CBT: a short-term fix?

I was speaking to one of my therapists about this, as he asked what kind of help and therapy I wanted and had suggested CBT as a possible option. I explained that I’ve had CBT before and that while I fully understand the models, the ideas etc, that I didn’t find it very helpful.

He asked me why I thought that was. I explained that a previous counsellor focused very heavily on the cognitive element – getting me to challenge my thoughts and such. The problem is that my beliefs are firmly held and not simply irrational manifestations of mental illness – they are supported by a whole host of very unfortunate things that have really happened to me over years, decades. They’re actually evidence based. I can’t just ‘un-think’ those things, or tell myself something is false when I really know it to be true. I feel like I’d be doing myself a gross intellectual injustice to even try.

And honestly, I can tell when I’m catastrophising, I can tell when I’m being irrational and when the ‘anxiety/depression is talking’… but a lot of the time I’m completely sound of mind when I’m having my destructive negative thoughts. I can’t simply convince myself of something that I don’t have it in me to believe. My thoughts don’t need challenging, because they’re not actually wrong, or invalid.

I added, somewhat bitterly, that CBT frustrated me as it didn’t deal with any of the issues that I actually wanted to address. It feels like the therapist is jovially suggesting “yes, okay, you have years of trauma and baggage but we’re going to IGNORE all of that and focus on how to make you act like you never went through it! How about that?”

It felt like papering over the cracks to make me more functional rather than actually ‘better’. Worse than that, it felt like that aim (of becoming more ‘functional’) wasn’t even for my benefit at all. It was so that I’d do better at work, be less of a burden to other people, be better able to survive/cope so no one else had to worry. “Fuck everyone else,” I grumbled, “I want to be okay for once. Why can’t that be the aim? Why am I supposed to settle for repressing my trauma so that I can function in spite of my obvious, continued discomfort? Why does it feel like no one even wants me to get better?”

He suggested that since I felt that the cognitive side was pretty useless for me, perhaps we could focus on behaviours I could change. I pointed out to him that that’s pretty hard to do if my beliefs won’t change. He agreed, but pointed out that I could try out behaviours that flew in the face of my beliefs and thoughts, just to see what happened.

“You want me to surprise myself, don’t you,” I mused, “to find evidence that opposes those beliefs.”
“Well, you said yourself – you can’t just unthink them. I’m just inviting you to sit with the feelings you’re having and not run away from the situation, see what happens.”
“I suppose experimenting to find real evidence to undermine them might be the only way to actually start to unpick them.” 
“Something like that. Action precedes confidence, did you ever hear that?”
“But how are you supposed to act in the first place, without confidence?”
“I don’t know, but it comes from somewhere, doesn’t it? You’ve done some things in your life that I’d never have the confidence to do. Even though you weren’t feeling very confident at all. In the moment, you became confident.”
“I guess so.”
“So why don’t we try to find a few ways that you can act, even when you’re not feeling confident. See what happens, and how it makes you feel.”

It still doesn’t deal with the root causes of my issues, but at least it feels more practical and useful to me than the cognitive aspect of CBT. Maybe it’ll grow on me after all.

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2 thoughts on “CBT: a short-term fix?

  1. I really like the in depth nature of this piece. Like you I underwent CBT whilst I was still at university. And again like you, I found its effect limited. Sure it helped me challenge some of the minor anxieties that plagued me, but it didn’t make a dent into the root of the cause itself. It just attempted to deal with the symptoms and not the root cause of it.

    While I would always encourage those with mental health issues to at least give it a go, I would be wary in saying that it’s an elixir to all of their life’s issues. It simply isn’t. Like you said, it tries to teach you how to function in everyday life, not tackle the essence of what makes me feel like hell on most days.

    On a final note, I also hated having to quantify how I felt about my anxiety/depression over the intervening weeks between sessions. It just felt completely useless and I had to force myself to not roll my eyes more than once.

    Anyway, rant over! Just thought I’d give my take on the matter at hand 🙂

    n.

    Liked by 1 person

    • Hey, thank you so much for your comment, and for sharing your own experiences of CBT! I do see the use of trying to restore functioning as a means of getting through life (my therapist points out that life goes on in the time between now and me actually dealing with my issues in all their complexity!) but that’s certainly not all that’s needed.

      Ah yes, did you have to fill out those blasted forms where you score everything numerically? I found those pretty useless as well. Particularly as my answer would completely depend on how bad my depression/anxiety was in the moment I was doing them. But then I feel like it’s one of many short cuts the profession tries to take – it’s quicker than talking to you at length to find out where you really are.

      Side note – I like the topics and issues you raise on your own blog, I’ve followed you as well 🙂

      Like

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