Anybody else find CBT and Mindfulness unhelpful?

[Blackcats7]

I have chronic depression and anxiety and ocd plus newly diagnosed with high functioning autism.
I have tried cbt from two different psychologists and find it utterly unhelpful.
The constant scoring makes me feel under pressure to under estimate my numbers to improve so as to validate my therapist by being a “good” patient.
I also absolutely despair of the way mindfulness is seen as a supposed cure all and feel I will scream if one more person suggests this to me yet again as it has been zero use to me.
I am physically disabled and have chronic pain and the various suggestions for relaxation are things I can’t do due to either physical or sensory limitations.
Is it just me and everybody else finds these things wonderful?

My DH is another who finds it utterly pointless. He has anxiety, depression and chronic pain. He gets so frustrated that it’s all this is offered in the NHS when he tells them it hasn’t helped before. Last time he had talk therapy they were supposed to be trying ACT (acceptance therapy) but the therapist just did CBT again. Mindfulness is mostly out to as it has a lot of visualisation and he can’t visualise at all which again just gets him stressed and frustrated.

The Curable app, which is a chronic pain manager, is all about breathing relaxation, if you can get your nervous system out of a fight or flight response, you can start to send calming messages that reduce the pain signals. But it takes a lot of work I really don't think it should be portrayed as an easy route. People who struggle with visualisation, there is a lot that you can do that is less abstract around breath work, using your hands to track the movement.

@NeverDropYourMooncup unfortunately my ex husband took my money and I now live on a small pension and disability benefits so money is limited. I have a mobility scooter but can’t sit for long most of the time so can only use it occasionally. Plus I feel vulnerable out on my own. Had to stop driving due to pain and anxiety.
I don’t like plants or even flowers indoors so not an option.
The things I enjoy now are mostly to do with my lovely cat who is an absolute joy and lifesaver to me.
I have some good friends but they all have busy lives and the last thing I ever want is to be a burden to anybody else.
No family.
It is all a bit shit and I think as others have said the opportunity to talk about how shit it is would be more helpful than trying to make me feel the shit is not the problem and I am.
I wish the NHS would treat me as a whole person rather than different departments who don’t interact or communicate and with Social Services spend money on practical and medical help and things which would actually change things for me as much as possible rather than the piecemeal nonsense which is what I receive.
If I had help to go out, help at home, surgery to help my hip and spine instead of endless hoops to jump through, adaptations to my home instead of telling me my income is too high by their assessment (even though they have seen I have hardly any savings) then perhaps I wouldn’t need a psychologist to make me feel how I feel is entirely up to me at all.

CBT and mindfulness is unhelpful for autistic people.

CBT is all about blaming yourself for not thinking or behaving in a neurotypical manner and mindfulness asks you to be in tune of your body and surroundings when you’re already hyper aware.

theyre the cheap options tho. My partner keeps getting referred for CBT- he’s done it at least five times since we’ve been together and instead of moving forward to alternative therapy he just gets referred again, “passes” with flying colours and discharged from the mental health services only to have to go through it again. It doesn’t help chronic cases. Doesn’t address the reasons why people struggle with depression just reinforces masking and thinking happy thoughts.

I have only done CBT years ago
A part of me did find it a bit patronising. It wasn't what I expected.
I am unsure whether I just wasn't the right person for it or what.
To be honest I think it helped more having someone to talk to.

As a qualified CBT practitioner, and with utmost kindness and respect, no that is not what CBT is all about. It's more about adjusting our ways of viewing situations and considering how we respond to them.
That being said it is also important to add CBT is not right for everybody or indeed for every presenting factor. It isn't always effective for autistic clients (though for some it can be). Like anything, there will be people who thrive on it and there will be people who thrive far better through other methods. This is why many CBT therapists (myself included) will happily take a different approach for autistic clients and adapt their modality to take this into account.
Equally CBT is not what I would consider for anyone experiencing trauma/PTSD. That needs a more compassion focused approach as CBT is not ideal for that for very important reasons. This is also why it is worth seeking private therapy over NHS if doable (I realise not possible for everyone) as NHS etc will tend to do very time limited approaches which (in my experience) do not work for either autism or PTSD and trauma.

@Blackcats7 would you be comfortable to share what area you are living in? I may be able to provide contact details for accessible low cost/no cost therapy within your area depending where you are.

@recyclemeagain I live in hampshire on the south coast but being housebound my current psychologist comes to me as travel and then sitting in a room somewhere is painful for me.
I have very little cash to spare as my benefits are already used to pay for help maintaining home and garden as I am pretty much useless in doing these things myself anymore.
I hate zoom etc as cannot bear my face on a screen or looking directly at someone. I can do telephone though but the only benefit of current psychologist is actually having a visitor to talk too in person so I do prefer that. She is a nice woman and I like her it’s just the method I find wanting.

I'm autistic and I hated CBT- tried it twice and found it patronising and unhelpful, and 'mindfulness' in the most popular way it was presented just didn't gel with my ADHD. I've now been in combined therapy (a mix of DBT, interpersonal, transactional analysis, and talk therapy) and I've found it far more helpful than CBT ever was. I also do incorporate some forms of mindfulness, not the 'colouring books and meditation' type but the 'focus on your surroundings to bring yourself down from a panic attack' type, which I find useful as well.

I've heard it said that standard CBT is often ineffective in neurodivergent people- and it makes sense, when the concept is about 'rewiring your negative thought patterns' it tracks that it won't work the same in people with differently structured brains. On the contrary, it often makes people more resistant to therapy after bad experiences. I've heard positive things about modified CBT used to help autistic people, and DBT seems to be increasingly popular amongst ND folks as well. If either of those are accessible to you, I'd definitely suggest trying it out

@Blackcats7 I can understand though it is very limiting if you're unable to do online or in person sessions. Telephone doesn't always provide the best level of support (though has its merits where other options are not possible). Good to hear you are comfortable with your current psychologist. I wonder have you broached this with them? They may be able to incorporate alternative modalities to help you get more out of your sessions. As with all therapies, you will get back from it what you are willing to put in so there's a lot of value in speaking up and saying you aren't finding CBT effective for you. Unfortunately I am in an entirely different area geographically so unsure of available alternate services but if I come across anything I'll add them to this post. But for now you are the best advocate for you as you know yourself best. Any psychologist worth their salt will be open to feedback from clients, you are always allowed to provide feedback at any stage.

I don’t recognise some of the descriptions of cat and mindfulness and I do find them
helpful in some situations. However, therapy isn’t a magic cure. If you’re in a situation that is causing you great distress I think it’s often the situation that needs changing.a psychologist is trained in different approaches so should be able to tailor to what you need. They should also be able to investigate whether your problems are actually anxiety or depression or are autistic overwhelm, burnout and trauma.

I have complicated chronic pain too and had a therapist for a long time who mostly did CBT, though there were no worksheets, I'm happy to say. I did find her helpful at the beginning, mostly because she made gave some good practical advice and was useful, as others have said, as someone to talk to who was not my husband or friends. And we did guided meditations which I found helpful at the time. However in later sessions I found my jaw dropping mentally at some of her suggestions, including basically ignoring my past trauma (physical and verbal abuse as a child) and the affect it had on how I react to certain situations today.

I'm lucky not to be under the NHS and am now with a therapist at my pain clinic who uses a variety of techniques and has experience in trauma. I'm finding her a much better fit,

I do empathise about the difficulties of travel and sitting in a plastic chair - I have trouble sitting too (back and hip issues, and I can't walk much either as I need an ankle replacement) and I feel it's generally a misunderstood problem.

My DH did ACT for a particular issue and it was very successful, so I think these kind of therapies can work in certain situations. It's a shame there is not a system with an assessment session to determine what kind of therapy might be useful, rather than pushing CBT on people for whom it is unlikely to work.

I won't send as you said you don't like them, so unmumsnetty hugs, and for you.

In the nicest possible way, if you're severely depressed, you're not going to think anything works.

Pretty much but I’m also autistic. I had clinical depression in my twenties and only drugs really helped. I’ve been in remission since I had my son though (12 years). He definitely helped too but a lot of it was rooted in my childhood and also in my infertility

ERP is what is needed for OCD not your usual CBT.

did a cbt course online through local nhs. I did not get on well with it and the therapist who assessed my answers weekly said that I was fine and didn’t need it. Even though I was in the biggest anxiety spiral of my life. I’ve not tried again to ask for help because I was made to feel like I was being over dramatic with how I was feeling as my answers said i was ok. I now just try and live with it as my scores for anxiety and depression aren’t high enough for them to prescribe, I think I manage to mask quite well as I “function” day to day

There is so much here that resonates me with me. As someone suggested above if you google 'Why CBT does not work for everyone?' or 'When mindfulness can be bad for you?' there is lots of evidence as to why it is not the panacea that some people seem to think. I think the NHS like CBT because it is cheap and can have short-term success but patients often have to repeat the process again and again and for many patients it can make them much worse but they don't appear in the statistics as they are deemed to have not done the homework or complied with the therapy offered.
It particularly doesn't work if your OCD behaviours are the result of trauma - trying to convince yourself that the worst won't happen if you do not perform your compulsions cannot work if you developed the compulsions to cope with something that did (or still is) happen(ing).
I am particularly concerned about the current push/campaign to have mindfulness lessons in all schools. I am sure that the campaign is well intentioned but will those with diagnosed mental health conditions be excused from the blanket approach thus outing them to their peers? Who will pick up the pieces if an undiagnosed condition is worsened by the mindfulness approach?
Our children and young people need mental health support in schools but this must be evidence-based and well resourced and not a performative way of ticking a 'wellbeing' box.

Me. When I had very severe depression mindfulness made me feel worse. Sitting with nothing but the thoughts in my head was very unhelpful. I did find some of the ideas of CBT quite useful though. I used it as a reminder that my brain wasn't working properly but it was in no way a cure.

Since feeling better I have tried meditating with sound though (often use sound baths on youtube) and find that very relaxing. Concentrating on an external sound rather than my internal thoughts works much better for me.

That isn't true. Depression definitely means you think negatively but if someone is engaging with CBT or mindfulness it is because they want to feel better. A very high dose of antidepressants worked for me but I recognised when they started to work and stuck with them.

Completely agree

As someone who had done these ‘course’ for years prior to my autism diagnosis and as someone who watches my partner regularly forced onto these unhelpful courses every few years as a gatekeeping method to the decent help he never gets put forward for, I say with utmost kindness and respect that the intention doesn’t filter through to reality. It’s basically shit and blames you for things beyond your control when your brain doesn’t work in the typical way.

you just have to go in any number of neurodivergent groups where people are saying these practices don’t help them and nobody is listening to them and you’re displaying that here. CBT isn’t really a listening therapy though it’s a think the way we think you ought to therapy

I’m aware how evangelical CBT and mindfulness practitioners can be (my stepmum is also one) but I and other ND people here are for the most part telling you what it says to them and you’re not listening.

@recyclemeagain You may well be one of the good ones, but I and others I know have had poor experiences with the CBT courses that are the only service the NHS are willing to provide.

I found being told "YOU are responsible for your anxiety and depression, YOU are maintaining it" very unhelpful.

As for CBT being unsuitable for people with trauma or PTSD, it would help if GPs referring us to these services actually did any probing to find out whether that is the case.

This is an interesting thread for me. I also found CBT unhelpful. - and was later diagnosed with ASD, which may explain why it wasn't helpful.

I also struggle with mindfulness. It's ok if I'm being asked to watch something and focus on specific moving bits (so visual), but any other approach is always a complete failure.

I was offered a course of ACT+ therapy as part of a research project for free. (acceptance and commitment therapy, + exercise). I did find that helpful, much better than CBT for me.

You do know that both of those activities are exactly what mindfulness is. Navel gazing is the opposite of mindfulness.