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Re: CBT vs. Psychodynamic Therapy (Sunny10)

Posted by littleone on November 3, 2004, at 15:04:12

In reply to CBT vs. Psychodynamic Therapy (Sunny10), posted by fallsfall on November 2, 2004, at 20:11:09

I have a few things to say to this, and I think I have to tell them the long way around, so if this is long winded, I apologise in advance.

The first T I saw was CBT orientated. He used to say things to me, and to steal a line from The Castle, all I used to think was "get your hand off it". However, in saying that, I have a real *sense* about people. I instantly know if they are a good person or a bad person. My radar immediately picked up bad person blips from him and I later found out he wasn't the most ethical of T's. So I think it's pretty safe to assume that the therapy failed because of our dynamics rather than because it was CBT.

To be honest, I really believe CBT can be very helpful to people who are kind of generally okay, but might just be having some troubles in some areas, eg either they just need someone to talk to, or if they have faulty thinking patterns. Or alternatively, if they are just interested in getting better enough to be functional again in the shortterm.

If however, you have more widespread problems with dealing with life, eg faulty thinking patterns, difficulties with setting boundaries, difficulties dealing with a wide range of people, etc, I would tend to think that this would indicate a more deep seated developmental problem. CBT can certainly help with the symptoms that arise, but I don't really think it adequately assists with the root problem.

** Slight trigger here **

For example, I'm currently a cutter. I find that if I really put my mind to it, I can stop the cutting for long periods of time. However, during those periods, I tend to do other things instead, like picking a lot or pulling out my eyebrows or whatever. I find that CBT helps with stopping each bad practice, but it really isn't addressing the underlying problem of me not being able to adequately face and deal with bad feelings.

** End of trigger **

After I dumped that T, I saw a psychodynamic T. I have no idea what orientation he took because he would never answer my questions. Kind of the old "and why do you ask" scenario. I can understand why they do this, but I believe it is really wrong that they don't provide you with basic information you are entitled to as a consumer purchasing a service. He was a real blank slate type and I found this so upsetting and offputting. Anyway, I think that whatever orientation he did take, he was very set and limited in his methods.

When this therapy wasn't working either, my GP referred me to my current T. He is a behaviouralist and the GP's logic was that I didn't need to learn that I had p**is envy or whatever, I just needed to learn better ways to cope with the world. I needed to learn new behaviours (which, by the way, is pretty much going back to CBT).

So we started off with Behavioural therapy, then when that wasn't sufficient, he switched to something else (sorry, but I've now forgotten what it was). I personally wasn't really open to that particular method/style and so then he switched to Interpersonal.

I really believe that what has made him a good T is the fact that he is so flexible in the approaches he takes. Some T's tend to find the method that *they* are most comfortable with, not necessarily customising their approach to their individual clients. As Yalom says, you need to invent a new therapy for every client (BTW, don't you just love his work! Although, it often makes me wish HE was my T. :(

I find all the different orientations so facinating, Freud vs Jung vs Horney vs Rogers vs etc. However, I believe they are basically just saying the same sort of thing, but going about it in different ways.

sunny10, it sounds like you have problems that are more deeprooted and probably won't be adequately dealt with by CBT alone. Your best bet is probably not to find a T who concentrates in a particular area, but one who is flexible enough to adopt whatever style and techniques he sees work best for you.

 

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URL: http://www.dr-bob.org/babble/psycho/20041026/msgs/411182.html