[Christina86]

I didn't know if this went here or in Self-Esteem, so if this is the wrong spot - please move it.

I'm a psych major. I'm currently taking Abnormal Psychology and for the first (past) 3 classes now - I feel abnormal, icky and just like a general failure as a human being.

She (my prof) talked about cognitive distortions today. I could have literally cried in class. She kept saying these things and she wasn't portraying anything in a good light - so now I feel even more %#@&#! up. I know I could have left class because it was just bugging me that much - but come on, how many people who are depressed don't have some sort of cognitive distortion? She used examples about what a depressed person thinks to themselves (sometimes) and I could have raised my hand and told her she was describing me. First class she briefly touched on SI - which upset me to no end. This class is going to be interesting - but at the same time, I think I'm going to get hurt in the process.

I so entirely wish now that my T saw me more often than every two weeks. One week today, could be worse I suppose.

Going through a rough enough time. He actually told me that he'd like to switch me to Mondays (he works Mon & Wed only) so that when I have a crisis I could see him twice in one week. I'd appreciate it so much if he would - but I want to keep that 9am spot. It's MINE. Mine mine mine. Seriously, I get overly jealous if I have to take another time spot. I feel ridiculous for saying that. God I wish everyone was that nice to me. I could have cried, because he actually seems to get a lot - even if he says some things that bug me to no end. But is that therapy? Getting under your skin? I guess so.

I'm already making a mental list of everything I want to say to T ... so much to say, so little time. I know what he's going to want to talk about though and I dont wanna.

Blah. Learning psychology stuff is fun and interesting and I feel better knowing what I'm going through - but then I feel stupid for not being able to "fix" myself. It's giving me headache seperating my reality from the stupid textbook.

... end random note from me. Sorry, I had to say something - this is driving me bonkers.

[lenjan]

I think everybody goes through something similar when they take that sort of class. Med students are notorious for coming down with every disease they read about, whether it's a remotely possible occurrence or not .

If we could fix ourselves, Ts would be out of business. My last one asked me once what it would mean if I could consider myself "normal." I said, "It would mean I could stop paying therapists." He wasn't too crazy about that idea .

Everybody needs an outside opinion. It's finding the people who can give you one while still admitting that A) it's only their opinion, which you can take or leave, and B) while you might need to change a thing or two, you're really pretty OK the way you are, even if whatever "thing" you're doing at the time isn't really their cup of tea, who are rare and to be cherished.

(((((((((Christina))))))) You have a lot going for you, whether you know it or not. I hope someday you can see it for yourself. Till then, my friend, and I love ya.

Candy

Hey. I had a bit of a hard time taking abnormal psychology classes too. The hardest thing for me was the attitudes of the students, though, I guess. Though the proffs got to me sometimes too, yeah.

I have a very real aversion to cognitive therapy. Mostly because I've only seen it presented in a blunt and overly simplistic way. Not just by theorists but by clinicians in practice too. I don't have a lot of time for cognitive theories, generally speaking. (I distinguish between cognitive psychology as information processing theories of visual perception and language processing and so on and so forth and cognitive psychology as a therapy approach. While 'cognitive therapy' is labelled so as to get some of the positive connotations of cognitive psychology there really is very little relation between the two).

I really do think... That cognitive therapy... Backs a person into a corner more often than not. Making them worse more often than not. Sigh. I'll end the rant now. (Yes I know that people get better but I do think that sometimes that is IN SPITE OF rather than in virtue of the theory).

With respect to cognitive distortion... There is some evidence to show that people with depression actually have a more ACCURATE self assessment than people without depression who tend to over-estimate themselves and their abilities. This finding has generated a great literature on how it might be adaptive / it might have pragmatic value to be self deluded. lol.

My main issue with cognitive therapy is that you need to endorse one or more of the cognitive distortions or you are being 'resistent' aka a bad client who isn't willing to participate in the therapy process. They attempt to get you to endorse one or more of the cognitive 'distortions' and then typically proceed to... Beat you over the head with them.

If you don't consciously endorse them then the theory goes that you UNCONSCIOUSLY endorse them in the form of preverbal schemas or whatever. Basically... Doesn't matter what you say you simply must endorse them (either consciously or unconsciously) because that is what their theory of emotions REQUIRES YOU TO DO.

The theory of emotions goes that cognitive distortions causes distressing emotions. If you are feeling a distressing emotion (like depression) then you simply must be either consciously or unconsciously endorsing the cognitive distortions on the book. Playing the therapy game requires you to state that you do endorse some of the cognitive distortions. The therapist gets all excited at this point and encourages you to challenge those cognitive 'distortions' head on. That is supposed to be how one is cured.

Repeat after me 500 times 'I am an absolutely wonderful individual'. Say it like you MEAN it. Keep on... Keep on... If that strategy isn't working for you then you simply aren't doing it properly - bad you!

This is a slight caricature but my experience with cognitive therapy is that it is often practiced this way. Change change change. We gotta change the feeling and the way to change the feeling is to change the thinking.

Fortunately that is only ONE theory of emotions. It is a very influential theory in cognitive behaviour therapy (because it justifies or rationalises their techniques) and it is also a very influential theory in some philosophical circles where people have a very rationalist view of emotions and where depression and phobias and the like are thought to be irrational BY DEFINITION (hence if your theory doesn't explain how they are irrational then your theory is defective).

Fortunately there is another theory of emotions that is gaining ground... On this theory it is acknowledged that emotions can occur in the absense of any conscious evaluation / judgement and the evaluations / judgements of emotion (insofar as they deserve to be called that) mostly AREN'T accessable (or changeable) by conscious introspection.

Emotions can be MODULAR responses. Have you seen the Muller Lyer illusion? The lines APPEAR to be of different length. You can measure the lines (reality check) and come to know that the lines are actually of the same length. This does absolutely nothing to prevent their appearing to be of DIFFERENT length, however. There would be something seriously wrong with your visual system if the lines actually APPEARED to be of the same length. The knowledge that they are the same length does nothing to penetrate the illusiory experience because the visual perception is a MODULAR process that is inpenetrable by higher level thought processes (there is an anatomical explanation for this.

Similarly with the emotion system some emotions (depression, phobias etc) are often MODULAR emotional responses. We can see that objectively there is nothing to be depressed about or afraid of but this does absolutely nothing to alleviate ones emotional state. If there is an evaluation of judgement that occurs prior that is often inaccessible to conscious awareness and telling yourself that the evaluation is false simply does nothing to alleviate the emotion in the majority of cases. The emotion is modular like the appearance of the lines being of different length is modular.

If this is so then how is it that people often do endorse the cognitive distortions? Most people are trying to play the therapy game because they really really really really really want to get better. People often confabulate when they don't know why. That is a fairly normal thing to do. The little lists of cognitive distortions cue you in to the confabulations that are required of you. People simply don't have very good access to the real causes of their emotional states, however. Therapists are good at getting people to confabulate in a way that is consistent with their theory, however...

So what is the mechanism of change then if it isn't challenging those thoughts?

One can view endorsing the cognitive distortions as a CONSEQUENCE of feeling the way one feels. A therapist REQUIRES you to justify yourself and in the attempt to provide justification you get yourself into cognitive difficulty too. If only it was as simple as endorsing the distortions confronting them and then being cured! Alas, things are not that simple. The theraputic relationship. The connection the bond the attunement between therapist and client. IMHO that is the mechanism of change. The difficulty I have with cognitive therapy is that the theory often PREVENTS the meaningful bond / connection because the therapy is all about hitting the client over the head with their alledged irrationality.

Is it irrational to jump at a coiled hose? The parts of the brain that respond to that don't have information to discriminate coiled hoses from snakes. They can't do it. Given that... And given the very real danger of being poisoned it makes good evolutionary sense to have false positives rather than false negatives. Not only is jumping at a coiled snake UNDERSTANDABLE it is only when one is forced to justify ones response that one says 'i thought it was a snake'. One didn't think anything at all, of course. In the attempt to get people to justify themselves...

Well... As you can see I had more than a few issues with Abnormal psychology (coming from an institution that was very big on cognitive behaviour therapy).

Sigh.

'Cause you can beat yourself over the head with your alledged cognitive distortions as much as you like and you won't cure yourself that way.

Or...

You can be kind and gentle to yourself and encouraging and sympathetic and that goes some way...

But mostly... It is about someone external being kind and gentle and encouraging and sympathetic methinks. A bond with another such that... One is better equipped to bond with oneself and with other human beings.

Sigh.

What happened to the humanity??????????

[pachyderm]

Very nice post, Alexandra. Mostly because it agrees with lots of my feelings on cognitive behavioral therapy.

Even Freud said that there is a difference between the therapist knowing something and the patient knowing it. "Knowing" is something more than a purely cognitive matter.

[pachyderm]

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alexandra_k said:
What happened to the humanity??????????

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Too scary (for the behaviorist).

[sunrise]

alex, great post. It pretty much sums up the way I feel about CBT. It is just not a good fit for me.

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Fortunately there is another theory of emotions that is gaining ground... On this theory it is acknowledged that emotions can occur in the absense of any conscious evaluation / judgement and the evaluations / judgements of emotion (insofar as they deserve to be called that) mostly AREN'T accessable (or changeable) by conscious introspection.

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Yes, this is much closer to what emotions are for me than the cognitive definition you wrote.

Knowing what I know now about myself and about therapy, if I went to a therapist and he became obsessed with trying to change my thinking, even when I told him that was not the problem, I would probably just leave. If the therapist can't adjust the therapy to fit what the client needs, then he is not a very good therapist, IMO. I have very rational and accurate thinking. My problem is not my thinking but dealing with my feelings, past trauma, etc. I remember once my original counselor (who was in general CBT but didn't force it on me overmuch) was convinced that I was exagerrating what would happen if I did X in my life (I think exaggeration is one of the types of distorted thinking that CBTers define). I was so desperate to get better that against my better judgement, I went through the process of doing X and then reported the extremely painful and awful results to her, worse even than my original assessment (which she had thought was "faulty thinking"). At that point, I think she saw that my thinking was accurate and could be trusted, and she became more flexible in her approach. Nevertheless I did leave her after a while and found a therapist who had a bigger skill set and could offer me more effective help and support. The great irony is that my insurance would reimburse 90% of the cost for this fairly limited and ineffective CBT counselor but won't reimburse a penny for my current eclectic therapist, who has pretty much saved my life.

[purplemoon]

Canders - I don't think we can ever fix ourselves. If there is one thing that my T has tried very hard to get across to me and is starting to sink in - is that we cannot do this alone. We are not islands. Even T's have T's or a collegue they can go to. It is so hard to see from the inside. I was just thinking the other day why didn't I see this a year ago - it is so obvious to me now.

And I remember when I took psych classes ( a long long time ago ) I thought for sure I should not be out among the population because there wasn't one thing I couldn't relate to. It is hard.

[pachyderm]

Some clarification on my thoughts about cognitive therapy -- to help me better organize my thinking, if not to help anyone else.

No doubt we do develop distorted thinking as children -- because as children there is almost no way we can understand why the big people do the things they do. Especially if they don't know themselves. But how do you correct your thinking? Not by being told it is distorted, and then told what the "correct" thoughts are. If that happens, all you learn is that somebody told you that your thoughts were distorted, and here are the thoughts you should think. There is no opportunity to learn on your own and form your own judgements about what is distorted and what isn't. You are still relying on "authority." And an authority that isn't very well put together, if that's the approach they take.

I realize this may be a distortion of what a "good" CBTherapy would do, but I think there are lots who do in fact do something along these lines. And most do not well enough distinguish what they really do, to keep themselves on a path to make their therapy really helpful.

[DePressMe]

I too was a psychology major and struggled through classes like abnormal psychology. Relating to the topics, illnesses, symptoms and such is common. But, it is especially hard when I really did experience and relate to the illnesses and symptoms. I had to kinda distance myself from the material and treat it as a class—not therapy. I kinda temporarily boxed my emotions and focused on the class as a student—not as a patient. If that makes sense. I suspect it is similar to what a therapist has to go through when they relate to what a client is talking about. Feel free to PM me if you ever want to chat about it.

[happyflowergirl]

Hi Christine!

I am also a psych major and at the beginning of my abnormal psych class the prof. (who was a pychologist) warned us that some of the material may upset us if we are close to the subject or know somone who was. THis class didn't upset me as much as Lifespan Developement and learning about the parenting styles. That was tough for me.
I think the classes and the training will get easier the more you deal with stuff. A lot of therapist have issues and have to find a way to not let that interfere with their client's issues. Good luck!