CBT and DBT.. lack of internal monologue?

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Sunnyboy2
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11 Aug 2015, 2:41 pm

I haven't been in therapy for very long, but for about ten days I was in a 'intensive' partial hospitalization program to better my mental health and they introduced us to both CBT and DBT.

Both of these, given DBT is essentially CBT plus extras, required this.. sort of understanding and processing of thoughts and understanding how to verbalize/self report these thoughts that I was suppose to be having. And going back, it reminded me of the 'stream of consciousness' exercise in language arts back a long time ago in school, you'd take a piece of lined paper and write everything that came to mind following a single internal thought (or that was the concept).. and I had significant trouble producing anything because I didn't/couldn't identify anything..

At rest I do not really think on any particular thing. I may take notice of events happening around me but they often do not strike my brain into 'thought overload'. If there is too much happening, its visual and sound overload. Not thoughts, not internal monologue.. If I had to say anything about thoughts that I may have that I try to identify, or give them any sort of a voice, they're like whispers or they have no voice at all.

My most prominent feeling and emotional state is often fearfulness, but no specific verbal thoughts go with it.. just memories perhaps.. but not words.

I mean, I obviously think. But I just don't have a specific capacity of thoughts to identify to use CBT/DBT in the right way, in my experience so far, I can't come up with things on short notice like what's bothering me or anything like that.. I use a journal now, to help me identify things going on but depressive thoughts were situational but the depression is non-situational. And the depressive thoughts I had yesterday do not pertain to the depression I feel today?

Does anyone else have a lack of internal monologue or know a therapy that might work better for my anxiety and depression? Or do I have to stick with the program I can only half use?



kraftiekortie
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11 Aug 2015, 8:37 pm

Your thoughts are your "internal monologue," even if they don't consist of words, per se.



Apple_in_my_Eye
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12 Aug 2015, 5:38 pm

I think I would also have a hard time with that -- I don't usually have verbal thoughts. Given KK's post, I wonder if it's related to "alexithymia":

https://en.wikipedia.org/wiki/Alexithymia wrote:
Alexithymia /ˌeɪlɛksəˈθaɪmiə/ is a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self.[1] The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating.[2] Furthermore, individuals suffering from alexithymia also have difficulty in distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responding.[2] Alexithymia is prevalent in approximately 10% of the general population and is known to be comorbid with a number of psychiatric conditions.[3]

It seems like that could affect even non-verbal thoughts about emotions. Heck, I even seem to have a hard time realizing when I'm hungry, thirsty or even in physical pain.



Waterfalls
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12 Aug 2015, 5:56 pm

Mindfulness might be an easier approach.



Ettina
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13 Aug 2015, 9:45 am

Sunnyboy2 wrote:
Both of these, given DBT is essentially CBT plus extras, required this..


I'm surprised to hear this. I have some similar issues with CBT, but I've found DBT is working a lot better. It doesn't really ask you to identify thoughts or anything - except maybe in the 'Describe' skill, but that's only one skill.

You might want to check out this website = DBT-Self-Help.



hurtloam
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13 Aug 2015, 2:49 pm

Yes, I had similar issues. I was asked to keep a diary and I didn't know what to write about how I was feeling. I wrote things like "my feet hurt" or "I have a headache" or "I'm hungry".

My therapist read over my notes and laughed. She told me that she had meant for me to write down how I feel emotionally and what circumstances surrounded that. Mostly I don't think about how I'm feeling, mostly I just feel blank or unhappy.

Have you explained to your therapist that you are having trouble putting your feelings into words. They might be able to help you. Talk to your therapist first before packing it in.