Is there really nothing more to CBT than positive thinking?

I'm not sure if my issue with my therapist is CBT or just the individual therapist himself.

At first, I really liked this therapist. Our first session went well, and he seemed like someone with whom I felt I could "click" personality-wise. Then at subsequent sessions, I started to feel almost like he was messing with me because how on earth can a therapist thing it's helpful to just repeatedly tell a client to think positively? His answer to everything is to either tell me to not worry about it or to ask me to find something positive in my life and then just think about that instead. He actually at one point told me to envision the day I graduated from college whenever I felt depressed or was in a bad situation. I'm sorry, what? I'm just supposed to walk around repeatedly envisioning myself walking at graduation all of the time? I told him I had to make a police report because someone called my house threatening to kill me (long story), and his response was, "Don't worry about stuff like that." I asked how the heck I was supposed to not worry about someone threatening to break into my house and kill me, and he said, "Well, there's nothing you can do until the person actually breaks in, so don't worry about it." Then when I told him I didn't agree that I should just stop worrying, and then all of my depression issues would lift, he just sat there dumbfounded unsure of what else to say to me.

Is this really all there is to therapy? Is this some kind of joke? Is it really an "a-ha!" moment for most people to be told to "think positive thoughts" by a therapist?

I haven't done CBT but that sounds seriously loony. I don't think that was CBT which actually deals with your thoughts and doesn't just tell you not to have them.

Akama's right, that's not CBT at all. This therapist sounds like he doesn't want to deal with your thoughts and is focusing on you just pretending to be fine so he doesn't have to do any work.

CBT is a process where the therapist helps you understand your thoughts, why you have them, where did they come from, and how to best battle them. It's not about simply ignoring them, since if it were that easy we wouldn't need therapists in the first place.

The other than you mentioned about someone threatening you... A good therapist validates your emotions rather than ignoring them. That's real fear, and that fear deserves to be expressed. Without expressing that fear, it gets bottled up and leads to TONS of problems.

I guess your story made me kind of angry, and I really do suggest you ask to be referred to someone else. Is that an intern or something? It's just really sad if that's all he wants to do... You deserve much better.

He sounds more like a coach than a therapist. I'd find another if that's all this guy has.

Thanks. I'm really frustrated because I came to him telling him I feel stuck in a bad life situation with no way out, and his response to me just makes me feel more hopeless. Like if this is what therapy has to offer, then therapy's just one more thing that can't help me. I don't know if I'm making sense.

No, he is not an intern. He's a licensed master's level therapist.

That doesn't sound like CBT to me.

I'm with Agentfyre on this: I think you need a different therapist, especially if you've expressed to this guy that his positive thinking approach is not helpful. CBT, in my experience, helps you to see things realistically and approach the problems (which actually do exist, in most cases) in a constructive manner.

Of course, if you don't want to give up on this guy, you could try to educate him. For instance, you could have him visualize treating appendicitis with positive thinking. Even he would have to admit that's a recipe for disaster.

My CBT T doesn't say anything like "don't worry about it" or "think happy thoughts".

He works with me from so many angles. I actually have to be careful not to openly scoff, even jokingly, at his suggestions because he will drop that tactic forever and keep moving on to something else.

Thank you for the responses, everybody. I researched CBT on the web and found numerous forum posts where other people reported similar experiences where their therapists just kept telling them to think positive thoughts, so I thought maybe that was just what these types of therapists were taught to do in school.

Yea, I think therapists like this give CBT a bad name. If you look for any websites on CBT you can find some useful information on what should be done, but there's a lot to it and everyone does it differently. Unfortunately... I think CBT can be so broad that many therapists just do whatever they want and call it CBT. I know a few therapists who use clinical words to describe what they do, and yet those words stand for specific techniques that they don't actually employ! It's frustrating, and offensive.

StillSearching11, what do you think you'll do?

Wow, if I had a therapist who took such an approach when I was suffering I would feel totally invalidated and like I was on a different planet. And the seriousness of what you briefly mentioned about a threat to you?! unbelievable.

I actually have only been exposed to CBT in a group setting. I've also studied it. I confess that I don't like what I know and have seen and heard. But the schema work seems powerful and potentially very helpful to many. It's deeper than the so-called positive psychology approaches.

I suppose any therapist could call themselves a CBT therapist, but unless they've had specific and intense training in CBT techniques, they won't get it right. CBT is hard work, not just for the patient, but for the therapist, too.

In my opinion, and I could be wrong, therapists untrained in CBT have been latching onto the label because there's usually no trouble getting medical insurance to pay for CBT because it's evidence-based and is one of the few therapies that has been demonstrated to bring about improvements that can be measured.

I also know some HMOs and hospitals run CBT groups led by nurses who were sent to a few workshops. I would call that Intro To CBT, but not actual therapy. (No disrespect to nurses. They just have different training.)

But if a therapist isn't specifically trained in CBT techniques they are not a CBT therapist. In fact, I know CBT therapists whose hackles raise when people say it's all about positive thinking. Positive thinking can actually be a cognitive distortion -- minimization of a real problem. No CBT therapist worth their salt would advocate it.

I found CBT to be worse than just think positive. I thought it treated clients like idiots.
There are some people who are helped by it and don't feel it is patronizing.

Well it is partly CBT. CBT is, at least the cognitive part, about looking at things logically, based on evidence, and challenging your feelings accordingly. So you say his answer is usually that either don't worry about things or focus on something positive. That does fit in with the CBT way of looking at things: What are the chances of X happening? Low? So don't worry about it (at least don't be so afraid). So if somebody threatens you, and you can't sleep cause you are deadly afraid of being killed, the chances of that are very low (assuming that same person has not done something to you before or anybody else and that all we are dealing with is just a person upset and making a mindless threat).

However, there are is more to therapy than that and it seems you don't feel heard or cared for or taken seriously. CBT works well within a caring relationship. It is very easy to feel ignored if the person is using logic and evidence not as a way to help you deal with emotions that are there for no "good" reason (feeling fear in face of a lion moving towards you will make you run for your life, which is good, but facing that same exact fear in face of an angry cashier is gonna be a problem) but as a way to trivialize your worries and your pain. When you feel something it is very real. A good therapist is able to work through that with you, and any solution, be it CBT related or not, if pushed on you (like to say think positively about graduation) can feel out of place and frankly, just dumb. Try to sort out if you and your therapist can get on the same page of if it's time for a change. Good luck.

This was my experience with CBT therapy as well... T would actually shake his head and facepalm in exasperation at me if I said anything negative. I felt rather patronized by it. But, maybe as others are saying here that might not be how CBT is really supposed to go. Personally I did a lot better in talk therapy, where it's more about T listening and help processing. I'd definitely look for a new T if this is not going well for you.

No CBT is way more than "think positive". It's actually much much harder. It involves taking a very hard look at the way you approach life and the thought patterns you have that may be keeping you miserable. Everything we see and experience in life goes through the filter of our mind. That filter may need adjustment.

Some people interpret that as "blaming the victim" for having this mindset - BUT you can't change the events that lead to the mindset, nor can you change it unless you accept that you do it.

It's true that we can play an active role in our own misery.

A good CBT therapist will help you understand WHY you think this way and HOW you can change it.

This is what I would consider an example of someone trying to do CBT therapy but barely seems to understand it themselves. What your T tells you to do is overly simplistic and something I might say to my 10 year old when she's anxious but not to someone in real distress.

CBT does involve replacing irrational, negative thoughts with more realistic and productive ones, but the process is much deeper and requires a significant amount of work. It's not simplistic at all. Some people don't mesh with the style, which is more straightforward and directive than some of the talk therapies, especially psychodynamic. So it depends a lot on your personality type sometimes as to how open to it you'll be. But for a lot of people it is very, very useful. It requires a lot of reflecting on your own behaviors and identifying ones that could be self sabotaging. The straightforward style of CBT can cause some discomfort in the moment, but if you have a good relationship with the therapist then you won't mind. A lot of people appreciate the work and feel supported and empowered to make important changes in their lives.

If this is the extent of your therapy and you are really interested in doing CBT, you might consider getting a new T. Here is a link with resources that may be usefule if you're interested:

www.acbt.org/help

Your experience with CBT and therapy in generally, is truly mostly determined by a good fit between you and your therapist (this isn't just my opinion, essentially all psychotherapy effectiveness research has shown this).

Also, CBT should not be about positive thinking - it is about realistic thinking. Some situations are just terrible, and a good therapist acknowledge this and validate your feelings. After you process them, they might help you think about whether there is a lesson in what happened. Sometimes people DID contribute to the situation (not always, like in the case of abuse), and a therapist might go over what you would do (even if you have 20/20 hindsight) differently.

Not all CBT is created equally - it is a theory that guides a therapist's treatment. The "quicker" CBT, which is what people seem to object you, is geared toward very concrete problems - e.g. panic attacks, OCD, insomnia, etc. It essentially gives you some skills to cope.

There are other "deeper" CBT based theories, and they tend to explore core beliefs/schemas (much harder to change). Guided by this theoretical standpoint, a therapist DOES explore the childhood origin of the schema and how it has affected you in the past. Then, they explore the assumptions you make about yourself/others/the future and how you have been "coping" based on your assumptions.

The goal is to gain insight on the fact that these maladaptive assumptions/ways of coping have contributed to some of the things that have happened to you (a good therapist does NOT place blame on the patient). A therapist then helps the patient do "experiments" to see whether these assumptions are true and helps change the way you interact with the world. They are not focused on necessarily seeing the world as a positive place, but coping with suffering better.

I think a CBT therapist does great disservice in discouraging feelings or reviewing the past. For this reason, it is important to ask a therapist at the beginning (or even during) treatment what they mean by "CBT" since not all therapy from a specific orientation is quite the same.

Other external factors also influence a therapist's approach - such as insurance, financial issues, etc. If there are time constraints, a therapist doesn't have the luxury of "going deeper" or developing the therapeutic relationship as much as they would like.