CBT vs Psychotherapy??

[~glowly worm~]

Hi all

Im currently in a dilemma.
I understand this site deals with panic disorders and my problem is primarily that
(Panic disorder, Health anx, emetophobia & travel anxiety plus other phobias including separation anxiety).

However i also have borderline personality disorder & OCD that stops me being able to talk about my issues fully and am recovering from an eating disorder, problems with not knowing if i want to get better even tho i do and lots of anger.

Since returnign from 18 months in hospital ive been seeing a brilliant therapist. They are the best in the area and very flexible, prepared to see me long term and work with me in the best way that suits me. However.. they are also saying there is no quick fix seein as ive been ill since about age 3 (hard to believe i know) almost all my life.

Anyway we are using no set method but its not really working. I feel im not making progress at all having had about 15 sessions.
Have had CBT in the past and it really helped me so was wondering whether i should ask to try this again? Am in a lucky position that i can if i want to but am afraid of leaving her sessions and making the wrong choice as i feel i can talk to her. but its all talk and no action (very psychotherapy based) and this approach has never worked for me. Weve even tried setting an agenda but just float around the issues every time-as theres so much to cover.

I understand how lucky i am to have this so its not a moan its just i want to recover as fast as possbile whilst maintaining it ;)


Please could someone let me know what they would do? Shold i ask to be referred for CBT instead? Will CBT deal with resistance to therapy, anger, identity issues and separation anxiety as wel as the HA and OCD and panic disorders? I have been ill for so long just want to get well now cant stand waiting or purely talking any longer..

Many thanks,

~glowly~

[Downsinthenorth]

Hi ~glowly worm~

Could you sign up for CBT while carrying on with your therapist? A two-pronged approach might be better for you, and it might be worthwhile checking out whether this is possible.

I understand how lucky i am to have this so its not a moan its just i want to recover as fast as possbile whilst maintaining it.

It's natural that you want to feel better as quickly as possible - I do, and I often feel angry and resentful because I'm saddled with all these horrible emotional disorders. :mad:

Regards :)

[~glowly worm~]

Hey downsinthenorth :)

Another most helpful reply thankyou :)
It was most reasuring to feel im not odd in feeling angry about having all this stuff in fact im almost ready to burst with it.
Your 2 pronged approach is a good idea, i might see if it is possible or whether it is ok to come staraight back to my current therapist if cbt doesnt help.

Sorry u have to struggle too :( but glad for your support ;)

~ glowly ~

[keval]

Hello glowly,

I appreciate that it's almost a month since you started this thread so you may have already sorted something out for yourself. However, have you considered Schema Therapy? From the description you have provided, I would suggest that it may be worth investigating. I'd particularly like to draw your attention to the following:

http://bpd.about.com/od/treatments/a/schema.htm

FYI, I have just re-started Schema Therapy after a 15-month gap. I used to see a private therapist but am just about to start up with an NHS therapist. I have OCD, GAD and 'other issues'.

Best wishes,

keval

[joselinton]

There is a similar thread on the board in clinical psychology. I suggest you check if you have not already. Although psychoanalysis in its own right has lost its luster, psychodynamic therapy, which relies on the same theories and history, is alive, well and are validated empirically. Pop psychology is certainly celebrated the TCC and its partners, and especially for good reason. But in terms of efficiency, I would not necessarily go with a victory for the TCC.

[cece]

Glowly I am biased because traditional therapy didn't help me much and cbt has given me my life back. So naturally I would recommend cbt. The one thing about cbt is that you really need to keep at countering your thoughts in the TEA forms everyday even after your cbt therapy is over. It has made all the difference for me:)

[Martin Burridge]

Recommend you discuss it with your Psychotherapist and also discuss with someone who has a CBT approach. Ideally if you can find a therapist who has trained in both CBT and Psychodynamic then it will solve the dilemma.

Places to find these are

The British Association of Counsellors and Psychotherapists
http://www.itsgoodtotalk.org.uk/therapists/

and
The British Association of Behaviour and Cognitive Psychotherapies

http://cbtregisteruk.com/

Accredited CBT practitioners will always have the letters MBABCP after their name

[cece]

Good advice and links Martin :)

[davew]

I'm biased because I spent years in psychotherapy and on meds with little to show for it. I am self treating using the cbt TEA forms from the book by sam obitz and having more success in four months of using them than I had total in psychotherapy. I can't speak long term but they sure help a lot in the short run.
So I would at this point unequivocably say CBT over psychotherapy:yahoo:

[~glowly worm~]

Thankyou so much people ;)


Mike i followed your advice, thank you :)
In the end my therapist discussed it with the referrer for CBT and there is a list as long as the rest of my uni life. So she is using CBT under guidance of the top CBT person in the team. Its not doing much to be honest so quite frustrating but i think

Dave you have a good point. My consultants only advice was yet more medication.. I have been relying so much on others to fix me but the hardest thing is doing it myself. Im glad you are finding sam obitz helpful, ive never used his approach or heard of him so that gives me hope.
I will check out his stuff and be back ;)

Keep plodding!

~ glowly~ xx

[davew]

Thank you for the kind reply Glowly:hugs:
It is hard helping yourself initially but really not so bad once you get over the initial trepidation and frustration with yourself. It's a process but one I am finding worthwhile thus far. If you decide to give Obitz's methods a try feel free to ask any questions and I'll try and be of assistance:shrug:

[~glowly worm~]

Hey Dave :)

Frustration would be the right word :( Im glad you are finding it worthwhile, gives me lots of hope! Do you mind if i ask if it is OCD you are experiencing?

As of yet i havnt checked the methods out in detail as have had so much uni work to do but MUST give it a try this week and will definitely let you know how it goes.

Thanks so much for the support,

~glowly~

[cece]

You're welcome glowly. I hope you are having success:)

[cece]

Thank you for the kind reply Glowly:hugs:
It is hard helping yourself initially but really not so bad once you get over the initial trepidation and frustration with yourself. It's a process but one I am finding worthwhile thus far. If you decide to give Obitz's methods a try feel free to ask any questions and I'll try and be of assistance:shrug:

I'm glad you are having success. I am a big TEA form/Obitz fan and have had good success using the TEA forms and continue using them to this day.

[~glowly worm~]

Thankyou guys..

Its such slow progress.. one thing seems to improve then another goes..wham booom binga bam...here i am! Replacing the previous issue..

I do seem to be finding that as my fear decreases my anger increses..so having to watch that.

Am still in therapy but working a lot harder outside sessions and when i see a challenge i try to tackle rather than avoid.. *gulp*

Hope you are doing well today and thankyou for your continued support :yesyes:.. ~glowly~ x

[cece]

Good to hear and remember that slow progress is still progress:hugs:

[davew]

Hey Dave :)

Frustration would be the right word :( Im glad you are finding it worthwhile, gives me lots of hope! Do you mind if i ask if it is OCD you are experiencing?

As of yet i havnt checked the methods out in detail as have had so much uni work to do but MUST give it a try this week and will definitely let you know how it goes.

Thanks so much for the support,

~glowly~

I do have some OCD issues but more generalized anxiety and panic issues drove me to try cbt.

[davew]

I'm glad you are having success. I am a big TEA form/Obitz fan and have had good success using the TEA forms and continue using them to this day.

This is great to hear Cece and I am interested in any continuing advice you may have for me. I really want the way I am feeling to last!!!

[cece]

Davew,
Just keep doing the TEA forms for 5 or 10 minutes daily and I think you will be fine. :yesyes:

[davew]

I certainly will. Hope I continue to make further improvements like you:)

[shauntheron]

CBT focuses on delivering quick results but works more on the surface.It does require a lot of work on your part but the benefits are great.CBT is a tool just as psycho-dynamic therapy is perhaps the question shouldn't be which is better, but under what circumstances one is more effective than the other.

[cece]

You will davew if you stay with them. Too many people start feeling better and stop using the TEA forms and then they wonder why a few months later they are back where they started. People that stay with them seem to keep any relapses away and I have not had any relapses myself:)

[davew]

You will davew if you stay with them. Too many people start feeling better and stop using the TEA forms and then they wonder why a few months later they are back where they started. People that stay with them seem to keep any relapses away and I have not had any relapses myself:)

That is encouraging to hear! I am working hard on them and keep making more improvements. I sure hope the improvements lasts and I am willing to keep at them if that is what it takes:)

[cece]

That is encouraging to hear! I am working hard on them and keep making more improvements. I sure hope the improvements lasts and I am willing to keep at them if that is what it takes:)

Good for you Davew I believe your future is bright. Please keep me posted on your progress?

[davew]

Thank you for the encouragement. I am still doing my TEA forms everyday and feeling a lot better. I really appreciate your help :yesyes:

[cece]

Thank you for the encouragement. I am still doing my TEA forms everyday and feeling a lot better. I really appreciate your help :yesyes:

You're welcome and good job:yesyes:

[davew]

You're welcome and good job:yesyes:

Thanks you are so nice and supportive! I forgot to ask how everything is going for you? I hope you are well:D

[cece]

Thanks you are so nice and supportive! I forgot to ask how everything is going for you? I hope you are well:D

I'm doing great! Thank you for asking:hugs:

[cathycrumble]

Will somone please tell me the title of the book

Cathy xx

[davew]

Will somone please tell me the title of the book

Cathy xx

Been There, Done that? DO This! by Sam Obitz (http://tao3.com)


Happy New Year to everyone!

[cece]

Happy new year everyone. Sorry I didn't get back here sooner just real busy these days... Glad to see DaveW answered your question about the book's title in my absence Cathy I hope it helps you as much as it helped me:hugs:

[davew]

Hi Cece and no prob answering in your stead. Hope I did it as well as you would have:blush:
I know I should come back and help others more but now I am feeling so good it is hard to make time to post:shrug:
I hope you and everyone are all doing great!

[cece]

You gave a great answer Davew!

[davew]

You gave a great answer Davew!

Wow thanks Cece:ohmy: I am honored as I know I still have a lot to learn but feel great right now and hope it continues.

[cece]

YW Davew. Keep that attitude and keep working on yourself and I'm pretty sure these feelings will last for you. Great work!

[davew]

I certainly will. Thanks for the encouragement!

[cece]

I certainly will. Thanks for the encouragement!

Never a problem. We all need encouragement:D

[merlotsmum]

Opps wrong thread - deleted content.

I have started CBT but plan to do physchotherapy as started this before my breakdown.

[cece]

Opps wrong thread - deleted content.

I have started CBT but plan to do physchotherapy as started this before my breakdown.

I hope your CBT is going well. Let me know if you have any questions or concerns?:yesyes:

[davew]

Opps wrong thread - deleted content.

I have started CBT but plan to do physchotherapy as started this before my breakdown.

Hi merlotsmum,
I hope your therapy is going gangbusters:hugs:

[cece]

Hi davew and everyone else too.

I hope everyone is off to a good start this holiday season:flowers:

[davew]

I can't even remember my holiday season, but I am very much looking forward to summer. Hope everyone else is too:D

[cece]

We tend to remember the bad more clearly than the good so I take that as a sign you had a nice holiday:)

[davew]

LOL, good point!

[cece]

I was totally serious when I said that:)

[yenool]

I know this is an old thread but it is an interesting discussion anyhow. I've had a couple of courses of CBT in the past but more recently I've been told I would benefit from long term psychotherapy, although I doubt I will be able to get it.

In my experience/opinion CBT is very good at teaching you how to recognise your thinking patterns and the emotional/behavioural responses to them. It is based on the belief that distorted thinking and negative automatic thoughts (NATS) lead to anxiety and behavioural responses that are not helpful. The basic theme is you learn to unpick your thoughts and restructure the negative ones into something more helpful and realistic. You are given exercises where you have to test out your beliefs by writing down what you expect before hand, expose yourself to the fearful situation and then evaluating what actually happened.

I had CBT about 8-9 years ago, combined with medication, it did help me get over very severe social anxiety and depression, get me back out of the house and functioning to a certain extent and I still use some of the skills today.

Like all talking therapies it does require a good therapist that you can bond with - some say this is less important with CBT than other forms of treatment but I don't believe this. I believe CBT will not work if you do not feel comfortable in disclosing the issues in the first place, and doing that is a very difficult and personal thing, especially for those with intrusive OCD style thoughts. CBT requires a significant amount of effort (e.g homework) and for that reason I'm not sure how good it is for those who are severely depressed and unmotivated - those people may first require some medication to bring their mood up to a level where they can cope with the demands of CBT.

There is a large evidence base for CBT but my issues with CBT are:

CBT is now seen as the panacea of mental health. It seems to be recommended for anything and everyone and the cynic in me feels this is not in the best interest of the patient, it is because it is a short-term treatment which is relatively cheap. It also places all the problems and responsibility on the patient - if you don't get better then often you are labelled as unmotivated or not emotionally intelligent enough to do CBT.

The whole basis of CBT is that your thoughts are 'wrong' and distorted, which is fine...... except for often people have negative thoughts because their social situation, health or life is genuinely crappy. Trying to restructure thoughts in that situation is patronising and no better than than reading one of those cheesy self-help books which tells you that you can achieve anything if only you "think positive".

I do not think CBT deals with underlying problems , it is more of a tool to deal with 1 or 2 major issues and deals with the 'top layer' only. It is like swallowing a painkiller for a tooth ache rather than addressing the root cause, it may numb the symptoms enough for you to get on with life but it is likely that at some point the pain will resurface. CBT is usually offered in about 6 to 16 sessions (normally at the shorter end of things) and so cannot really help complex multiple issues. I feel some of the methods taught can be counter-productive for certain issues; OCD, pure-O style intrusive thoughts and ruminating for example.

[harasgenster]

What kind of therapist are you seeing? If they are an integrative therapist they should be able to give you both. I would be surprised if, in your position, you had not been referred to an integrative therapist who could react and respond to your needs.

I feel like i'm becoming the poster girl for schema therapy on here now, but schema therapy combines psychotherapy and CBT together. I had it with DBT, which is indicated for BPD. I don't actually have BPD myself, but DBT is used for complex cases in general. I also had an eating disorder.

Personally, I have found CBT to be faster and more effective with behavioural issues - i.e. I'm agoraphobic and I want to go outside; I'm social phobic and I want to talk to people. It's been GREAT for that. For the root problems - i.e. identifying emotions (I was very emotionally closed-off) and finding out what has made me the way I am - what the really deep beliefs are - so that I can choose to challenge those beliefs has been the better long-term therapy for me. But everybody is different, so no one here can tell you what will be better.

I would definitely ask if you can have a CBT approach mixed with a psychotherapy approach, though, because then you get the best of both worlds!

[cece]

I do not think CBT deals with underlying problems , it is more of a tool to deal with 1 or 2 major issues and deals with the 'top layer' only. It is like swallowing a painkiller for a tooth ache rather than addressing the root cause, it may numb the symptoms enough for you to get on with life but it is likely that at some point the pain will resurface.

I would respectfully disagree with this part of your note. In my experience the way I was interpreting things was the major issue and all the crap I spent years (and lots of money) dealing with in talk therapy was the painkiller. The problem with talk therapy is that it makes you feel better but does not teach you any skills to get better. CBT helped me change the lenses I viewed everything through and I soon realized my jumping to conclusions and blowing things out of the proportion were the real underlying problem.

[davew]

I am in agreement with you Cece on this point. Now that I have learned to stop making the thinking errors that cause anxiety I rarely have problems anymore. CBT and the TEA forms have given me tools to turn my life around and I am soo grateful:D

[cece]

Good to hear and keep up the great work:flowers: