[shakespeare47]

I was introduced to it many years ago, but at the time, I didn't quite understand where the therapist was coming from, and didn't trust him.

What is CBT therapy like? What assignments have you been given? I understand that Albert Ellis is credited as being one of the creators of CBT therapy, even though he called his specific approach Rational Emotive Behavioral Therapy (REBT) What do you know of Ellis and his approach?

I've been trying to understand CBT and REBT therapy on my own, and have thought about giving myself my own assignments. Some of which may be to just decide not to react when people upset me. And maybe even to get into conversations with people who are upsetting me(or upset me in the past), to make it a point of understanding their point of view, even though I obviously disagree. (and the book, The Gentle Art of Verbal Self-Defense comes to mind in this context).

What is CBT therapy like, from your point of view?

[growlycat]

For me, my T was less inclined to use worksheets. Instead, he would help me break down problems into smaller parts. Homework might be exposure therapy say for my driving phobia. Step 1 he might ask me to drive to a street nearby that I've never been to. If I can do that then he may make the next homework more challenging. However , if it felt like too much we would talk about what barriers i felt in doing the homework. Then he might give me a homework assignment like look up that nearby street on gps without actually going there.

Just a snapshot but hopefully you get the idea

This is going to be long:

My T used CBT and REBT quite a bit, but he NEVER did the whole worksheet thing, and he didn't get all hung up on labeling thinking errors, etc. I think one of the problems and reasons why CBT often doesn't work well for people is that it is used by therapists who can't seem to get beyond the "textbook" and actually apply it individually to the actual client sitting in front of them. I also dislike that it is often termed a "short-term" therapy and that many label it as only for very surface-level work. NONE of those descriptions applied to how my therapist applied behavioral work in my therapy at all, yet he most definitely was using CBT and probably more specifically REBT in our sessions probably at least half of the time.

What my therapist did was to work with me consistently and diligently in the skill of recognizing when I have been triggered and exactly how to work my way out of that triggered reaction through some very step-by-step methods that on the surface were very easy but in practice took years to be able to internalize (which is why I think behavioral work generally does need to be long-term work, particularly when you are working to counteract decades of skewed thinking about the self that resulted from very young exposure to abuse).

So what did it look like in practice? Okay, I might go into session all worked up about something -- maybe something happened at school that has me all upset and anxious and angry. My therapist would work with me to work backwards from my upsettedness which was generally way out of proportion to the actual event. Rather than waste time blaming the incident or person that I say upset me, my T helped me recognize that when my emotional reaction is out of proportion to the current event, there is something going on in my thinking that is probably much older and much more self-engrained into my psyche that I need to figure out.

So, what was I thinking just before I got upset? "Well, I was angry because X was accusing me of Y." Again, the initial impulse is to focus on the current event, but the reality is the thought is older than that.

What was I thinking before that? This is harder because it happens in such a split second and almost on a subconscious level that I don't recognize it, but it IS there. Well, "I was thinking 'How dare X blame me for Y when I did nothing wrong!'" Closer.

What was the thought underlying that? Well, "I hate it when I am blamed wrongly." Better.

Where does that come from? Well, repeatedly my abuser said X to put the blame for my own abuse on me. Good.

How did that leave you feeling? I felt great shame and I'm tired of feeling shame over other people's grievous errors. Good. So, when X did this today, that triggered that old thinking which is where my reaction came from.

(Editing to add: This is where I don't agree when people say behavioral methods ignore history. It is at this spot that sessions could take some time and get rather intense as we explored that history specifically as it pertained to my emotional response at that moment. There is NOTHING surface-level about that kind of work.)

Can I set the old stuff aside and look at what happened today as the adult I am today? How can I look at the current event differently? And we'd process the current event, this time without the old baggage attached. My anxiety and anger would subside and I could think clearly enough to actively problem-solve the current event.

We did this over and over and over again until I could finally do this without him walking me through it. I finally internalized the process so that I could actively set my past where it belonged -- in the past -- and deal with my present in much more effective ways. Learning how to do this has effectively brought my once very severe PTSD reactions pretty much to a halt, has effectively given me strategies so that I am no longer debilitated by anxiety and depression, and has effectively calmed my whole being. I finally have some inner peace and have the ability to find that peace within myself, even at times when my world around me is highly stressful.

That's the power of behavioral techniques IF they are truly internalized with the help of a therapist who really knows what they are doing.

I was in a 12 weekly one-on-one program with a psychiatrist.

Lots of homework each week some of which I still do. It was groundbreaking for me.

[thesnowqueen]

My introduction to CBT was through this book: https://www.amazon.com/Feeling-Good-.../dp/0380810336

I found the exercises in it really helpful and was impressed enough to leave the therapist I was seeing (therapy not going anywhere) and find a new CBT therapist. I was lucky enough to see a leading CBT therapist. And, my experience was similar to Lolagrace's.

My own dysfunctional settings involve allowing others to determine my worth - meaning I can be euphoric when approved of, but destroyed when disapproved of. I also have a habit of condemning myself entirely when my attention is drawn to a single personal flaw. We did not trace particular beliefs back to earlier traumatic events as Lolagrace managed to do. We did discuss how my mother's pathology meant that early relationships were extremely tenuous and how I was drawn to over-monitor current relationships as a result.

HATE that book. It's the first one most people go to, but for me, all the focus on labeling every thought I had was frustrating and didn't really get to the issues. It's okay as an introduction to the concepts I guess, but I found myself getting bogged down in the details.

The book my therapist had me take a look at was The Anxiety & Phobia workbook. He didn't ask me to read the whole thing as much of it didn't pertain to me, but he had me read the middle chapters on mistaken beliefs and self-talk. They are very basic but very helpful outlines of REBT. It gave me a visual to refer to in order to help really learn the skills he was working me through in therapy. I did eventually work through the exercises in those two chapters which were really helpful in solidifying what we were talking about.

[kecanoe]

My experience is similar to Lolagrace's. I have never had a CBT-only t, but have learned to think about my thinking in the way described. Very helpful. If nothing else, I can at least notice that my internal reaction is out of proportion to an event and stop the outward reaction. This has been very helpful to me.

[bookgirl667]

My experience w/CBT was mostly negative. My tdoc seemed to view *everything* I felt as a distortion, and it felt really invalidating. And he did come at me with workbook and breathing and mindfulness exercises, all of which I'd seen before and felt like were a waste of my in-session time. Plus patients with my personality traits (subclinical obsessive-compulsive personality (NOT OCD but OCDP)) have been shown not to respond well to CBT - we tend to feel bossed around and controlled, which is exactly how I felt. Also when I talked about painful incidents from my past, the guy mostly said nothing other than, "Let's get back on track." Ugh.

All of this is so individual - what one person finds helpful, another may not; and a tdoc that is helpful to one person may not help you, etc. Personally, I ran away screaming to psychodynamic therapy, which I love, and haven't looked back.

[DechanDawa]

Ellis was inspired by Stoic philosophy, pragmatism, and later, a bit by Buddhism.

[shakespeare47]

Originally Posted by bookgirl667

My experience w/CBT was mostly negative. My tdoc seemed to view *everything* I felt as a distortion, and it felt really invalidating.

I suspect that one of the reasons I had an issue with CBT when I was first exposed to it, is because I came from a family in which it was common for my parents to tell each other, "you think that because you're crazy, and can't see it for what it is", in an abusive way. My brother also picked up on this tactic and used it on me....

It took a while for me to be able to acknowledge that most of the emotional reactions we experience are caused by the judgments we make.

[thesnowqueen]

Originally Posted by lolagrace

HATE that book. It's the first one most people go to, but for me, all the focus on labeling every thought I had was frustrating and didn't really get to the issues. It's okay as an introduction to the concepts I guess, but I found myself getting bogged down in the details.

The book my therapist had me take a look at was The Anxiety & Phobia workbook...

Loloagrace I have the Anxiety & Phobia Workbook and just never got into it!

I found the Burns helpful because it made me identify the thoughts/interpretations that were triggering extreme emotional states. For me this is invaluable because it gives a logic to ones experience. The anguish has not just arrived out of nowhere. Then it also gives some way of evaluating those judgments and thoughts. And lastly, correcting to a more realistic appraisal. For me this was very empowering.

That being said, my experience with an actual CBT therapist did NOT involve pen, paper, exercises and worksheets! Or anything in that vein.

LOL! That's funny! I definitely didn't read the whole book -- just those two chapters.

[DechanDawa]

Originally Posted by shakespeare47

I suspect that one of the reasons I had an issue with CBT when I was first exposed to it, is because I came from a family in which it was common for my parents to tell each other, "you think that because you're crazy, and can't see it for what it is", in an abusive way. My brother also picked up on this tactic and used it on me....

It took a while for me to be able to acknowledge that most of the emotional reactions we experience are caused by the judgments we make.

Have you thought abut DBT (Dialectical Behavior Therapy)? Its creator, Dr. Marsha Linehan, felt that CBT could cause people to feel invalidated because of all the emphasis on faulty cognition. So she incorporated more "acceptance of how things are" in her model which is very gentle. Dialectical means holding two opposing thoughts. In DBT that would be accepting how things are at the moment but also realizing if one wants to meet one's goals than one must be open to change. There is a forum here on DBT with a lot of people who graduated from DBT training programs, and they could tell you more. Officially, DBT is considered a cognitive therapy, so it is basically CBT without as much of the invalidating stuff. Good luck.

[thesnowqueen]

I had a T, before my CBT T who used to say - 'that's true for you', whenever she was basically disagreeing with me. Really pissed me off!

[songofthesea]

I disagree - it's empowering rather than invalidating - it hands you control over your own thought processes and emotions. That's not to stay it's not still a bit bull****** though, as is therapy in general.

[shakespeare47]

I think care has to be taken in how CBT therapy is approached and taught. But, to realize that "it really wasn't what happened that upset me, it was my thoughts about what happened" (especially when those thoughts aren't acknowledged and at least questioned) makes sense to me. And that can be realized in a way that is validating.

[shakespeare47]

Originally Posted by DechanDawa

Have you thought abut DBT (Dialectical Behavior Therapy)? Its creator, Dr. Marsha Linehan, felt that CBT could cause people to feel invalidated because of all the emphasis on faulty cognition. So she incorporated more "acceptance of how things are" in her model which is very gentle. Dialectical means holding two opposing thoughts. In DBT that would be accepting how things are at the moment but also realizing if one wants to meet one's goals than one must be open to change. There is a forum here on DBT with a lot of people who graduated from DBT training programs, and they could tell you more. Officially, DBT is considered a cognitive therapy, so it is basically CBT without as much of the invalidating stuff. Good luck.

Thank you! I'll definitely look into it.

[shakespeare47]

I recently came across Jim Byrne. He was trained in and used CBT therapy, was a supporter of Albert Ellis, and was part of a group of people who fought on Ellis' behalf when Ellis was kicked out of his own organization.

Jim Bryne has been open about the problems and limitations he sees in Ellis and the CBT approach. It's been eye-opening for me. (

) I also read Byrne's book: A Wounded Psychotherapist: The Childhood of Albert Ellis, and the Limitations of REBT/CBT

[feileacan]

Originally Posted by lolagrace

What my therapist did was to work with me consistently and diligently in the skill of recognizing when I have been triggered and exactly how to work my way out of that triggered reaction through some very step-by-step methods that on the surface were very easy but in practice took years to be able to internalize (which is why I think behavioral work generally does need to be long-term work, particularly when you are working to counteract decades of skewed thinking about the self that resulted from very young exposure to abuse).

I'm commenting that paragraph but not because I would like to comment specifically that post - I think it just describes quite well what happens in CBT (at least in my imagination).

My question is, why is a therapist necessary there? I'm sure that basically anyone is actually able to figure out such things by themselves, after having calmed down at least a bit, no? I should also say that my question is not coming out of arrogance but rather this is something I've always wondered about CBT and its applicability.

[lucozader]

Originally Posted by feileacan

My question is, why is a therapist necessary there? I'm sure that basically anyone is actually able to figure out such things by themselves, after having calmed down at least a bit, no? I should also say that my question is not coming out of arrogance but rather this is something I've always wondered about CBT and its applicability.

I think that's a fair question. Certainly plenty of people do manage to do it by themselves. When I had CBT I found that having another person (the therapist) there to hold me accountable and support me throughout was completely essential - it was hard work, and I think I would have given up without the knowledge that someone else was invested in it. That's very much related to the kind of person that I am, though, and I don't think it applies to everyone.

Originally Posted by feileacan

I'm commenting that paragraph but not because I would like to comment specifically that post - I think it just describes quite well what happens in CBT (at least in my imagination).

My question is, why is a therapist necessary there? I'm sure that basically anyone is actually able to figure out such things by themselves, after having calmed down at least a bit, no? I should also say that my question is not coming out of arrogance but rather this is something I've always wondered about CBT and its applicability.

I was not able to do this on my own. You base your comment on the assumption of a person with a healthy self-concept, no severe depression, a strong sense of self and of personal confidence, no struggles with severe anxiety, no severe PTSD symptoms . . . I needed the support and guidance of a therapist who did possess those qualities to walk me through that process over and over and over again while also working on strengthening my own self-concept, managing my depression and anxiety, improving my sense of self and my confidence level. Only after much repetition and practice with that kind of professional support was I able to finally truly internalize those skills. CBT skills aren't a quick switch that you just turn on and they automatically work; they take time to really internalize.

[DechanDawa]

Ellis produced dozens of self-help type books on REBT, Rational Emotive Behavioral Therapy, from which CBT was created. Ellis said that perhaps if one had mild or moderate neurotic tendencies that one might be able to correct their thoughts and actions by using the books alone. He said this was difficult because it is hard to be self-reflective. I suppose it could be done if one had specific goals.

I don't know. I have been trying to do it with very minimal support from a counselor and I actually think I am not seeing very much improvement, which is actually causing me to become more depressed.

[Pennster]

Originally Posted by shakespeare47

I think care has to be taken in how CBT therapy is approached and taught. But, to realize that "it really wasn't what happened that upset me, it was my thoughts about what happened" (especially when those thoughts aren't acknowledged and at least questioned) makes sense to me. And that can be realized in a way that is validating.

I have always been a little confused by the idea that it's one thoughts alone that upset one, rather than what actually happened. Like my mother died when I was a child. This seems to me to have been an intrinsically upsetting experience, and I can't get my head around the idea that it would have been possible to think about it in a way that would erase the pain of it.

I remember being totally confused by the Stoics when I read them in college, long before I had ever heard of CBT. Like their ideas about grief just didn't reflect my lived experience at all, and it seemed to me they were trying to deny the normal, human response to death.

But I realize plenty of other people find this kind of thinking useful! I get it for some things, and even for some types of grief, but I have a hard time agreeing that it is always one's thoughts that are the real problem.

[DechanDawa]

Originally Posted by Pennster

I have always been a little confused by the idea that it's one thoughts alone that upset one, rather than what actually happened. Like my mother died when I was a child. This seems to me to have been an intrinsically upsetting experience, and I can't get my head around the idea that it would have been possible to think about it in a way that would erase the pain of it.

I remember being totally confused by the Stoics when I read them in college, long before I had ever heard of CBT. Like their ideas about grief just didn't reflect my lived experience at all, and it seemed to me they were trying to deny the normal, human response to death.

But I realize plenty of other people find this kind of thinking useful! I get it for some things, and even for some types of grief, but I have a hard time agreeing that it is always one's thoughts that are the real problem.

I think you are bringing up some very salient points. The Stoics do say stuff like at first you focus on things like when you break a cup or plate to rationalize it is not so bad. Then accordingly you build yourself up to things like the death of a parent, spouse, or child. Ellis even cites this example in his book.

How unrealistic! This is also a criticism of Buddhism. I practiced it for 20 years and I an attest that Buddhism is "cold" - the Tibetan Buddhists don't even have a work for love in their vocabulary.

[Pennster]

Originally Posted by DechanDawa

I think you are bringing up some very salient points. The Stoics do say stuff like at first you focus on things like when you break a cup or plate to rationalize it is not so bad. Then accordingly you build yourself up to things like the death of a parent, spouse, or child. Ellis even cites this example in his book.

How unrealistic! This is also a criticism of Buddhism. I practiced it for 20 years and I an attest that Buddhism is "cold" - the Tibetan Buddhists don't even have a work for love in their vocabulary.

Thanks - I appreciate your reply! I still remember the exact wording of the Epictetus quote about not being upset when your wife dies. It just seemed so ridiculous to me, and so in denial of the power of love and loss. I was actually quite shocked when I found out there was a school of therapy based on Stoic thinking! Did not compute...