CBT: has it helped you?

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Okay, one thing which has worked for me is a conscious decision to turn down my internal censor, so that the default setting is that it's probably okay to go ahead and say it anyway, unless it clearly jumps out at me as inappropriate.

Combined with, if the other person needs space, go ahead and give them space, without the intermediate step of asking if they 'should' need space. And then later at my leisure, I can try and figure out if I made a mistake, if the person has issues, and often there's merely a probabilistic answer, at best.

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And then, paradoxically, perhaps raising your standards? You're a smart, intellectual person. Maybe the advanced edge of politics where you run two steps ahead of people, but not more than that? Or something similar. And no reason you can't do fun and meaningful stuff (meaningful in other ways) like animal rescue along the way.

I was religious for about a year and a half when I was 14 and 15. I attended an evangelical Friends church. In many, even most ways, we were more fervent than the Baptists. Read that as: doctrinaire and dogmatic. We believed, although we didn't say this but we did believe, that we had the answer for everything, at least the answer for everything which really matter or that had to do with how you should lead your life.

And some CBT therapists may be the same way. They may believe that if it's not working, you're just not trying hard enough or you're not believing hard enough. Others may have more of a light touch, looking at it as a variety of tactics and methods, some of them work with some people, some with others. Obviously, I think this second approach is better. But even then, I still have real issues with therapy (the therapist is supposed to be smarter than you; this unstated dynamic in which the therapist is supposed to have the final word on what something means to your life).

I left this mindset of religious beliefs, with about a ninth month period that was pretty traumatic, I wish that had been easier. Plus, even after that, I would have tremors of worry that I had offended some divine being, just by living my life. Now, sometimes I have some anger toward religion, of course I do. But generally, I'm pretty comfortable as an atheist / agnostic. Sometimes I even have a sense of humor about religion.

Every time someone has tried CBT techniques on me, this has been what it's like for me:

were i live the cbt therapist said she couldn't work with me as she didn't know how to work with someone with aspergers so i cant get cbt as she said it wouldn't work for me

I argue with what appear to me to be holes in their logic. This does not always go down well.

Very often true!

Cute picture

Ahaha, yes the exact same thing happened to me! After 6 sessions of CBT and the therapist getting confused as she couldn't think of replies to my points and anxieties, she said 'I think your problems are too complex for CBT to treat'. And I haven't been able to get any treatment or 'help' since. I did once meet a psychiatrist who agreed with my problem with CBT and said it was often like putting a plaster over the problem - after a course of CBT the patient can be okay, as long as the plaster stays on, but sooner or later it comes off and they are back to square one, or return having developed a different mental illness due to trying to cover up the problem with hollow 'cognitions' but not actually tackling the problem.

I haven't read all of what you have written Bumble, as I am struggling with concentration and would be overwhelmed with thoughts and then unable to reply if I did read it all as so much of it resonates with me, but I agree with everything I have read so far that you have written. Therefore I am probably not much help anyway as I agree, can't offer an alternative way of looking at it, and talking about CBT just tends to make me angry haha.

I don't mean to say that I think CBT is never helpful; in fact a lot of my own coping mechanisms I use on a day to day basis probably comes under CBT (yes they help me get by, but don't address the underlying problem). But I think that is why I find CBT patronising - because e.g. yes I am well aware that just because I am worried someone doesn't like me, 'looking at the evidence' I can see that the likelihood is that they probably don't 'not like me', or are neutral to me. But my worry is based on the fact that they still MAY not like me, and the CBT therapist to me is being untrustworthy when they tell me 'you are wrong, your worries are irrational'. Because although my worries are irrational in the sense that I get obsessed with 'what if what if what if' and all the different possibilities, I still MAY be right that the person doesn't like me, because of course, not everyone will like me.

I find it odd that e.g. Tony Attwood said CBT is meant to be quite a helpful technique for someone with aspergers because it is a supposedly a very logical way of looking at things. I don't find CBT logical, I find it to be terribly oversimplifying and shallow, to be honest (maybe I just don't know what logic is ). For example once I went to a support group with a CBT therapist running it, and a girl there had been bullied all her life because of the way part of her face looked. The therapist kept insisting that she shouldn't just assume that the people around her are laughing at HER, and that she is probably just being paranoid. This angered me because I didn't think lying to the girl was the correct way to help her. The part of her face that looked odd, looked very obviously odd; that isn't a bad thing, but the truth is the world is cruel and people will make fun or her for that. The therapist encouraging her to believe that her face doesn't really look odd and trying to convince her she's paranoid and wrong (when I'm sure she'd had enough of the same experience again and again and again to validate her belief that she was being bullied); I think I'd feel much more respected and gain more confidence if I was that girl, if the therapist said 'Yes you look unique, and bullies often prey on 'difference', especially if they can see you are already insecure about it. That is wrong and mean but it's just how it is. If people do that to you, they aren't worth sticking around - you can find people who will accept your uniqueness or even find it to be attractive, interesting.'

Another thing I see as insincere attempted CBT brainwashing is when therapists advise people with eating disorders to look in the mirror and repeat to themselves 'I am beautiful'. And they think that if you repeat a cognition enough then you will start to believe it. To me this gives out the message that it is very important to be and believe that you are 'beautiful' by society's standards. I think the message should be again that you are unique; that if you don't match society's vision of 'beauty', whatever that is, then that is fine - you are no less of a person. Also, to look in a mirror and say 'I am beautiful' - what does that even mean? Saying that doesn't change how you look, and don't even get me started on the fact that eating disorders wouldn't be cured by feeling 'beautiful' so again, I think they are completely addressing something that may look like the problem on the surface, but isn't actually the problem as it's the mental illness that is the problem. (sorry, going off on a rather personal tangent - I also have an eating disorder which failed to respond at all to CBT.)

Oh also: When I asked if there was a different therapy I could try, as the therapist herself had been the one to say CBT wasn't appropriate for me, the service said 'If CBT didn't work for you, you weren't trying hard enough and obviously don't want help, so we won't help you'. I think they saw me as awkward and uncooperative. But when I question things I am not trying to be awkward; I genuinely want the person to convincingly explain to me why I am wrong, if I am wrong. And I am just being honest; I cannot pretend to understand something that doesn't actually make sense to me, and I question precisely because I want to understand and help myself. Furthermore, for them to conclude that I wasn't trying hard enough was odd considering my therapist pointing out that my CBT 'homework' was always done by the next session, and very thoroughly so, along with me taking a very active part during the session in thinking about and responding to what she said. Unfortunately top marks for homework with maximum effort does not necessarily equal successful treatment.

I've done CBT and for the most part it has been helpful.

However, there are critical, real-time moments where a strategy beyond CBT would be really helpful. I mean, despite my CBT, I was unable to prevent the break up of an 8 year relationship because the techniques of CBT are not accessible to me during an autistic non-psychogenic seizure (meltdown).

i think what Tony Attwood said about CBT being good for us was that the person doing it has to understand us for it to be useful as we do think differently so it has to be applied in a different way also it didn't help that i know and understand a lot about the mind and the "tricks" used but the fact is most of the problems we have are not caused by the same things as a lot of NTs who go to CBT for the same issues it seems

Picture taken from here: http://hyperboleandahalf.blogspot.com.a ... t-two.html

I take issue with the way that CBT is characterized. It is not something that is done to you by a therapist. It is something you do to yourself. The therapist just explains to you how CBT works. Then you do the CBT yourself between therapy sessions, which means that:

If you are upset, you try to find the event that made you upset, look at the thought that triggered the emotion, and just question whether or not that thought is true. If you find that a thought is not true, you find a more realistic thought to replace it with. The next time that negative thought comes, you use the more realistic thought to cancel out the negative thought. At least that is how CBT was introduced to me. It has helps me a lot with my depression--when I choose to use it. (Sometimes I like being depressed or angry and don't want to question my beliefs.)

There is a big difference in questioning your beliefs and someone telling you that your beliefs are wrong. The latter (someone telling you that your thoughts are wrong) is more like Rational Emotive Therapy which was pioneered by Albert Ellis., not CBT.

If you have a therapist who discounts what you have to say or isn't addressing your issues, find another one! Seriously! A good therapist doesn't try fix you or treat you like a child. They listen (really listen trying to understand your perspective), they care, and they provide feedback and suggestions every once in a while.

But this is what I do naturally. I am always navel gazing (as they call it). I analyse every thought I have as I am very interested in understanding such things as how my mind works, the true nature of reality, perception and how such things come together to form the way I see the world and interact with it.

I feel CBT to be over simplified and find that it moves a person away from truth when it comes to the nature of reality as it too works with too many assumptions and tries to push a particular perception of things onto a person instead (it opts for positive rather than honest as 'Who am I' above touched on....they try to dress everything up in neat fluffy little feel good packages as to them a thought that is perceived as negative is always incorrect. This is erroneous...a thought percieved as negative can be just as accurate as a positive one).

I believe that eastern philosophies are closer to finding the true nature of reality than western ones. IE I'd rather consult a buddhist, they might be able to help me progress with my mediation, at the very least.



I have never come across a therapist who did this!

Plus I analyse so much already I am not sure that encouraging me to spend yet more time in my head analysing is a good thing if they want me to make social chit chat. I will be too busy analysing my thoughts to pay attention to the conversation at hand. And it won't stop at anaylysing my thoughts. Simply asking myself why I feel a certain way or why I am having a certain thought or what that thought means will result in my ending up debating the entire nature of the Universe and life as we know it in my head.

Ie

I can't think of anything to say during this conversation. I am bored, I want to go and do something else. Hummm I don't enjoy social chit chat, why don't I enjoy social chit chat and why do people have to keep pressuring me to talk when I don't have anything to say. When I do I will speak. I wish they would just let me speak when I have something to say naturally instead of trying to force me. Why does the social world have to be this way...can they not interpret my silence differently? Where do all these social norms come from? When did culture start..at what point in human evolution? Was it before we settled? How did our hunter gatherer ancestors live...what did they eat (I am into paleo nutrition so already my brain is back to its preferred interests over chit chat), how accurately can i simulate their lifestyle and diet in today's modern world? Hmm back to cultural beliefs for a moment and where they came from, I should read some books on anthropology, I must go to the library and do that but what about the truth of reality? is the truth of reality the same as the version of reality our culture teaches us via its belief systems or is it different. I suspect it is different...did out ancestors know this difference? Did they see the truth of reality or were they conditioned by their culture too? I need to go do research now....

*leaves social situation to go home*

I also have issues with the background noise at busy places (not afraid of it, no panic attacks just can't hear over it and it hurts my head a bit), don't really register what is trendy socially and what is not, have difficulty keep up with the speed of social interaction such as thinking up replies fast enough (good at missing my moment due to taking too long to think up something to say) and tend to get blank brain syndrome which I don't feel bad about but I do get sick and tired of other peoples constant complaints that I don't talk enough. argh.

The problem is I enjoy my ponderings about the true nature of reality and paleolithic lifestyles more than I enjoy the conversing about someones social status and social game playing. Ergo I am going to keep drifting off to that which my brain finds more fascinating...it is in my nature to be that way. I am really good at spending hours and hours pursuing that which i find intersting but am terrible at getting anything I find boring done.

Plus it feels like too much hassle these days. I mean all this fuss just to find a bit of romance and some congenial conversation about subjects of fascinating mutual interest? All the game playing and f*****g about with social rituals just for a night out at the theater or a day at a museum with company?

I honestly don't know if I can be bothered. Seems like a lot of fuss for something so small.

It is not as though I need someone to live with me or look after me etc, I live alone and want to keep it that way. Any one I lived with would have to be so compatible with me they would literally have to be my one and only soul mate. I like the space and freedom and the alone time that living alone provides.

Ok I take a long time to get around to my house hold chores because I am easily distracted by my fascinations but I get around to getting things done eventually (In my own time a luxury I have when I live alone...i can take all the time I want to get around to doing some things) and I manage to look after myself in the most ways (can feed and dress myself) even if I can't cope with social interaction well enough to work with other human beings.

I wonder if I can self employ from home...

I want to work for myself some how.

Anyway I have lived on my own since i was 17 and whilst I have mostly been unemployed due to my social problems (only really fitted in an academic college environment where people accepted me even if I was odd because of my grades) I can still cope with living by myself all the same. I am a very independent person in that way and don't need social relationships for the purpose of having someone to live with me or care for me. I can dress and feed myself and I like to organise my own day even if I don't organise it in a way that people think I should. They just don't think that having my hobby time is important where as my hobbies mean everything to me...don't try to separate me from them they mean too much to me. I adore my interests and fascinations, I feel so excited by them, I love them so much...and I don't like people insisting I should drop my evening in with them in favour of going out to some social party. Now if they want to join me in pursuing either one of our shared mutual interests or even one of their own whilst we both sit quietly together (if possible) doing our own individual thing that is fine, but (for example) I don't want to stop practicing piano (my lastest precious precious precious precious baby...ooooooo it excites me as does listening to and watching Evgeny kissin...he pulls the cutest faces when he is playing, so cute) just to go make chitty chat and I don't think my therapist will understand that..she will want the change it, they always do, just as they mentioned wanting to change my routines too.

NO NO and NO

I have my routines organised in the way I do to make my life more organised, efficient, and enjoyable.

I certainly don't want my samenesses changes.

This is not what I went to therapy for...I just wanted to know how to get people to back off and accept me for who I am and I wanted help with finding a friend.

I don't want to be something different, I don't want to give up my precious beautiful wonderful passions and fascinations, I don't want to change any routines or samenesses I have....I like my routines too...I wouldn't have them if I didn't. They don't cause me distress, people trying to change me does.

Always trying to make me into something else, more as they think I should be.

Meh CBT might not be right for me, maybe its something else I am looking for.

I share your concerns about CBT.

When I was first referred for, as it turned out, CBT (almost 2 years ago), I went to an initial 1-1 session (as it was obvious from the 'assessment' I wouldn't cope in a group situation) where the person I met with told me she would look into an ASD diagnosis, but that I was to keep this feelings diary until the next session, where I noted how I felt in certain situations and rated them on a scale. This was problematic for me on a number of levels - I have serious issues with identifying and naming emotions (alexithymia), the concept of 'rating' emotions on a numerical scale seems counter-logical to me anyway (assuming I could identify the emotion anyway) and the overriding problem is that I can rarely separate different 'feelings' when I'm upset or in meltdown anyway. I only last 15mins into the second session until she said I was being referred and they didn't deal with ASD/Aspergers anyway.

A few months ago I received a diagnosis of Aspergers. It was recommended I receive CBT, but by someone who was mindful and experienced with the difficulties that people with Aspergers have. I was referred to the same people as before (as that's who the Primary Care Trust use for CBT), even though I told my GP they told me before they don't deal with Aspergers. The initial contact was a disaster - telephone conversation (which I can struggle with anyway) which they were 45mins late in calling for (they knew I have Aspergers and they gave me the time - I don't do well with changes and unplanned/unexpected); I asked for clarification on a couple of questions they asked, explaining I have difficulties with comprehension at times, and was told they "couldn't put words in my mouth" and they just repeated the question; they got very flustered and 'huffy' with me and, even when I said I was incredibly anxious at the time, they did not try to help me at all; then they suggested a series of group sessions or an online course, which is theoretically better (and the option I've gone for, as I couldn't manage a group situation), but in reality is unlikely to provide much help at all.

I'm not holding out much hope - they're going to ask about feelings and changing them, but when you don't understand your emotions this is incredibly difficult. Trust me, I don't think there are many people who want to be a better person more than I do, but I think the fact I don't fit into their neat little box means it's just not going to work for me (oh, I wasn't allowed to say I was different places on their little chart dependent on situations, they could only accept one number). I can't really afford to look for a private therapist either, so support will cease for me.

I think CBT is probably a really effective strategy/therapy for lots of people, but I suspect for many with Aspergers, or who are on the Autistic Spectrum, it just throws up a lot more anxiety and stress/trigger points.

I apologize in advance for quoting the whole thing. I was going to continue to debate the exact nature of CBT with you, but I don't think the problem is with CBT itself. I think your problem is with the therapist and the treatment plan you feel compelled to participate in (a treatment plan that you feel is not helpful).

I have never been told to use CBT for anything other than depression, and it works quite well for my depression. I don't know how well it works for other things, because I have never tried to use it on other things.

I still stand my by assertion. You need to do whatever is within your power to get a different therapist, someone who meets your treatment needs.