Is CBT really worthwhile?

[sandrew255]

Hi All

So I finally went to my GP and was recommended to self refer to a local "clinic", who made an appointment for me to take part in a telephone assessment in order to suggest a way forward or suitable treatment. The assessment was ok. I found it hard to talk about some of what I am feeling to a complete stranger, partly because it is so personal, and so interconnected - everything is a long story. Also, many of the things talked about are things I have never put into words before. Anyway, it happened, and the very nice lady suggested I might attend a series of group sessions aimed at teaching us to change our thought patterns and consequently behaviours using CBT. If that was not effective then we would look at some one-to-one sessions. A couple of days later I received two self help guides produced by Tyne and Wear NHS about stress and depression.

I suppose I feel good that I have actually made a start, but I feel very conflicted about the whole CBT thing.

I have been through the self help guide on depression, and attempted to fill in the sections where you list your own feelings and analyse your thought processes.

One of the statements that really got me wondering was "It is important to remember that you might still occasionally have some of these sorts of thoughts (gloomy, negative) when you are not depressed. The difference is that you would generally dismiss them from your mind."

Is this just poor use of words, or is the aim of CBT to make you "dismiss" gloomy thoughts and focus on positive things? It strikes me that many of the things that are triggers to my "gloomy" thoughts are not things that can or should be dismissed.

Also, the whole thing about getting out, do some excercise, be sociable etc etc - yes I know it will raise my spirits - but is that the goal I am aiming for?

It all feels a bit like taking a happy pill, so you can choose to ignore the reality of things.

I can sort of see that personal issues - eg debt, aging parents, job, hobbies etc can be looked at in a more positive light, but it's wishful thinking at it's most rose tinted to think that it's all hunky dory..

And how do I look at the disgusting state of our society, and the apalling effect of our species on the planet in a positive light?

I can gain some small comfort from the fact that not everything is a total disaster, but is it right to decide to dismiss the stuff that is dreadful in order to make myself feel a bit better?

I think this feeds in to something that is at the root of my dark moods - our culture seems to be all about the individual, and how important we all are, how we all deserve to be happy and live in a perfect house with a perfect family - regardless of the cost, or who/what is paying it.

It strikes me that this self help guide is saying - everyone deserves to be happy, and the way to acheive that is to look on the sunny side, and get out more.

Is this not exactly the same as saying "buck up, old chap - what you need is to do more sport and stop thinking too much"?

What does anyone think? Have I misunderstood CBT? Is the guide I have - CBT for Dummys? Has anyone really benefitted from CBT? Am I just scared to commit to it?

I have a second phone chat in 10 days to discuss how I feel about going forward with these group sessions, and I need to get my head straight.

[Hidden]

Hi

I think it is a matter of horses for courses. I actually agree with you about CBT and would not want to learn to focus on the positives and forget the negatives because I think feeling the reality of my life and situation is healthier and enables me to form relationships where I feel real and can get to know the other person as they are. However many people find CBT useful as for those who like the approach it is excellent at enabling people who like the approach to think differently about things.

You say you do not want to feel positively about some things in your life - I wonder whether you have spent any time in counselling or similar, talking through the things that can't be changed, sharing your feelings and coming to terms with them - usually that involves sharing feelings of anger and ultimately of grief for the sadness of reality. It may be that you accept things alone but sharing them enables a coming to terms that feels quite different and enables a closeness to others through the shared sense of life being difficult and painful at times but still worth having - it's called the depressive position and is subtly different from depression in that it involves sadness rather than depression and does not interfere with the ability to feel deep pleasure and let go of the past. If you think that approach is for you then counselling or talking psychotherapy may be more your taste as it is mine.

If it is, don't ignore CBT as it may enable you to cope better with the negative feelings whilst not diminishing your ability to feel them.

Suex

[sandrew255 in reply to Hidden]

Thanks Sue - that's interesting to hear. Maybe I will go to the sessions to see if it feels more useful in a social situation rather than reading it off a page. It will be interesting to meet some new people anyway. If they are anything like the people on this site then I look forward to talking to them.

Andrew x

[gardengnome]

i noticed an article the other day about a study that showed the majority of regular people do have unwelcome thoughts. What turns the thoughts into depression is what we do with the thought. I wonder if when the book spoke about dismissing thoughts, they meant being sceptical and questioning when intrusive thoughts popped up, the opposite of having the negative ideas spiralling around in your head, getting amplified every time the thought is repeated. i know for myself thoughts can become like a muddy track, everytime i drive over the same track the rut gets deeper and deeper because i have made that thought far too important in my head.

[Hidden in reply to gardengnome]

We receive a negative thought from our emotional mind, & we go with the thought & let it lead us to unwanted emotions & feelings..That's what's called being "lost in thought", & that's what people should try to tackle..The way to combat those thoughts is with mindful distraction, & the more often you do it the less of them your get..You can do anything "mindfully", & so can practice it anywhere & everywhere.

[Hidden]

I went to cbt and found it quite useful to understand some of my behaviours with a view to being able to change them. I found it all very superficial though and no good for deep seated trauma. I think you should try it coz it might help a bit and you have nothing to lose. I will give you an example of cbt. I have a problem with authority and if my boss calls me into the office I immediately think I am in trouble and become a bit defensive. If I am criticised for anything I get very upset and can't take it. The cbt counsellor did a chart showing how the emotions worked ie it was the parent/child thing and a vicious circle. I was shown how to break that cycle by interrupting it mid way through. It has helped me a bit but not a huge amount. Good luck with it. x

[Hidden in reply to Hidden]

What ever you don't like buddy or rather what ever upsets you, is the very practice you need to learn how to deal with it..Your boss isn't the one upsetting you your upsetting yourself every single time, unless of course he was to hit you..So you haven't done enough practice & training yet, it's as simple as that..I mean think about it how do words actually hurt anyone?, how is it possible unless we let them hurt us?..If you give your bosses words power over you, then you are letting his words hurt you emotionally..It doesn't matter whether he's right or wrong about what he says, his words should not make you angry..So believe me you need that guy, because it's something you need to work on..So what you do is you see your boss as practice, & you stand there & see if you can listen to what he says without attaching negative emotions..There's no point what so ever in getting upset no matter what he was to say to you about you, because it won't change what he's just said....If you want to really confuse your boss do this: the next time he says something which would normally upset you, take it & don't react negatively & see if you can stay calm cool & collected..If you can't stay calm walk away, & try again the next time someone upsets you..It's only practice, & it will never come without a lot of it..So see it more of a game, or a challenge if you like.

[Stilltrying_]

Personally I find CBT has its uses but can seem very inappropriate and in my opinion does not work well when you are extremely distressed. For me really I had to deal with what was really causing my depression which is basically how I have perceived myself and how I have related to people.

There are so many therapies out there and it is a question of which one you relate to as being able to help you the most and which one you are currently "ready" for. I particularly like at the moment the idea of the inner child and being kind to the child as I believe it is that part of me that hurts so much and now I understand how it happened and why I hurt and I can make intellectual and emotional sense of things I feel I am pursuing the right path.

CBT tends to concentrate on getting rid of negative thoughts. Other therapies suggest more realistically to see them as something running in the background rather than the star of the show which makes more sense to me .

Also I agree with all your comments about the state of the world. I think it does have a lot to do with some general feelings of depression but I also think that when we are personally happier we can still see the many things that are wrong with the world but not feel so depressed about it.

Let us know how you got on anyway. I would not say not to do CBT; just that if may be just one step or part of the process rather than the whole solution although for some it works very well just as it is, so it is an individual thing.

Gemmalouise

[Hidden]

Yes mate you've misunderstood it, but don't worry that's exactly what i did before i got the gist of it..You don't end up with a positive mind, & that's not what your after..You want a neutral logical thinking mind, that decides whether or not an emotion is appropriate at the time....If you get angry, upset, lonely, jealous, bored, depressed etc etc, this is the cure to it all....For example you mentioned debt, so I'll use debt an example of how your mind will work if you do the training..Lets say your in debt, & it could be A LOT of debt it doesn't matter how much..You can look at it 3 ways you can think negatively & worry about it, even though you know worrying won't make it go away..You can think positive about it even though you know that won't make it go away, & you can keep doing that forever & it will never go..Or you can think logically & neutrally without fear or worry & emotions, & come up with the most logical practical solution to your debt....A better way of putting it is if you we're to realize that every time you got bored, angry, lonely, worried etc you was causing the emotions/feelings yourself by your thinking, could you still allow your self to manifest those emotions/feelings?....At first you will still get the unwanted thoughts/emotions/feelings, but as you practice they will get less & less until they almost vanish forever.....It is completely amazing stuff it really is, but won't come without a lot of practice..This can't be learn't intellectually by anyone it has to be practiced, until your mind is back to normal which is neutral & logical..Your'l know when that starts to happen, because a lot of things just won't bother you like they used to....My example maybe wasn't a good example, but if you give me an example of any problem/worry I'll tell you how someone who's done the training would see that problem.

[21esme]

Hi,

CBT has it's place but for me it doesn't address the underlying problems but is a tool to help to try and manage negative behaviours/ thought patterns. I have been to four CBT sessions with the NHS. It has some use but I find the private counselling more useful for understanding why I am how I am.