Posts tagged therapy
Posts tagged therapy
That’s probably not how I’m going to phrase it, but it’s pretty much exactly what I need everyone who treats me, now and for the foreseeable future, to hear.
I’ve done that stuff already. The techniques helped, some of them a lot more than others, but I am firmly convinced I’ve reached the maximum benefit I’m going to get from them, and my patience is now gone. Yes, OK, fine, I will indeed pay attention to the world around me “in the moment,” and of course I will try to avoid deliberately giving myself messages that make me feel like crap. Let’s do some other kinds of problem-solving and person-centered type stuff now, please.
For heaven’s sake, the long-term treatment outcomes all show that CBT, DBT, and every other “empirically demonstrated” therapy out there only work for about half the patients, and the effects only last three or so years in most cases. You’d think they’d have a backup plan by now - Beck was writing about CBT in the 1970s, and Linehan drew up DBT in the late 1980s and early 1990s.
Maybe I’ll write my own book. I’ll call it “Phase II Therapy: When You’ve Realized There’s Only So Much Manuals Can Do For The Folks With Chronic, Serious Problems, And You’re Really Not Interested In Doing Another Round Of The Exact Same CBT Lessons YET AGAIN.”
And if I write it, I promise that I’ll put some of the words in scare-caps. Just because I can. Moreover, I will limit myself to merely three or four mentions of how much I want to puke when someone tries to recite a DBT acronym at me.
"Hate" is the wrong word, but I’m not sure what the right one is, so let’s just run with it for now.
(I actually definitely hate running, but never mind that.)
The tool in question is part of my “get out of bed” toolbox - I’m not a big fan of anything in that toolbox, to be blunt, but this particular tool is nothing compared to “setting gazillions of timers” and “always take sleepy meds so early you can never, ever, ever see another midnight movie” in terms of negative emotional reactions.
The tool is perhaps best stated as: “instead of staying in bed, go lie on the couch instead.”
I find that I’m awfully critical here. That’s kind of annoying, as I like to think of myself as reasonably positive and even cheerful (I work to try and keep the cheerfulness genuine - it’s one of the ways I hide how I’m feeling, so I have to be careful.)
Anyway, so here are some wellness and self-care techniques, and therapy lessons, that I use and appreciate to varying degrees:
Therapy assignment for the next two weeks: write down my achievements for each day.
The challenge: ask someone at church if I can hang out with them at some point.
(Yes, really, this was my homework. It was ALL of my homework. It took me from April 29th to today, to get myself up to actually doing it. This is the first time I’ve asked anyone to hang out, other than my sisters, in something like eight years.)
So I went and got myself a treatment planner guide (they’re books published for therapists and social workers who need to sort out what kind of treatment they’re going to provide a person) and am going to figure out the answer.
If only they gave you extra credit in therapy.
(BTW, buy them used if you want one; they’re really pricey new.)
I got a private Ask about CBT and how it’s worked for me, and I put so much work into it that this modified version is going up here now.
First: Try some online CBT to see how you like it. Nothing can answer your question as well as trying it out. My first exposure to proper CBT happened in the hospital, and that’s not a recommended starting point.
Second: Consider reading Mind Over Mood or Feeling Good. These are two classic CBT books, and they include a lot of exercises and advice. Almost any therapist in the world who teaches CBT has read these books (I’ve found them in virtually every mental health office I’ve ever been in, including my career counselor’s office and my psychiatrist’s office.) They absolutely should be at your local library (seriously, if not, tell your librarian that they need to get it because FOR HEAVEN’S SAKE.)
Now, onto MY answer.
This is a continuation of my thoughts on the “standardization” implied by/discussed in that article I linked to earlier. That study basically said that having patients go through a standardized course of treatment at a mood disorder worked better than discharging the patients directly into care in the community. It’s important, sort of, to recognize that the study was done in Denmark, BTW: the treatment in the community probably didn’t involve the same issues that it does here in the US.
This - “if you got good enough therapy your bipolar disorder wouldn’t bother you” - is one of the things that many in the community of practitioners/fanboys of CBT (and its descendants) constantly assert, and it is deeply, deeply stupid. It’s also completely unsupported by the science (example.)