[jexa]

Hi all,

I was thinking more about CBT, and wondering about people's experiences with it. If you have been in CBT, I'd like to know why it worked/didn't work for you. Did the treatment make sense to you while you were in it? Did you do your homework? What was the treatment like? Did it involve disputing negative thoughts primarily, or did you also do exposures? Did you have a good relationship with your therapist? How long were you in therapy? What were you working on?

Please, any input would be appreciated -- even long and detailed stories of your experiences in CBT! Trying to understand..

[deliquesce]

CBT has worked wonders for me in helping with my severe OCD/perfectionism thing. i had tried it with a few other therapists before and it was hopeless, but i think last year my depression had lifted enough for me to feel motivated and in control enough to tackle the OCD thing head on.

as you know, CBT should be about BOTH cognitions and behaviour. for me the cognitive work consisted primarily of building up (and maintaining) motivation to keep combatting the perfectionism thing; looking at how my compulsions were doing nothing to help prevent the anxious outcomes i anticipated etc. the behaviour modification (exposures) involved having to stop my compulsions; austin-t helped me by giving me phrases to repeat to myself instead and for the most part i did attempt the homework we agreed on. e.g., i compulsively write out things multiple times so instead of stopping it altogether, i would try to at least reduce the number of times i did it.

a huge part of my treatment involved building up enough belief in my self efficacy to achieve what i wanted without the crutch of my compulsions to get me there. i still want perfection, just without the anxiety . and after a little taste of success, it gave me more motivation to keep trying.

it's an ongoing struggle, and some times are worse than others, but if i keep practising when i'm not stressed then it's not so habitual when i am in stress-situations (like exams!). i focussed on it solely between april-november last year; and i feel good enough about my ability to manage the OCD/perfectionism on my own that i'm dealing with other stuff this year instead. i may still require 'touch ups' and may well need to dedicate another few sessions here and there to maintaining what i've learnt, but i do believe it'd be a waste of my time to continue therapy solely for the purpose of managing the OCD.

i think the big difference between CBT last year vs all the other therapists i've seen is that my therapist has OCPD himself, so our relationship was very strong. with some of my previous therapists i've felt very ashamed to even admitting what some of my compulsions are but so often with Austin-T it became a game of one-upping each other so we could laugh about it instead. and it's helped me see that if he can manage it and a be a (ridiculously successful) therapist, then i can do the same too.

I feel like I've already gone over this recently, but I'll just focus on your questions.

CBT has really helped me in organizing my thinking. I have bipolar disorder and PTSD and both of those tend toward racing thoughts, rumination, and negative self-talk. Being able to slow my mind down and work it like I'd work a problem or a puzzle is really constructive for me. I can now make sense of what is going on up in this head of mine, and that has led to healthier behaviors within myself, my family, and my relationship with my husband.

CBT didn't always make sense to me because at first I was so good at suppressing my own thinking that it was hard to access my thoughts. That's another really helpful aspect of CBT for me; I do much less suppression than I used to do.

My t has NEVER given me worksheets to fill out. He prefers to keep practicing it with me verbally in therapy until I internalize it, which I've gotten pretty close to at this point. He sometimes gives other kinds of homework, but not really specifically CBT stuff.

In therapy, we do focus on thoughts (that's the cognitive part). It's a lot of working backwards through things. Hard to explain. For instance, I told him today how much I am dreading some work meetings for the next two days. Rather than continue to simmer in the feelings of anxiety and anger about the meetings, he had me back up. What am I thinking about when I'm thinking about the meetings? What am I dreading?etc. Then I looked at my thoughts and could sift through them, deciding where I was catastrophizing, predicting, mind reading, etc. By the time I left his office, I was much calmer, no longer angry. I'll be able to go into those meetings and be much more relaxed. As far as exposures go, I'm not exactly sure what you mean. Are you talking about dealing with phobic kind of situations? That would certainly be a cbt thing, but those aren't my kind of issues really.

I have an excellent t and we get along very well. There is a lot of laughter between us. We genuinely like each other. I've been in therapy with him now for 5 years. I'd say in the last year I've finally gotten to where I've started really internalizing what I have learned. It was a slow process, complicated by very complicated bipolar disorder with med adjustments and hospitalizations.

While I still have difficulties with bipolar disorder that lead to depressive episodes, I am finally spending more time stable than unstable which makes it even easier to practice my CBT skills regularly.

I have very severe OCD and CBT has really worked for me. It's taken years though.

Did the treatment make sense to you while you were in it? Not at first. It took a LONG, LONG time. I thought it was kind of skirting around the issues, but I can see now how much it has helped.

Did you do your homework? Not much homework. No worksheets or anything like that.

What was the treatment like? Did it involve disputing negative thoughts primarily, or did you also do exposures? Mostly disputing and analyzing negative thoughts which is excruciating with the OCD. It was paralyzing at times, but I finally started to understand after a LONG time (like I said, LOL).

Did you have a good relationship with your therapist? Very good.

How long were you in therapy? Years and still am.

What were you working on? Severe OCD and anxiety. Major Recurrent Depression. PTSD. Eating disorders. Severe self injury.

We do much more than CBT, but it has helped me so, so much along with several medications.

[Ascension]

The basic premise of CBT is to gain more control over ones behavior by way of being in tune with what our feelings are and why we have them and why we deal with them the way we do. It really is very hard to do through the intensity of anxiety, depression etc. The best place to start is by looking back on a recent event that was a source of extreme emotional intensity. How did I respond to that emotion? It is easier to think of the more understandable, action, then the more esoteric, emotion, or feeling associated with that event. "I had to get out of the store because I felt overwhelmed by all the people and I got too anxious." Okay I have an action. Now I focus on that action and try to gather why I did that. "I felt anxiety about all those people." Okay I understand what I was feeling. But why would being around all those people cause me to feel the need to run away or remove myself from that environment? Was I justified to feel that way? "I respond to being around of people negatively because as a child I was picked on by my peers because I was an emotionally unbalanced child and was an easy target."
But what do I do with all of that? The next time I am in the store and I feel that way, I try not to immediately respond to that anxiety but to try and connect with what I am feeling and why I am feeling that way and is it a reasoned feeling and/or response to the situation? "I am an adult now, I can protect myself if someone decides to make me a target and I am not going to let my insecurities and suspicions dictate what I can or can't do." As I said earlier in this post it is much easier to look back after the fact because it takes practice and repetition with the process to gain enough control of anxiety and emotions to apply these techniques in the moment. I hope this helps and if you have any more questions please feel free to respond to this post.

[skyliner]

CBT did not work for me

[winterbaby]

I think that negative thoughts do make our brains get into a pattern where our minds "go there" when triggered and I think that's what CBT is trying to stop. I hate it, but it does work at times for me. My mind can ruminate for hours and hours on negative things.

[jexa]

Thanks for those who wrote out about why CBT worked for you! This is very helpful. I am actually interested in this personally but also thinking about doing a study on people's perceptions of different therapies.. so this is really very helpful to me, to see why CBT worked for people. You guys are helping me think more about this (don't worry, I won't share any of your responses with anyone). I wonder about personality differences affecting treatment efficacy, and other factors..

Originally Posted by skyliner

CBT did not work for me

Why, skyliner? Can you talk about what CBT was like for you? Did you like your therapist? How long were you in therapy? Can you describe what it was like to try your CBT skills? Is there a different kind of therapy that has worked to help you?

Originally Posted by winterbaby

I hate it, but it does work at times for me.

Winterbaby, when does CBT work for you? When does it not work?

[sadden]

I have done some cbt within ACT, but don't like it! Have been with T for 8? ish years. CBT never feels as "organic" as his other eclectic/supportive therapies. More like learning a new, foreign language or somthing...new vocabulary, sentence building, awkward attempts to control my thoughts, frustration! (Sorta did homework...had workbook w.ACT-he never "checked" it...just re-enforced skills I was working on...I wasn't very regular w. wb...it mostly felt like I was ripping the scab off my emotional owies) I have major depression w/ psychotic features, PTsd, and some other stuff. Cbt helped most w/ PTSD and anxiety stuff. Can't do skills when I am depressed
at all. Interpersonal therapy feels more like it has to do with me and my life and emotions than how I "behave" (artificial dicatomy? probably) Relationship with T? I still (after all these years!) have times when I don't trust him. But mostly I do. Today I do...I think.:0) Those are my thoughts for what its worth...?