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limitations of CBT

13 years ago 0 +0 / -0 356

I picked the title "limitations of CBT" for this topic title but I do NOT want to discourage anyone from learning CBT. The information and this forum has been invaluable to me.

That said, I have to say, I do not think I am dealing with cut and dried panic (then again, who is dealing with anything cut and dried, life is complex). The best explanation I can come up with for how this site and my life converge is that I feel panic (along with anger and hopelessness)when I have a strong negative emotion. So far, CBT is impossible to practice during the actual emotion. It feels like trying to open an umbrella in a hurricane - the storm winds of emotion are so strong, there is nothing I can do in the moment. I know that sounds defeatist and I know someone (Davit and others who I appreciate for so much wisdom and honesty) will challenge me that there is always something we can do in each moment in life to try to help ourselves but for now, when I am in the eye of an emotional storm, it feels like there is nothing I can actually do. And the pain of it is so real, that I want to be able to do something, so the inability to do anything to calm the storm leads to thoughts of "this is hopeless" "I am hopeless" and it feels like the storms will never end, they will keep coming and throwing me around for the rest of my life.

The jury is out on whether I simply need medication to address whatever is happening during those storms. i.e. that what I am afflicted with cannot be cured without medication.

CBT, helpful as it is for my negative thoughts during the day, is not really possible during the storm. During the storm I do not know what to do. I really don't. I do not want to describe fully what happens to me during the storm. It is bad, it is painful and deeply distressing. It is grief, sadness, fear, anger and terror all rolled into one very long moment.

That is why I have started going to therapists and why I am open to taking medication now. I am tired of enduring the storms. I am burning out.

I thought that CBT was going to help me with the storms but since it is not, I am starting to develop anxiety about when the next storm will hit. Will I be able to manage it? Will I be around people who will judge me for it? Will it be unbearable? How long will it last and which part of my day will it disrupt? Which activities will I miss out on due to it? Should I even plan anything if this is how I have to live? these are the anxious thoughts caused by feeling out of control about the storms. I am sure there are lots of people here who can relate to those sorts of thoughts and worries.

In between the storms, I function fairly fine, as well as anyone can when they are in a hurricane of emotion that tears them down for an hour or so every second day. When I am pulled down by an emotion, I feel horrible. The pain is intense. Once it passes I flip back to "regular scheduled programming" and I clean up, do my work, get things done, etc.. People who see me would never know I was feeling completely overwhelmed and hopeless 10 minutes earlier because i am talking, carrying on conversations and so on.

What is this and what do I do about it? I realize this site is for the panic program and that has helped me with the negative thoughts when I am not in the middle of a storm but it has not been something I can use during the storm. And I am enduring too many storms too often lately. They are unrelenting and I am getting really burned out from them. Yes, they start with a negative thought. But they trigger an emotional reaction before I can really intervene. And is it possible to intervene in an emotion? Can we actually prevent emotions once they start? Are they not somewhat automatic? Can you stop yourself from feeling something or is that suppression? I need to knnow how to do whatever I need to do to live the life I want to live. I don't want to be ruled by my emotions and I don't want to suppress them either.

Once the negative emotion has been activated, I am taken into the storm. I hope someone can help me determine what will help or at least confirm I need to wait for medications to reduce the severity of my negative emotions (assuming I was prescribed something that will actually affect the storms at all which I pray it will).

I have considered how to use the exposure aspect of the program here but I can't do a planned exposure to my emotions. Or can I? Right now they hit me without warning, they are triggered by things I am able to identify. So is my next step then exposure to a trigger to a strong emotion in a planned setting as the program talks about here?

13 years ago 0 +0 / -0 6252

loves trees

I had a doctor that put in my file that I was bipolar, odd that he also put in there that I was a hypochondriac. Next Doctors comment when I said I was upset about this was. "even hypochondriacs get sick". I had more luck with him. Both MDs not Pdocs.

If you go to www.anxietycanada.ca you will see what this canadian medical group has to say about anxiety disorders. This is a canadian health care approved non profit site giving information only, not selling books or cures. Just so you know you are not out to lunch. They outline very clearly that some people do need medication. That some need CBT and that some need both. I've had better luck with MDs and when referred the chances are better he will refer me to some one reliable or at least more compliant with my wishes.

Unfortunately some doctors (I've run across them) have there own agenda and if it doesn't cure you it must be your fault.

In Canada the doctors are paid by the government and there performance checked periodically via patient questionnaire. Some still fall through the cracks, mostly because they are the only one working that area of the country. Having letters after your name is no guaranty. They have to eat too so you will run across those in it primarily for the money. I have also found female doctors and nurses more efficient also on average. Yet My female friends say the opposite often.

Doctors hate the internet. Yet some will use it for a tool sifting out the garbage so you don't have too.

I have one major rule about the internet. If it is primarily trying to sell you a book that will cure you it is probably garbage. If it is right at the beginning trying to sell you a book on information it is probably legit. If they are selling their storey, it may or may not be relevant.

Do not rule out all the internet, after all is that not what we are doing right now and it is free and works.

Last option would be a naturopaths. Beware though that they often over prescribe herbals and some of them can be dangerous. Especially as there are no controls.

I would recommend you start over again with your local GP or a new one if you don't get along with the one you have.

According to the therapist I was seeing it is possible to do CBT with out meds but it takes longer and negative thought is harder to fight. (no way to get a rest from the thoughts) If you know this one fact it can help. If you know it is going to be harder it can give you an edge.

The only way you will know if you need meds is to find some one to prescribe them. Please don't use sites offering meds without a prescription, you don't know what might be in them.

Here for you, and feeling sad for your predicament.

Davit.

Ps, members of the mint family work but work better if used with ginger. Lemon Balm by itself is good, as is sleepy time, Mint and ginger. Camomile by itself. Avoid putting too much sugar in it, it can make you hyper.

13 years ago 0 +0 / -0 4027

Loves Trees,

Sounds rough and turbulent and raw...

13 years ago 0 +0 / -0 356

I think all my hope about the usefulness of the psychological profession was flushed down the toilet today. I have seen 2 psychologists and 2 counselors and none of it has helped. This lateset visit feels like it made things worse because this person told me to stop trying to find help / solutions to my problems online and sent me on my way. I do not know what they expected me to do. It only took me 10 minutes upon leaving their office to be in tears of anger and hopelessness.

They also told me medicaiton wasn't going to help me. That was really inconsiderate, thoughtless. At this point I accept that I need something short term to help me get through each day emotionally and it was thoughtless for someone to tell me basically well, I don't know what I was told. Not to read anything about my condition and not to take medication as it won't help. Although they said "meh, maybe it will take the edge off. who knows".

Personally I think that if this person, and the other people I have seen, heard that their own child or someone they loved got this sort of "treatment" from someone and paid over 100$ an hour for it they'd be angry too. This wasn't "help" of any sort. It was a quick way for them to make a buck. I should have gone into that profession. Apparently you can earn lots of money by asking people to talk about their childhood, tell them not to read any books and send them on their way.

I have a message for all "helping" professionals out there. No matter what, you must spend at least the last 10 minutes of any session ensuring you are talking to your client about do-able actions they can do when they leave your office. You cannot use the full hour, especially of a first session, to have the client give you their background and family history because that client , regardless of their problem, probably came into your office because they are wanting some help. Taking their money after getting them to review family history for an hour without giving them any help or advice is wrong in my opinion. Yes history and backstory and family history matters but please understand that it is the therapists' goal to get as much of that info as they can in the first session. The client wants some help. I wish this therapist would have set aside the last 10 minutes to discuss what I can do today, this week and next week to help myself. I left their office feeling as hopeful as someone who was sick and told there was nothing that could be done. This is not good service!

I would like to believe that this is not all there is and that if I keep persevering I will find someone who becomes a real helper to me in this time of need. My pain is real, I know that, and I am angry that I paid so much for no help for it.

In a day or two I am going to let them know I cannot book a second appointment unless they tell me how they plan to help me. In the meantime I will sit here scared of when the next episode will hit me and how in the world I am going to manage it since I have no skill to do so and was expecting them to help me with that. I refuse to stop reading online if that is the only source of help for me. I feel like going to sleep until my medication kicks in which apparently will be in several weeks. Until then I do not know how I will manage each day emotionally and the demands I can't meet when I am feeling so bad.

13 years ago 0 +0 / -0 376

Hugs has it right... maybe you could redo the tests in your Panic toolbox and print the results out for your next visit. My personal preference is for a Psychiatric Nurse (working w/a pdoc they can prescribe meds) as they seem more willing (able?) to listen, they cost a lot less, and are frequently available for questions and emergencies 24/7. Unfortunately, they are few and far between... but it's worth checking to see. Just don't give up.... and in the meantime I hope you will keep coming here, do the tests and the lessons and it will help. I hear your frustration Loves Trees and I know when you are feeling badly it is hard to keep trying to find the help you need. You sure seem determined and I think that is a really good thing to hold on to. Hang in there. Let us know how it goes....

13 years ago 0 +0 / -0 4027

Oops,

I meant Dr P(not "V") Farvolden, who is the resident expert...

13 years ago 0 +0 / -0 4027

Hi LovesTrees,

It’s tough, even with conventional medicine, to be able to tell if you’re getting good help. We’re human, and there’s this helplessness which I find takes over, and we need someone to trust.

Maybe asking the forum facilitator or Dr V(in the “ask the expert” column of the forum) one or both can recommend an evaluation tool. I’m sure everyone would appreciate it, and it would help efficiencies of the systems. He’d probably have something more current than “The Feeling Good Handbook” empathy scale/feedback form by DD Burns MD. This was a classic with 10 questions and what went good/bad, but Dr V is so connected and current, he’d hook us up with an update!

I was fortunate, since I was able to see a couple of MD’s, but in between, some unqualified guy lured me, through someone I trusted, into a “process” that sucked the life out of me and my wallet...and he still “practises”, since anybody can hang up a shingle. He wouldn’t appreciate an evaluation tool, as wouldn’t anybody who is insecure or incompetent.

Buyer beware is important, but we’re in this grey area, with our grey matter, when we’re dealing with something less tangible than a rash or a lump or limp...we all have to walk that road..... good luck

13 years ago 0 +0 / -0 14

Hi,

I'm not sure if your from canada or the united states, but if you can go to a Psychiatrist you may have better luck. A Psychiatrist being a medical doctor can both suggest and prescribe medications for help in anxiety and depression. Some are better than others. I agree that looking for help outside of CBT online can be determental to helping yourself. There are no quick fixes, just hard work. If you live in Canada Pyschiatry is free another plus.

All the best Kevin

13 years ago 0 +0 / -0 356

Well it happened again. I was told by another psychologist that I am probably fine and not needing medication. this is very very frustrating. beyond frustrating.

This is causing me unbearable emotions. I am getting really tired and worn out from all the visits and attempts to "do something" when all I am really doing is burning through money for these people to tell me I am not this or that and just need to learn how to cope better.

I was also told to stop self diagnosing via the internet. Which is not really accurate. What I am doingg is trying to find something that will help me. There is nothing wrong with that. I don't pretend to know what is wrong with me, I am grasping at anything that will help.

I wasn't given any real advice and this process of finding a good therapist is expensive and so far causing me more grief because I just get more discouraged when I come home from another useless appointment.

13 years ago 0 +0 / -0 376

Loves trees.... Unfortunately, you are not alone in psych "professionals" declaring you fine.... even when you tell them you know you are not. High functioning people with mental illnesses baffle the "professionals" .... we don't fit their clinical guidelines.... for ppl with my diagnosis, it typically takes 7 years of treatment before anyone even comes close to getting it right. I've seen some really bad pdocs and therapists... I've seen some really good ones.... and I've seen many more who meant well and caused more damage out of ignorance than the bad ones all put together. (I briefly saw a counselor who determined I needed to have demons caste out! Sheeeeeesh!) Anyway, we must advocate for ourselves and trust our own instincts. It took me a long time of giving my power away before I came to understand the importance of this. Just because I have a form of mental illness, does not mean I'm incompetent. I dare say... neither are you. I found this to be a great place to get excellent feedback that can be trusted. I'm rather certain you will find the same. Hang in there, sweetie.... the mental IS extremely painful, extremely draining, and extremely serious. Let no one tell you elsewise. I reiterate what others have written ... we are here for you.

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limitations of CBT