Psycho-Babble Psychology Thread 354179

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CBT questions

Posted by fires on June 5, 2004, at 23:53:51

I've been requested to consider CBT by my PDoc. Can anyone help me find info. RE:

Studies that looked at CBT vs. time since Dep. started (i.e., Did CBT result in improvement of Dep., or could it have been time, by itself,that could have caused improvement.)

Studies that looked at the effects on patients who failed to improve with CBT. Did patients get "blamed"?

Studies that looked at patients feeling guilty for having to have CBT (i.e., my incorrect/negative "thinking" made me ill)

Studies that have looked at whether or not CBT can make a patient more Dep.? (Seems most therapies have that potential).

I realize these are rather unusual Q.s, but CBT doesn't seem to get "balanced" reporting in the journals. BTW, I'm not interested in critiques of CBT done by psychoanalytic organizations or therapists (if there are any still left ;) )

Thanks

 

Re: CBT questions

Posted by lucy stone on June 6, 2004, at 10:17:15

In reply to CBT questions, posted by fires on June 5, 2004, at 23:53:51

BTW, I'm not interested in critiques of CBT done by psychoanalytic organizations or therapists (if there are any still left ;) )
>
> Thanks


There are many psyochanalytic therapist and organizations still around. I am currently in analysis and it is transforming my life. Analysis isn't for everyong but neither is CBT or any other particular form of therapy. Every person needs to find the approach that is right for them.

 

Re: CBT questions

Posted by fires on June 6, 2004, at 12:55:36

In reply to Re: CBT questions, posted by lucy stone on June 6, 2004, at 10:17:15

I'm not trying to be sarcastic, but I'm very curious to know if Psychoanalysts still use the couch during therapy. Also, do you go multiple times per week (to therapy)?

For my opinions about PA, please see the following link:

http://skepdic.com/psychoan.html

Thanks

 

Re: CBT questions lucy stone

Posted by Pfinstegg on June 6, 2004, at 15:16:40

In reply to Re: CBT questions, posted by lucy stone on June 6, 2004, at 10:17:15

There is so much gradation in the types of therapy, with CBT and DBT emphasizing changing incorrect or unobjective thinking, to psychoanalysis at the other end, which these days is not very much like what Feud described. It has grown into a very interactive process, with the relationship betweenn analyst and patient being at the center; free association and dream analysis are used, also. Some people lie on the couch, which does help a person regress back to their original traumas, but others prefer to sit up. Many people do some of each, depending on what feels best at different moments.

I think it's important to realize that while fully-trained psychoanalysts are only a minority of all therapists, almost all psychologists, psychiatrists, social workers and counsellors receive at least some training which is psychoanalytically oriented, As soon as someone in training begins to study intrapsychic and interpersonal factors, psychoanalysts and psychoanalytically-oriented therapists enter in as teachers and mentors.

Like Lucy, I am in psychoanalysis. I am also finding that it is life-transforming in terms of gaining a solid, confident self (which had been very damaged by childhood by neglect and abuse). There is no question that it is extremely taxing in terms of energy, time and money, but I do think that it is by far the most effective treatment that I could possibly undergo for my difficulties. And except for the frequency of visits and the use of the couch (most of the time), it is not very different in content or emotional interactions from the majority of the therapies which posters talk about here- just more intensive.

 

Re: CBT questions

Posted by lucy stone on June 6, 2004, at 15:29:03

In reply to Re: CBT questions, posted by fires on June 6, 2004, at 12:55:36

I find it interesting that in your original post you stated that you did not want critiques of CBT by psychoanalysts or psychoanalytic orginizations, yet you posted a link to a site critical of analytic therapy. Not really fair, IMO. When I was considering analysis I did alot of research and I did run across the site you posted. It critiques classical Freudian anyalsis which is very rare these days. Modern analysis is much different from what Freud did! I did therapy with my T for about 9 months before we gradually increased the number of sessions and moved into analysis. What we do in analysis is not much different from what we did in therapy, it is more a difference in frequency and intensity. I go four times per week and I do lie on a couch although I don't have to. I could sit in a chair if that was best for me. I like the couch because it lets me focus totally on my internal world. When things are very intense I also cover my eyes because even looking at the ceiling too distracting. My T and I talk a lot and my sessions are not totally free association. We do associate around dreams but he doesn't really intrepret them. It is more my finding out what they mean with his help. For example, I once dreamed that he was pulling me out of deep water. We talked about it, and I decided that it meant that he was rescuing me from the difficulties in my life. I don't know if that was what the dream *meant* or if associating around the dream clarified by thoughts. I have been in analysis for a little over 3 years, and I am happier, less depressed, have a better marriage, yell a whole lot less at my kids, have stopped the bulimia I had for 20 years, and have less desire to drive into trees. That's a lot of improvement in my life. It's the right approach for me.

 

Re: CBT questions

Posted by fires on June 6, 2004, at 18:15:47

In reply to Re: CBT questions, posted by lucy stone on June 6, 2004, at 15:29:03

About fairness: Go ahead and post a link to an analytical group that is critical of CBT, and everything will be "even".

If Psychoan. works for you who am I to say otherwise. BUT :), Have you considered that the mere passage of time, may have helped you. Also, in analysis for over 3 years! My goodness. I had psychotherapy before, but couldn't possibly foresee staying in it for 3 years.

I live in Southern Calif., and except for wealthy patients, psychoanalysis is not economically feasible for most. I've only see them mentioned in Beverly Hills and Newport Beach, and catering to the rich and famous -- especially movie stars.

I checked the referral list at the Southern California Psychoanalytic Society web site, and found only 38 psychoanalysts listed , and 2 were in the Phoenix/Glendale AZ area.. All were located in very upscale communities.

This is one of my longest posts (ever). I'm fascinated by your description of your taliking about dreams. Did the talking about the dream about drowning in deep water relieve any of your symptoms? I'm curious what talking about a dream does to change one's mood and or behavior(s). I just don't get it -- probably never will, which is probably why I found most psychotherapy not only useless, but somewhat harmful: it delayed proper pharmacological treatment and it left me feeling like I had "failed" therapy. Imagine the consequences and ramifications on one's psyche when one feels one has "failed" therapy!!!

Just one more comment: 6 weeks on Parnate(and then staying on it for 15 years) did more for me than many years of off and on therapy with several different therapists.

Thanks

 

Re: CBT questions

Posted by fires on June 6, 2004, at 18:23:01

In reply to Re: CBT questions lucy stone, posted by Pfinstegg on June 6, 2004, at 15:16:40

I've been out of therapy for so long, that I don't even know what DBT is? Dynamic BT?

I'm curious why CBT wouldn't be just as effective as psychoanalysis, and be much faster and less expensive?

Thanks

 

Re: CBT questions

Posted by lucy stone on June 6, 2004, at 22:02:50

In reply to Re: CBT questions, posted by fires on June 6, 2004, at 18:15:47

Well, I live in the capital city of a poor state. We don't have any movie stars around here, few country singers maybe. I'm not wealthy but my husband and I do make a good living. There is no doubt that it costs alot in time and money but it's something I am doing for me and most of the time it is not something I dwell on. My husband is totally supportive and says that he can't think of anything more important to spend the money on. I don't think that 3 years is a long time to be in therapy, after all it took me a lifetime to get where I am and I can't expect to change overnight. And no, it is not just the passage of time. Plenty of time had passed in my life without the kind of change I am going through now. I think your post is a good example of why there are so many types of therapy. Some are good for some people, some for others. If you think CBT is right for you I wish you well. Psychoanalysis is right for me and I am very happy with my progress.

 

Re: CBT questions fires

Posted by Miss Honeychurch on June 7, 2004, at 10:10:42

In reply to CBT questions, posted by fires on June 5, 2004, at 23:53:51

I have been in CBT therapy now for 11 months to tackle my depression, anxiety and raging hypochondria. It has worked wonders.

But it is hard, hard work to change your irrational thought patterns. At least for me. I always marvel at how people can do CBT for three months and they're fine. Not me. But my T also takes a pretty eclectic approach, he is not strictly CBT although that is his orientation.

I find CBT to be a relief. To know that I can aid my depression through thinking and to be at the point where I can identify my irrational thoughts and replace them with rational ones. I think that has taken me the longest. ANd also to get rid of all of the "shoulds" "musts" and "have tos" in my language and way of thinking.

I go once a week. Soon we'll go down to twice a month.

I know I would have enjoyed psychoanalysis as well, but I definitely could not afford that. I can't even really aford 4 times a month (with a copay of $35 per session)but I know I need it. ANd my T keeps convincing the insurance company I need it.

 

value of dream talk

Posted by Miss Honeychurch on June 7, 2004, at 10:17:43

In reply to Re: CBT questions fires, posted by Miss Honeychurch on June 7, 2004, at 10:10:42

My T and I analyze my dreams all the time. I find it very helpful, mostly in the fact that I am learning to trust my instincts. My dreams sometimes point out potential problems, provide solutions, or uncover fears/feelings/anxieties which I normally mask in real life. By analyzing your dreams, you are listening to your subconscious which knows a helluva lot more with what is really going on with you than you conscious does!

Dream analysis has made me realize that it is OK to listen to my subconscious and to pay attention to it. Your dreams are rich in imagery and problem solving. You just have to know how to look at them.

 

Re: CBT questions

Posted by Dinah on June 7, 2004, at 10:51:27

In reply to Re: CBT questions, posted by fires on June 6, 2004, at 18:23:01

> I've been out of therapy for so long, that I don't even know what DBT is? Dynamic BT?

Dialectical Behavioral Therapy, developed by Marsha Linehan, incorporating elements of CBT and eastern philosophy. I always think of it as a kinder and gentler CBT.

> I'm curious why CBT wouldn't be just as effective as psychoanalysis, and be much faster and less expensive?
>

Because, thank heavens, people are individuals. There is no one size fits all therapy, just as there is no one size fits all medication. CBT teaches useful skills, and I think everyone should be exposed to them. A therapist who doesn't use a few CBT techniques in dealing with a patient with an anxiety disorder is not one I'd like to have. A therapist who used *only* CBT with posttraumatic stress disorder, a chaotic childhood, a dissociative disorder, or a personality disorder is not one I'd like to have.

But that's why there are a lot of therapists out there. It's up to us to discover which sort of therapy is best designed to shore up our weak spots. Ideally, you'll get a lot of help from the therapist but realistically there are a lot of therapists who are wed to their technique.

 

Re: CBT questions

Posted by lucy stone on June 7, 2004, at 11:08:16

In reply to Re: CBT questions, posted by Dinah on June 7, 2004, at 10:51:27

I think Miss Honeychurch's two last posts are a good example of a T combining approaches. She says that she is doing CBT but that she and her T also analyze dreams. Her T is taking from both CBT and psychoanalytic aproaches to find the best way to help her. I think this is typical of good Ts, and Miss Honeychurch obviously has a good one!

 

Re: CBT questions

Posted by fires on June 7, 2004, at 13:25:08

In reply to Re: CBT questions, posted by lucy stone on June 6, 2004, at 22:02:50

>>Psychoanalysis is right for me and I am very happy with my progress<<

I'm happy you find it useful, but I must admit that I'm still skeptical (in a healthy way).

BTW, during my ongoing research on CBT, I learned that a previous therapist of mine is the "Director of Training" for The Southern California Society for Ericksonian Psychotherapy and Hypnosis. It too (Ericksonian), sounds far out to me. I don't know what he was doing therapy wise with me!? At the time it seemed like CBT.

Best Wishes

 

Re: CBT questions

Posted by fires on June 7, 2004, at 14:23:48

In reply to Re: CBT questions fires, posted by Miss Honeychurch on June 7, 2004, at 10:10:42

I had no intention of getting so involved with this thread, but interesting topics keep getting introduced.

You mentioned Hypochondria. Are you aware of the latest thinking on that Dx?

Link to article:
http://preventdisease.com/news/articles/hypochondria_is_real.shtml

I'm wondering why your CBT has lasted 11 months. I thought one of the hallmarks of CBT was very short term therapy?

Best wishes

 

bothered by this

Posted by lucy stone on June 7, 2004, at 15:22:22

In reply to Re: CBT questions, posted by fires on June 7, 2004, at 13:25:08

I'm sorry, but I am enormously bothered by this. What gives you the right to be skeptical of my chosen form of treatment? Many of the treatment forms people on this board choose would not be for me, but I am not skeptical when they say that they have helped by them. This is a support board, and it is not helpful to people when others express skepticism for their chosen form of therapy. It doesn't make me doubt my choice of treatment, but it triggers the anger and sense of outrage that I am dealing with in my therapy. I am tempted to tear into you, but I can hear my analyst's voice in my head discussing with me why I would want to do that, who I would be attacking, and what I think it would get me. That voice is stopping me from a behavior that I know is not good for me.

 

Re: bothered by this

Posted by fires on June 7, 2004, at 15:38:18

In reply to bothered by this, posted by lucy stone on June 7, 2004, at 15:22:22

Are you saying that my skepticism about your chosen therapy is so disturbing to you that I should not voice my skepticism? That seems convoluted to me, but I will be glad to stop posting on this if others agree with you.

You must be aware of the controversies surrounding all psychotherapies. To not discuss them doesn't settle well with me, but that's how I am > Always want to hear both sides of a controversy.

Sorry for causing you distress.

 

Re: CBT questions fires

Posted by Miss Honeychurch on June 7, 2004, at 15:40:41

In reply to Re: CBT questions, posted by fires on June 7, 2004, at 14:23:48

Everything I have read of CBT indicates it is a short term therapy. I have no idea whay it has taken me this long. I'm sure a lot of factors come into play with different people. I have discussed my concern about this with my T but he says it is a mistake to compare myself to other people and that I have come a long way. Perhaps I was more disturbed than I thought. It has also been VERY hard to dismiss my irrational thinking. Perhaps some people can do this better, but it has been a real struggle for me. Perhaps I am an anomaly or perhaps I'm just slow.

 

LucyStone - Re: Bothered

Posted by rockymtnhi on June 7, 2004, at 15:46:13

In reply to Re: bothered by this, posted by fires on June 7, 2004, at 15:38:18

I agree that we should not pass judgment. We are all here for the same reason: to offer and receive support.

I have been in CBT for over a year now too. It depends on how often the sessions are and what obstacles must be overcome. CBT generally is short-term but not always. Some go back for tune-ups after CBT ends.

For any therapy to work, one must work at it. That includes work on the part of the client and the therapist.

Let's continue to be supportive of one-another.

 

Re: LucyStone - Re: Bothered rockymtnhi

Posted by Miss Honeychurch on June 7, 2004, at 15:56:53

In reply to LucyStone - Re: Bothered, posted by rockymtnhi on June 7, 2004, at 15:46:13

Rocky, I feel better to know that you too have been in CBT for over a year. I think if you have mild anxiety and some depression you can go in for 3 months and be great. For me, I am NOT on medication and I came in with severe anxiety and depression.

 

Re: CBT questions fires

Posted by Miss Honeychurch on June 7, 2004, at 16:01:33

In reply to Re: CBT questions, posted by fires on June 7, 2004, at 14:23:48

That's an interesting article. For me, the easing of my severe anxiety and depression has eradicated my hypochondria. My T treats hypochondria as a SYMPTOM of anxiety and depression, not as a disorder in its own right.

Also, I am not on any form of medication, so perhaps that may be one reason for my slowness with CBT. My depression and anxiety were pretty severe.

 

Re: CBT questions

Posted by fires on June 7, 2004, at 16:05:11

In reply to Re: CBT questions fires, posted by Miss Honeychurch on June 7, 2004, at 15:40:41

Thanks for the info.. I have an old book by David Burns, MD, titled "The Feeling Good Handbook", 1989, which is about "cognitive therapy".

On page 468 he states that: "If you have been working hard in your psychotherapy for a couple of months and you feel stuck, you may benefit from a medication."

Maybe your in this group? Just asking, not implying.

 

Re: LucyStone - Re: Bothered

Posted by fires on June 7, 2004, at 16:19:32

In reply to LucyStone - Re: Bothered, posted by rockymtnhi on June 7, 2004, at 15:46:13

I've run into this "problem" on other groups. People say not to be judgmental and don't offer different viewpoints/explanations. This has come up when I have made posts regarding the dangers of herbal meds. I felt I was providing a good public service (supportive) by warning others about health threats -- others said that I wasn't being supportive. Why would I want to support people engaging in dangerous health practices?

What would you suggest a good reply would be to a woman on this group, if she came forth and said that she was improving tremendously since she had started having sex with her therapist?

I think a judgmental reply would be the best thing for her. Supporting her just because her therapy is working well seems illogical, in this case. Of course there are those who don't think that therapists shouldn't be restricted from having sex with patients, but I don't want to go near that topic!!

I hope you see my point.

 

Re: CBT questions

Posted by fires on June 7, 2004, at 16:39:14

In reply to Re: CBT questions fires, posted by Miss Honeychurch on June 7, 2004, at 16:01:33

I've had 3 major depressions in my life. None followed "triggering events". I had electroconvulsive therapy as a last resort for my first episode and like therapy, and inadequate med trials, it didn't help. Time alone and some dietary changes seemed to help (wheat and milk eliminated).

My second episode resolved in about 6-8 weeks thanks to Parnate and a psychiatrist who, didn't believe in psychobabble. Close to my discharge day, he told me when he entered the room, "You won't believe what a nurse just asked me?" I asked him what she had asked. He said that she wondered if he was going to start working on my problems since I was greatly improved. He asked her what problems she was talking about, adding that Depression WAS my PROBLEM. We both got a chuckle from her attitude.

My 3rd episode was late last year and Effexor and Clonazepam helped bring me out of that. Thank God I had a good Resident at a Univ Med Ctr, or I wouldn't have stuck with Effexor due to the tough physical symtoms I experienced with every doseage increase.

I know that some psychobabblers will probably rush in to tell me that Effexor is going to kill me, they did on the med. site, but that's ok.;)

I couldn't imagine in my wildest dreams how CBT could have gotten me out of Dep. when I couldn't think well enough,talk loud enough, or communicate anything other than my most basic needs.

Anyway, I'm glad it is working for you.

 

Re: LucyStone - Re: Bothered Miss Honeychurch

Posted by karen_kay on June 7, 2004, at 17:41:07

In reply to Re: LucyStone - Re: Bothered rockymtnhi, posted by Miss Honeychurch on June 7, 2004, at 15:56:53

miss honey,

i too was in CBT for over a year. it's helped me tremendously in overcoming anxiety and finding new ways to deal with stress. i have found that i no longer 'flip out' over minor details or daily stressors. i think my therapist was veyr helpful in also discussing dreams, past memories and other things not usually typical in CBT thereapy (am i even right in saying that? i'm no expert so i could be wrong).

sometimes it takes some longer than others. but, CBT was very helpful for me. also helpful though, were other techniques incorporated into therapy.

 

Re: LucyStone - Re: Bothered

Posted by fires on June 7, 2004, at 18:00:34

In reply to Re: LucyStone - Re: Bothered Miss Honeychurch, posted by karen_kay on June 7, 2004, at 17:41:07

I don't wish to sound condescending, but I don't generally "flip out" over minor details or daily stressors. My PDoc may disagree. ;)

I'd be very interested in learning what, if any reasons, were learned to be responsible your flipping out?

Best wishes


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