CBT not really working... - Social Anxiety Forum
 
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post #1 of 8 (permalink) Old 12-15-2012, 11:52 AM Thread Starter
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CBT not really working...


Hi, i've been reading this forum for a while but I've never posted.
I'm posting it in this forum because although social anxiety has a fair impact on my life it is the result of 'body image problems' which is what the therapy i've been getting has been focusing on. I was only down to have 6 sessions of CBT but after the 6th (this week's) we agreed that it will carry on, I would guess for another 6 weeks but it hasn't been stated. My problem with it is that I totally get it and get what I should be doing to try and change things - I can recognise where I think negatively and see how it affects my mood, and that in order to feel better I have to challenge those negative thoughts. But understanding that and actually being able to DO it are two completely different things and i'm finding it near impossible because I really am ugly, I look disgusting in the mirror, I feel like it is just lying to myself if I consider otherwise? I have a break from therapy for a couple of weeks now and I told my therapist i'd try really hard to challenge all my negative thoughts so I can work hard to 'unstick' myself but I just have a constant stream of them and really bad habits of comparing myself to people that I don't know how to stop practically, and I'm so scared its not going to work and i'm going to be stuck miserable and alone all my life, everytime I try and think positive (about my appearance, my personality, uni work, the future) the negative just creeps in and I end up getting frustrated with myself for not being able to be positive and scared I won't be able to change and bursting into tears and then that just makes me feel defeatist about it and I want to try even less. He keeps asking me "do you WANT to get better?" which I find really irritating because of course I do or I wouldn't be going to the sessions?! I just need some guidance about how to actually go about it because it just doesn't seem to be working for me at the moment, I keep trying but I just feel a bit hopeless...
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post #2 of 8 (permalink) Old 12-15-2012, 11:31 PM
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I've done CBT before. I was in Dialectical Behavior Therapy. Worse 5 weeks of my life. One of the boys took a liking with me a definitely affected my mood in a negative way. He later showed me a list of people he was going to kill. What's worse is that he (like me) was conducting social human experiments... And using me and this other girl as the subjects. The other girl and I didn't know we were just subjects to him. I don't know, I just don't feel like you should have to pay to talk to someone (therapist). I understand it is THEIR time. But if you need to rant/vent, Internet (to me) is the best place.

A lot of the concepts in CBT are just basic. It's crap you already know. Like, the "PLEASE" or "IMPROVES" thing. It's crap that's on the Internet. I regret ever having to pay for that bullsh!t. Seriously, I googled word-for-word some of the worksheets they gave us, and I found it. The little "workbook" they gave us were just random PDF files from the Internet.

Solution: Don't try to make yourself positive then. Live with being negative. I feel that people who are pessimistic are more...Intelligent because they understand things going on in the world which would normally depress someone. I'm not talking pessimistic like trying to bring down everyone else (although this does sometimes happen), I'm just saying you don't need to force yourself to be positive.

I felt like a nut doing some of the crap my therapist told me to do, and got mocked and made fun of more for listening to her.

And yes, you are lying to yourself by forcing yourself to be optimistic.

The sessions aren't going to make you better. You actually doing the work that they assign you will make you better. You already pointed out that understanding what needs to be done for improvement and actually doing what you understand are different.

The only advice is to actually do it.
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post #3 of 8 (permalink) Old 12-16-2012, 12:25 AM
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You may be hitting a plateau....or progress may not be noticeable at the moment.
I would not stress about it. Just focus on what you can do.

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Live and HELP live is better!

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post #4 of 8 (permalink) Old 12-17-2012, 10:03 PM
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expecting to see SA or BDD improvement after 6 sessions of CBT is like expecting to lose 30 pounds after going to the gym 6 times.

If you've had BDD for a long time and it's deeply ingrained, then you're in this for the long haul. Expect to see about a half-inch of change after 3-4 months of CBT, and a little more than that after a year.
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post #5 of 8 (permalink) Old 12-18-2012, 06:33 AM
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Quote:
Originally Posted by lolarose View Post
i'd try really hard to challenge all my negative thoughts so I can work hard to 'unstick' myself but I just have a constant stream of them and really bad habits of comparing myself to people that I don't know how to stop practically, and I'm so scared its not going to work and i'm going to be stuck miserable and alone all my life, everytime I try and think positive (about my appearance, my personality, uni work, the future) the negative just creeps in and I end up getting frustrated with myself for not being able to be positive and scared I won't be able to change and bursting into tears and then that just makes me feel defeatist about it and I want to try even less. He keeps asking me "do you WANT to get better?" which I find really irritating because of course I do or I wouldn't be going to the sessions?! I just need some guidance about how to actually go about it because it just doesn't seem to be working for me at the moment, I keep trying but I just feel a bit hopeless...
Hi Larose, Let me see I can help.

CBT can be a very fruitful therapy option. Unfortunatley it has some limitations which can often be worked around by an experienced therapist.

From your description, It appears that you have come across one such limitation.

It is sad that you therapist asked you the question-"do you WANT to get better?" This quesion assumes that you are not trying, when in actual fact you are most likely doing the best and getting frustrated that your best is not acheiving what you want. This can eaosily lead to a feeling of hopelessness.

How can we challenge or stop thoughts that seem to have a mind of their own. Quite often any sort of self-challenge will naturally become sabotaged by the tendency to be self-critical because our efforts are not working well for us.

Ironically self-critism is negative thinking too and negative thinking cannot really work well as a tool for stopping negative thinking.

In addition, when we are prone to any form of emotional difficulty, the inability to challenge negative thoughts is created from not having enough of What I call the "mental muscle" required to stop certain thoughts.

These thoughts are not like other thoughts because we have become so sensitive to them that they just pull us in regardless of our efforts to control them.

What's more these thoughts are so powerful that they seem to force us to behave in certain ways in order to cope.

Any muscle that is not used for a long periord of time naturally wastes away. before the muscle can be useful again, we have to do some regular work to build it back up again.

The brain can be likened to muscle as well. If we grow into a habbit of letting sensitive thoughts drive us, our mental muscle for dealing with these sensitive thoughts grow weak. Unfotunately, many people grew into the habit of beign driven by sensitive thoughts from their childhood, as such their mental muscle would naturally be very weak when they come across these thoughts.

Fortunately just as with physical muscles, there are practical things we can do to build up our mental muscle so that we can have more staminar and be in better control of what our mind does.

These strategies help us be in the driving seat of our thoughts so we have the control to decide what thoughts we want to follow through or ignore.

As a CBT practitioner myself, I regularly use these strategies as an aid to CBT to help people break through the barrier of challenging negative thoughts if they find this aspect of therapy too challenging.

They are:
  • attention training
  • mindfulness and meditation: I find these two exceptionally helpful for gaining control over negative thinking patterns.
  • Compassion focussed CBT
You can do a google search on them if you want to learn more about them.

Our perceptions in life are the true sources of stress not life itself.
Deal with stress and avoid stress dealing with you.
Adewale Ademuyiwa
http://www.stresstherapist.net/fighting-anxiety-disorder.html
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post #6 of 8 (permalink) Old 12-18-2012, 02:11 PM Thread Starter
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Originally Posted by ToucanSam View Post
expecting to see SA or BDD improvement after 6 sessions of CBT is like expecting to lose 30 pounds after going to the gym 6 times.

If you've had BDD for a long time and it's deeply ingrained, then you're in this for the long haul. Expect to see about a half-inch of change after 3-4 months of CBT, and a little more than that after a year.
But this is free treatment on the NHS, and I guess they wanna push you through as quick as possible. I'm not feeling good but i'm not totally housebound or anything like some people might be, so I don't know wether they would take things any further if I dont suddenly have an epiphany in the next six weeks... probably just send me away, which is a shame because I really feel like I could do with the support at the moment. I'm scared things might get worse if I just go back to having to deal with it all by myself again. The leaflet my GP surgery sent me about the service says they offer up to 12 sessions...

Also, this will probably sound silly, but i've not actually been officially diagnosed with BDD, just low mood and anxiety owing to poor body image. I've suspected I have BDD for a while, cos before I went to the doctor I tried using this book and a lot of the compulsions listed as BDD symptoms mentioned match. But i've never raised it with a doctor beyond the fact that I absolutely hate the way I look and the way it effects my mood and in social situations, because I don't want them to think I'm self-diagnosing or something, and the right questions have never really come up.
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post #7 of 8 (permalink) Old 12-18-2012, 02:19 PM Thread Starter
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Originally Posted by exrovite View Post
Hi Larose, Let me see I can help.

CBT can be a very fruitful therapy option. Unfortunatley it has some limitations which can often be worked around by an experienced therapist.

From your description, It appears that you have come across one such limitation.

It is sad that you therapist asked you the question-"do you WANT to get better?" This quesion assumes that you are not trying, when in actual fact you are most likely doing the best and getting frustrated that your best is not acheiving what you want. This can eaosily lead to a feeling of hopelessness.

How can we challenge or stop thoughts that seem to have a mind of their own. Quite often any sort of self-challenge will naturally become sabotaged by the tendency to be self-critical because our efforts are not working well for us.

Ironically self-critism is negative thinking too and negative thinking cannot really work well as a tool for stopping negative thinking.

In addition, when we are prone to any form of emotional difficulty, the inability to challenge negative thoughts is created from not having enough of What I call the "mental muscle" required to stop certain thoughts.

These thoughts are not like other thoughts because we have become so sensitive to them that they just pull us in regardless of our efforts to control them.

What's more these thoughts are so powerful that they seem to force us to behave in certain ways in order to cope.

Any muscle that is not used for a long periord of time naturally wastes away. before the muscle can be useful again, we have to do some regular work to build it back up again.

The brain can be likened to muscle as well. If we grow into a habbit of letting sensitive thoughts drive us, our mental muscle for dealing with these sensitive thoughts grow weak. Unfotunately, many people grew into the habit of beign driven by sensitive thoughts from their childhood, as such their mental muscle would naturally be very weak when they come across these thoughts.

Fortunately just as with physical muscles, there are practical things we can do to build up our mental muscle so that we can have more staminar and be in better control of what our mind does.

These strategies help us be in the driving seat of our thoughts so we have the control to decide what thoughts we want to follow through or ignore.

As a CBT practitioner myself, I regularly use these strategies as an aid to CBT to help people break through the barrier of challenging negative thoughts if they find this aspect of therapy too challenging.

They are:
  • attention training
  • mindfulness and meditation: I find these two exceptionally helpful for gaining control over negative thinking patterns.
  • Compassion focussed CBT
You can do a google search on them if you want to learn more about them.
Thank you, you've explained this well. I'm will look those things up
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post #8 of 8 (permalink) Old 12-18-2012, 10:32 PM
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Originally Posted by lolarose View Post
i've not actually been officially diagnosed with BDD, just low mood and anxiety owing to poor body image...I don't want them to think I'm self-diagnosing or something, and the right questions have never really come up.
alot of people get hung-up on their diagnoses, so some therapists avoid them, because they have a tendency to become self-fulfilling prophesies. People with emotional/mental disorders tend to have self-doubt and a poor self-image, and thus are susceptible to the power of suggestion: if a therapist diagnoses a patient with XYZ disorder, then it just reinforces any suspicions which the patient already had, and presto! - he wakes up one day with an acute case of XYZ.

This forum is overflowing with threads titled "I think I have xyz", self-diagnoses based on a Google search, a peer's comment, or a hunch. There's an old saying that "the patient who diagnoses himself has a fool for a doctor". So, leave the diagnosing to your therapist; your job is just to sit there and cry your eyes out, and to be 100% candid and honest with them. If they don't diagnose you with BDD, then breathe a sigh of relief and say a quick prayer of thanks. Then, get on with your therapy.
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