CBT limitations?

i don't know if i understand the whole process of CBT quite right, but from what i do get the idea is that you change the self talk, actively track and change the negative thoughts, then work on actively changing the behaviour and TADA! the feelings change... right?

is that reasonably close to the idea?

because if it is then it's a crock.

i did an awful lot of that stuff before... and my T seems all jacked up about what it is that "happens" or "why" i sometimes break out of my defeating patterns and take concrete steps that are more positive... ie i was extremely distressed about my job and possibly losing it, and had the old-pattern-option of giving up and falling back on the unreliable advice of H. i wasn't able to reach T by phone and it was a long weekend... so after suffering for days i decided to find a middle ground with my boss and do short shifts. My T was really into what happened or what i was thinking that made that happen.

ok. i can understand why he would be, esp considering his love of Ellis. Pattern changing obviously has benefits.

BUT... what i find personally is that what is does is make my life more functional. i mean, it kept my job. Not letting myself once more walk out of a dirty kitchen allowed me to get my dishes done. I can see how this stuff can get "things" done. Yup, makes me a more productive person. Does it make me feel any better? Not one iota.

And it's not just with the process with therapy. i have always managed to get the tough going ... well, not always. i have yet to experience even one instance of it where it resulted in me feeling better. i feel like crap.

i am so tired of this.

i am very interested in other therapy types... humanist for example sounds very interesting to me.

i just want to <font color="#000088"> FEEL </font> better.

Quick reply cos I really must got to bed!

CBT- is very good for changing the negative into the positve thought but doesn't really deal with the 'why?'

REBT- (Ellis-Great psychologist) is a slightly harsher form of CBT but very good for dealing with a problem straight away.

In my opinion you need to move on to the 'why?' you feel the way you do. The origins of that feeling and where it comes from. It's difficult to do.

My T uses an eclectic approach which is a mish-mash of CBT, REBT, NLP and PAC. I'll explain some other time if you want to know more about that. Basically it's delving deeper into the personality for a greater understanding of knowing what is going on and why.

Got to go to bed now!

I concur. I like to use CBT to help myself to stop beating myself up, worrying about what others think etc. However, I also like to get at unresolved issues. I had some unresolved issues in childhood. I also have some at work. I think working on changing the behavior has helped me to not add more unresolved issues but I have spent more time in session trying to resolve the unfinished stuff. What good is helping oneself not to make one's life worse if you don't work on rectifying the mistakes, unfinished business etc too?
I am not sure what my T is trained in. I have read on psychoanalysis/psychodynamic which focus a lot on past experiences. I suspect that my T has had training in this because she is perfectly comfortable with the transferance in our relationship. I have wrote letters to people (just for therepuetic purposes) as a way to fully express my feelings about past childhood issues, the death of my great aunt and grandma. I think that might be more of a Gestalt technique. I am planning on writing letters about work as a way to work through my anger concerning past issues at work. The current manager didn't have anything to do with these past issues yet I still feel them whenever something happens at work that bothers me. I hope you find a way to augment CBT with other ways to work through whatever issues that you may have.

Gerber, have you asked your therapist if she/he can 'do' some psychodynamic therapy with you?

My t and I, I have made it very clear to her that unless I ask for the cbt she should take it as a given that I want the psychodynamic approach. It feels great! To each its own, they say. CBT alone is much too stifling for me.

my T actually wants to pursue schema with me, an offshoot of CBT that apparently has elements of psychodynamic, Gestalt, CBT and some others i think. We haven't gotten there yet.. in 5 months it's been crisis after crisis.

i know my T is more of a CBT kind of guy... i think i would really like a psychodynamic approach... but i am too scared to ask... i am afraid he might not want to keep seeing me... like maybe he would feel like his training was not what i need.

he did make some comment about humanism the other day... i forget exactly what he said but it made me think that maybe he has some training in that area.

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gerber said:
i don't know if i understand the whole process of CBT quite right, but from what i do get the idea is that you change the self talk, actively track and change the negative thoughts, then work on actively changing the behaviour and TADA! the feelings change... right?

is that reasonably close to the idea?

because if it is then it's a crock.

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I think if depends on how the "CBT" is done. If it results in adopting a "happy face" to cover up the real feelings, then it will fail. I haven't seen any therapy's labels that describe what really happens in the therapy sessions. That can range all the way from brainwashing to listening. Will your therapist really listen when you bring up your concerns? I guess there is one way to find out.

There are two people involved in a therapy situation. A good therapist will be aware of his/her own feelings, and thus able to hear someone else's. A less aware therapist may try to avoid hearing someone else's fears, because they hit too close to home.

I understand your confusion. I don't see much difference between CBT and "positive thinking."

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SunGarden said:
I understand your confusion. I don't see much difference between CBT and "positive thinking."

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Done correctly, it's actually more about "stopping negative thinking". It may seem like a quibble, but it isn't, really. When you learn to silence the irrational self-talk, the rational stuff that's left probably won't be all roses and sunshine. Even though I'm still depressed, CBT finally let me accept that my depression isn't my fault, which in turn meant better treatment compliance.

CBT doesn't really work for me. I am a really clear thinker (my profession has taught me that) and so don't really need help with changing my thoughts. My problems lie elsewhere (more on the feeling side of things), and I have found the eclectic approach of my therapist to be just right (humanist/systems/psychodynamic/gestalt with EMDR for past trauma).

I did have a previous counselor who used some CBT. I thought some of her suggestions for dealing with the symptoms of my depression were good, and did help me feel somewhat better (such as getting my sleep problems under control), but she did not have the tools necessary to help me really get to the root causes of my depression, which was necessary for me to finally conquer it. I always felt a bit that by focusing on superficial symptoms, she was just applying a bandage to a wound. My current therapist was actually interested in healing the wound.

I look back on my time with these two therapists and think maybe I came to them in the right order. I used the first counselor for some CBT stuff getting me kind of back on my feet again with the depression. Then I had a break from therapy. And then I found my current T and was stable enough to be ready for some deep and painful work to deal with my real problems. I sometimes wonder how therapy would have been if I had originally just gone to my current and wonderful T and skipped the limited but helpful CBT lady?

I think once a person realizes a certain therapeutic approach is not a good fit, a talk with the T could maybe get him/her to switch to an approach that fits better. If that is beyond his/her capability, the T could give some referrals to professionals with experience in other approaches. On the other hand, studies have shown that the effectiveness of therapy is due to the relationship with the therapist rather than the exact approach, so if the relationship is good enough, maybe it can help surmount the CBT if it is not the best fit for a particular person.

I saw a t briefly, at the initial consult I asked her if she'd be amenable to doing psychodynamic work with me. She said she mainly does cbt but was trained in psychodynamic and if that is what I want she will do it.
Turns out, she was unable to do the psychodynamic work, she was so heavily cbt...she herself joked about her inability to remain on the psychodynamic track....
I miss her, as I liked her...yet, if she's unable to engage with me in the way I need her to....then of what good is it that we get along well?

I found another t...what I really like about her is that she really listens to me about what I want and don't want with regard to treatment modality. I am so moved by her 'flexibility'.. where another t might say, 'I do cbt and I feel this is what will help you' she might say to me, 'I do cbt but if you feel it isn't helpful to you...tell me what you'd like from me and I will provide that...'
I don't know that she is the most skilled t around...but I love the fact that she is so willing to hear what it is I want and tries to do it the way I like her to.

I have to agree with Sunrise that CBT, in the short-term sense of it, didn't work for me either.

My T is CBT but he adjusted for me. I didn't realize he was adjusting until it came up once but he did adjust. I'm glad he could do this for me.

Well, sometimes I'm glad. This is such a hard process