![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by jay on March 12, 2003, at 20:21:50
I have found one of the reasons many of us have a tough time with CBT is often our lack of chance to practise it, even with the 'homework' assignments. That is, practise what we have learned. Dinah mentioned difficulty in translating CBT to more self-actualised goals and progress.(Not really being able to internalize and process what has happened.) I think there is another type of therapy can compliment CBT and may be better for developing just that, creating more inner-awareness, but I'll save that for a separate topic.
Depending on your goals, finding a friend, relative, someone you can practise some of your skills with can increase your confidence in achieving your goals. The whole idea here, and this can be a bit self-defeating if you don't pace yourself comfortably, is self-management. There are some CBT counsellors who may even likely teach you how to administer certain aspects of CBT so you can use them down the road. In many ways, a CBT counsellor takes on more of a "mentoring" role, rather than an expert role.
Is anyone in CBT right now who may want to share in respect to goals? Or, does anybody want to just throw out an example of a goal, real or fictional?
(I would, but I'd like to work with others on this. I myself am in the process of starting CBT, and am fishing out some basic goals to start with.)Jay
Posted by PuraVida on March 12, 2003, at 23:06:04
In reply to CBT - Using it and putting it into action..., posted by jay on March 12, 2003, at 20:21:50
I have posted to this ... where is it??? AGH! :)
PV
Posted by PuraVida on March 13, 2003, at 0:09:11
In reply to Re: CBT - Using it and putting it into action..., posted by PuraVida on March 12, 2003, at 23:06:04
I hope this time this gets posted. Earlier this evening I wrote an example of my first experience with my distorted thoughts - mainly "shoulds" - don't know where it went - I'm SURE I hit confirm!
So, here is not so much a goal as a problem: I have been stressing because I have been active as a volunteer in a non-profit, and I'm not sure I want to continue. I do believe volunteer work is good for me (+1) and I can use it career wise (+1) but...I am frustrated. I got involved in this org. because it was worthwhile and needed help - it was dying, and run by a clique. I had not joined years before because of this. But I thought - maybe, I can make a difference. I have -we revived the club, last year, that is. But the old guard is still making blatently obvious "suits me" decisions, and I am the only one who speaks up. This year no one has renewed yet, and the board (I am on it) is making more dictator-like decisions to a dwindiling club. Thing is, this club is just a part of a larger community, and I am beginnning to get embarrassed that I am part of this self-serving board.
So, I want to quit - but this is where the CBT comes in. My shoulds, and others kick in - you just are too much of a perfectionist - that is the way life is! If you feel so strongly - stick it out - unless you are too weak... If you had better people skills, you could bring them around. SO, I say, no - I am not comfortable with this - I take a stand. But then - I think, I'll just go somewhere else, and the same will happen again. Is it me?
So, HELP is appreciated on the previous, if anyone has time or inclination to follow. I';d love to know candidly what you can see, CBT-wise, in my thoughts.
Thanks,
PV
Posted by jay on March 13, 2003, at 12:44:20
In reply to Re: CBT - and me- - a query, posted by PuraVida on March 13, 2003, at 0:09:11
> I hope this time this gets posted. Earlier this evening I wrote an example of my first experience with my distorted thoughts - mainly "shoulds" - don't know where it went - I'm SURE I hit confirm!
>
> So, here is not so much a goal as a problem: I have been stressing because I have been active as a volunteer in a non-profit, and I'm not sure I want to continue. I do believe volunteer work is good for me (+1) and I can use it career wise (+1) but...I am frustrated. I got involved in this org. because it was worthwhile and needed help - it was dying, and run by a clique. I had not joined years before because of this. But I thought - maybe, I can make a difference. I have -we revived the club, last year, that is. But the old guard is still making blatently obvious "suits me" decisions, and I am the only one who speaks up. This year no one has renewed yet, and the board (I am on it) is making more dictator-like decisions to a dwindiling club. Thing is, this club is just a part of a larger community, and I am beginnning to get embarrassed that I am part of this self-serving board.
>
> So, I want to quit - but this is where the CBT comes in. My shoulds, and others kick in - you just are too much of a perfectionist - that is the way life is! If you feel so strongly - stick it out - unless you are too weak... If you had better people skills, you could bring them around. SO, I say, no - I am not comfortable with this - I take a stand. But then - I think, I'll just go somewhere else, and the same will happen again. Is it me?
>
> So, HELP is appreciated on the previous, if anyone has time or inclination to follow. I';d love to know candidly what you can see, CBT-wise, in my thoughts.
>
> Thanks,
>
> PVOK..I'll take a few shots, but remember that my interpretation just like with medication is subject to YMMV..so I hope others join in as well. :-)
Let's start from scratch. You outlined a general goal (volunteer) and said is was worthwhile to you because a)would help your career and b)is good for you.(These are a bit vague...but am I right to assume the second part meant you would receive "satisfaction" from volunteering?) Does that sound right to you? Just checking. What is really important here remember, is to focus on yourself and your reactions and behaviour. Reason being, it is all about you positively benefiting from the situation.(And remember, this doesn't mean I nor anyone is discounting what other people do to you.)
So, you volunteered, but immediately encountered difficulty with your personal relations to others in this organization. So those where roadblocks to you receiving part b of your goal, that you would receive satisfaction from your action/behaviour leading to your goal. (Is that what you meant by being "good for you"?)
Anyhow..will leave it at that for now, and again, I'd like to hear what others have to say too. :)
I'd just mention before I go that there seems to be a great gap between your goals and your behaviour (volunteering at this specific organization.)So, what do you,..others think?
Take care..talk to you soon,
Jay
Posted by PuraVida on March 13, 2003, at 15:46:55
In reply to Re: CBT - and me- - a query » PuraVida, posted by jay on March 13, 2003, at 12:44:20
Hi Jay,
Well, I'm not sure I have encountered problems with interpersonal relations - I get along fine on a personal level with everyone. I guess its more the political games that I have problems with. In work, too. Will think on this some more.
PV
Posted by Krissy P on March 14, 2003, at 0:48:35
In reply to CBT - Using it and putting it into action..., posted by jay on March 12, 2003, at 20:21:50
In many ways, a CBT counselor takes on more of a "mentoring" role, rather than an expert role.
(I really agree with this statement) When I did CBT, I kept a journal for 3 years. It helped me to not only get my thoughts out, but prepared me and my therapist for the next homework assignment.
Can you elaborate on your question about throwing out a goal, real or fictional??? I may have a brain fart, but I want to do this, when I get a clearer understanding of what you mean:-)
Please get back to me,
Kristen
==================================================================================================
> I have found one of the reasons many of us have a tough time with CBT is often our lack of chance to practise it, even with the 'homework' assignments. That is, practise what we have learned. Dinah mentioned difficulty in translating CBT to more self-actualised goals and progress.(Not really being able to internalize and process what has happened.) I think there is another type of therapy can compliment CBT and may be better for developing just that, creating more inner-awareness, but I'll save that for a separate topic.
>
> Depending on your goals, finding a friend, relative, someone you can practise some of your skills with can increase your confidence in achieving your goals. The whole idea here, and this can be a bit self-defeating if you don't pace yourself comfortably, is self-management. There are some CBT counsellors who may even likely teach you how to administer certain aspects of CBT so you can use them down the road. In many ways, a CBT counsellor takes on more of a "mentoring" role, rather than an expert role.
>
> Is anyone in CBT right now who may want to share in respect to goals? Or, does anybody want to just throw out an example of a goal, real or fictional?
> (I would, but I'd like to work with others on this. I myself am in the process of starting CBT, and am fishing out some basic goals to start with.)
>
> Jay
Posted by Krissy P on March 14, 2003, at 0:56:01
In reply to Re: CBT - and me- - a query, posted by PuraVida on March 13, 2003, at 0:09:11
Hi, could it be that even though you felt it worthwhile and that you wanted and could make a difference, and they needed help, that maybe you were feeling responsible because you didn't join years before when you knew it was dying??
I am trying my hand at CBT here-bear with me :-)
I see a lot of doubting of yourself. (you asked)
I wonder what would happen if you did hang in there, continue to speak up, etc. I bet you would be the best candidate for a possible future regarding this organization? Maybe?
Just some thoughts, hope it helped:-)
Keep me posted please.
Kristen
==================================================================================================So, here is not so much a goal as a problem: I have been stressing because I have been active as a volunteer in a non-profit, and I'm not sure I want to continue. I do believe volunteer work is good for me (+1) and I can use it career wise (+1) but...I am frustrated. I got involved in this org. because it was worthwhile and needed help - it was dying, and run by a clique. I had not joined years before because of this. But I thought - maybe, I can make a difference. I have -we revived the club, last year, that is. But the old guard is still making blatently obvious "suits me" decisions, and I am the only one who speaks up. This year no one has renewed yet, and the board (I am on it) is making more dictator-like decisions to a dwindiling club. Thing is, this club is just a part of a larger community, and I am beginnning to get embarrassed that I am part of this self-serving board.
So, I want to quit - but this is where the CBT comes in. My shoulds, and others kick in - you just are too much of a perfectionist - that is the way life is! If you feel so strongly - stick it out - unless you are too weak... If you had better people skills, you could bring them around. SO, I say, no - I am not comfortable with this - I take a stand. But then - I think, I'll just go somewhere else, and the same will happen again. Is it me?
So, HELP is appreciated on the previous, if anyone has time or inclination to follow. I';d love to know candidly what you can see, CBT-wise, in my thoughts.
Thanks,
PV
Posted by PuraVida on March 14, 2003, at 1:46:17
In reply to Re: CBT - and me- - a query » PuraVida, posted by Krissy P on March 14, 2003, at 0:56:01
Thanks Kristen -
Yes, self doubt. Also, Jay - I was unsure about what you meant by goals.
PV
Posted by Dinah on March 14, 2003, at 4:06:19
In reply to Re: CBT - and me- - a query, posted by PuraVida on March 13, 2003, at 0:09:11
I just wrote a long post in reply, but erased it because I realized I was doing a lot of projecting. :)
Do I hear you correctly in that you are saying that you get trapped in *shoulds*? That this has ceased to be enjoyable for you, but you feel compelled to stick it out because you *should*?
If I heard you correctly, wouldn't CBT require that you break down the *shoulds* and reality check them?
Some possibilities:
*Should* you stay on because, darn it, you're no quitter. You *should* be strong and not let them drive you away. But you're ending up doing something you don't enjoy because you're being held hostage by *shoulds*. It would be a sign of strength to walk away.
*Should* you stay because you think you can do some good? You're the only one who stands up to these people and who will do it if you don't? It's a worthwile endeavor and you *should* do good without regard to whether or not you're enjoying it. But are you using your energy wisely? Should your strength be saved for other battles? Some people relish the politics yet manage to accomplish good things anyway. Maybe that sort of person should be on the board.
*Should* you stay because this is the way the world is and you have to learn to deal with it? Is this really the way the world is, or is this just the way this group is? Is it possible to get along well in life without learning to deal with the sharks? (I don't actually know the answer to that one. I've sort of constructed a world with minimal contact with sharks. But that sort of world wouldn't suit everyone.)
Of course, your issue in this might not be a *should* issue at all. I'm trying to remember my CBT. There are shoulds and catastrophic thinking. What are some of the others?
Posted by Krissy P on March 14, 2003, at 11:10:19
In reply to Re: CBT - and me- - a query » PuraVida, posted by Dinah on March 14, 2003, at 4:06:19
Posted by Ilene on March 14, 2003, at 11:42:57
In reply to Re: CBT - and me- - a query » PuraVida, posted by Dinah on March 14, 2003, at 4:06:19
Posted by Krissy P on March 14, 2003, at 11:43:55
In reply to Oh yes, I *should *say so! (nm) » Dinah, posted by Ilene on March 14, 2003, at 11:42:57
Posted by Krissy P on March 14, 2003, at 11:44:52
In reply to Oh yes, I *should *say so! (nm) » Dinah, posted by Ilene on March 14, 2003, at 11:42:57
Posted by PuraVida on March 14, 2003, at 12:39:39
In reply to I meant LMAOROTF *should* have corrected my typo (nm), posted by Krissy P on March 14, 2003, at 11:44:52
Here are the ten cognitive distortions:
1) ALL-OR-NOTHING THINKING: You see things in black-and-white categories. If your performance falls short of perfect, you see your self as a total failure.
2) OVERGENERALIZATION: You see a single negative event as a never-ending pattern of defeat.
3) MENTAL FILTER: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.
4) DISQUALIFYING THE POSITIVE: You reject positive experiences by insisting they "don't count" for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.
5) JUMPING TO CONCLUSIONS: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
5a) MIND READING: You arbitrarily conclude that someone is reacting negatively to you, and you don't bother to check this out
5b) THE FORTUNETELLER ERROR: you can anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.
6)MAGNIFICATION (CATASTROPHIZING) OR MINIMIZATION: You exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or other fellow's imperfections). This is also called the binocular trick."
7) EMOTIONAL REASONING: You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."
8) SHOULD STATEMENTS: You try to motivate yourself with should and shouldn't, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. The emotional consequences are guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
9) LABELING AND MISLABELING: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself. "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him" "He's a Goddamn louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
10) PERSONALIZATION: You see your self as the cause of some negative external event, which in fact you were not primarily responsible for.There is a pretty good site at http://congnitivetherapy.com and
here is a page of CBT links: http://www.actualizations.com/cbt.htm#links
Posted by Ilene on March 14, 2003, at 13:48:42
In reply to CBT: List of the cognitive distortions, posted by PuraVida on March 14, 2003, at 12:39:39
Thanks for the list. It's a tape-this-to-the-fridge item.
> There is a pretty good site at http://congnitivetherapy.com and
My browser says there is no such site.
?--I.
Posted by PuraVida on March 14, 2003, at 15:49:40
In reply to Re: CBT: List of the cognitive distortions » PuraVida, posted by Ilene on March 14, 2003, at 13:48:42
Oops - try http://www.congnitivetherapy.com!
PV
Posted by bozeman on March 14, 2003, at 21:36:04
In reply to Re: CBT: List of the cognitive distortions, posted by PuraVida on March 14, 2003, at 15:49:40
It was just a typo
this should work.
PuraVida
Thank you SO much for posting the list of distortions. I've been trying to find it for several days. Thanks!!!
bozeman
Posted by Medusa on March 16, 2003, at 5:36:10
In reply to CBT - Using it and putting it into action..., posted by jay on March 12, 2003, at 20:21:50
Yes Jay, great idea. I'm coming into this late, so I'll read the rest of the posts in the thread and see if I still have questions, or if you guys have solved all of everyone's problems and gone out to play ...
Posted by PuraVida on March 22, 2003, at 0:16:24
In reply to Re: CBT - Using it and putting it into action... » jay, posted by Medusa on March 16, 2003, at 5:36:10
Hi all,
I have been feeling horrible again, despite two (2!)nights out with friends in a row. I'm not thinking any distortions that I can identify, I just feel like crying, but I can't. Anyhow, I found a site called mindfixers.com, and I did the survey. I then did a similar survey on amenclinic.com, and both told me I had Limbic AD -which comes from an oversactive limbic system of the brain, and looks like depression. The plot thickens...
Anyhow, I did a google search for "limbic ADD" and found that our CBT cognitive distortions were listed here as ANT's - and a frequent symptom of Limbic Add'ers. Hmmmm...
PV
Here it is:
Limbic Prescriptions
Rx #1: Every thought matters! Kill the ANTs in your mind.
Rx #2: Surround yourself with people who provide positive bonding
Rx #3: Great smells.
Rx #4: Philippians 4:8
"Finally, bretheren, whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is of good repute, if there is any excellence and if anything worthy of praise, let your mind dwell on these things."
Rx #5: Medications include Norpramin, Tofranil, Wellbutrin and other antidepressants
Summary of ANT Types:-- All or nothing thinking: thoughts are all good or all bad.
-- Always thinking: using words like always, never, every one, every time.
-- Focusing on the negative: only seeing bad in situation.
-- Fortune telling: predicting the worst possible outcome.
-- Mind reading: thinking you know what another person is thinking.
-- Thinking with feelings: believing negative feelings without questioning them.
-- Guilt beatings: should, must, ought or have to.
-- Labeling: attaching negative labels.
-- Blame: blaming someone else for your problems.
Posted by Krissy P on March 22, 2003, at 1:16:00
In reply to Re: CBT - Using it and putting it into action..., posted by PuraVida on March 22, 2003, at 0:16:24
Posted by fi on March 28, 2003, at 17:14:08
In reply to CBT - Using it and putting it into action..., posted by jay on March 12, 2003, at 20:21:50
I've tried the other things for depression (meds which certainly help most of the time, traditional therapy). The only thing I havent tried is cognitive/CB therapy, but I dont think I particularly have any distortions. And I'm not prepared to put my Prozac down the sink just to keep a therapist who disapproves of them happy.
There are things that make me gloomy but they are true (eg frail health of parents, ageing myself..)
And I dont know if they cause my depression anyway.Has anyone else given it a try in these circumstances, and how did it go?
Fi
Posted by bozeman on March 29, 2003, at 15:07:22
In reply to Re: CBT - what if thoughts accurate?, posted by fi on March 28, 2003, at 17:14:08
Hello Fi!
We haven't "talked" before, as I'm pretty new to posting, but I'm glad to "meet" you. :-)
What I'm about to say is based on my own experiences only, not intended as global generalization.
I don't have the impression that CBT is "anti-medication". When I was dealing with the distortions (this was many years ago, and I'm not even sure it had a catchy name like CBT in those days. I don't remember them calling it anything special, but the list of ten distortions PuraVida posted awhile back is sure what we were working through) they were presented to me as something to add to my "toolkit" so to speak, so I would have a broader variety of coping skills to deal with the many, varied, very real stresses in my life. My therapist even told me he didn't think there was anything really "wrong" with me, I just had an amazingly complex and stressful life, and no available support system at that time, and that any person, no matter how strong, would eventually start to crack under pressure like that. So he worked with me to give me more resilience in the face of unavoidable stress, and to make healthy coping mechanisms more of a habit instead of something I had to work to achieve. For instance, the "not taking things as personally directed at me". Especially when I was under stress, my initial reaction to unkindness and backbiting from my screwed-up boss was to take it as personally directed at me, even though I could sit and ponder it rationally and realize that the man was completely unconscious in his life and that his misery was directed at *everyone* in his general vicinity because his loathing was really directed at himself. We just all received the obvious fruits of it. Ron's point (my therapist at that time) was that we make it a habit for me to NOT take things personally so every time the boss did something stupid/unkind/ridiculous, I wouldn't have to spend two hours talking myself through it, which was especially valuable since the boss did these things at least once a day and it was eating up a huge chunk of my time and energy dealing with it and defusing its effect on me. Ron also helped me see that my best defense against this very unhappy individual was that, on the rare occasion that he really did intend his unkindness and criticism as a personal attack on me, that if I were in the habit of not taking it personally, not only would I be much less harmed, but I could take some kind of sense of accomplishment in knowing that he didn't have the satisfaction of getting to me, and that it probably drove him nuts. :-)
Learning to process my thoughts and feelings and deal with my "inner self talk" more proactively was incredibly valuable. I, too, didn't think that some of the distortions applied to me, but working through them with a talented, caring therapist was still of benefit, as I discovered some ways I was fooling myself and diffusing my energy that I hadn't realized I was doing, on my own. I wouldn't think of it as a "substitute" for medication, per se. If you're sick you're sick, regardless of how you got that way, and you still need medication to make you well. Even if the way you got sick was allowing others to make you feel helpless (I have read documented studies that depression can be induced in animals by taking away their sense of being able to affect their environment), you are still unbalanced and need the meds. I see CBT as a way to make you more resilient so you are less likely to need meds, or may need them for a shorter duration if you do, but not as a substitute for meds per se.
But I also view meds (for many people, admittedly not for all) as a means to an end, not the end in itself. I am on medication right now because (due to health reasons) I got so weak and tired that I lost the ability to think cognitively and clearly about things in my life so my coping skills were of no use to me. I got so bad that even once my health began to improve, I couldn't break free of the negative patterns that had set in, in my psyche. I am now working very hard to cognitively address those patterns, while I have the safety net of the medication to keep me from falling into the Pit of Despair. For me, medication is a tool, like the other pieces of my "toolkit". Eventually I hope to be able to put it back in the kit, for later use if need be, but not to keep it as a constantly active tool.
I hope this helps some. As always, Your Mileage May Vary. Best of luck, whatever you decide to do.
Peace and Good Health to you.
bozeman
Posted by fi on March 30, 2003, at 5:17:50
In reply to CBT - Even if thoughts ARE accurate it still helps » fi, posted by bozeman on March 29, 2003, at 15:07:22
Hi Bozeman
Many thanks for such a long and interesting message- really helps! I'd got stuck on 'but they're true', but can now see the skills could be a useful part of the toolkit.
I got concerned that if I went to see someone they would disapprove of meds as I followed a link from an earlier message to a website about CBT which included 2 chunks of text about how unproven and unhelpful antidepressants were (apologies if I misunderstood- bit of overgeneralising, perhaps!)Having that discussion with a therapist just sounded frustrating.
I like the idea of adding something *extra*, and with the possible advantage of needing meds less or even not at all, which would be wonderful. And as you say life can be very complex and stressful.
Thanks again for a great message!
Fi
Posted by noa on March 30, 2003, at 10:43:56
In reply to CBT - Even if thoughts ARE accurate it still helps » fi, posted by bozeman on March 29, 2003, at 15:07:22
I see both meds and therapy as essential. To try to separate what is biology and what is psychology seems nearly impossible to me, for my own experiences anyway.
Posted by bozeman on March 30, 2003, at 18:08:56
In reply to Re: CBT - Even if thoughts ARE accurate it still helps » bozeman, posted by fi on March 30, 2003, at 5:17:50
Hello Fi
You may still possibly run into a CBT therapist who is anti-medication, but in my experience they are not all that way. Before scheduling an appointment, perhaps you could do a "phone screening" with the therapist to see if you click together and ask how s/he feels about CBT as an augment to medication therapy? Or some clinics these days even have brochures, etc, other written "propaganda" that outlines their treatment techniques in general terms. Before you spend your time and money in a visit with the therapist, and put yourself in the possible situation of encountering an anti-med therapist, maybe the staff will be willing to give you enough information for you to be able to tell. My own experiences with contemporary clinics in my area is that they actually do marketing based on their treatment programs, and you'll be able to tell if they are pro, neutral, or anti-med by their "recruiting" materials. But that may not be true where you live.
You're very welcome, and I hope you have a good experience, and learn some new skills for your "toolkit"!!!
Best wishes,
bozeman
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