therapy models/orientations

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I strongly believe that cbt serves to mask/prolong the repression of emotions for which clients enter therapy.

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withit:
That is a very interesting thought and I have wondered about the same thing!

I've continued this on "Afraid to leave my T" thread.

However, having thought about it more since yesterday when I was thinking of returning to the T, I am going to forge ahead and go with the new T ir we 'fit' and if not I will continue looking for an analytical psychotherapist. My future depends on it. I am so tired of the emotional confusion, the emotional meltdowns, being alone and afraid.

Thank you so much for the book reference. I intend to see if it's available on Amazon and order it. It sounds interesting.

sidony: A site I like to go to often is www.guidetopsychology.com and this site has helped me understand the different types of therapies and what my current one is ... and what it isn't., as well as what I want... and what I don't.

Also I have talked for some time (over a year) to someone online at another site who is a trained and educated therapist (Doctorage in psychology and analytical thinker) but who doesn't practice. She has been wonderful and has hleped me see things that I need help with and about the different approaches of the various models/orientations.

Thanks so much for your posts!

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I strongly believe that cbt serves to mask/prolong the repression of emotions for which clients enter therapy.

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I kind of feel the same way, although I know CBT can be so helpful to some people. When I had CBT, I felt it was a band-aid on the surface but had no effect on healing my root wounds. So if you take the band-aid off, there is the same old problem, not even healed a wit by the CBT. I'm making such great progress now that I have a T who does not use the CBT model.

ECHOES, congrats on your decision to "forge ahead" with the new T. I hope when you meet with her, that you will "click."

Sorry, but if you both received that impression from you experience with "CBT" then the therapists were not using CBT.

Cognitive Behavior Therapy is very much sifting through your thinking (and speaking) and what causes or caused you to think that way in the first place, and how you behave/react because of the improper/irrational thinking.

But it's good to hear you have Ts who are helping you now.

I haven't gotten through this whole thread yet, but thought I'd go ahead and add this in anyways.

The problem these days is that you are often limited in the number of mental health visits you can make and therapists know this and are sometimes limited as well. Insurance companies are pushing for quick treatment. This leads to the bandaids instead of true healing. There just isn't time allowed for complete in-depth therapy unless it comes out of your own pocket.

I only get 30 visits a year and it drives my psychiatrist crazy - he keeps saying that's 30 for me and 30 for the therapist and I have to correct him. I was fortunate last year in that my therapist made a payment plan for me once I maxed out on visits. Unfortunately, it looks like that may happen again this year. $$$ I'm so hoping the federal parity act to pass this year. It will mandate that you must treat mental health care the same as other health care - so if you don't limit other visits, you can't limit mental health either.

yes, everyone needs to contact their Senators and urge them to pass this Mental Health Parity Act!!!

Dear and sweet and supportive (((Sky)))...., with all due respect for you and your many years of therapy,, and with respet of my own 12 years or so of therapy... I am aware of what CBT (and REBT) are. They are not what I am interested in persuing and have not helped me in the way I want. CBT did nothing for me; REBT was a bit more helpful at the time, but I want to do more, learn more, delve deeper. The behavioral therapie.... to me.... imo.... are about someone telling me how to think and ultimately about changing... "correcting..." faulty thinking and changing behavrior. The emphasis is on behavior that results from thinking. I want to go at it from the opposite end of the spectrum.

With analytical therapy, you don't choose 'topics' to discuss each session and you don't have homework. You arrive at your appointment feeling however you feel and you talk about that or whatever you feel like talking about. There is not something to solve or conguer in that session, just ideas and feelings to explore and delve into. Way into. Howeverf you feel and whatever associations you have about that are what you talk about. If you are lonely you talk about that, not about volunteering to solve it (stop the feeling, repress the feeling, deny the feeling). Instead, you head right toward it and explore it.

Anyway, I'm very very glad it works for you. I think that's wonderful! And I think you are a great person here.

But....it doesn't work for me. Somehow I am feeling like I need to apologize for wanting this.

I want to go deeper. I want to know how I think and why I do and where it comes from before any attempt to make changes; in fact, change occurs because of the understanding. It takes time. It it takes going deeper. It is a very wonderful experience to explore and discover. And the breakthroughs are wonderful to experience also; they can bring a calm and peacefulness that is amazing and can last for days the clarity settles in.

Different strokes for different folks. If we were all the same and had the same experiences and opinons and preferences we would only need one type of therapy. It would also be a very boring world.

Happy and peaceful therapy to all. May it be all you want it to be!

Sky, I didn't explain it well, but yes, my original counselor was using CBT. I've made it sound like she was not helpful at all, and that is not true. Bless her heart, she did help me with some of the symptoms of my depression, and coping skills too, but her methods did not get at the root of my problems or provide an avenue to solve them, once I was ready for that. However, I really value what I did get from her. She helped me do better with day to day functioning during the worst moments and prepared me for my next T, who is helping me heal. I think she was higher on the "B" end of CBT than the "C" end, but she did try some "changing thinking" with me too. However, since irrational thinking wasn't really my problem, it wasn't a good fit. As ECHOES wrote, different strokes for different folks.

ECHOES, please don't feel you have to apologize for wanting analytical therapy. It's a grand adventure and has helped so many people. Definitely worth a try!

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The problem these days is that you are often limited in the number of mental health visits you can make and therapists know this and are sometimes limited as well. Insurance companies are pushing for quick treatment. This leads to the bandaids instead of true healing. There just isn't time allowed for complete in-depth therapy unless it comes out of your own pocket.

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You've hit the nail on the head, WinterRose. It is hard to achieve true healing in a short time frame. I think your 30 visits a year is actually quite generous. Right now, my current T is not reimbursable by my insurance so I pay everything out of pocket. There has been something liberating about not depending on my insurance company for my therapy. I pay for this therapy because it is important to me, it is working, and I deserve it. No insurance company is going to dissuade me that this is not worth doing because they won't pay. I am lucky enough that I have a job and can pay for this. I make it a priority and put it in my monthly budget.

Don't forget that a big part of the success of treatment is the 'corrective emotional experience' with our therapist. i have this idea that a therapist who is hooked on the cbt approach might be too quick to jump in with some 'interventions', when all you need is for her to hear you and allow you the space to be. I have found that often when my t just allowed me to sit with my feelings I was then able to deal with them better. Telling me how to change my thinking goes against the idea of sitting with our feelings and let them ride the wave. Forgive me if i'm not making sense as it is long past my bedtime.

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ECHOES said:
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sidony: A site I like to go to often is www.guidetopsychology.com and this site has helped me understand the different types of therapies and what my current one is ... and what it isn't., as well as what I want... and what I don't.

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Thanks. The description of Psychodynamic Psychotherapy sounds very much like it's talking about the sessions I go to. I don't know the specific approach or variety though. Guess I'd have to read more.

Thanks, Sidony

I am having such a hard time feeling like I'm getting "better" in therapy! My T says she's eclectic but has actively taken the CBT approach with me.
I dunno why, but this isn't really sticking for me. I try sooo hard to argue my patterend thinking (I DO have irrational thoughts and according to her, skewed perceptions) but at the end of this arguement in my head----i get nowhere. I keep coming back to the thought, the same thought.
She tells me, try to go back to the first time anyone told you this etc, or the first time you heard this etc and think if the source was reliable etc. It's so not working for me.

At an intelliectual level I know where much of my negative self talk originated but coming to this clarity hasn't changed a damn thing. I ruminate now as if my syptoms have worsened under this approach. I wonder if I'm failing at CBT or whatever. Furthermore I can't really explain why/how it's not working!!!!! Arghh, so frustrated. I'm sure my t can tell I'm not excellng at this. I wonder how to make it "click" for me. It seems to overwhelming a task for me to change years of thinking patterns. Plus, does this allow me the sense of healing? Not yet, I feel like all the past traumas are minimized, like I tell her one horrible thing, she thans me for sharing and tells me I'm courageou and then tries to "change" how I think about it.

I'm failing CBT..........

"I strongly believe that cbt serves to mask/prolong the repression of emotions for which clients enter therapy."

yea maybe that's happening.

((((Talulah))))

You so eloquently describe your frustration. CBT is helpful to many people, so I see how it can feel like failing when it is not clicking for you. (I'm one for whom it is not the ideal therapy either, so I hear ya!) How long has your T been using CBT with you? If you have given it a good try, and a long trial, maybe it is time to try a different approach. Can you discuss these very issues with your T? Maybe she has in her own head a plan, like "I will try CBT for 3 months with this client, and if it doesn't seem to be working, I will move on to Plan B." Maybe she can make her plan more transparent to you. Also, maybe she has a really different perspective than you and thinks CBT is working. And she can give you some "evidence" to show it is helping you. It's hard to tell what they are thinking unless we ask.

Also, I think when someone says they are "eclectic" it doesn't necessarily mean they can do all therapeutic approaches. For example, someone can be eclectic if their training was primarily one approach but they practice another, if that makes sense. So a therapist may have been trained primarily as a contextual family therapist, for example, but favors CBT in practice.

there are some significant problems with cognitive restructuring that result in it being a strategy with limited utility.

basic emotional responses are modular. i'll give you an analogy. have you ever seen the muller lyer? which of the following two lines is longer?

http://facweb.furman.edu/~einstein/g...ndpdemo/75.jpg

most people say that the top line looks longer. and indeed, it DOES look longer. now take a ruler and measure the lines. they are of equal length. does RATIONALLY KNOWING that the lines are of equal length help with their APPEARING to look different? No, it does not.

what is happening with the illusion is that our visual system is being fooled. there are basic visual processes that result in the lines appearing to be of different length. Those basic visual processes are impervious to our background knowledge (that what we are experiencing is illusory).

Basic emotional responses can similarly be modular (impervious to what you rationally know). Part of it is because low level emotional responses are triggered by the amygdala whereas our 'rational knowledge' is localised in higher cortical areas. There are many more projections from amygdala to higher cortical areas than there are from higher cortical areas to amygdala. What that means... Is that quite often we can find ourselves experiencing an emotional response that we know full well is inappropriate to the situation but our rational knowledge is simply not in a position to change how we feel.

So we can feel like we are disgusting and dirty even while rationally knowing that we aren't. That rational knowledge doesn't change how we feel, however. Saying 'I am a worthwhile human being' 100 times a day is of limited utility because the message doesn't get to the amygdala...

It isn't you... It is a fact about brains... Different people have slightly different wiring... Trauma... Tends to mean that people have even less projections from higher cortical areas back to the amygdala and it also means that their amygdala responses are more intense than usual and more easily triggered.

I personally found cognitive restructuring to increase my sense of shame (I felt ashamed that I had 'irrational' thoughts and feelings). In other words, I found it to harm more than help. It encouraged me to deny what I was feeling and thinking on because the implicit message that I took was that it was not okay for me to be thinking or feeling the way I was (it was considered 'irrational' and therapist was focused on changing it).

So... The therapist can switch strategies to acceptance (if the therapist has acceptance in their tool kit).

Hi Sunrise, great ideas.
I've been trying for a year +
I see her tuesday and will discuss with her why it may not be working for me. Also, the part about asking for evidence that it is, is great advice, so thanks I am going to do that as well. because maybe I'm wrong and it is working eh?

I have some hints as to why. Just as negative talk was given to me and the sources identified, positive things were also given (in a negative way) by my abuser and trust and perception skewed in that regard. So when I "tell" myself those nice things, I've heard them from nasty sources and I think this is why it may be hindering me. I'm going to discuss that with her as well. Although that will lead to some personal stuff I wasn't ready for.....so we'll see.

Yea, about the eclectic. for sure. what the eff does that MEAN to me???

(((Sunrise, thank you)))

Sidony,

Yes, imagne my surprise when the psycholgist said she did psychodynamic psychotherapy, then turned out it was just the guided imagery/hypnotherapy! I was very excited about her and kept waiting to get to the good talking. Several months of meeting and trying to talk and paying copays... grrr..

And the insurance company will pay for this, but not for what I want.

Alexandra, your post is so informative and clearly elucidites the limitations of cognitive therapy. Kudos to a post well written.

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ECHOES said:
Sidony,

Yes, imagne my surprise when the psycholgist said she did psychodynamic psychotherapy, then turned out it was just the guided imagery/hypnotherapy! I was very excited about her and kept waiting to get to the good talking. Several months of meeting and trying to talk and paying copays... grrr..

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Ugh, how annoying. I'm pretty sure what I'm experiencing is true psychodynamic psychotherapy. It's enormously helpful to me.

Curious if the guided imagery thing is helpful at all? I don't think something like that would be for me, but I guess it's different for everyone.

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And the insurance company will pay for this, but not for what I want.

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Naturally. Insurance companies stink. But if you can possibly swing it financially, a good therapy relationship is going to be so worth it. For me, it's one of the best things I've ever done for myself.

Sidony