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  #1  
Old May 13, 2010, 07:20 AM
imapatient imapatient is offline
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Update on my shopping experience. I'm terminating with my 2 T's and looking to replace them with one local T.

I had 1 appt with 3 different T. Open to trying one of those another session. But I've seen a different person 2x and have a 3rd "tryout period" session in 3 hours. I'm not shopping again until I decide on whether to stick with him or not.

He's a CBT based T. I haven't had CBT; psychodynamic has been what I've had re: T's approaches. One current T is behavior oriented and thinks I should get a CBT T; the other is psychodynamic and thinks I should seek a T with that orientation.

I have questions about CBT.

It seems like a great skill to have and that it can help with distorted thinking, but it seems more like a tool to learn rather than something for long-term therapy. It seems to me that CBT is well-suited for me as something new, and that it can help with a major problem I have--distorted thinking. However, it seems like it must be limited in scope, i.e. that there are other therapy needs that it isn't well-suited to or does not address. The short-term orientation of it, as I've read about it, has me concerned.

I know I'm being vague; I'm being abstract because I don't enough yet to form many concrete questions. I can't imagine it being enough; good to learn and go through, but not the only thing I need.

Can people comment on the pros and cons of CBT, the limits to it, etc?

Thanks.
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  #2  
Old May 13, 2010, 09:11 AM
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deliquesce deliquesce is offline
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i think CBT can be useful. unfortunately, the only extended experience i had with it was with old-T, and he wasnt a very good therapist. maybe a bit too cut/dry, which is CBT-style, but most CBT therapists have empathy and he seemed to be lacking in that regard.

CBT has helped me overcome a lot of my perfectionism/OCD-type thoughts and behaviours. probably used it with austin-t for about 6months, and it was very good with that. i think for some of my deeper issues it wouldnt be very good, especially the growing up stuff and trust issues.

e.g., it took me a long time to trust old-t (and i never fully did) but one of the CBT things he encouraged me to do was look at evidence i had for/against trusting him. he would often say that he had never hurt me, that he had many years experience as a therapist etc. it did help somewhat, but i think the lack of empathy - of any human relating - prevented me from trusting him and feeling safe. austin-t on the other hand is very open about himself, so even when we were doing CBT i didnt feel judged by some of the things i shared. of course, CBT would make me look at why i felt i would be judged, but i needed someone who was more "close" to help me reap the benefits of what CBT has on offer.

i think CBT could be of immense use to you, impy, but i would worry that it wouldn't address some of the stuff you might need to work through. the feelings part, especially - we're both analytical, so CBT makes sense. but ive derived most benefit from learning to be vulnerable with pdoc/austin-t. i dont think CBT encourages that as well as other modalities.

but if you do have concrete goals (e.g., overcoming OCD/perfectionism, managing anger, making more friends etc) then CBT would be the first thing i would recommend. because it IS very solution focussed, and i find that to be of immense benefit - you see change almost immediately. on the other hand, if it is a more general "processing" you're after, then i dont think CBT is the best type of therapy for that longer term stuff.

austin-t offers both psychodynamic and CBT, so we switch between it. when i go in saying "i need to fix this" then we do CBT, but when it's unclear what i need then we do more psychodynamic stuff.
Thanks for this!
imapatient
  #3  
Old May 13, 2010, 09:17 AM
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deliquesce deliquesce is offline
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p.s.

here is an old thread, dont know if you might find some useful info there: http://forums.psychcentral.com/showt...ight=cognitive

and a PC article on it: http://psychcentral.com/lib/2007/in-...ioral-therapy/

one thing to keep in mind is that CBT is the gold standard therapy against which pretty much every other therapy is measured. so it might be worth giving it a go, even if it is for a short time. i think it's kind of the building block that everyone needs to try first, and then if there are further problems you can look further afield.
Thanks for this!
imapatient
  #4  
Old May 13, 2010, 09:46 AM
Anonymous32910
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I've been with a cbt therapist now for a bit over 5 years, so I don't think of cbt as a short-term therapy at all. It has been through cbt that I've made the most progress in dealing with my thought processes and my feelings that result from them. I haven't seen that cbt limits the scope of what I work through in therapy at all. Instead, it is a way of looking at the vast scope of issues that I have to deal with with more rational, logical, healthy eyes.
Thanks for this!
imapatient
  #5  
Old May 13, 2010, 10:35 AM
Anonymous32910
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http://counsellingresource.com/types/cognitive-therapy/

This is a good overview article.
Thanks for this!
imapatient
  #6  
Old May 13, 2010, 01:02 PM
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sunrise sunrise is offline
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Quote:
Originally Posted by imapatient
One current T is behavior oriented and thinks I should get a CBT T
So the behavior guy didn't do cognitive work as well? It seems not so many Ts are only behaviorist these days. (I find a behaviorist approach quite useful on myself. I have used it for years as "self-help", a long time before I went to see a therapist.)

Quote:
It seems to me that CBT ... can help with a major problem I have--distorted thinking.
This sounds like a huge plus. If you don't address the distorted thinking with CBT, would you address it in some other way? I think all types of therapy would be more effective if the client had undistorted thinking. So it could be that you could work on the distorted thinking issue with a CBT therapist and then be very ready to work on most any other issue subsequently with the same therapist or a different one with a different orientation.

Quote:
it seems like it must be limited in scope, i.e. that there are other therapy needs that it isn't well-suited to or does not address
What do you think those other therapy needs are? I am extremely analytic and what some people consider an overly rational thinker. I have found the approach in my therapy (largely humanistic) to be really good for someone like me, who needed to learn to detect that I was feeling something, to identify what I was feeling (am I angry at someone? am I sad right now? am I disappointed? am I hurt? ) , to get in touch with my true self, to find "my voice,"--all the cliches. I am not sure if CBT could have helped me with those problems.

Quote:
I can't imagine it being enough; good to learn and go through, but not the only thing I need.
Maybe you could make a list of your needs in therapy and put down whether you think CBT could help with that need or not, then show your list to the CBT therapist you have seen and ask if he agrees. That way you can get a practitioner's expert opinion.
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Thanks for this!
imapatient
  #7  
Old May 14, 2010, 07:14 AM
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deliquesce deliquesce is offline
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how did it go, impy?
Thanks for this!
imapatient
  #8  
Old May 14, 2010, 09:47 AM
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Lamplighter Lamplighter is offline
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Impatient got to ask a question here - why do you say you have distorted thinking? Is that something you yourself have come to realize, or is it something your Ts have told you? If you yourself are aware and accept that your thinking is a bit sus, then CBT sounds like it could be quite useful - because you would be open to accepting alternative ways of thinking without being made to feel like there’s something wrong with you.

I personally am really antipathetic towards CBT - I don’t believe you can separate thought and emotion - one doesn’t ipso facto precede the other and the kind of experiences that create distorted thinking generally have their origins in emotional rather than rational understanding anyway (unless it’s an issue of mental illness of some sort).

This reply is a bit late sorry, as I see you will already have seen the CBT therapist. What did you think? Are you any clearer about which approach to go for?

Torn Mind
Thanks for this!
imapatient
  #9  
Old May 16, 2010, 08:14 AM
imapatient imapatient is offline
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Quote:
Originally Posted by deliquesce View Post
how did it go, impy?
Hi everyone. Thanks for the replies. Apologies for being late to return here. Special thanks to Deli of whom I requested a command performance of that indelibly deliberative deli-insight and brain power by commenting for me.

As if terminating from two T’s at the same time and trying to find a new one wasn’t stressful enough, I’ve been sick for 2+ weeks from side-effects of Buspar and withdrawing from it. I had a nightmare last weekend that began with an Urgent Care appt that went way, way bad. Been on my mind all week, so less mental energy spent on other issues. See an upcoming post about this horror story soon.

Quote:
Originally Posted by Torn Mind View Post
Impatient got to ask a question here - why do you say you have distorted thinking? Is that something you yourself have come to realize, or is it something your Ts have told you?


I think it (or is it feel it? ). T’s agree when it comes to stress, I get much more frazzled than is called for—very often—and don’t think as clearly then.

Quote:
Originally Posted by Torn Mind View Post
I personally am really antipathetic towards CBT - I don’t believe you can separate thought and emotion - one doesn’t ipso facto precede the other and the kind of experiences that create distorted thinking generally have their origins in emotional rather than rational understanding anyway (unless it’s an issue of mental illness of some sort). Torn Mind
I actually have been the same way re: CBT and my main T for 1.5 years now is not a fan of it. I’ve been told by multiple T’s and pdocs over the past year that it might be good for me to try it. Too much “analysis” by/of me in the and not enough attention paid to addressing the behavioral side, about how to make changes in how I think and live. After 20+ years of therapy, I agree with the concept that different avenues might be worth trying. And I agree that CBT sounds like it might help me deal with stress better. That’s the key issues. My T’s in the past year (I have 2 individual right now: one local, one via phone and a group therapist) have changed my diagnosis, seeing that my big issue is anxiety and not depression. I see what they mean about how I get just paralyzed by anxiety, or worse, my thinking gets distorted, and it takes up all my time. Time better spent otherwise. Sunrise, to your comment; yes, you got it right about why I need it, and hopefully about it working to help with that.

Quote:
Originally Posted by sunrise View Post
So the behavior guy didn't do cognitive work as well? It seems not so many Ts are only behaviorist these days. (I find a behaviorist approach quite useful on myself. I have used it for years as "self-help", a long time before I went to see a therapist.)
Sunrise, no, I didn’t mean that. I used behavior in an overall sense. Sorry for the confusion. I didn’t think of that T as being CBT, but somewhere on the behavior side is where that T thinks I need help most. Done psychodynamic forever. [And that “he” is a she and she said Take a walk on the CBT side, doot)

Quote:
Originally Posted by sunrise View Post
I am extremely analytic and what some people consider an overly rational thinker. I have found the approach in my therapy (largely humanistic) to be really good for someone like me, who needed to learn to detect that I was feeling something, to identify what I was feeling (am I angry at someone? am I sad right now? am I disappointed? am I hurt? ) , to get in touch with my true self, to find "my voice,"--all the cliches. I am not sure if CBT could have helped me with those problems.
This is exactly me, to the nth degree. If I had a dime for every time I’ve been told I overanalyze, over-intellectual, think too much, etc. I’m pretty good at expressing my feelings if I recognize them, but the problems for me is like with you: I don’t know what I’m feeling. That’s something coming out of therapy this past, year, too, the understanding that I don’t do well with “feeling” my feelings. Identifying them. Major problems for me.

So, I went in with some issues written down, having researched criticism of CBT and went over them with the T. Generally, I feel better about it. He sees 1.5 to 2 years of work—so far—needed. I thought the time-frames were much shorter. It was a highly intellectual discussion that covered a lot of the ground. I’m more comfortable going forward. I guess I look at it as an opportunity to try something different—very different. Skill-building in learning how to better handle stress and think more clearly. If I could save time and anguish from when I’d nowadays get so stressed out (over little things even), I’d function much better. To help with that, is a big plus. Like Torn Mind, I’m skeptical and on the same issue of thoughts and feelings.

A question I asked was, “What empirical evidence supports the idea that thoughts about events cause feelings?”— that being where CBT differs and is new-ish; another way I put it: “what demonstration of the causal direction between emotions and thoughts has been made to show that CBT is right in the model it uses?” He said there is none. No one knows how it really works, or why it works. Just like there are unanswered questions about any therapy or meds (my comment: or about anything, getting very epistemological about it). I said, “so there is a black-box involved always, and CBT has just changed the traditional wisdom for trying to guess how it really works inside.” He said, “yes.” But it really doesn’t matter how it works he said, because the process has been shown to be effective, as have other things. If it works, that’s what matters. I can’t do justice to the conversation and perhaps the soundness of his reasoning, but intellectually I’m not satisfied by far. And I have pretty rigorous stands when it comes to philosophy of science, and maybe as a T he doesn’t want to get very deep into that with a patient. Or can’t, yikes! Who asks a question like that? I don’t begrudge him for a limited response, and he gets points for not trying to give me double-talk about the matter. I’m satisfied enough.

Anyway, I’ll keep seeing him for a few more sessions and then see how it goes. I like him pretty well so far.
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