# CBT no longer working



## TheMachine (Nov 24, 2009)

I'm not sure if this is the right place for this thread but I'll go on.

I've been doing CBT on and off for years now and although there has been some occasions where I had success, it hasn't been overall successful. I still haven't given up on it because it's the most successful psychological treatment out there and I believe I can eventually figure it out and overcome SA and depression. 

The problem is that when I start doing some self-CBT and rationalize my negative thoughts, my mind accepts that the rational thoughts may hold some truth and then I start to develop confidence. 

With this confidence, I'll do things I don't usually do like catch up with an old friend (I have a major fear of phoning/texting friends), go out shopping for stuff and even say hello to random people. Heck, I even strike up conversations with store clerks. I also put in more effort to study and find employment (I'm jobless atm). I even watch tv shows that I never thought I was interested in.

So everything seems rainbows and butterflies at that point. But the problem is that this newly found positive thoughts and beliefs doesn't last long and usually after a few weeks, I lose the confidence and I'm back to square one. 

Then, I try the same methods of looking at things rationally but it no longer works. It's like as if my mind all of the sudden says "Nope it's all a lie or it's all BS" and gets tired of the positive affirmations I feed it. Then I get stuck with anxiety and depression and struggle to overcome them.

I keep trying to rationalize my thoughts and beliefs but my mind is being stubborn and just persists to not accept it as a possible truth.

Is this a common thing or am I doing something wrong? 

I'd like to hear from those of you who've experienced CBT.
Cheers!


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## hoddesdon (Jul 28, 2011)

When I did CBT we were told that there would always be steps backward, but not to lose heart because of that. Everyone experiences steps backwards when learning something new. I can remember a German teacher saying that: there are episodes where you stagnate, where you step back and when you seem to make great strides. I am not sure whether that scenario matches exactly what you are talking about, though.


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## Serephina (Apr 13, 2010)

Putting the CBT to one side(because I don't do it), this is what my life is like and has been for years. I think it's the same for everyone regardless of whether or not they have SA ..... they have cycles of being extrovert/introvert. It's just relative to each person what their 'normal/average' level of extroversion is. 

Those of us with SA just have to work within a different range of extrovert/introvert to others who don't suffer from it.

I tried CBT when I first sought help for depression(about 10 years ago), but it didn't help.


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## Quiker (Apr 9, 2014)

I'm all for CBT, I know statistically it's shown to be effective. I can't personally testify that it's helped me, but I've been giving it a go for about three months now. Lately though, every time I leave a session I feel worse than I did coming in. Does that happen to anyone else? Is that a bad sign?


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## Steinerz (Jul 15, 2013)

CBT just made me feel bad. With no results.


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## Quiker (Apr 9, 2014)

It's all a matter of mindset. If you go into it thinking it won't work, well then you're setting yourself up to fail. But sometimes when your psych makes you rehash and talk about all these serious and awful things, you can't help but get that "I want to curl up in a ball" feeling once you walk out the office. What's the turning point? They keep saying the answer is mindfulness, but that's a practiced state of mind that takes quite some time to achieve...


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## Just Lurking (Feb 8, 2007)

What good can CBT do, or any therapy at all, when all you really want to do is crawl under a rock and die, or be otherwise unconscious or totally unawares?



Serephina said:


> I tried CBT when I first sought help for depression(about 10 years ago), but it didn't help.


Can I ask how severe your depression was/is? Did anything in particular help it? Any alternative to CBT?

Errrgh... pardon me, please, if this is deviating a bit from the topic...


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## minimized (Nov 17, 2007)

It's too bad CBT cannot undo a completely broken brain.


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## Quiker (Apr 9, 2014)

I don't want to cast a dark shadow over this topic. I don't normally feel like I want to crawl under a rock, I've just been finding my CBT sessions unhelpful of late. It's either unstructured free association blither blather that seems to lead nowhere, or I'm directed towards rehashing some painful **** that makes you sit back and revel in how ****ed up you've been feeling for so long. Maybe you have to go through that hurt before you improve? And CBT has helped countless people, I'm sure. I figure a fair number of people on this site can testify to that. I guess it's just a trial and error process. You have to find the right shrink and make yourself more available and accepting of change. 

For instance, from my point of view my SAD and possible Dysthymia (still questioning the legitimacy of my psychiatrists diagnosis) is a result of a series of unfortunate events - I had a ****ty year where bad thing after bad thing happened and I felt like I just developed a bitter tinted lens on life. My psych keeps telling me it's not the events or circumstances that dictate how I react and feel in a given situation, it's how I interpret it. They say 'approach negative situations with curiosity and interest' as opposed to the innate 'run and avoid negative stimuli' approach. This is all well and good, but very much easier said than done. 

There is no easy cure. This **** takes time. And remember, it's not that you're brain is broken. It's just chemicals in the end.


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## Serephina (Apr 13, 2010)

Just Lurking said:


> What good can CBT do, or any therapy at all, when all you really want to do is crawl under a rock and die, or be otherwise unconscious or totally unawares?
> 
> Can I ask how severe your depression was/is? Did anything in particular help it? Any alternative to CBT?
> 
> Errrgh... pardon me, please, if this is deviating a bit from the topic...


I'd come within a whisker of killing myself, got it all planned and the means arranged.

It wasn't so much depression about my personal situation although that was part of it, it was a very deep depression about the state of the world including the situation in Iraq and in Palestine; the extent of cruelty to animals(I'm vegan), the ongoing situation for the poor of the world etc etc. I was put on an anti-depressant(Sertraline) which helped in that I felt I was in the middle of a warm, thick cloud and my brain was all fuzzy too, lol! Plus, I eventually found a counsellor(third time lucky!), who was really on my wavelength ...... I think this is really important if you have counselling, there are so many bad ones around. I saw her weekly(I think), for about 6mths. She definitely helped me move forward quite a bit.

Eventually, of course, the anti-depressants just became an irritant because the whole point of them is that they cushion you while you alter the situation that has made you depressed or it fades to a manageable level(as in a bereavement).

I also went to some group therapy and art classes(about 6 to 8 people), which I enjoyed but eventually gave up because getting there was too stressful.

My current situation is that the deep depression is still there, just underneath the surface, but on a day-to-day basis I am fairly contented and take pleasure in little things. I very rarely leave my home. My hold on life is very very light and I feel as if it would only take one small thing for me to 'leave'.

I don't know how helpful this is for you. My current level of peacefulness is largely due to my age, I think. I wish you well and hope you find your peace .

PM me if you want to talk more about this.


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## Just Lurking (Feb 8, 2007)

Serephina said:


> I don't know how helpful this is for you. My current level of peacefulness is largely due to my age, I think. I wish you well and hope you find your peace .


I know what you mean about the state of the world. It sounds a bit dramatic to say it, but it's true, and it's a contributor to my depression as well (that's not to *blame* the world -- it is what it is, and it's up to the individual to adapt to it and deal with it).

Thanks for sharing your experience, much appreciated.


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## minimized (Nov 17, 2007)

Quiker said:


> I don't want to cast a dark shadow over this topic. I don't normally feel like I want to crawl under a rock, I've just been finding my CBT sessions unhelpful of late. It's either unstructured free association blither blather that seems to lead nowhere, or I'm directed towards rehashing some painful **** that makes you sit back and revel in how ****ed up you've been feeling for so long. Maybe you have to go through that hurt before you improve? And CBT has helped countless people, I'm sure. I figure a fair number of people on this site can testify to that. I guess it's just a trial and error process. You have to find the right shrink and make yourself more available and accepting of change.
> 
> For instance, from my point of view my SAD and possible Dysthymia (still questioning the legitimacy of my psychiatrists diagnosis) is a result of a series of unfortunate events - I had a ****ty year where bad thing after bad thing happened and I felt like I just developed a bitter tinted lens on life. My psych keeps telling me it's not the events or circumstances that dictate how I react and feel in a given situation, it's how I interpret it. They say 'approach negative situations with curiosity and interest' as opposed to the innate 'run and avoid negative stimuli' approach. This is all well and good, but very much easier said than done.
> 
> There is no easy cure. This **** takes time. And remember, it's not that you're brain is broken. It's just chemicals in the end.


I wish. I think it's more than chemicals. There is something there that cannot be replaced after all the **** life piles on. It's just years more of drugs and half-talking to look forward to... can only imagine what kind of damage was done over years of torment and isolation in formative years.


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## Quiker (Apr 9, 2014)

It seems like you and me share the same outlook. That nucleus at every thought, suggestion, and ideation that there's always something bad or something that will go wrong. That where we are now can't or won't change, and that any and all attempts to get to a different state of mind has innumerable obstacles. But the truth is, that's just a frame of mind, the so called antithesis to the rose tinted lens. Sure there will be scar tissue, but as long as we're proactive and seek help, and open ourselves to new ways of thought, all the weight and burden from those formative years can make less of an impact.


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## TheMachine (Nov 24, 2009)

Thanks for the reply guys.

I've realized that with the cognitive part of CBT, you're convincing yourself that the negative thoughts you have is false and the alternative-rational thoughts are the truth.

So basically, you brainstorm some alternative thoughts that seem more rational and fits the context of your situation. Problem is what happens if your mind is so stubborn that it rejects the alternative thoughts and strengthens the negative ones?

Take my mind for example. I get sick of hearing/reading the same alternative thoughts. At first I believe it then I just stop comprehending it. It becomes like 'blah blah blah whatever.' I need to find a way to convince myself that I'm an okay guy and that it's not a big deal.

So say my situation is being scared to do anything. I learn that my problem is low self-esteem. I feel useless and inadequate. I feel like I don't deserve friends and nobody will like me. I also feel like I won't be able to hold a job. Even though these are feelings, they stem from my thoughts about myself and the world around me.

Here's a summary of my thoughts:

Negative thought 1: I'm not allowed to make progress in life. 

Negative thought 2: It's wrong if I get things I want. 

Negative thought 3: Everything I do to better myself ends up backfiring.

Negative thought 4: This society hates me. Nobody is nice. There must be something wrong with me.

Negative thought 5: F*** everyone for not giving me respect. I never did anything bad to deserve to be treated with such distaste. 

So that sums that up. I keep thinking that everybody thinks I'm worse than Satan. Now, I know most of the world don't think this because hardly anybody knows me but it feels like that everyone who meets me or even sees me automatically thinks that I'm like a creepy serial killer or a bad guy. 

Now I do believe that it's how people see me. I've had people who treated me really harsh in the past so it made me believe that everyone thinks this badly of me.

But is it really what people think of me or is it what I think of myself? It doesn't feel like I'm judging myself but I do believe I don't belong in this world because a lot of people don't give me a chance. I feel like its how everyone will see me if they knew about me.

Anyway I've been repeating alternative-positive thoughts to challenge those above mentioned thoughts/beliefs and it does work for a bit then it stops working and I'm left with these negative thoughts.

Am I doing CBT correctly?


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## Quiker (Apr 9, 2014)

I don't think there is any singular right way to do CBT. It's a process, and the entire domain of psychology struggles with conceptualizing and categorizing behavior and 'disorders' into neat definitions like depression, bi-polar, etc... So by no means should you blame yourself if you're frustrated at slow progress with CBT. I myself am frustrated. But it sounds like you're well informed as to the objective approach.

Bear with me here, Psychology is a social science for a reason, and although I have a B.A in Psychology, I am by no means a licensed therapist.

Like you said, there are is the so called dichotomy between negative thinking and the rational/logic realities. They say those who suffer from SAD and depression tend to have a negative thought complex, kinda a feedback loop where any and every situation and event is received and interpreted in a negative fashion. You could be walking down the hall at work and say hello to a coworker and notice they don't respond or acknowledge you. You could think 'they hate me, what did I do to them? Am I ostracized? God I'm so awkward. Why the **** do they have to be so cold?'. That would be the negative thinking, the status quo. What you're supposed to do is take a step back and objectively say 'there are so many scenarios to explain this. They could have not heard me, they could be in a bad mood because of something unrelated to me, etc...'. 

The innate and immediate response blaming yourself is the spark to the powder keg, as far as I see it. You can't turn that switch off and always approach things objectively in the immediate present, but what you can do is take a moment out of your day, when things like this happen, and recall that all the visceral and pervasive negative thinking is simply bare-bones thought. And by this I mean, it's just an idea in your head. It is simply a thought that occurs that has no proof whatsoever to back it up as a truth in reality, and if you let it fester than it will send you spiraling into a negative thought loop, roping in and connecting your own self-reflective thoughts of low self-esteem and social standing. All of these thoughts aren't related on their own, but they become so when you indulge yourself in negative thinking. 

So what they tell me is to simply acknowledge that these thoughts have no real substance. If you can look at a thought like 'this person clearly thinks I'm weird' and tell yourself there is no proof of this, that your perspective is jaded to begin with, and to try your damndest to focus on something else in the moment (meditation, positive thoughts, work, etc...) you might find that those negative thoughts will pass, and as they pass you'll avoid sparking an emotional reaction. Hopefully you see where I'm going with this. If you objectify the negative thinking, assess it as an abstract and unsupported thought, and focus on something real in front of you, you'll find that you can step around and avoid the subsequent emotional response. Granted, it won't work every time, and you have to be persistent, but if you keep it up it becomes more secondhand.


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## Pam (Feb 14, 2009)

TheMachine said:


> Thanks for the reply guys.
> 
> I've realized that with the cognitive part of CBT,* you're convincing yourself that the negative thoughts you have is false and the alternative-rational thoughts are the truth.*
> 
> ...


I bolded some of what you said because it really stood out and I'll try to address it.

I am no fan of CBT. I think it's shallow and doesn't focus on feelings enough. But, it isn't totally useless and can help a little bit if it's done better. It seems like therapists aren't really applying it the right way (from all the negative things ppl have said about it over the yrs I've been here on SAS).

There are actually 5 steps to it (acccording to a book I read a long time ago by Martin Seligman). You never try to just do a 180 and try to tell yourself the opposite of what you believe. If that was possible, no one would need a counselor to tell them to do that. We can't just positively affirm away negative core beliefs. I think they need to grow and evolve into other beliefs. But it doesn't neccesarily take forever.

I think the alternative thoughts you mention should be thoughts that you DO believe, in conjunction with the original negative one. Like on your Neg Thought #3, you could make a small change in the wording. Say "SOMETIMES when I try to better myself things backfire." If you believe that, then it actually should be a little relief. Because it's not EVERYTHING--just some things backfire. This way, you leave room for the few times where things worked out, where you were successful, etc. (and you should try to consciously think about those times) Over time little changes like this are supposed to affect your outlook, which makes you more optimistic and open to trying things, thereby eventually making you more successful. And so on, lol. Sorry if that sounds too simple-minded. But my point is, you only reword the thought a little. Never tell yourself something you don't believe to try to "convince" yourself--you're too smart to be fooled by yourself.  I've told counselors "I'm not dumb enough to believe something I don't believe!"

Your negative thoughts remind me of me. A few of them sound like things that were learned over time from other people? I have PTSD from an abusive and neglectful childhood, and learned to have extremely horrible beliefs about myself. Maybe you have that and if so, you can eventually have new experiences that will convince you that these beliefs are actually wrong. That is supposed to be the behavior part of CBT. Doing something and then realizing how it doesn't support your previous negative thought. Anyway, I can relate to having these beliefs forced on me and then deep down, I don't really believe them, but they are still in there torturing me. Then what happens is they get projected out and now we think the whole world sees us that way too, when really, they don't. Because of #5 on your list where you show anger, and also how you question if it's you or others that really believes these things, that tells me there is some strong part in you somewhere that will fight and win in the end.

A very helpful, entertaining, easy-to-read book that helped me change some of the ways I see things is, LEARNED OPTIMISM by Martin Seligman. He's famous for the "learned helplessness in dogs" psychology experiment. And learned helplessness is a big cause of depression in people (and dogs). Some of your negative thinking above sounds like you might feel not in control of anything either. The dogs eventually learned to resign themselves to doing nothing and laid there and let the shocks come. They had run out of fight. Anyway, the book is really good and he actually teaches you how to be optimistic in a concrete way and it really affects how you feel. And when you feel better, you can think better. It's older, from the 1980s, but if you feel like reading a book, it's good!


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## Pam (Feb 14, 2009)

*Negative thought 1: I'm not allowed to make progress in life. *

I can really relate to this. I came across a Bill Of Rights for Children of Alcoholics or Abusive parents--something like that, and one of them (there were 20) was:

_"I have the right to carve out my place in the world."_

I cried when I first read that because I didn't feel that at all! Am working on it and with support from others I am learning that hey, maybe I CAN have a place here! Just like everyone else! 

*Negative thought 2: It's wrong if I get things I want.*

Who says? Why?

*Negative thought 3: Everything I do to better myself ends up backfiring.*

As I said above you can change this to be more realistic and you will see right away that it isn't EVERYTHING, or ALL THE TIME.

*Negative thought 4: This society hates me. Nobody is nice. There must be something wrong with me.*
*Negative thought 5: F*** everyone for not giving me respect. I never did anything bad to deserve to be treated with such distaste. *

These two show how you are kind of having a back and forth about where to put blame--on yourself or society. Keep getting angry and standing up for yourself. Get mad at who or what ever made you feel this way!

My whole life I always wanted to know what did I do so wrong? What is so wrong with me? (that I was so hated by my father) and I never could come up with a good enough reason. I knew i was good deep down, but at the same time I was living a life that agreed with them that I was garbage. I was so hurt and wanted them to like me. The thing is, it had nothing to do with me at all. It was them, they were (for reasons I'm just beginning to understand) weren't able to see me as an individual whole real person. So, logically, I wasn't _treated_ like one. End result=me with a frucked up head. But I see now--there wasn't and isn't, anything wrong with me. I didn't cause it. And you don't cause others to react the way they do. I hope you can be relieved of that burden sooner than it took me to figure it out!


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## TheMachine (Nov 24, 2009)

Quiker said:


> I don't think there is any singular right way to do CBT. It's a process, and the entire domain of psychology struggles with conceptualizing and categorizing behavior and 'disorders' into neat definitions like depression, bi-polar, etc... So by no means should you blame yourself if you're frustrated at slow progress with CBT. I myself am frustrated. But it sounds like you're well informed as to the objective approach.
> 
> Bear with me here, Psychology is a social science for a reason, and although I have a B.A in Psychology, I am by no means a licensed therapist.
> 
> ...


I think everyone is wired differently so even though people with depression have similar symptoms, they still have different specific issues. There's a whole lot more disorders yet to be classified.

I know that you can look at these situations rationally but my problem is that they relate back to these negative beliefs I hold about myself deep within me. I can see now why I'm convinced that these logical explanations are disregarded and the negative thoughts seem to be true.

It's a lot simpler to change to have alternative views about negative events but changing beliefs is a different kettle of fish. I tried the Dr Thomas A. Richards program and he says that you will believe what you tell yourself repeatedly, provided that it's logical so that your brain accepts it as a possible truth.

In this program he says to add the 'Maybe' and 'Perhaps' to the statements so that it helps the mind justify that it could be the truth. It's like a shift from one side of the line to the other. First you have to get to the line before you cross over. But then even my mind stops listening to and believing the positive statements.

It's a tougher situation to break out of.


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## TheMachine (Nov 24, 2009)

Pam said:


> I bolded some of what you said because it really stood out and I'll try to address it.
> 
> I am no fan of CBT. I think it's shallow and doesn't focus on feelings enough. But, it isn't totally useless and can help a little bit if it's done better. It seems like therapists aren't really applying it the right way (from all the negative things ppl have said about it over the yrs I've been here on SAS).
> 
> ...


Thanks for your reply Pam.

You're right that it's unlikely to all of the sudden start believing the opposite thoughts, that would need a miracle. But I'm not just saying the opposite, I'm saying neutral statements with 'probably's' and 'maybe's' that's supposed to help your mind shift towards the positive beliefs.

You're right that you need to develop positive beliefs you already have. But my negative beliefs are still strong and hard to overcome. Even when I try focusing on the positives, the mind kind of brushes it aside and just focus on the negatives. Even my positive experiences in the past from behavioral experiments get disregarded. It's weird. You're right that we're not dumb enough to change beliefs but it's possible to twist the negatives around.

I'm sorry for your bad upbringing. Mine wasn't the best too but it was both parents and teachers that have verbally abused me in the past when I was a child because I used to behave badly. I think that's where my issues stemmed from. I don't think I have PTSD because I didn't experience anything extremely horrific. I think I do project my own insecurities onto other. It's like 'hey if I think this way about myself and remember all the abused I got in the past, then it must be how everyone views me' and then I try to avoid because I'm ashamed of myself.

I might consider that book although I've tried reading self-help books in the past without much success. I know it's important to have hope and be optimistic to make forward strides in life.


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