[Lola5]

I started CBT with my T two years ago. Over the past two years none of it has worked and my anxiety has gotten much, much worse. It's my fault this happened. My T would give me worksheets and exercises to do and then I just couldn't do them outside of session. I would forget or feel too overwhelmed so I wouldn't complete them. He taught me to restructure my thoughts and do muscle relaxation and we would do it in session. Then outside of session I couldn't do it. I would try to restructure them sometimes and it wouldn't work. Most of the time though I allowed them to get the best of me and escalate. He would tell me good things in session for one situation and I am unable to apply it to other similar situations.

Now I'm really sick and I lost my job and had to drop out of school. My T feels we can't work together anymore because I'm not progressing and he's recommending I do DBT instead. But that's not going to work either because I can't bring myself to put in the effort to change. That's what it comes down to. I am paralyzed when it comes to putting in the effort. I don't know how to fix this.

[Amyjay]

No, it's not your fault. CBT is only good for some things. There are many issues it doesn't help at all. If you weren't able to use CBT effectively it was because it wasn't the right therapy for you. It's the therapist's responsibility to tailor the therapy to suit the clients needs. If it didn't help you because you weren't able to apply the techniques inbetween sessions then it doesn't mean you failed, it means it wasn't the right treatment for you. One therapist I saw used CBT techniques with me and they were absolutely useless. Luckily I was only saw her for a very short time before being assigned my proper T who didn't use CBT thank goodness.
DBT is a much more intensive type of therapy and I think it would potentially be of much greater benefit for you. I am so sorry you've lost your job and had to drop out of school. DBT might be really useful for you right now to help you get back on your feet.

[mostlylurking]

I'm glad that your T is finally doing the right thing and recognizing that CBT doesn't seem to be the right method of therapy to address your particular form of anxiety. That is not your fault, it's just a case where CBT didn't work; it certainly doesn't work for everything. Anxiety is a truly awful feeling, and I'm sure that if some CBT technique had been really helpful, you'd have flocked to it, and used it to get some much needed relief. I think you're putting a lot of blame on yourself when really, this just wasn't the right tool, that's all.

An alternative explanation for why it seemed to work in session is that you were with someone who was being caring, who was there with you, actively assisting you, leading you through relaxation techniques that can be (in my experience) much harder to do on your own than when you're led through it by someone kind. The human relationship may have been what actually worked during your sessions, not the techniques.

Just to let you know there are other options out there, my therapy has been far less structured and has never involved "homework" outside of session, but it has been highly effective for me, and anxiety was one of my main symptoms at the start.

Don't feel locked into your T's recommendations, necessarily. If you can, if insurance and so forth allows it, you might want to think about what model of therapy sounds good to you at a gut level, or you might want to look at local therapists' pages and find someone you have good rapport with regardless of which techniques they specialize in. Therapy should not be something done to you where you are given "homework" whether it's helping or not, and are expected to comply. It should be something where you choose the things you find helpful. It should be shaped by the client's needs and what helps them the most. Therapy should be empowering, not disempowering.

I think DBT is mostly for people who have trouble making changes. You might be surprised.

Also, true DBT means someone is available 24/7 by phone to coach you on how to use the skills you've learnt so far in your current situation.

You might also be able to work with a different, more eclectic CBT therapist. Or maybe you need a little help (such as trauma treatment, medication, ..) before you have 'room' to put CBT into practice.

Please don't feel bad about CBT not working for you. For some people, it really doesn't help and they do better with other modalities.

I did way better with Acceptance and Commitment Therapy and Dialectical Behaviourial Therapy.

Don't have to change. Just need to find what works for you.

[Lola5]

Thank you for the support! It's hard to feel like I'm not to blame for this. For some reason I'm unable to take an active role in my own treatment. I'm just waiting for it to happen to me meaning that I'll just get better. I know it's stupid, but I am paralyzed from taking an active role and doing something to help myself. It just feels like too much work. How do I get over this?

[mostlylurking]

What I did to help myself was just to talk, and then in between sessions I just kept finding myself thinking about therapy. None of it really felt like work exactly, but some of it was certainly unpleasant, because a lot of emotions came to the surface and were sometimes strong enough to disrupt my daily life or keep me from sleeping. What part of therapy feels like work, specifically?

[ElectricManatee]

Originally Posted by mostlylurking

What I did to help myself was just to talk, and then in between sessions I just kept finding myself thinking about therapy. None of it really felt like work exactly, but some of it was certainly unpleasant, because a lot of emotions came to the surface and were sometimes strong enough to disrupt my daily life or keep me from sleeping. What part of therapy feels like work, specifically?

This sounds a lot like my experience. I was committed to going to therapy (making and keeping appointments) and to talking about my feelings in session as clearly and honestly as I could. That's all I needed to get started letting my T help me. Then once some of the big feelings started feeling smaller because my T and I were working on them together, my life felt more manageable and it became a little easier to do things that would help (like exercise and journal and read books relevant to my issues).

It would not have been helpful for me to be in a therapy situation where I felt like I could "fail." I can only be myself and let my T support me in the best ways she knew how. If I feel too stressed about something, we leave it and come back later. She doesn't ask or require me to use up my energy and willpower on exercises if they don't feel natural or helpful to me. I completely understand your urge to be disappointed with yourself for not "doing enough" to get better, but I don't think it is justified. As my T says, sometimes you just can't do it, and that's okay too.

My depression is a symptom or expression of some fairly substantial core pain, and therapy is the process of gently opening that up so it can heal. Doing that makes the depression lessen on its own. The therapeutic relationship is central to helping me, more than any techniques. However, I do think DBT might be useful in terms of helping you get to where you are more able to manage your life outside of session. The outside coaching aspect of a full DBT program would be really useful to me, and maybe some of the other aspects would get you on the path to finding and employing coping skills that feel natural and helpful so you WANT to use them.

There is hope for you to get better. I don't think it's a sign of failure that CBT wasn't useful for you, and I hope you are able to find some new treatment that is useful for helping you feel better.

[Lola5]

Originally Posted by mostlylurking

What I did to help myself was just to talk, and then in between sessions I just kept finding myself thinking about therapy. None of it really felt like work exactly, but some of it was certainly unpleasant, because a lot of emotions came to the surface and were sometimes strong enough to disrupt my daily life or keep me from sleeping. What part of therapy feels like work, specifically?

What do you mean about "thinking about therapy" in between sessions? Like what you talked about or what you want to talk about next time?

The part that feels like work is the stopping and restructuring/reframing my thoughts, stopping the ruminations, doing the relaxation techniques...those kinds of things. Anything that my therapist and I did in session that I was supposed to take away and apply in the real world to situations feels like work that I just can't do.

Originally Posted by ElectricManatee

This sounds a lot like my experience. I was committed to going to therapy (making and keeping appointments) and to talking about my feelings in session as clearly and honestly as I could. That's all I needed to get started letting my T help me. Then once some of the big feelings started feeling smaller because my T and I were working on them together, my life felt more manageable and it became a little easier to do things that would help (like exercise and journal and read books relevant to my issues).

How did you and your therapist work on your feelings? Was it by talking about them or using certain strategies?

[ElectricManatee]

Originally Posted by Lola5

How did you and your therapist work on your feelings? Was it by talking about them or using certain strategies?

Mostly by talking about them. At the very beginning when my world felt like total chaos, it helped just to go in and know that she would listen. Sometimes we would talk about ways to deal with practical problems (like, "How might you approach your boss to tell him that this project isn't working out?"). Other times it was just her expressing empathy and sort of helping me "hear" myself and get in touch with my own feelings. Just lots of talking and building a secure relationship with her. Some laughing and joking around too.

My T focuses a lot on self-care (literally doing things to care for yourself, whatever is healthy and makes you feel good, like petting a dog, going on a walk, etc) and on building healthy relationships. So sometimes she will encourage me to do something like call a friend or make time for a hobby, but she never pressures me or follows up about whether I was able to follow through. She knows about strategies for certain things like meditation and dealing with cognitive distortions, but I haven't been too interested so we haven't talked much about that. My therapy isn't so much about any techniques, but it is about growing in a solid relationship and learning how to trust people and relate better so I can connect with other people in my life too.

[Lola5]

Originally Posted by ElectricManatee

Mostly by talking about them. At the very beginning when my world felt like total chaos, it helped just to go in and know that she would listen. Sometimes we would talk about ways to deal with practical problems (like, "How might you approach your boss to tell him that this project isn't working out?"). Other times it was just her expressing empathy and sort of helping me "hear" myself and get in touch with my own feelings. Just lots of talking and building a secure relationship with her. Some laughing and joking around too.

My T focuses a lot on self-care (literally doing things to care for yourself, whatever is healthy and makes you feel good, like petting a dog, going on a walk, etc) and on building healthy relationships. So sometimes she will encourage me to do something like call a friend or make time for a hobby, but she never pressures me or follows up about whether I was able to follow through. She knows about strategies for certain things like meditation and dealing with cognitive distortions, but I haven't been too interested so we haven't talked much about that. My therapy isn't so much about any techniques, but it is about growing in a solid relationship and learning how to trust people and relate better so I can connect with other people in my life too.

Is your T psychodynamic? Just curious what his/her modality is?

[ElectricManatee]

Originally Posted by Lola5

Is your T psychodynamic? Just curious what his/her modality is?

She considers herself primarily a relational therapist, similar to what is described at this link. I will note that the success of this type of therapy depends a lot on the fit between the therapist and the client, so it's super important to find a therapist who makes you feel comfortable and safe.

[Lola5]

Originally Posted by ElectricManatee

She considers herself primarily a relational therapist, similar to what is described at this link. I will note that the success of this type of therapy depends a lot on the fit between the therapist and the client, so it's super important to find a therapist who makes you feel comfortable and safe.

That is very interesting! I agree, the relationship with the T is very important in any modality.