I've 'Failed' CBT - Suggestions for next step?

[Chester]

Well after 20 plus sessions and some great progress with a supportive and understanding therapist it appears that I've hit a roadblock and have been told in all but name that I've failed CBT (or it's failed me)

The problem is I've treat it much like a degree course, I've devoured the books, I've done the homework, made the notes and I expect it to be *click* fixed!

I've fully engaged but only with my head. I know I can get better but I don't BELIEVE I can and this means CBT is not suitable for me.

My therapist is going to think things over and god love 'em they have been superb, couldn't have made some weeks without them but has anyone else had this experience of failing and where did you turn next?

I'm fairly worried the NHS will just dump me or say 'well we did our best, its your fault'

[Tessar]

Hello Chester. My suggestion would e to keep at it. Don't give up on CBT. Even though right now, it seems you have failed (best to avoid labelling yourself as usually it is a derogatory label). Anyway, it's not a case of failure, it's that it hasn't worked SO FAR. It could till work. Believe me, it took me probably three years to get there and it was very hard. Even now a decade late I re-read my notes and make sure I too up my skills. Simply because you learn the techniques behind CBT doesn't make it happen. Inputs your desire to fix your problems ultimately that does it. Where you mention having had some great progress, what are the bits that have worked for you? Have you had any "wow" moments when a sudden realisation comes to you? That something did fall into place. Remind yourself that it's disproportionate thoughts, unrealistic thinking that gets you into a mess in the first place. So that is what makes success so difficult. It's a long road but you can still get there you know, don't give up otherwise all that hard work wouldn't have a purpose. It's not easy to "let go" (in body) but that is what it will take.
That roadblock is the crux of what is stopping your recovery. It's hard to take on board new angles on things. It's hard to believe the evidence you find that discounts the beliefs you are holding into. It's hard letting go of those thoughts, beliefs etc because they feel so real. The hardest part of CBT for me was letting go of those beliefs. I still, after all these years, have to fight off the beliefs that depressed me so much in the first place. I wish they would go away for ever. But it is an ongoing battle I fight. I can't give it up. Because if did, all the old crap would come marching back and no way a,pm I having that. Not after I have come this far.
So take heart, it can still work. Maybe you need to find a way of being perhaps emotionally connected to it all. You have the knowledge but it's that bit extra you need to initiate & then maybe you will find success.
I will say that giving up "habits of old", "beliefs" is really really hard. I make no bones about that at all. It feel alien to consider another viewpoint, it really does. Despite that, if you can find a way of approaching this with your whole self, it can still be a success.

[Chester]

Thanks for your reply Tessar, I have a feeling the therapist will be taking the decision out of my mind as she feels my progress is stuck because of my expectations of a quick fix (which after 22 sessions isn't likely!)

I just struggle to see how I'll overcome this 'belief' problem. It's like I'm studying for the exam, knowing it all and then failing

[Speranza]

Are you very intellectual? I had this problem and I had no idea that I was 'feeling' things in my head instead of my body. I hadn't even realised that they were called feelings because we feel them - I always 'thought' my feelings...

You can get through the block if I did, that's for sure!

[Chester]

Are you very intellectual? I had this problem and I had no idea that I was 'feeling' things in my head instead of my body. I hadn't even realised that they were called feelings because we feel them - I always 'thought' my feelings...

You can get through the block if I did, that's for sure!

I am. Very much so. It's a weak spot of mine.

That's interesting. Thank you. Food for thought

[Tessar]

Well, you can read books and digest information, but putting the theory into practice is the key part. I suppose it's a bit like training to do a job and the actually getting stuck into the work itself, the point made below about being intellectual and about feelings is extremely valid
To give you an example.... After a few sessions, my counsellor noticed that I was unable to describe my emotions, I couldnt label them. I was very well aware of them but I think I was so scared of them that I couldn't elaborate on what it was like. I was scared it would make me gt upset. The idea of crying in front of my counsellor seemed way too uncomfortable so I tried to avoid my emotions or talking about them even more. so, what my counsellor did did was press an imaginary "stop button" in my sessions any time she could see that I was Struggling by something triggering my emotions. Even before I started my counselling, I knew I needed to let go and trust her, to cry in front of her but it felt so uncomfortable, I worried it would consume me and I'd never stop crying. Well, eventually I did cry. I wish I could have just completely let go but at least I managed to talk enough about things that finally the emotions truly surfaced.
Since then, I don't cry in every session. But it's those emotions rearing their head, that I don't have control over. Instead of pushing them back.... Now I can let them out. I still find it very uncomfortable but in terms of helping me get better it is necessary for me. In fact, as a result, in every day life now I am no longer scared of my emotions, they won't hurt me, they are natural. I am more connected to them than ever before, not being scared of them anymore is very helpful.
Ah well, I hope this is helpful. And I hope too that you can find a way to get past your block..... :-)

[kittikat]

I agree, I had 28 sessions of CBT with a brilliant therapist and actually made good progress while having my sessions. Without the motivation of seeing the therapist each week, it was up to me to continue the hard work I had put in during the sessions....

Cue - quick fix? NO!! This is something that needs to be practised and repeated continually by yourself if you want to move forward...never say never...therapy was good for you, you just need to keep up the positivity you had while attending.

My therapy finished last November but it has been a long, uphill struggle for me. I HAVE made progress, my mind just likes to give me a reality check every now and then which makes me doubt myself. It's about being positive, so never tell yourself it wasn't for you...just keep at it and in time you will find that the 'coping strategies' become almost second nature ...good luck.

Kitti

[Tessar]

When I was doing therapy, I think I was so desperate to have a close friend or a mother figure, that my therapist filled both bills. But of course I always knew the therapy would end & I would need to carry on with the work myself. I worried when we finally came towards finishing that I'd sabotage my hard work to get more sessions. But in the event, I didn't do that.
This time round when seeing my counsellor, although of course we have a bond and it's lovely seeing her, I know and have always reminded myself that I am there not to find friendship but to help myself deal with things that are uncomfortable in life or upsetting. I have made sure that I am doing things for ME this time. That I am doing it to improve the quality of my life. Also that once I have offloaded and made myself feel stronger again (& received advice & support along the way) that I will be strong enough to carry in the good work myself.
It is hard to do that without the support of a therapist or counsellor but thats when we need tom draw upon the skills they have helped us learn, to draw upon the new awareness we have. at the same time this is where friends, family (the ones who really care about you I mean) can be your support. Also you can support yourself too. Be kind to yourself. Is hard but it can be done. Also, something I didn't have last time was this place. Oh how I wish NMP had been around all those years go when I did therapy. But it's here now and is a place to share so much with others in a similar situation. :-)
I don't know about anyone e,se, but sometimes just being able to come home and share with others that something significant had happened in my day is such a reward. It might just be that I realised I hadn't followed a negative though pattern. Or that I managed a difficult situation. If I share these things with my partner, she can't relate to why they are important to me. That's not her fault and she isn't my therapist or counsellor so it's ok. But being able to say it here
, with people it really means something to.... Well that is really good.
So people....you keep up the good work. Continue to nurture yourself. You have the knowledge now. Push yourselves because it is worth it. Don't fall back into old habits. Don't waste all that effort you have out in, BECAUSE YOU ARE WORTH IT.....!!!

[Chester]

Thanks for everyone's advice and experiences

I had a chat with my therapist this morning and she's of the opinion I should stop with CBT because she feels we'll keep hitting a wall and I'm simply too self critical. (ie - I expect to be back doing what I was doing 18 months ago when I was fine as opposed to judging it from a personal low point)

The issue as many of you have picked up is that head and brain are engaging fully with CBT but my heart isn't and until it does then it's an exercise in futility.

I've got a wee while to think about things but intensive CBT or psychotherapy has been mentioned

[yenool]

The one aspect I didn't like from my experience of CBT is the impression given that all negative emotions are down to 'incorrect' thinking and all we need to do to get better is 'correct' our thoughts and if this doesn't work somehow we have failed, aren't trying hard enough, not committed, etc.

I just don't think that it is always possible to control or restructure thoughts - and while some thoughts may be highly negative they may also be realistic/true too. In some regards CBT is a glass half-full/self-delusion approach to life.

I think CBT is very good for reasonably narrow issues that can be worked on intensively with lots of short term goals, but I don't think it is so useful for people with wider or more complex issues - for example, multiple mental health problems combined with difficult family/social situations, physical health problems, etc.

I think for many of us it is also difficult to separate our feelings from our thoughts and behaviours. I had some good success overcoming a crisis situation with a combination of CBT and medication in the past but have found it only helps so much and has limitations.

Unforunately CBT appears to be viewed as a mental health panacea these days and in many areas short courses of CBT is pretty much all that is on offer for those with mild to moderate mental health problems.