I think I'm allergic to 12-step stuff

My current therapist with whom I've now had 3 (or is it 4) visits is a licensed family marriage therapist (California), and I thought was going to evaluate me, set treatment goals, and get on with things. I'm stressed, depressed, burned out and miserable, meds aren't working any more and to get better and avoid relapses, I need to combine the meds with a proven therapeutic strategy such as CBT, which she listed as one of her therapeutic methodologies.

Mostly the sessions aren't really going that way, and when I broached the subject of a treatment plan at my last session, she hemmed and hawed and said "well what is it you would like to work on?". I sort of thought we'd sorted that out on the first visit.

Not what I was expecting, obviously. I was thinking there was more to cognitive behavior therapy than a few generalizations about how it takes awhile to recover from bad things that happen to us (I expect that coming in, but I also expected some specific plans, maybe some homework, etc.), that journaling and yoga and meditation are good (yup, been doing that forever), and to learn about assertiveness training (been there done that, it's worked well for me since I first did assertiveness training 25 years ago).

She also seems to be enthused with 12-step ideology and asked me several times to read "Codependent no more" (fortunately I found a copy for 1 cent on Amazon) and that would sort things out for me.

I am not codependent, I am not alcoholic, my spouse is not alcoholic or abusive, and our marriage is a happy one, a loving and romantic partnership between two best friends that feels like we're enjoyed a 16 year honeymoon.

I have some personal issues with the cultish religious overtones (I am agnostic), even though they say your "higher power" could be anything, even a piece of furniture. I don't buy into the "we are powerless" stuff, and I don't like how every feeling is reduced to a prepackaged slogan.

I have known 12-steppers in the past, even dated one for awhile, and though he was proud of having stopped drinking and could tell me exactly how many days it's been since his last drink, from what I could see all he'd done was swapped alcohol for gambling -- you could see his eyes light up with anticipation as soon as he started talking about it, just the way you would expect any other kind of addict to look forward to the next "hit". All of his social life revolved around AA meetings, AA friends, and AA slogans. Everyone's an addict, everyone needs AA, anyone who tries to conquer addiction without AA will fail, ad nauseam

There seems to be nothing in AA about learning from past mistakes and putting them behind you and going on with the rest of your life. AA doesn't seem to have any higher success rate or lower relapse rate than any other form of addiction treatment, including deciding on your own to quit doing things that are harmful and stupid, according to some of the research I've seen, and I don't want to become the kind of person that typifies an AA member. That isn't me, and isn't who I want to be.

I managed to get more than halfway through reading "Codependent no more" and found less and less of myself and my issues in each page I read, even though the book is supposed to help "anyone" with "any" kind of problem (therapist said "just ignore the word 'alcohol'"). It's now in the trash, which I almost never do with books, and I'm ready to fire my therapist (in as nice a way as I can) and find someone else. She's a nice lady and I'm sure we could have been great friends in a different context, but the only steps I've felt like "working" so far are the ones out of her office and back to my car after the sessions.

Is it standard these days for therapists to go with generic "one size fits all" therapy (no point asking or discussing with the client what I want to do with this), and to push 12-step ideology to the exclusion of all else? Is CBT just another name for AA and all its offshoots? How horribly disappointing, if so.

Sounds like you might prefer a different type of therapy.

I did not find the 12-step program helpful to me. I also don't find cognitive therapy to be very deep or helpful to me.

I did like this site that has a lot of info on therapies and therapists: www.guidetopsychology.com . Maybe you will find it helpful too.

it sounds to me as if your t is not the best fit for you. i'd look for another one. i also like that link that echoes posted about therapy but if i remember correctly it mostly takes a psychodynamic approach. i'm an ex 12-stepper (adult children of alcoholics although i wasn't from an alcoholic family) and i found it incredibly helpful after trying just about everything else and none of those other things worked for me. but if it doesn't appeal to you then don't sweat it. people are different and need different types of help. i hope you do find something that does help.

with reflection. It doesn't sound like your T is a good fit. The one thing I have learned is that the 1st priority is to find a good fit. It makes all the difference in the world.

I had a really hard time with all the powerless stuff in 12-step programs too. I know it works for some people, but not for everyone. Helplessness and powerlessness have been my themes throughout my life, and I need less of that, not more. There is some good stuff in CBT (which is very different from 12-steps). It doesn't sound like you are getting a lot of CBT. If you are interested in books, you might look for the ones from David Burns for CBT information.

Even though I didn't like 12-steps, I relate to being an adult child of a dysfunctional family. Books on that have helped me, such as "Healing the Child Within" and "A Gift To Myself" by Charles Whitfield. Those books mention 12-step concepts, but are more psychodynamic, and help you to understand how growing up in a way that doesn't allow you to be fully who you are limits you as an adult, and how you can recover.

I don't know what issues you are dealing with, or if you like using books to help with your therapy, etc. I think that your therapist sounds open to feedback on what kind of treatment you would like. It takes a bit to find that out, for both you and the T. If something isn't working for you, tell her. If there is something you feel is missing, tell her that too. Therapy is ultimately work that you have to do for yourself. The T is there to help you with your work, but that's really all that any T can do. The more self-directed you are, the better you will do in therapy and the more it will help you to accomplish your goals.

I'd find another T, one that can work authentically.

doesn't sound like you and your t are a good match. why not do some looking around for another T? many will give u a short 15 minutes to "meet". not all do tho. jme, but i think it' s pretty quick when u know it doesn't fit. no point in going further with this T unless something changes for the better. i have found tht phd's in psycho. are the ones that best meet my needs but this is just for me. let us know how things turn out. i wish you good fortune in finding the t that u are comfortable with and that adresses the needs you feel u have. oh an dond't get discouraged...i met some pretty far out ineffective t's out there as well as good ones,imho.

I'd say definitely find a new T. For starters if your issues aren't with your husband / marriage, why are you seeing a family, marriage therapist?

As for wanting CBT and getting 12 steps pushed on you, that in my opinion is simply professional incompetence, they are two completely different things. Personally I'm a member of AA, and kind of like the 12 steps, but I do have a life outside of AA. The treatment centre I went to was not 12 step based, but rather used a variety of approaches including CBT. I personally found it very helpful, and have since used CBT principles in other areas of my life.

A book that is good on CBT is Mind over Mood. Sorry I can't remember the author, but I got the book off of Amazon. It's a combo text workbook that uses and explains different CBT techniques to look at different emotional problems. It's a standard workbook in a lot of the hospital based CBT groups up here in Toronto.

Good luck finding a therapist who is a better fit.

--splitimage