![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 91. Go back in thread:
Posted by Dinah on June 2, 2003, at 11:20:19
In reply to Re: CBT and metacognition » Dinah, posted by Larry Hoover on June 2, 2003, at 10:11:40
I was merely remarking on my own experience. Mind you, I didn't have formal CBT therapy at the time.
What happened was this. In my preteens/early teens I basically fell apart. All at once I became the picked on kid at school, we adopted my brother, and various and sundry other stresses. I developed an all consuming phobia/OCD obsession with people vomiting. I became almost agoraphobic. I behaved very badly (acted out). I went to a psychiatrist for a year, and was on thorazine for that time. One day I decided I didn't want to be that way any more.
I didn't have any access to CBT or CBT literature. I was only thirteen or fourteen. But on my own I came up with many things that I later recognized from CBT. And I did them very well. I became functional again. As far as I or anyone else knew, I was just fine.
When I went into therapy twenty years later for a recurrance of my OCD symptoms under the new stressers of marriage, my therapist was very CBT oriented. But he discovered that it just didn't work with me. Because I could believe everything he said with every fiber of my being. I could do the homework. I could say what I was supposed to say, and believe it too. I couldn't possibly believe it more. But it didn't reach deeply enough. I had an intellectual understanding and belief in what he said. I had lived it for twenty years. But I simply could not stretch it deep enough.
In fact, with some OCD self help books based on CBT principles, I pretty much conquered my OCD. Or at least got it under control enough that it was no longer a problem for me. I can sing my obsessions. I can laugh at them. They go away. The panic attacks pretty much stopped. But guess what? My OCD had served a purpose. Without the OCD, other symptoms emerged. My mood regulation abilities destabilized. I went from a relatively high functioning person with OCD to a not well functioning person with my OCD under control.
CBT, with me, had its limitations.
I'm not denying its usefulness. I'm just saying that with some people it works better than with others.
I like CBT, I prefer DBT. But I just think it needs to be seen as a tool, not a cure-all.
(P.S. If I had it all to do over again, I'd take back the OCD and panic attacks, and never have tried to overcome them. I don't know what purpose they served, but whoo-boy, it must have been an important one.)
Posted by mattdds on June 2, 2003, at 11:29:39
In reply to Re: CBT and metacognition » mattdds, posted by Dinah on June 2, 2003, at 10:59:36
Dinah,
My apologies for misinterpreting your comments. I have my own insecurities that sometimes become quite apparent. You see, had I been in metacognitive mode, I might have seen other ways of interpreting what you said <wink>.
I will be the first to admit that CBT works better for some than for others. And you're absolutely right in that it is extremely dangerous to "blame" the patient. But this is not the impression I get from CBT. Perhaps from some misguided CBT therapists, but not CBT in general.
For example, one of the "cognitive distortions" is, in fact, blame! David Burns does a very good job of dispelling the myth of blame (even for treatment failure). Blame is just an extreme oversimplification of a phenomenon that had too many variables for us to see, so we attempt to find a scapegoat. In depression, the scapegoat is oneself. In anger, another person.
You see, you interpret CBT as "blaming" you or "faulting" you. Perhaps you had a therapist that "blamed" you for not getting better. This is unfortunate. I agree that this is extremely misguided, and counterproductive. There have been studies that have shown that therapeutic empathy strongly predicts whether patients will remain in treatment (and subsequently get better)
On the other hand, if I cannot take at least some responsibility for my own recovery, than even the best therapist in the world has no chance of helping me. We need to move past this myth of fault and blame, and work on real problems. Blame (and the guilty feelings that follow) is just another delusion in depression's vast repertoire.
I see CBT as holding me personally responsible for my own state of affairs, but not in a "blaming" or "faulting" way. Again, there is a subtle but definite distinction between "blaming" and "holding responsible". Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
Best,
Matt
Posted by Dinah on June 2, 2003, at 11:39:31
In reply to Re: CBT and metacognition » Dinah, posted by mattdds on June 2, 2003, at 11:29:39
> I see CBT as holding me personally responsible for my own state of affairs, but not in a "blaming" or "faulting" way. Again, there is a subtle but definite distinction between "blaming" and "holding responsible". Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
>
Hi Matt. I'm afraid that that subtle distinction is one of those ones that my mind is not nuanced enough to make. And believe me, there are many. My therapist goes around and around with me sometimes to get me to understand distinctions between things that to me are the same. I don't really get the distinction between holding someone responsible and in some way blaming them for not living up to those responsibilities.The feelings of blame I get came not from my therapist but from the literature. Perhaps if my mind were capable of more subtle distinctions, it wouldn't be a problem for me, but it is. My therapist was flexible enough to back off from the strict CBT approach that is his initial response to anxiety disorders and move to a modality that was more useful to me. He still incorporates CBT concepts. He just doesn't rely on them exclusively.
Isn't that also the main reason for DBT? Marsha Linehan found that CBT didn't work for her target population, in part because of a high dropout rate. So she incorporated other concepts into her DBT so that it would better suit that type of patient.
I always see that as a mark of good therapy - flexibility.
Posted by Larry Hoover on June 2, 2003, at 11:54:12
In reply to Re: CBT and metacognition » Dinah, posted by mattdds on June 2, 2003, at 11:29:39
> Dinah,
>
> My apologies for misinterpreting your comments. I have my own insecurities that sometimes become quite apparent. You see, had I been in metacognitive mode, I might have seen other ways of interpreting what you said <wink>.I'm glad you recognized that. One of the outcomes of metacognition is flexibility. Same facts, different conclusion. Not getting stuck on the first cognition that comes to mind.
> For example, one of the "cognitive distortions" is, in fact, blame!
Blame is nothing more than giving the past a second chance (or more) to hurt you.
>Being held responsible for my own recovery is, to me, empowering! I am no longer the helpless victim, but the master of my destiny.
>
> Best,
>
> MattThe way I would put it is: "Here I am. Now, where do I go from here."
The past can serve as an anchor, or a solid footing for a move into the future.
The past can be informative (by remaining descriptive about it).
If you've suppressed the emotive content surrounding an experience, then releasing that through catharsis can be a liberating experience. If you've ever carried something heavy for too long, you'll know what I mean. Putting it down feels really good. Finally finding a bathroom after a long search for one, is another example.
However, ruminating over situations which cannot possibly change (history is immutable), only serves to reinjure over and over again. Rumination stops at the point of feeling. You never get to the resolution phase. It's a decision, to not let go.
Not trying to convince anyone of anything.
Lar
Posted by Larry Hoover on June 2, 2003, at 12:01:44
In reply to Re: CBT and metacognition » Larry Hoover, posted by Dinah on June 2, 2003, at 11:20:19
> I was merely remarking on my own experience.
I'm sorry. I wasn't trying to convince you of anything. I was trying to show how understanding denial is a key component of successful CBT.
Denial is like holding your finger on a weighscale. You distort the measurement. If you cannot accept that you are even doing that, you most certainly will never come to understand why you have chosen to cope that way.
Lar
Posted by Dinah on June 2, 2003, at 12:14:30
In reply to Re: CBT and metacognition » Dinah, posted by Larry Hoover on June 2, 2003, at 12:01:44
So not trying to convince someone of something is metacognition, eh? :) I always just thought of it as common sense. For the most part I've never found anyone to say "Oh, of course! You're right! Why didn't I see that before?" lol. I always figure you can state your point of view, but not expect anything to come of it. Or as I always like to say "What I do (or say I guess) is what I do. What other people do (or say) is what they do."
Acceptance? (see, I did listen to my therapist)
Posted by Larry Hoover on June 2, 2003, at 12:48:05
In reply to Re: CBT and metacognition, posted by Dinah on June 2, 2003, at 11:39:31
> Hi Matt. I'm afraid that that subtle distinction is one of those ones that my mind is not nuanced enough to make. And believe me, there are many. My therapist goes around and around with me sometimes to get me to understand distinctions between things that to me are the same. I don't really get the distinction between holding someone responsible and in some way blaming them for not living up to those responsibilities.Really excellent issue to examine....
Here's my slant.
Holding someone responsible implies that there are duties or obligations arising from a decision, and that these are implicitly part of the decision. The individual is "expected", I guess, to take that on, regardless of outcome. I would say the responsibility is "built in", a priori. Like criminal law.
Blaming is reactive in nature, flowing from others (or self), based on outcomes. In this case, the responsibility is "added on", post hoc. Like moral indignation.
I'm not suggesting that these are mutually exclusive. Far from that, as both can reasonably arise from the same situation.
Here's an essay on the subject, if you're interested:
http://plato.stanford.edu/entries/moral-responsibility/Lar
Posted by Squiggles on June 2, 2003, at 14:59:02
In reply to Re: responsibility and blame » Dinah, posted by Larry Hoover on June 2, 2003, at 12:48:05
This is turning into a thick subject;
I imagine that many days, maybe months,
maybe years are spent on analysis with
a therapist. Perhaps it helps some people
to cope by learning ways of behaving that
did not know before meeting the therapist.In my case, there would be a number of
obstacles i think why this kind of therapy
is not for me:1. I don't believe that someone with
a psych. degree knows more than i do - i have
two university degrees and almost finished
the doctorate by a course. I'm not bragging --
just saying that i think i have the rational
capability to analyze problems - my problems
are not mine, but other people's.2. My doctor does not believe i need a therapist.
He believes i need drugs.3. My doctor, even if he did believe in
CBT, is not able or willing to take me off
my drugs.4. I have lived most of my life with the
problems and habits i have inherited. I do
not have enough time left now to restructure
my life.5. I know what i want.
6. I believe that i am fortunate to have the
life i have, problem-filled as it may be in
the light of the misery about 95% of the human
race lives in. In a way, i do not want the
yuppy lifestyle, which i think CBT is part of.Squiggles
Posted by mattdds on June 2, 2003, at 20:03:27
In reply to Re: responsibility and blame » Dinah, posted by Larry Hoover on June 2, 2003, at 12:48:05
Larry did a good job with the blame / responsibility thing.
Here's my take, which is very close. I am going to try to make some definitions.
Responsibility - A sense of awareness of one's potential influence on an outcome. This sense of awareness realizes and accepts the implicit limitations of being human. It also encompasses an awareness of other mitigating factors that are involved in the outcome.
Blame - An awareness that gives excessive, and arbitrarily selective attention to the influence one had on a *negative* outcome. It fails to recognize that there were other mitigating factors involved in the undesirable result.
Does this help?
All the best!
Matt
Posted by mattdds on June 2, 2003, at 20:21:21
In reply to Re: responsibility and blame » Larry Hoover, posted by Squiggles on June 2, 2003, at 14:59:02
> i do not want the
yuppy lifestyle, which i think CBT is part of.What on earth are you talking about? This is a sentence, and appears to make sense, but on closer examination is just word salad! How did you make the connection between "yuppy-ism" and "CBT"? I don't see it. All you've done is create a worthless ad-hominem argument. And you seem to be reduced to labeling people!
Also, your argument goes something like this:
A. Yuppies are undesirable people.
B. All CBT'ers are yuppies
C. CBT'ers are undesirable peopleCould you kindly tell me what yuppies are and why they are so undesirable? You seem to take pride that you are not one of "them", and it gives you some sort of moral superiority.
Are all CBT'ers yuppies? Am I a yuppie, since I was helped by CBT?
I feel like this discussion could be really productive. And I'm having a lot of fun. Let's try to stay reasonable, and lay off the labeling.
Thanks,
Matt
Posted by Dr. Bob on June 2, 2003, at 20:36:22
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 20:21:21
> > i do not want the
> > yuppy lifestyle, which i think CBT is part of.
>
> This ... on closer examination is just word salad! ... All you've done is create a worthless ad-hominem argument. And you seem to be reduced to labeling people!Different points of view are fine, but please don't post anything that could lead others to feel accused or put down, thanks.
> I feel like this discussion could be really productive... Let's try to stay reasonable, and lay off the labeling.
Exactly! :-)
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by Squiggles on June 2, 2003, at 20:47:28
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 20:21:21
I mean that the therapy style which is
in vogue now, and suggests an appeal
to the rational (hence cognitive) part
of man, is part of an image of modern man.
The image of man who, through his cogitative
abilities is able to work out his emotional
problems. The image of man who, through
assisted analysis of his habits and the
process through which he has acquired them,
will be able to change himself through his
own bootstraps.It's rehashed Freud, and badly cooked at
that -- as Freud understood that emotional
problems, when not part of psychosis or
biological disorders, were problems of the
irrational part of man. The irrational part
of man, meaning his needs, his drives, his
fears, do not respond to reason. They respond
to compassion, love, and sympathy.Cognitive behaviour therapy is good for
those who do not need therapy at all, but
simply a good shoulder to cry on or a good
friend to speak to. This is an old fashioned
view. It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.As for a syllogism, well i did not think of
it that way, but if i were to put my point
in premises and conclusion, it might look like
this:A. CBT is a yuppie philosophy in psychological treatment.
B. Squiggles does not like the yuppie philosophy.
- Therefore, Squiggles does not like CBT.or
If CBT is a yuppie trend and Squiggles
does not like yuppie trends, then Squiggles
does not like CBT."YUPPIE" is an acronym for "young urban professional"
and perhaps if you are in Britain it is not a common
phrase there. It is basically what happened to
hippies when they became capitalistic and also
were referred to as the ME-generation in the 80s
when ambition, self-determination and economic
control became fashionable again.Sorry, about the labeling; i hope i did not
cause offense. I am speaking for myself and
generally. I suppose what i want to stress
is that in mental illnesses, compassion and
kindness are far more important than talk
therapy; and this is particularly important
when the psychological problem deals with
affective disorders. I suppose i agree with
Hume (the Scottish philosopher), "reason is
the slave of the passions".Squiggles
Posted by Squiggles on June 2, 2003, at 20:51:42
In reply to Re: please be civil » mattdds, posted by Dr. Bob on June 2, 2003, at 20:36:22
I'm not sure whom you are reprimanding
here Dr. Bob, me or Mattdds; but judging
by the past posts, i think you mean me-- *again*,
LOL.OK - i really am not aware of causing offense
at all - infact i thought i was receiving it.But i will try to change my ways - maybe this
is a lesson in cognitive behaviour therapy.Squiggles
Posted by mattdds on June 2, 2003, at 21:56:02
In reply to Re: responsibility and blame » mattdds, posted by Squiggles on June 2, 2003, at 20:47:28
First off, I didn't intend to make you feel put down. Getting my first PBC from Dr. Bob was kind of a downer, I really do try to behave. I just get a bit emotional about this stuff.
>>I mean that the therapy style which is
in vogue now, and suggests an appeal
to the rational (hence cognitive) part
of man, is part of an image of modern man.
The image of man who, through his cogitative
abilities is able to work out his emotional
problems. The image of man who, through
assisted analysis of his habits and the
process through which he has acquired them,
will be able to change himself through his
own bootstrapsSo the main problem is that it is in style? It doesn't seem very popular to me. I feel nerdy and cheesey talking about it to anyone but my wife. Even here, a mental health support board, I get the feeling that everyone thinks it's hokey and that pharmaceuticals are much sexier.
>It's rehashed Freud, and badly cooked at
thatCBT is the antithesis of Freud. Have you read anything at all by Aaron Beck, who is kind of CBT's grand-daddy? Practically the first 10 years of his career were spent debunking the whole Frued thing.
>>Cognitive behaviour therapy is good for
those who do not need therapy at all, but
simply a good shoulder to cry on or a good
friend to speak to. This is an old fashioned
view. It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.I cried on my mothers shoulders for two weeks straight when I was in my second year of dental school. All the psychiatrists at my school had thrown their hands up in the air, wondering what to do. I cried on the shoulder of my wife all year, literally.
It was only after the therapy that I began to improve, and my therapist was anything but a "shoulder to cry on"; he was caring, yet stern and insisted that I should continue on fighting.
>>It is not a yuppy view, as defined by
say GQ magazine or shrill empowerment-hungry
radio announcers.Wait, is this a typo? I thought you just said it *was* a "yuppy" movement.
>>"YUPPIE" is an acronym for "young urban professional"
and perhaps if you are in Britain it is not a common
phrase there.I am aware of what the acronym (and label) stands for, as well as the history behind it. But I was asking more about the connotation, which seemed overtly negative to you. For instance, I am young (just over 25), live in New York City (urban), and will shortly be considered a professional when I graduate from dental school. So by your definition, I am a yuppie. But are these three criteria the ones that make yuppie-ism so terribly bad? I don't ever read GQ magazine and I dress like a slob! And I don't really listen to the "shrill empowerment-hungry radio announcers", whoever they are. So am I a yuppie? Why are you so put off by people that fit these three criteria?
>>I suppose i agree with Hume (the Scottish philosopher), "reason is the slave of the passions".
So do I. But I don't think this issue is totally black-or-white, (almost) nothing is. At times I feel my reasoning is largely driven by emotion. Other times I feel the opposite. This is not out of tune with CBT. CBT is not "thought control", it is just heightened awareness of thinking. CBT actually discourages suppression of thoughts, or attempts at thought control. You are encouraged to be a passive observer of thoughts. Thought intrusions are almost completely emotion dependent, without a doubt. But where we go with these intrusions is what CBT emphasizes. Do we continue to ride the negative pattern out? Or do we choose a way of looking at things that is either more accurate or beneficial?
Lastly, I am absolutely 100% certain that I will not persuade you to my way of thinking. A part of me wants to, my competetive side (the one that got the best of me when I got the PBC from Dr. Bob). But deep down, I know the futility of arguing with someone; it only strengthens their preconceived notions (even mine were strengthened, and I am totally aware I have them too).
See, I wanted this to be a positive discussion, one that would enlighten all of us. I much would have preferred a discussion about *doing* CBT, and the actual dynamics of it. Instead I / we set it up to be a combative, one-upmanship about our opinion on CBT.
Is anyone interested in actually talking about the dynamics of it or techniques, or research, or how it is supposed to work? This is what I wanted. And hope that we can get there.
Out of breath,
Matt
Posted by zenhussy on June 3, 2003, at 0:21:35
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 21:56:02
>>>....Getting my first PBC from Dr. Bob was kind of a downer, I really do try to behave....
>>>Even here, a mental health support board, I get the feeling that everyone thinks it's hokey and that pharmaceuticals are much sexier.
Matt,
First, please don't be bummed by the PBC. You and Squiggles appear to be having a very civil discussion and no one is trying to lob lables and judgements out there. I think you are doing a fine job of expressing yourself and thank you for doing so so clearly.
Second, I do NOT think CBT is hokey nor do I think pharmaceuticals are sexy. I did however get a huge laugh from that sentence. I hope you can get a smile as well from the enjoyment it brought me.
Just chiming in to say CBT is a valuable tool in many cases and my experience with pharm. drugs has not been sexy in the slightest. I mean not in the tiniest iota!
I don't have enough cognition left today to add anything of substance here but wanted to give you smile hopefully.
Take care and keep discussing. Thank you.
zenhussy
Posted by mattdds on June 3, 2003, at 0:55:53
In reply to sexy pharmaceuticals vs hokey cbt » mattdds, posted by zenhussy on June 3, 2003, at 0:21:35
Zenhussy,
Thanks, you have no idea how much that means.
Best,
Matt
Posted by zenhussy on June 3, 2003, at 0:59:30
In reply to Re: sexy pharmaceuticals vs hokey cbt » zenhussy, posted by mattdds on June 3, 2003, at 0:55:53
> Zenhussy,
>
> Thanks, you have no idea how much that means.
>
> Best,
>
> MattGlad to have helped. I just muffed up post on other board indicating to me I need to eat a bit and hit the hay. I am not typing clearly nor thinking (that stopped hours back! ha ha) well so I'll try to gracefully bow out.
zenhussy (tripping over chair as she gets up from pc desk falling across cord under chair, etc.)
Good night Matt = )
Posted by Squiggles on June 3, 2003, at 6:44:19
In reply to Re: responsibility and blame » Squiggles, posted by mattdds on June 2, 2003, at 21:56:02
Hi mattdds,
I think you are absolutely right --- a discussion
about the dynamics of CBT would be more to the
point.My scepticism about its power is based on
an assumption about how we think, not on
experience. So, you should take my argument
with a grain of salt.Also, i did not realize you were only 25 yrs.
old, and that may put things in perspective
a bit - as i am twice your age and very
conservative in my views about psychiatry.Sorry, to be so uptight.
Squiggles
Posted by Larry Hoover on June 3, 2003, at 7:50:06
In reply to Re: responsibility and blame » mattdds, posted by Squiggles on June 3, 2003, at 6:44:19
> Hi mattdds,
>
> I think you are absolutely right --- a discussion
> about the dynamics of CBT would be more to the
> point.
>
> My scepticism about its power is based on
> an assumption about how we think, not on
> experience.More than one assumption, I think.
> So, you should take my argument
> with a grain of salt.Already had to. That's not a put-down. Let me explain.
At times, your thinking seems almost visible, following a predictable course. Thinking patterns are habits.
When you start listing the reasons why a certain conclusion seems valid to you, it is as if you are trying to convince yourself, not us, that your initial reaction is a valid and rational response. Moreover, such a tactic is distractionary, more likely to divert attention to the minutiae of individual propositions, rather than the original point in discussion.
Because thinking patterns are habits, the more ingrained the habits are, the more difficult it becomes to change them. Your conclusion that some people are unable to do this work is not supported by the evidence; it is supported by certain types of habitual thinking. An example, you provided right here:
> Also, i did not realize you were only 25 yrs.
> old, and that may put things in perspective
> a bit - as i am twice your age and very
> conservative in my views about psychiatry.Although rigid might be more precise, I read into this a version of, "You can't teach an old dog new tricks."
> Sorry, to be so uptight.
>
> SquigglesThe quintessential requirement for CBT therapy is a desire to change. If you're happy where you find yourself, or if fear of change exceeds your willingness to change, then you will remain where you are. If the pain of staying the same exceeds the fear of change, then you'll do something proactive.
You said something quite different, yesterday. "Cognitive behaviour therapy is good for those who do not need therapy at all, but simply a good shoulder to cry on or a good friend to speak to." CBT is good for people who are willing to face themselves. And, you also said, "my problems are not mine, but other people's." If you think you'd be happier without problems, or more specifically "other people's problems", you've failed to recognize that you're the one who's not happy. If you can't disempower other people's problems in your cognition, then you're the one with the problem.
These are the dynamics of CBT, as you requested. It really is a dynamic process. You have to act your way through every part. It isn't some dry "couch visit" with an academic. You leave each session with a set of challenging new behaviours to try out (and those behaviours include new cognitions, because thinking is a behaviour).
Methinks you're dismissing something that you would find helpful. Recall from last week my comments vis a vis your parents and their take on your mental illness....you felt relieved by those new thoughts that I offered up. That's CBT in a nutshell.
Lar
Posted by Squiggles on June 3, 2003, at 8:05:55
In reply to Re: responsibility and blame » Squiggles, posted by Larry Hoover on June 3, 2003, at 7:50:06
Well, you write very well, that's for sure.
As i said in my earlier post, i don't want
to continue a critique of the value of
CBT and its merits.For what it's worth, i will say that i appreciate
having the net to exchange ideas. And regarding
my personal problems, i am certain that the
things which are in your power you may be able
to change, but the things which are in other
people's power, you cannot -- only your attitude
to them.Social psychiatry, which is what CBT seems to
fall in, is a lot more like politics than
medical treatment.Squiggles
Posted by Dr. Bob on June 3, 2003, at 22:11:03
In reply to Re: responsibility and blame » mattdds, posted by Squiggles on June 2, 2003, at 20:47:28
> Cognitive behaviour therapy is good for
> those who do not need therapy at all, but
> simply a good shoulder to cry on or a good
> friend to speak to.Please don't post anything that could lead others to feel put down, thanks.
Bob
Posted by Squiggles on June 4, 2003, at 9:50:26
In reply to Re: please be civil » Squiggles, posted by Dr. Bob on June 3, 2003, at 22:11:03
Sorry Dr. Bob,
Being on your site is going to be
a lesson in diplomatic skills.Thank you for holding up a mirror.
Squiggles
Posted by Dr. Bob on June 4, 2003, at 18:52:04
In reply to Re: please be civil » Dr. Bob, posted by Squiggles on June 4, 2003, at 9:50:26
Posted by Dinah on June 7, 2003, at 11:39:22
In reply to Re: responsibility and blame » Dinah, posted by Larry Hoover on June 2, 2003, at 12:48:05
And if I'm responsible for making myself better, aren't I to blame if I don't?
I still don't understand. Can you use baby words?
Posted by Dinah on June 7, 2003, at 11:51:43
In reply to Re: But if I do bad things, aren't I bad?, posted by Dinah on June 7, 2003, at 11:39:22
I have a fear of vomit.
This week we went to the beach, which I associate with Spring Break. Ok, I know it probably isn't accurate to assume that every inch of the hotel, hotel room, and beach was covered with vomit, but you get the idea. Plus people throw up off the side of boats into the ocean.
Ok, I know that spring break was a while ago. And the hotel has been cleaned. I know that the ocean is a big place and fish probably eat the vomit anyway.
I did the right things. I played in the surf with my son, I made sand castles. I slept in the hotel room. My clothes fell on the hotel room floor and I wore them anyway. I let my son walk in his socks aroung the hotel and then get in his bed. I acted ok. I reminded myself of all of those things that I knew that made my fear of vomit unreasonable.
But there wasn't one second there that I wasn't aware that the entire place was contaminated by vomit. As the sand and water got *everywhere* there wasn't one minute I didn't feel contaminated. If you were to ask me if I had a good time, I would say yes, it was terrific. But at some more visceral part of myself I would acknowledge no, I didn't. I could barely sleep and the whole vacation is just surrounded in a miasma of vomit for me. I hated that vacation. I hate going to the beach.
I've been dealing with this fear for close to thirty years. I've exposed myself to this degree many many times. I can hold the bowl when my son is sick without running away screaming. I can do my breathing to keep from panicking.
Can CBT offer me anything else in this area?
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