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Re: Question for gg. » alexandra_k

Posted by gardenergirl on February 4, 2004, at 23:01:29

In reply to Question for gg., posted by alexandra_k on February 4, 2004, at 19:05:28

Thanks for asking. I am in training right now (4th year in grad school) to become a clinical psychologist. It's interesting that I appear to be CBT oriented in my posts. I'm actually more dynamically oriented. The model that appeals to me most is an emotion-focused one called process-experiential. It is an integration of CBT with humanistic/existential/gestalt, etc. What I really like about it is the focus on emotional re-experiencing that you then tie into the cognitive piece. The model views both as part of a cognitive-affective structure called schemes, which drive what we do, how we feel, and how we think. (I wish I had empirical evidence for you about the existence of these schemes. Wouldn't it be nice if we could see them in the brain?)

I had a very brief experience with CBT many years ago that was disatisfying. A high number of profs in my school, including my supervisor are all CBT therapists. My experience in classes focusing on CBT is that is feels *to me* to be rather empty and superficial. I think this is because I am a really feeling oriented person. I am pretty sensitive to my own emotions, even if I don't understand them. I also think that empathic attunement is one of my strengths in therapy versus listening for irrational beliefs.

My supervisor get into collegial debates all the time about whether feelings cause thoughts/behaviors or the other way around. Today he objected to the "accompanying" when talking about feelings and thoughts. As a CBT, he views feelings as the *result* of thoughts. I just don't agree with this on a gut level.

So, a long-winded, as usual, answer to your question, I see a psychodynamic T for a couple of reasons. First, he was the one assigned to me--luck of the draw. But more important, it really fits for me. I have really narcissistic parents and thus, had a really invalidating environment, especially for a sensitive child like I was (and am). This results in atypical depression, which has been chronic for decades. I'm not sure that CBT would really target the underlying hurt and needs which are driving my depression. I think I really needed my parental transference with my T. It's scary, and I leave sessions feeling really drained, whereas I would leave CBT sessions feeling like, "so now what? I know all that." (I hope that doesn't sound arrogant. It just was too cognitively based for me. I NEED to feel stuff to understand it.)

I certainly incorporate aspects of CBT into my treatment, including relaxation training, occasional homework, and pointing out irrational thinking at times. But I really care more about helping the client to articulate their feelings, and more importantly, to re-experience them with me in session, in order to better understand them and thus use the adaptive information that feelings can give us. Or to have a corrective emotional experience with me.

Does this make sense? Please ask questions if I have rambled too far off track.

It's tough when you do not get to choose your T. If I had a CBT T based on luck of the draw, I wonder if I would have stayed in therapy very long.

Good luck.
gg

 

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poster:gardenergirl thread:309476
URL: http://www.dr-bob.org/babble/psycho/20040131/msgs/309585.html