Does Cbt Work?

[fstevo2009]

Has anyone had CBT and if so did they find that it helped them?

[hummm_mabbe]

If you are able to form a good, close connection fairly easily with your therapist, then CBT can be effective for a number of things. However, deep issues of mistrust or issues that prevent engaging with the therapy will hinder progress, if not stop it in the case of not being able to form a good therapeutic relationship. The assumption that the patient can form this relationship is a core one of CBT, maybe look it up online as its recognised as one of the weaknesses of CBT for personality disorders. There are a vast array of reasons a person may be 'blocked' in this regard, but especially by trauma.

CBT enjoyed a strong early life of peer review and research, but much of this reputation has been called into question because of recent 'meta-analyses' - that is, the averaging out of results over lots of studies. It has always been known to have a high relapse rate, even when the intitial success rate is good. Meta analysis shows that CBT is not the pancea it was previously thought to be, and other therapies are seen as equally effective.

I guess the short answer to your question is, it can be effective for some, and do very little for others - and the key part of this is the nature of the relationship with your therapist. Despite its reputation as an easily applied, manualised therapy, this doesnt pan out in reality and the relationship is still key. Find a good T you can relate to and trust, and CBT could be the thing that really lights your world up (as I found with my first T). Alternatively it can leave you somewhat underwhelmed and possibly even feeling invalidated (as I did with my second and third T). As you can tell from the number I had, I replapsed after my first therapy experience, even though that experience was extremely good.

CBT has undergone changes lately that make it more emotions focused as a result of blending with compassion and mindfulness based therapies. It has always been popular with the NHS and US medical insurance because it is time limited and easily taught to new trainees.

Its really a case of suck it and see - for some its brilliant, others not, much like anything. Just remember the importance of the relationship - the therapy type is just the structure but the relationship is the foundation and anchor. Make sure you find a T you like and can trust, and open up to. Some people like the idea of CBT because it lets them try to overcome emotional problems without having to go into emotional depth or face troubling experiences. If you prefer to avoid feelings, CBT (at least in its okder guises) may let you do that - but be aware that avoidance of feelings may also be the very problem that needs to be addressed.

My personal experiecne was that CBT was a stage I needed to go through, a step on my journey - but it was just that - a step. It unfortunately reinforced some elements of my character that were actually problematic. Thats not to say it cant be the "whole hog" for others though.

Ross

[roxy222]

has roughly 50% ish sucess rates

very effective for aspects of mh like eds, phobias ocd paranioa etc,

but can manipulate emotions and that never provides a long term solution

what is it that your conisdering using it for?

really its waht you feel most comfortable with thats often most helpful

[fstevo2009]

has roughly 50% ish sucess rates

very effective for aspects of mh like eds, phobias ocd paranioa etc,

but can manipulate emotions and that never provides a long term solution

what is it that your conisdering using it for?

really its waht you feel most comfortable with thats often most helpful

I just want to feel happy again so was thinking about CBT,haven't felt happy for about 3 years.

[Roses]

CBT has really helped me when I have had it to focus on 2 specific things. I had 6 months for relationship stuff as I was failing and it was a real trigger for my SH and OD. Then I have 10 weeks on SH alone. It has helped but it has only scratched the surface. I am hoping to get some DBT or de-sensatisation has been mentioned. We'll see.

[_-Rach-_]

Cbt helped me alot but alot of the "professionals" are starting to realise that you do need to continue with cbt after your first batch of sessions for it to keep working. Instead of thinking a group of sessions will in effect "cure" you...well thats what i have been told recently in an assesment anyhoo

I really bonded with my Psychologist whilst going through it all...and some days i would come out of my sessions so mind boggled i thought it was doing more harm than good...but i couldnt of been so wrong. Things havent been so great lately (i had cbt last year) but thats not to say everyone will benifit from it or begin to feel worse after it, everyones different.

[Ruth24]

has roughly 50% ish sucess rates

very effective for aspects of mh like eds, phobias ocd paranioa etc,

but can manipulate emotions and that never provides a long term solution

what is it that your conisdering using it for?

really its waht you feel most comfortable with thats often most helpful

Jesus thats low! I thought it was higher. It is supposed to be the best way to approach BPD, or so they say...but those stats are quite depressing

[Roses]

Nah the DBT, schema or de-sensitization stuff has been recommended to me xxx

[Ruth24]

Nah the DBT, schema or de-sensitization stuff has been recommended to me xxx

thanks roses. Thats the last time i listen to my sister-a GP who thinks that personality disorders don't really exist and are over diagnosed. God i would hate to be one of her patients! She thinks the solution to BPD is a slap in the face and to pull your socks up-like mother like daughter. I can't believe we have a similar genetic code :)

[Roses]

OMG that is so cave person type opinion. Bloomin' GP's they are called 'general' for a reason you know. If it was up to my family I would never have told a living soul their deep secrets. The one thing I have learnt is that family can't be relied on. The friendships we choose for ourselves are more powerful than we give credit to. xxxxx

[Ruth24]

So true roses. very well said

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

[hummm_mabbe]

Maybe a better question to ask here would be HOW does CBT work? That might help to understand its limitations.

The idea of CBT is that feelings and actions flow from thoughts and beliefs, and that those thoughts and beliefs can be uncovered. By creating a 'supposition' - an alternative to those belifs and thoughts that is 'more healthy', it is then possible to test that new belief by using experiment. By experiencing alternate outcomes in life, the idea is that the change starts to become permanent, leading to 'recovery'. It does and should encourage some emotional experience, but this is not the prime focus.

Its a grand theory, and one that certainly does work within certain constraints. It aims at surface symptoms, and limited specific life situations. Where it falls down is in the realm of deeper emotions and broad character related issues. For example, for some people it is not possible to truly access the core of what is going on for them only through thoughts and beliefs - the emotional turmoil that lies underneath may not actually HAVE words attached to it. Somehow the same things keep happening over and again, and nothing seems to interrupt the cycle. This is common in trauma, and in conditions that have their origins in pre-verbal stages of life - the deeper attachment related issues for example.

I had written a shed load more stuff with loads of detail and examples, but realised it was unlikely to be read at that length. Mabbe if others are interested I will put some of it up, if not I shall just keep it to say hello to when im bored :)

[Dryad]

"if you just saw it this way then you would feel better"

This is exactly what I feel like I'm being told in CBT. It's all well and good to say "Think of it this way" but if your problem is that you can't control your paranoid and untrusstworthy thoughts how can you change them.

I totally agree that it can be helpful for treating specific problems but for me it has been no use really other than to make me feel frustrated at my therapist because I can't just not think things. I've struggled my way through it but if anything I think it has made me worse rather than better.

That's just my experience though I think a lot of people have had a lot of success with it.

xx

[hummm_mabbe]

"if you just saw it this way then you would feel better"

This is exactly what I feel like I'm being told in CBT. It's all well and good to say "Think of it this way" but if your problem is that you can't control your paranoid and untrusstworthy thoughts how can you change them.

I totally agree that it can be helpful for treating specific problems but for me it has been no use really other than to make me feel frustrated at my therapist because I can't just not think things. I've struggled my way through it but if anything I think it has made me worse rather than better.

That's just my experience though I think a lot of people have had a lot of success with it.

xx

Hi Dryad

I experienced the same thing, and in all honesty it has taken me a year and a half of only focusing on emotion, instead of words, to start to see change. For me, the feelings are so hard to define. They can come on the back of a fleeting glimpse of facial expession, or tone of voice. A fleeting 'glimpsed feeling' of a time from the past, that happens so fast I dont even notice it, unless I know how to pay attention. And even when Im paying attention, there can be so many feelings that I dont understand and have no name for - they just arrive in a wordless jumble and I struggle to even begin to define them, to myself or my T. It has taken a very long time to tease those apart and see that there are sometimes 3 or 4 feelings arriving together - so how could I ever have summed them up in a nice neat thought package? It has meant learning to listen to what is going on organically, being with a feeling for long enough that I can understand it, and then start to allow images from the near or distant past to arise. After doing this for a long time, broad pattenrs start to appear, but they are FEELING patterns, not word or action (I think this so do this). They are unique to me, they do not fit a manual. Until I focused on emotion, it was like I was bunged up.

[Suzie87]

I'm quite interested in it, but I'm not big on talking about myself and often find I feel worse when I've been to counselling so I decided against it. My counsellor did suggest this online CBT programme though - Living Life to The Full, it's called. It has print outs and activites and things to do in your own time. I'm slowly working through it, I'm not sure it's helping but I'm just giving everything a go at the minute.

[roxy222]

has roughly 50% ish sucess rates

very effective for aspects of mh like eds, phobias ocd paranioa etc,

but can manipulate emotions and that never provides a long term solution

what is it that your conisdering using it for?

really its waht you feel most comfortable with thats often most helpful

Jesus thats low! I thought it was higher. It is supposed to be the best way to approach BPD, or so they say...but those stats are quite depressing

DBT has about 60% ish and schema 70% ish in terms of success rates, although i have no idea how they work these things out

emotions based therapies have much greater success from what iv came across, although i dont know if there have been % success rates done yet seen as they are only just v slowly creeping back into fashion

really think it depends on what people need though, in my experinec validation from any person goes way further towards healing than any set of ideas, hence the reason why emotions based ts would be more sucessful as they are about dealing with whats going on for someone, being there to support them as they lead, rather than fitting a person around a set of intelectal ideas.

[Suzie87]

What is DBT and schema? Sorry I'm not clued up with these terms.

[hummm_mabbe]

Hi Suzie

Schema is a blend of a number of therapy types, meaning it can apply those parts most helpful to the person. It uses a broad range of emotional, behavioural and cognitive approaches within one framework, and has 'specilaised' sub types for treating personality disorders. Schema was actually developed in response to the realisation that CBT was not helping a lot of people, mostly those with deep set charatcer issues or personality disorder. It kind of draws from just about every type of therapy you can think of, but pulls it together in a co-ordinated way. Those success rates are taken from 3 year long studies of treating BPD.

There are two major types of schema - the mode approach, and the schema approach. The mode approach is more used for personality disorder.

Hope this helps! Although this might feel distressing to you, nowadays there are few therapies that belive you can see much difference by avoiding feeling anything. Emotional avoidance is one of those character related problems that can be so thorny, because if the person will not let themself feel painful emotions, quite often they can get stuck. Schema will ask you to feel, as will most therapies nowadays - even increasingly CBT. It might be worth considering that, instead of whether you can find yourself a therapy that doesnt ask you to feel, that in fact its the fear of feeling that is part of your problems. Therapies that make you feel DO make you feel worse at first, because they stop you bottling it all up and trying to ignore all the pain that keep leaking out when you least expect it. If you are hurting as a result of therapy, that is unfortunately, or fortunately, a sign of progress. This is not an appealing concept to many with PD's, who may spend their lives trying hard not to feel anything.

Ross