# Huge doubts about CBT, should I quit?



## TuckersLaw (Feb 5, 2013)

Hello everyone,

I am new here, I hope it is OK if I jump straight in with this thread. 

I am 28 years old and female. I have been in therapy (for the first time) since early last November. Social anxiety is the major issue for which I am seeking help, however there are accompanying things such as more generalised anxiety, depression, lack of self-confidence, lack of focus, lack of motivation, insomnia, etc., that I also want to get help with. From my readings of these fora I gather that this is not an uncommon 'suite' of issues.

Having been three months in therapy with a practitioner of CBT I am becoming very worried and annoyed that I don't feel any different, don't see any changes in myself or my feelings. I am no better in social situations, I have no self-confidence, I still feel like crap a lot of the time, I feel unmotivated and like my life is going nowhere and is pointless. This is how I felt three months ago. The most noticeable difference is a much depleted bank account.

I feel as though the CBT processes do not really help. The in-session stuff and 'homework' I've been given always seem to be really obvious 'tricks' that just don't work on me, if you know what I mean. I am becoming very frustrated with the tasks my therapist gives me. As an example, this week I was asked to write down, in the form of a personal letter, what advice I would give to a (fictional) child of mine who was in the same position as me and asked me for help. 

I am finding this exercise almost impossible. It is very frustrating for me, I feel silly doing it and I feel somewhat patronised by the apparent gimmick of the exercise. The aim seems to be that I will write up a bunch of sympathetic, rational advice (which will suddenly be really easy because it's for someone else rather than myself) and then I'll be able to look at it and go 'hey, this actually applies to my situation, what do you know, I knew the answers all along, hurrah!'. But the thing is I have tried this. I have tried just talking to myself rationally about my problems. I have tried telling myself there is no reason to be scared of people. I have tried telling myself that I actually can do things I think I can't. I have tried feeding myself a bunch of platitudes. Anything I could possibly write in this 'letter' would be something I have tried telling myself and that hasn't worked. If it worked, I wouldn't be in therapy. It is not that simple. I have not been able to do the exercise and I cannot see the point.

I am supposed to have done this this week and I have to go in and see her tomorrow. I am thinking of just going in and saying I think this exercise is woefully simplistic and unhelpful, saying I don't feel CBT is helping me at all and I might as well save my money.

On top of this I don't feel as though my therapist is giving me anything I really want. For instance, I have said that I have had problems sticking with an interest/career. I have drastically changed life/career directions 5-6 times in the last decade or so and I am sick of doing it. I want to be able to stick with something at least long enough to become competent but I seem incapable of this. I always lose interest and go off in another direction. I want to improve my long-term focus but she does not seem to want to acknowledge this as a valid goal. Our conversations about this consist largely of her trying to convince me that I should accept my lack of consistency. But that is simply not how I want to live my life. I accept that I will never be perfect, but why should't I want to improve somewhat? I feel like my self-confidence would improve if I could develop enough focus to become good at something. I really want her to help me get better at this and if she won't, why am I paying her?

But mostly it is the CBT itself. I feel like the exercises are nothing more than elaborate versions of things I have already tried on myself.

Is it common to feel like this about CBT? Is it just not right for me? Should I just quit?

So sorry for the massive post - I don't really have anyone else to talk to about this.


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## AussiePea (Mar 27, 2007)

The thing with CBT is you need to have 100% belief in it, for it to work. If there is any doubt about the methods or your scepticism of the overall process then it is very hard for the techniques to pay off since they work by you having to really trust what you are practising and most importantly not giving up on.

Given your post I honestly couldn't see it being a technique which will work for you and perhaps you need to try a different approach, perhaps some kind of gradual exposure or similar. It really is just trial and error unfortunately, and it can be very frustrating as a result.


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## socialanxietyfix (Nov 30, 2012)

CBT does work. The difficult part is having the persistence (and perseverance) to get through it. Despite it's simplicity, the actions you're engaging in will help you as you'll be dulling down your social anxiety reactions - one situation at a time.

I recommend you not quit and see the program your therapist is providing completely through. If at the end of treatment you feel absolutely no better, you can always go a different route. However, CBT does have an effect (however small) on MOST people. Like anything though, you have to practice to gain the mental muscle memory (for lack of a better term).


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## starburst (Feb 5, 2013)

Hello to everyone
I have just joined this forum, though I have no official diagnosis, I recognise I have experienced many of the symptoms of social anxiety disorder.


@SpinDoctor
Its quite clear you see as a major problem with your social anxiety/depression condition the deleterious effect it has on your ability to stick to a plan of action stretching over many years, ie a career/life direction. From what you've said I would guess you are quite smart, probably a lot smarter than your therapist, and you have a natural desire to stick with something, and dedicate yourself to it, and thus achieve something worthwhile, something that you value, a cherished goal. There is absolutely no question that such aims can greatly benefit any kind of mental health problems and improve self-confidence, you are definitely on the right track there. 

What your therapist is saying re accepting inconsistency is not quite right - but it could be right in a sense, that is a certain degree of inconsistency WITHIN an overall solid structure of consistency. Its a bit like when artists/designers/musicians break the rules - the reason they are so successful at it is because they understand the rules very deeply in the first place - for example the Beatles were very knowledgeable about the structure of classical music, and they combined that knowledge with 'skiffle' music.

Its not clear from your post what your areas of interest are - but you have to think about what you really genuinely like to do - is it business, arts, technology, literature, etc etc. No-one can really tell you what you LIKE to do, you have to really discover that for yourself. Ask yourself what do you naturally gravitate towards time after time. That is to say, you do this or that thing, jumping around for a while, but is there something that you naturally always return to? Eg do you like to write, or do you like sport/exercise, or reading, or going to concerts etc etc.

What is the essence of your own identity - because in a room full of people you feel more comfortable if you know who YOU are, even if you are totally different from everyone else.

When you cannot stick with anything for very long, and 'switch', it is sometimes refered to as a 'shift of executive control' or a 'locus of control shift'. You begin in one frame of mind, and it cannot be sustained. You slip out of that frame of mind, and actually go into a different identity maybe. It could be because of 'dryness', loneliness, so you have to try and connect with the outside world, share what you do (and technology can help with that).

Ultimately you want to be ONE unified person, with a consistent direction in life. You are smart enough to figure that out, and not accept therapy that is not really working for you. I would not spend money on such therapy, and look elsewhere.

I don't know if it'd be helpful to you or not but some books I read which give some good insights into these problems are :
Trauma Model Therapy by Colin A Ross MD
The Divided Self by RD Laing
Self and Others by RD Laing 

Some of this material is maybe more applicable to the more extreme cases, though it is pretty insightful and interesting for a wider audience also.

There are no easy answers, but keep looking for things that could help you, and don't waste your money on anything that isn't really helping. Everyone is different, and what works for one may not work for another.


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## Sierpinski (Jun 17, 2012)

I have found CBT to be extremely effective for OCD. And I don't think you "have to believe in it 100% for it to work." It works because it works.

But that doesn't mean that it works for SA or depression. The claims made on behalf of CBT for depression have turned out to be questionable: [ http://bjp.rcpsych.org/content/196/3/173.full.pdf ]

People who respond well to psychotherapy are evidently enjoying the placebo effect. One problem with this is that the placebo effect is genetically variable. Without the right allele, you won't have the placebo effect.


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## SVIIC (Apr 15, 2005)

AussiePea said:


> The thing with CBT is you need to have 100% belief in it, for it to work. If there is any doubt about the methods or your scepticism of the overall process then it is very hard for the techniques to pay off since they work by you having to really trust what you are practising and most importantly not giving up on.


Yes, that's what I think, especially based on my experience with OCD.

If you don't have yourself in the right mindset, then CBT may relive some anxiety and make things a little better, but ultimately I don't think you're going to get very far and it's only going to come right back anyway.

e.g. You're afraid of going outside because you feel terrible about yourself. If you force yourself to go out, it'll probably get a bit easier, but if you're still feeling the same way then it's not really going to go away and even though going out MIGHT make you change your mind a little... if it doesn't, then you're still in the same place ultimately.

Thinking the right thoughts alone isn't going to "cure" (or treat or w/e) SA or an anxiety disorder, but neither is exposure alone IMO. I really think you need both.


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## Twelve Keyz (Aug 28, 2011)

yeah, CBT is poop for social anxiety.


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## bottleofblues (Aug 6, 2008)

You remind me of me with one of my own unhappy experiences with a therapist many years ago. I also felt frustrated with the exercises i was supposed to do, i still did them but it didn't change a damn thing. Here's an analogy, like my brain is a tennis court and each 'rational counterstatement' as they call it i use, is like a tennis ball being thrown outside the court from the inside, but there's really thick glass around the perimeter of the court so no matter how hard i throw it it or how many, the balls just don't get to the other side.
I can see them from the other side, i can hear them but they don't get through, they just have no effect. They bounce off an impenetrable wall of resistance. I would stick it out and try and give it as much of a go as you can, it might work for you or it might not. But if it doesn't you're not exactly an anomaly, you'll join the legions of others like me who have found this therapy to be about as useful as tits on a bull.


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## MrWibblyWobbly (Mar 2, 2012)

The problem with how a lot of CBT is being carried out these days is that it has become the go-to "brief therapy." Basically, success is defined as how fast the therapist is able to get the patient up and functioning again -- not on the specific problems and path of healing that you might need as an individual. This is really a shame because the original forms of cognitive therapy, those developed by Drs. Aaron Beck, Albert Ellis, et al., are actually pretty brilliant. But it REALLY gets watered-down and over-simplified by therapists who, much of the time, haven't actually received much training in the nuts-and-bolts underpinnings of cognitive theory. So what you get, much of the time, is basically someone who present you with a grab-bag of different techniques to counter your thinking patterns... but it's extremely superficial.

This is what you would expect if you received CBT from someone trained under Aaron Beck at UPenn:


Some analysis of your childhood/upbringing, and examination of the core beliefs and mental filters that you developed from that experience. You wouldn't delve into the past as much as insight-oriented therapies (like psychodynamic therapies), but just enough to get a sense of why you have the beliefs that you do and learn to have some compassion and self-understanding to be patient with yourself.
Some explanation of the cognitive model of therapy: how thoughts work, how cognitions interact with physical sensations in the body, how thought patterns develop and affect your behavior. If your therapist received training more recently (or engages in continuing education), he/she may also be well-versed in the neurobiology of depression, anxiety, trauma, etc. and use that to help elaborate the therapy.
Then a targeted, personalized action-plan that addresses your desires and goals. The therapy will then be designed to help you move in that direction, and target any self-imposed obstacles skillfully.
The actual therapeutic interventions, meant to tackle thoughts and behavioral patterns that are getting in your way. These can include the sort of thing you're describing (writing a letter to someone in a similar predicament), but it should identify and target repetitive, recurring thoughts of yours, and ultimately foster what's called "de-centering" - the ability to live outside your thoughts. More recent versions of cognitive therapy integrate mindfulness meditation, which I've personally found very helpful.
If you're like most people who get CBT, you're probably not receiving anything like what is desribed above. If that's the case, I'm sorry. Perhaps take a look at some of the better books written about cognitive therapy to "fill in the gaps" that your therapist isn't really addressing. _Feeling Good_ by David Burns is actually pretty good. Anything by Aaron Beck himself is also a good read, though might be a little technical.

Another option is ACT (Acceptance and Commitment Therapy). I think this might be a better match for you because it focuses, not on logically arguing destructive thoughts and feelings, but accepting them, and learning to live a full life in spite of them. I've personally found ACT very helpful, although I still use some of the CBT stuff. If you'e interested, I recommend _The Confidence Gap_ or _The Happiness Trap_ by Russ Harris. Because of it's more action-oriented approach that emphasizes personal values and goals, I think it might better address what you're looking for.


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## roblox (Jan 22, 2013)

I also read up a little on cbt and frankly I don't think I want to try it. I don't like talking to people especially about my feelings. I mean how do they expect this to cure social anxiety if someone like me doesn't want to bother with talking to someone?


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