I'm having a difficult time relating what I want and need with my therapist. He is primarily CBT with a smattering of other things.

How does one know if they're more suited for psychodynamic, or perhaps other kinds? He's very solution based, but not as much emotional. Granted, I don't give him much of a chance. Lately I've been very closed off and am mostly assuming he can't do deeper work. But this could be my insecurities and projection...

"She had blue skin, and so did he. He kept it hid, and so did she. They searched for blue, their whole life through, then passed right by- and never knew."

[growlycat]

For me, the T is more important than the style.

I've had good and terrible T of many stripes.

Sounds like it is probably more an issue of you being closed off right now than therapy style. You might try talking to him about just that and see what kind of response you get.

My T is also primarily behavioral, but not exclusively so, and he does do a great deal of "deeper work". I think where CBT creates issues is in situations where it is declared a short-term therapy (which is absolutely not necessarily the case) and where therapist seem to be married to worksheets and stuff that don't foster good dialogue between client and therapist. I would not be a fan of worksheets myself and my T has never used them even though he is very behavioral in his approach.

As in all things therapy, some T's are better at their work (regardless of the approach) than others. I haven't gotten the impression your T lacks skills, so perhaps that dialogue about how you are feeling closed off and your assumptions about his approach would be a good place to start.

[Depletion]

I think that a lot of this depends on your background and how you tend to think about things in general. If you have a lot of family trauma and you find that it is helpful for you to understand what went on a more conceptual level, then I think that psychoanalysis might be more helpful, but if you find that you are constantly overwhelmed with emotions, and do best in or might benefit form a structured environment then I think you might find CBT more helpful. I know that a lot of creative and more academically minded people tend to prefer psychoanalysis. But I don't think that this is because it has more merit as a therapy, I think it just has to do with it being more open to one way of thinking than another. Same with CBT, some people just think in away that fits homework assignments and predictability better. I guess the question is do you find creativity of routine more soothing?

But I think what other people have said here about finding a t who you connect with is the most important.

Also if you find that you are feeling emotionally closed off I think it would be a good idea to get to the bottom of why that is happening. Does your T remind you of someone or something that would make you hesitate to be open, or is there an issues that you need to talk about that you are trying to keep yourself from working on because it feels scary?

[lostwonder]

For me personally I don't think CBT would be helpful. I am very logical and deliberate in my behavior. I am emotionally over regulated with what some would say are too strict boundaries. I function incredibly well in society. I have many people I do things with, but keep them all at bay. I've got some big stuff I'm working on (past trauma, introjects, and major dissociation), but the end goal of my treatment would be to allow myself to listen to my emotions and form close relationships.

[AllyIsHopeful]

Without a year of *some* use of CBT, I would not be able to face trauma work. If we had jumped right into revisiting the past last year, nothing good would have come out of it. I would have probably been hospitalized more than once or worse- in a hospital after making a dumb decision or possibly being. . . not alive.
I'm not kidding. CBT was the best thing possible for me because I gained so many coping skills and I feel like I can handle trauma work now. It's going to be hard as hell still, but thanks to CBT, it is now safe for me to "go there".

[Sometimes psychotic]

Cbt really isn't deep or emotional...they tend to deal with current issues like within the last year or so and it's a whatever works approach. That's not to say that emotions can't be discussed but if you are looking for resolution of childhood based issues that's not going to go well with cbt....it's more about changing the way you think and being open to other possibilities and interpretations of events...works well for anxiety, mild depression and that sort of thing...

Originally Posted by Sometimes psychotic

Cbt really isn't deep or emotional...they tend to deal with current issues like within the last year or so and it's a whatever works approach. That's not to say that emotions can't be discussed but if you are looking for resolution of childhood based issues that's not going to go well with cbt....it's more about changing the way you think and being open to other possibilities and interpretations of events...works well for anxiety, mild depression and that sort of thing...

Actually, that hasn't at all been my experience. We worked on childhood issues as they affected current issues. Did MUCH deep, emotional work using CBT, and my depression issues have been extremely severe but the CBT work has improved those problems greatly. Again, depends so much on the therapist's skills.

[Sometimes psychotic]

Originally Posted by 1914sierra

Actually, that hasn't at all been my experience. We worked on childhood issues as they affected current issues. Did MUCH deep, emotional work using CBT, and my depression issues have been extremely severe but the CBT work has improved those problems greatly. Again, depends so much on the therapist's skills.

Is it possible that your T is trained in other areas outside of cbt as well? It may be that because I had cbt for psychosis which is considered more genetic/biological and less emotion based so that was the focus of my T but I can tell you we never even mentioned my mom or dad or how those relationships are/were. Also I routinely see cbt T's mentioned as having a lack of transference in the relationship due to the less emotional nature of the interaction. I just wonder which of our experiences is more normal if either is...

I think most T's use a combination of techniques rather than being hard-fast with only one approach. My T is probably 75-80% behavioral in his approach. But looking at the past was directly tied to the CBT work, not done separately, so who know?

I think transference issues can come up with a T of any approach as evidenced by what others have said on this forum. True, transference absolutely never comes up with my therapist, but that doesn't have anything to do with my therapy with him being any less emotional; I just don't tend towards transference issues.

[Depletion]

Originally Posted by 1914sierra

Actually, that hasn't at all been my experience. We worked on childhood issues as they affected current issues. Did MUCH deep, emotional work using CBT, and my depression issues have been extremely severe but the CBT work has improved those problems greatly. Again, depends so much on the therapist's skills.

I'm also under the impression that CBT does not deal with the past exactly. I thought the CBT was only interested in the past as it relates to understanding present patterns. The goal to me seems to be more about undoing present patterns that started in the past, rather than processing the past directly. And I think that emotions are more important to CBT when they inter fear with daily life. But I'm not sure how CBT works for someone who has a tendency to repress. Does CBT have away of noticing this?

[Sometimes psychotic]

Originally Posted by 1914sierra

I think most T's use a combination of techniques rather than being hard-fast with only one approach. My T is probably 75-80% behavioral in his approach. But looking at the past was directly tied to the CBT work, not done separately, so who know?

I think transference issues can come up with a T of any approach as evidenced by what others have said on this forum. True, transference absolutely never comes up with my therapist, but that doesn't have anything to do with my therapy with him being any less emotional; I just don't tend towards transference issues.

Mine was pure cbt....it was part of a study on cbt so that was all they used. I realize is isn't the normal situation as most T's are encountered in the wild and not in an academic environment.

And yes the transference stuff can come up in any relationship but I know my T never even spoke about herself or her experiences or even remotely judged mine..she would ask how I felt about things but everything was technique based and only if I expressed the desire to change something...if they were ever to make an impartial artificial intelligence that could supply therapy techniques she would be the model...in contrast I did develop transference with my pdoc because he seemed to care about me as a person and share things about himself as well. For me the emotional component defined whether I got transference or not. Just my experience I have no doubt it would vary for others...

Originally Posted by Depletion

I'm also under the impression that CBT does not deal with the past exactly. I thought the CBT was only interested in the past as it relates to understanding present patterns. The goal to me seems to be more about undoing present patterns that started in the past, rather than processing the past directly. And I think that emotions are more important to CBT when they inter fear with daily life. But I'm not sure how CBT works for someone who has a tendency to repress. Does CBT have away of noticing this?

It's actually both. You process the past (how that is done can vary widely) in order to rework how things in the past affect things in the present.

I had HUGE issues with repression and suppression. What I find CBT helps with is forcing myself to really pay attention to my thinking which is a real problem for those of us who repress memories. My T worked with me on kind of working backwards; it's a bit hard to explain but I'll take a stab at it.

So, hypothetically something is going on in my life that is causing me a problem (anxiety, depression, anger, etc. -- strong emotional reaction generally). I am reacting triggered by something probably in a way that is out of proportion to what is actually going on. T has me stop and work backwards; what was I thinking just before I had that reaction (because I am so good and repression, it is often hard to even figure that out). It can take some digging, but generally I'll find my reaction is one either I would have had earlier in life to something that happened to me or the reaction has become habitual because of old beliefs I have about life or myself that developed due to issues earlier in life. Then we look at those incidents, those beliefs, where did they come from, do they still serve me positively now or can I consider changing those types of thinking, etc. since they may not have a thing to do with my reality now? That isn't surface work; that is deep and emotional and often very painful work. But I find over time that I am able to leave the past in the past and move forward.

[Sometimes psychotic]

Originally Posted by 1914sierra

It's actually both. You process the past (how that is done can vary widely) in order to rework how things in the past affect things in the present.

I had HUGE issues with repression and suppression. What I find CBT helps with is forcing myself to really pay attention to my thinking which is a real problem for those of us who repress memories. My T worked with me on kind of working backwards; it's a bit hard to explain but I'll take a stab at it.

So, hypothetically something is going on in my life that is causing me a problem (anxiety, depression, anger, etc. -- strong emotional reaction generally). I am reacting triggered by something probably in a way that is out of proportion to what is actually going on. T has me stop and work backwards; what was I thinking just before I had that reaction (because I am so good and repression, it is often hard to even figure that out). It can take some digging, but generally I'll find my reaction is one either I would have had earlier in life to something that happened to me or the reaction has become habitual because of old beliefs I have about life or myself that developed due to issues earlier in life. Then we look at those incidents, those beliefs, where did they come from, do they still serve me positively now or can I consider changing those types of thinking, etc. since they may not have a thing to do with my reality now? That isn't surface work; that is deep and emotional and often very painful work. But I find over time that I am able to leave the past in the past and move forward.

For me we would go through my thought process but we never bothered identifying the original source...it's not really necessary. Identify the thought pattern is it useful or not, if not cognitive restructuring etc.
So for example....feeling bad at work because I don't feel fast or sharp enough...I feel stupid. She would ask is your boss stupid...I would say no. If you were stupid do you think it would be smart of her to keep you around....no. So basically I must not actually come across as stupid or she would not keep me on. We never ID'd why I felt stupid just that I did and it was in fact inaccurate...so in my case it was just surface work....if there is something deep and underlying we never talked about it we just invalidated it on a surface level taking away any power it might have had.

[Depletion]

Originally Posted by 1914sierra

It can take some digging, but generally I'll find my reaction is one either I would have had earlier in life to something that happened to me or the reaction has become habitual because of old beliefs I have about life or myself that developed due to issues earlier in life. Then we look at those incidents, those beliefs, where did they come from, do they still serve me positively now or can I consider changing those types of thinking, etc. since they may not have a thing to do with my reality now? That isn't surface work; that is deep and emotional and often very painful work. But I find over time that I am able to leave the past in the past and move forward.

I think that this is the thing that rubs me the wrong way about CBT. I think it is all fine to investigate where an idea comes from, but the fact that you can just change or learn new beliefs as a way of undoing trauma is completely puzzling to me. I think that I just see what CBT therapists call beliefs as painful emotions that have to be worked though that are attached to the trauma. I don't really see the belief as some flexible thing that therapy can target. Beliefs to me are things that are constantly being reinforced by the outside world, and are something that people will always internalize and struggle with. To me it is about recognizing where the belief is coming from and what purposes it serves. This to me offers away of diffusing the belief, but I don't think that it will ever go away, or that it can simply be replaced with a new idea. But I do think you can find ways to push back against it or argue with it, rather than simply accepting it. Maybe I'm splitting hairs here, but there does seem to be an important distinction to me.

Originally Posted by Depletion

I think that this is the thing that rubs me the wrong way about CBT. I think it is all fine to investigate where an idea comes from, but the fact that you can just change or learn new beliefs as a way of undoing trauma is completely puzzling to me. I think that I just see what CBT therapists call beliefs as painful emotions that have to be worked though that are attached to the trauma. I don't really see the belief as some flexible thing that therapy can target. Beliefs to me are things that are constantly being reinforced by the outside world, and are something that people will always internalize and struggle with. To me it is about recognizing where the belief is coming from and what purposes it serves. This to me offers away of diffusing the belief, but I don't think that it will ever go away, or that it can simply be replaced with a new idea. But I do think you can find ways to push back against it or argue with it, rather than simply accepting it. Maybe I'm splitting hairs here, but there does seem to be an important distinction to me.

I don't think we disagree except that I do believe those old mistaken beliefs can go away (I've seen it in action), but I never use the the "simply" to describe that process. It isn't easy.

[growlycat]

Originally Posted by Sometimes psychotic

... as most T's are encountered in the wild and not in an academic environment.

This turn of phrase made me smile!! I have visions of a comedy sketch involving naturalists, maybe the late Steve Irwin, stalking therapists in the wild. Crikey!

[Sometimes psychotic]

Originally Posted by growlycat

This turn of phrase made me smile!! I have visions of a comedy sketch involving naturalists, maybe the late Steve Irwin, stalking therapists in the wild. Crikey!

That would be a great show....I love the image

[Partless]

Originally Posted by winenot3

I'm having a difficult time relating what I want and need with my therapist. He is primarily CBT with a smattering of other things.

How does one know if they're more suited for psychodynamic, or perhaps other kinds? He's very solution based, but not as much emotional. Granted, I don't give him much of a chance. Lately I've been very closed off and am mostly assuming he can't do deeper work. But this could be my insecurities and projection...

I think people mostly switch when they hit a dead end with one kind of therapy. The answer to your question is not easy and depends on you and your problem. It's not like any of these therapies have the kind of scientific basis that, say, use of antibiotics does for particular infections. I think at this point if you have a good therapist who is ethical and experienced and meshes well with you, the particular therapy (assuming it's approved by some governing body) is not that important.

In short, some people think that it's all about you and how you see your problems. If you want to locate your problem in childhood, CBT is useless. Psychodynamic is the choice. But some might say it doesn't matter how you see your problem, that there is an objective way to decide what your problem is and how to help you get better. In that case, assuming CBT is determined to be helpful to you (by some objective standard), your refusal or frustration with it can only be seen as your resistance.

Regardless, if you have the money and time, it never hurts to get an opinion from a good therapist with a different orientation. But eventually you need to settle. Don't go jumping all over the place. That'll get you nowhere. My 2c

[stopdog]

My experience with CBT was that it treated clients like they were idiots. I found it condescending and patronizing and it did not help me at all. In fact it made some things a lot worse for me. I found a couple of studies - including one big one from I think the Netherlands - that found CBT making some things a lot worse.
Some people find it very useful but I don't know what conditions or issues it is better for or hurtful for across the board. I would think it like everything else -some it helps and some it does not and it is a lot more based on the person than the issue.
I think trying out a lot of different kinds is a good idea. It is hard to know what they are like even with descriptions. Plus I see two psychodynamic ones and they are nothing alike.

[iheartjacques]

I think most of my T's used a mix of approaches.