=\"http:\/\/www.benkrefta.com\/transformation\/wp-content\/uploads\/sites\/8\/2012\/03\/mindfulness-meditation-002.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-102\" src=\"http:\/\/www.benkrefta.com\/transformation\/wp-content\/uploads\/sites\/8\/2012\/03\/mindfulness-meditation-002.jpg\" alt=\"in my head\" width=\"460\" height=\"276\" srcset=\"https:\/\/www.benkrefta.com\/transformation\/wp-content\/uploads\/sites\/8\/2012\/03\/mindfulness-meditation-002.jpg 460w, https:\/\/www.benkrefta.com\/transformation\/wp-content\/uploads\/sites\/8\/2012\/03\/mindfulness-meditation-002-300x180.jpg 300w\" sizes=\"auto, (max-width: 460px) 100vw, 460px\" \/><\/a>For the last 4 months I had been seeing a therapist once a week to try to tackle my issues of negative thoughts, avoidance and fears. Yesterday was my last session after we both concluded that it was not making a significant impact on these aspects of my life.<\/p>\n<p>That&#8217;s something like the 4th or 5th metal health worker I&#8217;ve seen in attempting to resolve some of my problems, so it&#8217;s really disappointing to have given it my all and had expectations for lasting change, yet nothing substantial came of the process. Especially as I was refereed to her by a big-name Psychiatrist I&#8217;d seen previously who had a lot of faith in her abilities.<\/p>\n<p><strong>The Format:<\/strong><\/p>\n<p>The first 3 or 4 sessions were pretty much for her to gather an understanding of my issues. I&#8217;ve got A LOT and it was clear that I&#8217;ve been dealing with long term depression and destructive habits for most of my life. Dealing with a case like myself is enough to test anyone I&#8217;m sure!<\/p>\n<p>I did feel frustrated that after the 3rd and 4th sessions we were still discussing what&#8217;s wrong with me instead of taking positive actions to deal with it. Was this too much to ask? Before she met me, she had a chance to check out her referral notes about me and I helped by giving her a really well constructed and concise 2 page document about my life history, my problems and what it was I felt needed attention. To be honest, I hoped we&#8217;d be able to role with some solid, positive recovery strategies after the 1st or second session.<\/p>\n<p>I did take the opportunity to say if I felt things were not going as I&#8217;d expected and if I was happy. She knew that she wasn&#8217;t the first person to attempt to tackle my issues so didn&#8217;t just want to go over the same ground, which was good. If I mentioned I wasn&#8217;t sure or was expecting more, she replied &#8220;it&#8217;s early days and it wont happen over night&#8221;. I know I can be quite impatient, so I let her have that one! I guess it makes some sense that if I&#8217;ve been living with a long term habit, I can&#8217;t just switch it off after a few hours of therapy (or can I?).<\/p>\n<p>The next 10 or 11 sessions were pretty much a mix of listening to my issues and debating the validity of my negative thoughts. It turned out that she did end up going over a lot of the same stuff previous counsellors and therapists had :s This was particularly frustrating when covering certain strategies which I have no faith in or that do not resonate with me. For example:<\/p>\n<p><strong>&#8220;Let&#8217;s explore your childhood&#8221;<\/strong><br \/>\n&#8211; let&#8217;s not! Not because I had a particularly bad one, but more that I don&#8217;t feel digging up the past is going to help me in the here and now. I felt that previous therapists had got me to do this so that I could dig up a painful memory, make me upset and they would feel they&#8217;re doing a good job to see me &#8216;release my emotions&#8217;.<\/p>\n<p>In theory, that sounds reasonable. In reality, it makes the patient feel shit, then helpless as they can&#8217;t change their past, and then they leave the session with one extra negative thought in the front of their mind!<br \/>\nMy latest therapist assured me this was important to gain understanding of myself and hoped that identifying when a habit may have formed, it would lessened the power my habits have over me. Or at least I think that was her main objective?<br \/>\nIn theory, that sound reasonable. In reality, having the insight into my past, is interesting and that&#8217;s as far as it goes! Common sense tells us that we are a product of our experiences and I can&#8217;t see how this type of personal insight can even begin to change one&#8217;s long established habits or the way one interprets the world.<br \/>\nMaybe I missed the point? Maybe childhood regression techniques can help if one can then re-code a past memory or memories? If so, I wasn&#8217;t aware of any NLP style techniques we used to do this :s And even if I could re-code the first memory I had of a now destructive habit, I do not believe that would negate the 1000s of other times I had gone on to think in the same way as part of the habit, or offset the &#8216;evidence&#8217; I&#8217;d acquired to support my negative beliefs and thoughts.<\/p>\n<p>So to summarize the whole childhood thing, for me it&#8217;s a useless strategy. Perhaps unless it&#8217;s done properly and there&#8217;s more to it than just &#8216;let&#8217;s just look at your past&#8217;<\/p>\n<p><strong>&#8220;Thinking errors and counter statements&#8221;<\/strong><br \/>\n&#8211; The idea is for one to recognise their irrational thoughts and to counteract with a positive, rational thought. This sounds great and is what CBT and most therapies I&#8217;ve tried are all about. However, there&#8217;s a couple of big flaws in this system, for me at least&#8230;<\/p>\n<p>Usually this is done via crappy photocopied worksheets from self-help or psychology textbooks. If you&#8217;ve read books like &#8217;10 days to self esteem&#8217; by David Burns, you know the format. In one column you&#8217;re asked to think of a negative belief or thought that you regularly have- this is the easy part for most people! In the next column you&#8217;re asked write why the belief is considered &#8216;irrational&#8217; or destructive- this is common sense for most people and so more an exercise in insulting the patient&#8217;s intelligence. Lastly the patient is asked to consider an opposing , positive thought for the belief or thought.<br \/>\nIn theory this sounds like a perfect model for tackling thinking problems and would be if it worked, but it doesn&#8217;t for a number of reasons:<\/p>\n<p>#1 Certain thoughts may be &#8216;irrational&#8217; when compared outside the patient&#8217;s mind and if one has a different interpretation of the world from the patient. However, rationality is subjective and based on personal experience and knowledge. For example: if I write down &#8220;the world is a scary place&#8221;, such a statement is not irrational in my mind because that is my logical interpretation based on the real-world evidence I have gathered to support this belief! Granted, the evidence is subjective as is one&#8217;s interpretation of the world, but typically this exercise does not address this subjectivity issue. Instead, you&#8217;re asked to write down the common sense reply- what most people would consider irrational. So for &#8220;the world is a scary place&#8221; I might write, &#8220;it&#8217;s not all bad and most of the time bad things don&#8217;t happen&#8221;. This is true, and I know it is true! However I will still ultimately ignore this truth and instead put my trust in the equally true and more emotionally powerful evidence I&#8217;ve gathered to support my negative thought.<\/p>\n<p>#2 It is vital for one to believe a positive counter statement. If I hate working out, but tell myself &#8220;I like working out&#8221;, it doesn&#8217;t change anything- they are just words and can&#8217;t counteract the well defined, negative experiences or attitudes I have towards working out. The last column makes the assumption that one is in a positive enough mindset to believe in a positive alternative. Sometimes I get really depressed and my brain becomes encased in a negative barrier. It&#8217;s crucial to get out of this state before attempting such a task. When I&#8217;m in negative mode, I realize the blinkers are on and I am unable to comprehend a positive alternative. So to write down an opposing statement would be of no practical use in the same way writing down &#8220;I believe the sky is green&#8221; makes it so.<\/p>\n<p><strong>Overall the experience lacked impact:<\/strong><\/p>\n<p>It all sounds dismissive and as though I&#8217;m not giving it a shot. That&#8217;s not the case! I really do try. I&#8217;ve tried these typical &#8216;challenge the negative thought&#8217; exercises many times and they have no lasting impact, so I&#8217;m simply stating my reasons for why this is. I have some good ideas of how these strategies could be improved or replaced with completely new approaches, which I&#8217;ll save for another post. For now I&#8217;m pointing out that while my therapist seemed to have a tool-box full of tools for helping, she didn&#8217;t know how to use them properly. To expand the analogy- she might be successful hammering a nail into a piece of wood, but I&#8217;m like a concrete block so you need to either hit a lot harder or use a different tool and know how to use that tool effectively!<\/p>\n<p>Instead, whenever I asked to discuss certain issues or work in a way she didn&#8217;t know how I&#8217;d get the typical bullshit lines: &#8220;we&#8217;ll look at that later&#8221; or &#8220;that&#8217;s something we need to work on&#8221; and then always never actually end up working on it! My friend remarked on how, according to a book about the Dalai Lama, therapists will use the &#8220;we&#8217;ll visit that next time&#8221; type of phrase when they basically want to shut you up or don&#8217;t have an answer. Not very encouraging!<\/p>\n<p>I&#8217;m hoping to find a therapist or individual that can relate to these obvious therapy flaws and has been driven to formulate the practical, long-term strategies for change which prove to work time and time again- especially with the suborn, &#8216;concrete&#8217; cases like myself. I feel the therapists I&#8217;ve seen so far are happy to learn the basic therapy framework at university, from courses or text books and apply it to patients, but don&#8217;t ask: &#8220;why isn&#8217;t this working?&#8221;, &#8220;how can I make this better&#8221;, &#8220;how can I communicate in a way that my patient can relate to&#8221; and so on. I guess it&#8217;s easier and more beneficial for the therapist&#8217;s sense of self worth to solve the easier cases and chalk the difficult ones up as unresolvable?<\/p>\n<p><strong>The Good:<\/strong><\/p>\n<p>She was a nice lady.<br \/>\nReasonably smart and experienced.<br \/>\nIt was great to offload some of my issues and have her take on what I&#8217;m doing and why<br \/>\nSeeing her was a positive step in the right direction and an excuse to leave the house.<br \/>\nShe assisted me in discovering a little more about myself.<\/p>\n<p><strong>Conclusion:<\/strong><\/p>\n<p>It wasn&#8217;t a complete waste as I got some things out of the experience. However it&#8217;s very disappointing to feel I didn&#8217;t actually get what I came for! I question if I am indeed an unsolvable case as I put in a lot of effort to &#8216;solve&#8217; myself, yet on a day-to-day basis I am often very worried about my current and future prospects, am easily stressed and in an appalling state of mind 75% of the time. However if I could improve the strategies therapists use on me and probably many others and that&#8217;s not even my job then perhaps there is a strategy that will be beneficial to me? There are people out there who I feel more confident in- I&#8217;ve become a fan of self help guru Anthony Robins recently and if I were to write a comparative case study between his thoughts and strategies and my recent therapist (I wont mention her name) there is no doubt he&#8217;d prove far more competent.<\/p>\n<p><strong>One thing I&#8217;ve always felt I need is:<\/strong><br \/>\n1- motivation<br \/>\n2- an action plan that works for me<br \/>\n3-active support in adhering to my action plan<\/p>\n<p>If someone was knocking on my bedroom door everyday to wake me up, threatened to pour water over me if I lay in and reward me with things to look forward to throughout the day if I get up, then I&#8217;m really confident I would finally resolve my sleeping in issue! I will try to do this by myself, but you know what it&#8217;s like- if you&#8217;ve got someone there who will interrupt your current lifestyle, someone to support you and act as a real-life threat, then it&#8217;s a totally different experience!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>For the last 4 months I had been seeing a therapist once a week to try to tackle my issues of negative thoughts, avoidance and fears. Yesterday was my last session after we both concluded that it was not making <a class=\"more-link\" href=\"https:\/\/www.benkrefta.com\/transformation\/2012\/02\/15\/ending-cbt-style-therapy\/\">Continue reading <span class=\"screen-reader-text\">  Ending CBT-style Therapy<\/span><span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[11,20],"tags":[],"class_list":["post-29","post","type-post","status-publish","format-standard","hentry","category-rant","category-review"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p68SmO-t","_links":{"self":[{"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/posts\/29","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/comments?post=29"}],"version-history":[{"count":4,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/posts\/29\/revisions"}],"predecessor-version":[{"id":149,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/posts\/29\/revisions\/149"}],"wp:attachment":[{"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/media?parent=29"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/categories?post=29"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benkrefta.com\/transformation\/wp-json\/wp\/v2\/tags?post=29"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}