View Full Version : Struggling with CBT - is it my fault?
Hello everyone
Sorry if this is a bit long with all the background...
I have been experiencing more or less constant anxiety with lots of physical symptoms, worry and panic for nearly two years now, following an episode of palpitations/tachycardia while driving to work one day. From that day onwards I became very ill, unable to leave the house without severe anxiety even when accompanied. I had to resign from my job because of this and have also become quite depressed as a result.
When it first started and I was off work sick I had the usual 12 sessions of CBT, but didn't find it very helpful as we ended up focusing on driving to work as if I had a driving phobia - but obviously it's much more than that since I feel anxious all the time, even just sitting at home. Eventually I got referred to the local Community Mental Health Team and was really hoping that this time things would improve. I had to wait a while for the psychology sessions to start but after my assessment appointment I felt really hopeful as the person I was seeing seemed to understand the problem and gave me some good reasons why the CBT I'd had previously hadn't worked.
But now, after nearly 6 months of weekly psychology sessions, I feel NO further forward whatsoever! The last few sessions I have been feeling more and more frustrated and angry at how they've gone (and I'm not usually an angry person). We have been focusing on trying to stop negative thoughts and predictions (like thinking that I'll never get better) but I just can't seem to stop thinking like this. Yesterday in my session when I made a negative remark about not feeling any better than last time, the therapist started to get quite nasty about it. She told me that nothing she did made any difference to the negative voice so she was going to stop trying to fight it for me and it was now up to me to make it go away! She then told me that this week I should walk from my house up into town alone (20 minutes walk each way) and go into the voluntary centre up there and register for voluntary work, then walk home all on my own! And she knows I'm struggling just to walk 5 minutes away from the house on my own without panicking! It seemed like such an unrealistic goal to set, I immediately felt ten times more depressed and just wanted to cry, but when I explained that I genuinely felt it was unattainable she just went off on a rant about how thinking negatively about it meant I would automatically fail.
I came away from the session feeling a total failure because I know I won't be able to do what she's telling me to do (essentially, to make myself better and just get on with life). But whenever I try to explain how I feel she just dismisses it as "negative talk". I feel like everything I say annoys her - like she thinks I'm deliberately trying to be difficult or something. I'm starting to really resent the sessions - but maybe this is a problem with me rather than her and it would be the same whoever I was seeing? To be honest it's getting to the stage where I feel like she'd rather I lied and said I was feeling better, rather than telling the truth and saying that I don't feel better, so she doesn't have to deal with the fact that I'm not improving!
I suppose I just wanted to see if this is normal in any way, perhaps just a phase I need to go through with the therapy and it will improve, or maybe I am misinterpreting what she is saying and making too much of it? Why does nothing seem to work for me??!
CBT didnt work for me either and at the end of a years worth of sessions, i was basically left hanging by my psychotherapist.
Thanks Steve
I've got a horrible feeling that's what will happen to me too - after all they're not going to continue the sessions indefinitely!
It seems like it just doesn't work for some people... Don't know why.
Did you find anything else that helped?
I'm trying to find something at the moment.
Hi
Sorry to hear you are having a rough time at the moment
CBT doesn't work for everyone, however reading your post it seems as if part of the problem with it not working lies with your psychologist. Reading between the lines it seems as if she is getting frustrated with you because what she is suggesting is not working for you.
She is there to help you and at the moment she is taking her lack of ability to help you out on you.
Maybe you should be thinking in a slightly different way that the "ball is in her court" as she is not giving you the necessary skills to overcome your problems. However CBT is far from one sided, you need to put a lot of effort in to it, so maybe next time you go say you felt that the goal she set you was unrealistic as this present moment but you tried by taking a daily walk for 20 mins instead. You must try and give her something to work with and if you still feel unhappy ask your GP for some alternatives, maybe just a different therapist would work better with you.
Just because she is a psychologist doesn't make her good at her job, just look at all the threads about GPs here some are good but some are bad.
Hope this helps and don't be so hard on yourself but try tiny steps instead of the big jump as she suggests.:)
Megan
eight days a week
05-05-11, 23:33
Some great advice from Megan there, so I'd try that first of all :)
My nagging suspicion though is that this therapist might not be for you (from what you've said because of her, not you!).
At my therapy centre they have big signs on the walls of who to contact if you're not happy with your treatment, I don't know if it's the same at your place. My therapist has been great so I haven't taken much notice of them. But one I did see and recognise is for PALS so you could try looking them up (easy to find and they're there I think exactly for when your treatment isn't satisfactory).
First though I'd give it a couple more sessions, if you can, with what Megan suggested, but is you still feel the same I'd either tell my therapist (but I know that takes a lot) or contact someone to complain or even just explain why you and your therapist's approaches don't match.
The very best of luck, and really hope that it all works out, please keep us updated :)
I agree with a lot of what Megan73 has said. CBT is not actually a soft option as you have to do a lot of the work yourself - and if you don't/can't engage with it, then it won't work.
I've had CBT myself quite recently, and ended up going for about 4 months as I had quite a lot of problems. I was paying for it privately, so I suppose that helped me to do all the various assignments, as if it didn't work, it was my own money I was wasting!
However, the therapist I went to did things in a very structured way; he was always quite remote, but you can't expect a therapist to be your pal as it doesn't work like that - they have to be a bit remote from you. BUT - you do need to feel at ease with them, as otherwise you can't trust them to help you. Also, they're there to guide you, not just provide a magic cure. :)
I did feel a bit frustrated with CBT at first as I found some bits of it too simplistic, but also I had to accept that a lot of my anxiety was caused by me feeding it through negative thoughts and thinking of the worst case scenario all the time. I think that until you can do this, then it's hard to move forward.
Of course, it can be pretty difficult getting out of the "woe is me, I am being completely controlled by my anxiety" mindset. I certainly had problems with this aspect, and I had to find the way to take responsibility for managing and controlling it myself.
Thank you so much for your replies...
I think you are right Megan, I do feel like she is now getting frustrated with me because what she has suggested hasn't worked. I think the difficulty I have is to know whether it hasn't worked because I haven't tried hard enough with it, or because she hasn't explained things properly, or because the approach just isn't right for me. A lot of the time I agree with what she says and I know it's true logically, but it doesn't seem to change how I feel. I know that I need to put the work in too, but because I'm getting so frustrated with the situation it's getting harder to get motivated - and it doesn't help that a lot of what she tells me to do (like going out for short walks) is similar to what I tried during my first course of CBT, which didn't really work, so I automatically don't think it will work this time and that annoys her.
I think you are both right, I need to talk to her properly. I have got a break of 2 weeks now as she is away but will try to use the time to write down what I want to say and what is bothering me so I don't get sidetracked and brushed aside by her next time. The problem is, she will probably just tell me I'm being negative again! And I really don't want to cause trouble either - I get worried about upsetting her which is silly I know!
I will also have a look at the leaflets they gave me, to see what I should do if I'm not happy with the treatment - I don't remember seeing anything in the waiting room but then I'm often feeling very anxious at that point and not really paying attention to what's around me!
Blueangel, that is exactly me - "Woe is me, I am being completely controlled by my anxiety" - and I know it's not a helpful attitude but I'm struggling to get out of it and control it myself... Which is probably where I am going wrong!
I'm usually quite strict with myself and I do complete all the assignments, but often with the attitude that they won't make any difference, since I feel I've already tried these methods during the first course of CBT I had, without much success (for example, I've been going for a short walk by myself, even if only for 5 or 10 minutes, almost every day for the last 2 years, but my anxiety about it has remained more or less the same during this time). I'm finding it very hard to engage in that respect because I feel like I'm just re-doing something that didn't work the first time round - and when I try to talk about these concerns the therapist just tells me I need to think more positively about it and can't/won't really explain why it didn't work before (or why it might work this time).
I have also found some of the CBT too simplistic at times, and I do tend to dismiss these parts as I think "I already know that, it doesn't make any difference" - but perhaps if I really tried to think about it and believe it, it would help me more. A major problem I've had is when they tell me that feeling panicky can't hurt or kill me etc etc - I know it can't, but I'm still terrified of the feelings and the possibility of losing control, which the CBT doesn't seem to be addressing - the actual fear of the feelings themselves rather than what might result from them.
I know my attitude is part of the problem but I can't seem to shake it off - and being told to "make" myself change how I feel just isn't working!
Hi Abs79
Just wondering how you were getting on?
Megan
CBT did not work for me either. I'm going to have a bath now so I'll write a proper reply later when I have more time. I'm only writing this on here now so I can find your post again! :blush:
Hello Megan and Shoegal
Sorry it's taken me a while to reply... I've been trying not to think about it too much since I've had a break from the psychology sessions while my psychologist is away. It's starting again this Wednesday and for the last day or two I've been feeling more stressed and getting upset and frustrated again thinking about what she said last time. I did make a list of points I want to raise with her, but I was quite upset at the time so I think I will need to edit it before I show it to her!
I have also got myself a little voice recorder thingy to take in with me, so I can play it back to my partner afterwards and see if he thinks she's being unreasonable or if it's just me misinterpreting things.
I will try to update this after Wednesday's session to let you know what happened, if you are interested! I am dreading it to be honest as I haven't tried to walk up to town like she told me to, as just going round the block as been difficult. So she might have a go at me about that, which won't be nice.
Shoegal it would be nice to hear your input since I've read a few of your other posts and you sound quite similar to me!
Thanks for your support.
Abi
I had CBT last year and had 20 sessions which is the absolute max they can give you on the NHS in this area. The average is around 12 normally. They were not a waste of time but its so frustrating that it didn't seem to magically improve everything. I put a lot of work into it and pushed myself but this year I am more anxious and stressed because of it! By doing it, things now seem impossible if that makes sense. I have no idea after it how I am ever gonna get back into normal life / work etc. It sort of opened a reality to me of how hard its gonna be. I think I pushed myself too far. I did get things from it like challenging negative beliefs and also I thought things were real and that everyone was looking at me and it teaches you to find evidence of that in reality!
NICE did a study and said that CBT helped 70% of people who had it. However people are now challenging that statistic and it could be far lower people who have long term benefits from it! It can really help with any fear and phobia based problems but so many people feel upset when it didn't work fully for them! I feel quite upset about it because I put effort into something that was hard work! But its not the end, there is plenty of other avenues! There is some thinking that the psychology world deliberately inflated the percentages of people it helped because services like the NHS massively invested in it. I would love to see a real study with no bias which showed the real percentage of people who are helped by it. too much emphasis is placed on it being the cure all! it can help but not everyone! CBT has replaced a lot of psychotherapy services in some areas because of the original NICE findings, its a little controversial!
I realised from having CBT there is a fault with it. It concentrates on changing thoughts and challenging behaviour and pushing / motivating you. confront your fear and do it kindda thinking. But it doesn't really care about your emotions or personal issues. I want to have normal therapy now to deal with my problems! CBT doesn't care about any emotional things or work through problems. That is my criticism of it! I think its better to have psychotherapy (non cbt) and CBT at the same time if you have it! There is a root to anxiety or in my case social phobia and agoraphobia. like why don't you want to go out? CBT doesn't really address that!
I had the same thing about they were very supportive during the CBT. my therapist was good. She even took me to a local shopping centre and we had tea in a coffee place at a busy time. She made a massive effort to help me. On the last session she just gave me a photocopied book of local services and told me to try a psychotherapy now and didn't care afterwards! they need an after care to prevent basically what happened to me :(
A lot of people do not find CBT works for them and it doesn't mean you have done anything wrong! there is other therapies and paths to try! xx
Hi, I think the point is that no therapist can work miracles, they are not a quick fix, and it takes a huge amount of hard work and input from us to make things better... we can choose to remain a victim of our own lives, or we can choose to break free from our emotional chains and spread our wings... I used to "blame" the therapist, but in reality it was me who was choosing to make her the "baddy", instead of facing my fears :(
deepreason
10-07-11, 01:52
I did CBT every week for a year and that was a fair bit of money down the drain as it gave me no benefit at all. I'm now doing psychoanalysis and it's really usefull. The chap who helps me is great and he does actually work a fair bit of CBT into our sessions without me realising even.
macc noodle
10-07-11, 09:07
What can I add to these comments that have been posted already - all of which contain elements that I agree with.
First of all, I am on my 6th session of CBT now for treatment of severe health anxiety and hospital/doctor/treatment phobia.
Secondly, in my heart of hearts I really doubt that it will ever be completely cured as I have had it like forever but I do need it to be manageable - so I feel my expectations are realistic.
Thirdly, my desire for change and quality of life away from this vicious circle I find myself in is far greater than I have ever experienced before.
So, anyway, here I am at the start of my CBT journey but already mine seems to be more optimistic than your experience and I am really sorry that you are having such a tough time.
However, before it will even come close to working you have to commit 110% to it - and try to achieve all that is being asked of you. I was asked at one session to invoke a panic attack by overbreathing - after the initial "no way" response, I agreed to at least try - which I did despite reservations!!!
If your therapist is setting you unrealistic goals, you need to have the courage to say so (my therapist is excellent in that she acknowledges the futility of asking too much too soon and encourages that we take "baby steps" as she calls them).
Right at the start of the CBT, we jointly agreed goals to be set and how we were going to achieve them - this made me feel instantly part of the process rather than just another "patient" who was going to be cured if they did what they were told and not cured if they didnt.
Facing your demons is HARD and not an easy option at all for anyone! But if your desire to feel better than you do now overrides your fear and apprehension about trying what is suggested in CBT, then you are already on the way to success.
Our brains have learned a pattern of behaviour and response to situations that create the fear and anxiety and we can retrain our brains not to do to this. CBT is an excellent pathway to achieving this.
Please dont dismiss CBT as a pathway to freedom from your suffering. It does seem that your current therapist is not in tune with your state of mind and that maybe the problem is that she has not taken the time to assess you in sufficient depth and to allow you to express your expectations and from that jointly create a plan for your sessions which will offer you some success.
Ask her if you can reassess the situation and agree a joint plan of action for the remaining sessions - doing this alone honey will give you a sense of power and control over the problem rather than continuing the pattern of helplessness and feelings of despair.
Good luck
:)
I think it can be dangerous to go blindly unprepared into any kind of therapy. It can open some really nasty cans of worms for those of us with deeply buried problems. It can bring "the monster under the bed" out into the middle of the room, then leave us to deal with it without actually knowing how. I was in group psychotherapy for just over a year, and unfortunately because there was no support in or between sessions, I just crumbled under the pressure. My childhood sexual abuse issues were not dealt with gently or supportively, and I am now in a kind of limbo. Any kind of therapy can be harsh, and most us will go into it blindly unprepared. Unfortunately the only way for us with deep-seated problems (especially from childhood) to "move forward" is to stare our monsters in the face, so they no longer have power over us...
Most of us have learnt and lived with certain "out-dated" coping mechanisms for all of our lives... these perhaps carried us through childhood and kept us "safe" in our vacuum... but no longer work for us as adults. Therapy is about challenging our out-dated, stale thought processes. It literally is like "changing the habits of a lifetime", and it is extremely painful, and makes you very vulnerable... it's not something to go into lightly or without a real conviction to change... because without that conviction you will fail to even scratch the surface. Therapy is about "getting real", and real can be a pretty painful place... but once it's been faced you can never go back... you will be able to embrace and get to know the new "you", and life will be so much clearer :)
Thanks everyone for the advice and comments. I'm still feeling quite down and hopeless about it all but it's always good to have opinions from others. I've had a break from the sessions for a few weeks but it will be starting again soon so I need to get into a more positive frame of mind! (not easy since I seem to be feeling worse than ever).
I do feel like I need to sit down with my therapist and reassess the problem and what we're trying to achieve as it feels a bit like I've lost sight of it at times and we just go round and round in circles and I come out feeling even worse...
DanielJ I too have read of studies claiming that the NHS has bought massively into CBT and cannot now admit it's not actually very effective after investing so much in it, but I don't know how true that is!
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