CBT resistant/receptive

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I once had a course of Cognitive Behavioural Therapy. I found I absolutely could not engage with the process or the intentions of the therapist at all. It seemed that I could not accept the models of behaviour and thought that the system seems to be based on. None of the aspects of it hit their mark, despite the therapist's efforts and trying a couple of different approaches. I wanted to know whether this is common or uncommon among people who have tried CBT.

I've had similar experiences to what you describe. I've been in therapy for much of my adult life. The ways in which the CBT talk therapy was supposed to address issues didn't work well for me. I'm autistic, with cPTSD, and have an old brain injury producing a near split-brain condition, and I could discuss cognitive patterns all day and not have the discussion touch my feelings or motivations. And I could also work through changes in behavior that sounded great (for a neurotypical person), but when I would attempt to put those in practice, my feelings or executive function limitations would prevent me from carrying them through. It sometimes felt like I was at the bottom of a well, listening to the therapist chatting with my brain's verbal center somewhere far overhead. With a recent therapist, I found myself frequently having to explain my autism and neurology to her. I didn't feel much connection and I didn't feel validated when I described my experiences. Oftentimes she would have trouble understanding my simple declarative statements or would forget important facts. After seeing her for 8 years I ended up going through a divorce, got laid off from my job, and had some serious health problems in short order and found that when I needed support, she just wasn't there. Just no real connection. I switched to a christian counselor and that's worked out very well - we use drawings and paintings which let me communicate much better and I really feel understood and believed. I can speak well, but deep underneath I'm not very verbal. The new counselor understands my autism and challenges and works with me not to deny them, but to work with them and visualize what are meaningful goals for me. It's been a night-and-day difference, although still quite challenging. Over the years I've had the most success with therapists who were flexible in their approach.

My poor therapist. She tried, but it was a waste of time. She was in way over her head with someone as complicated as me. It's one thing to understand how to treat someone with PTSD, or bipolar, or depression, or anxiety, or autism, but how do you "therapise" someone with all the above? There is no written criteria for that. You just kind of wing it - and fail. CBT was wasted on me as was her feeble attempts at getting me to meditate. How can a mind like mine, which races at 100 mph constantly, be slowed down to focus and concentrate? It can't. That's just the nature of my thoughts. At least the therapist tried.

I tried it for two different things with two different therapists, one for social anxiety/low self-esteem and one for an eating disorder.

The former was just a total wash. I ended up quitting after several months. It's weird; I wanted to not be anxious, but I didn't like not being hypervigilant and anxious, either. It felt safer to assume everyone hated me; I didn't want to run the risk of assuming otherwise and then bothering everyone. I knew my thoughts were irrational (the 'that person I just met for two minutes already thinks I'm a giant boring slob' sort of irrational), but just couldn't get over the fear that my irrational thoughts were right, which didn't exactly provide incentive to challenge them.

The eating disorder one went better, I guess, since there was a tangible outcome--"hey, I didn't actually gain weight from doing X." There's not as much tangible reward for challenging social anxiety thoughts, by comparison. But it took me years to get to the point of where CBT would even be helpful for my eating disorder. Even that was hard, and the temptation to cut corners on the exercises was very hard. I only did it for a few months before I moved, and I quickly went back to old habits soon after.

I don't go to therapy anymore, but CBT would not be my choice if I did go back. CBT is good for when you are certain you want to make a change, can tolerate uncertainty, and are willing to put in the effort. I am generally always resistant to changing because I am afraid of not being able to control or predict the outcome of situations perfectly, so I was not willing to put in the effort.

I generally only seem to make strides when I decide a situation is so untenable that I can't live like this anymore and even the uncertainty of trying is better than the current hell (like with my eating disorder, which I struggled with for years before deciding abruptly that I was going to get better, because I couldn't live like I was anymore. I just hit a breaking point.) Therapy helped support me until I reached that "breaking point," I guess, in that I had someone to talk to while I was lonely and someone to threaten me with hospitalization if I went too off the bender with my eating habits, but it didn't actually do anything to change my behavior.

I'm so glad this poll came up, as I've been pondering this very question lately. I have a long history of depression and CBT has never worked for me. I've often wondered whether AS had anything to do with it, so it's good to know it's not just me. I suspect this is why the vast majority of psychologists/counsellors/social workers haven't really been able to help me; because they're just trained to 'follow the recipe' for CBT, and then when that doesn't work, there's nothing they can do.

I'm going through another spell of depression at the moment, and have now progressed to the point where I have to admit I have a problem and I need help, and thus begins the process of trying to find someone who can actually help me and isn't just generically trained in CBT. I've had enough bad experiences with therapists, this time before I even see them I'm just going to ask straight-out whether they can provide a variety of different approaches to therapy or whether they just do CBT and that's it.

I have had CBT at least once before - around 5-7 years ago, and it was long before I had autism suggested to me.

The psychiatrist had referred me to CBT again a couple of months ago (after he had mentioned I could be autistic) and before the session I had read something that suggested CBT doesn't work very well with (particularly) Aspergers as it's a condition to do with how the brain is wired and trying to change that with CBT doesn't work.
Anyway, we didn't do any CBT because the councillor had seen I had tried it before and when she saw all the notes I'd made about myself relating to autism she basically gave up and said I need to see the physiatrist again...

To me CBT seems to be the equivalent of trying to learn times table through repetition rather than actually learning how it works, and as such I'd say it had no effect on me

I haven't had CBT, but I read a book on it many years ago. I never used the specific practices described in the book, but I've gotten a lot from the basic idea of noticing my thoughts and asking if they are reasonable, realistic, and helpful or not. This has helped me to not make things seem worse than they really are.

I had successful CBT for self harm back when I was 12/13. The therapist specialized in autism and had already been working with me for years.

That's interesting- the only successful CBT I've ever had was with a therapist who specialized in autism as well.

I did CBT before I was diagnosed with (but aware of the possibility of) Asperger's. It was helpful in highlighting my issues with thinking style - catastrophising etc.

It didn't help at all in building confidence to go out and be a party animal. [No surprise there.......]

Agreed.

I've had CBT twice and could not engage with it because it's time-limited, scripted and it doesn't address any deep rooted problems you may have; it's all about changing the way you think. There were times when I wanted to discuss my feelings in great detail and would often go off on tangents, but my therapist's would always bring the conversation back to what they thought was important. Whenever I tried to broach a subject that wasn't in their script, they would either stare at me and quickly change the subject, or repeat themselves. It's difficult to open up to people who behave like indoctrinated robots.

One of the worst things about the whole process was being blamed because I didn't "get better" within a particular time frame and being accused of not wanting to make positive changes. I think it's dangerous to hold vulnerable people responsible when they haven't made any progress. Surely therapists must understand the damage that can do? Why not just appreciate that people are individuals and that what works for one person, might not be suitable for another.

That's amazing, word-for-word, that's exactly what I went through. Thanks for posting that, it's so good to know that it's not just me and not just my fault.

Thinking back my CBT counsellor was OK for the first few sessions when we talked about thinking styles. Quite freindly and chatty. Then towards then end when we were talking about getting out more I now get the feeling she must have realised it was a lost cause. I do remember having the impression that she had "fallen out with me" for some reason.

Probably more likely she was just fed up of reading all that stuff from the booklet (that I could have read myself) knowing it wasn't going to make a scrap of difference.

^ Yes, but I also suspect that it's not only CBT that's the problem; it's the therapist too. If your personality clashes with theirs, then nothing will work, regardless of the style of therapy. It takes time, patience and money to find someone who is the correct fit for you, and not everyone has the opportunity to pursue all of the options available - I know I don't.

I think that society still sees therapy as an indulgence, especially if it's open-ended with no time limit and not just a quick fix. This is a problem because some people need more time to conquer their issues and shouldn't be made to feel like a failure if they don't fit a particular mould.

One more thing... Because those of us on the spectrum tend to be more logical than neuro typicals, maybe that's why CBT doesn't really work for us. If you had a problem that needed addressing and one method wasn't getting results, you wouldn't continue to do the same thing over and over would you? You would explore other avenues and understand that there is often more than one solution to a problem.

I've tried CBT a few times. When I was younger (teens/early 20s), I guess I didn't understand it, or see what I could get out of it, or wasn't in the right place in my life, so it wasn't helpful.

I tried it again a couple years ago, and it helped me a lot on a couple of points. For one, for a long time I've had a low sense of self-worth and did things to make others happy but was unhappy myself. I realized that I had always taken the idea of "putting other people's needs before yours" very literally, as well as the idea of what "needs vs wants" are. These flawed thinking patterns (among other things) were leading me to constantly sacrifice my own emotional well-being and devalue myself. The CBT helped me to really understand I *deserve* to be happy.

So, I think CBT can be a big help, but isn't the solution to every problem.