CBT...No idea how it supposed to help me.

[Jagorey]

I'm currently having CBT sessions for extreme depression and anxiety, the issue I have is that I don't really understand how it's supposed to work or how it's actually helping me, I've been given some 'homework' involving a diagram about negative thinking but I'm at a loss how this is supposed to help me, I don't feel any different than when I started and l'm not really learning anything. Is this normal ?

How long have you being doing cbt?
I'm having emdr, started march and it took till September for me to see a difference and even now I feel its two steps forward, 1 back it isn't a continuous improvement. I previously had cbt and similar happened. Unfortunately my treatment suddenly stopped (nhs so funding issues) and I went backwards, so feel you really need to get to the end of the road with what ever treatment you have.

It’s not for everyone, and it’s certainly not deep therapy -

But for a lot of people it can really help reframe thinking, and reduce spiralling and ruminating

If you are at a loss as to how it’s supposed to help, then ask your counsellor to explain it better - you need to get how it’s meant to help you in order to put the work in, and with CBT you do have to practice it

CBT is about giving you tools to better manage your reactions and thinking patterns to things.

You have to put the work in - it won't magically cure you.

Could you raise your concerns with your therapist?

Good luck

I've had CBT. It is genuinely useful.

I'll explain more later but for now just stick with it and do what you're asked and give it a chance. Stay the course.

Unhelpful thinking is about identifying when you're thinking about things the wrong way and being negative when you don't need to

CBT is designed to teach you the link between your thoughts, feelings and actions. So (for example) you think someone doesn't like you, that makes you feel sad or angry and you drink too much or eat shit food as a result. But you have no evidence that the person doesn't like you - maybe they were just have a shit day which is why they didn't smile at you.

We have about 6,000 thoughts a day (possibly a lot more) but thoughts aren't facts - they are just ideas that flit through our mind, sometimes as a result of things we see, hear, touch or things we have experienced before, or just totally random. If we believe our thoughts to be true we can feel or behave in a way that's not helpful. CBT teaches you to be more logical and analytical about the way we think so that we can ignore or disprove thoughts that are simply wrong.

I don't know if you've seen it already but this 'worksheet' is really helpful;

https://www.getselfhelp.co.uk/docs/ThoughtRecordSheet7.pdf

CBT is great for some people but doesn't work for others. It's generally the first line of treatment because it's relatively easy and cheap as a therapy format and has a pretty decent success rate. But it doesn't nothing for me at all.

I didn't get it and hated / avoided the homework because it made me feel terrible. I was meant to have 6 sessions, was extended to 12. Something clicked in week 10 or 11 and I felt amazing. I didn't have a ooh my hippocampus is doing this so this response, I just felt loads better one day. It's definitely worth keeping at it IME.

CBT can be very helpful but it isn't instantaneous. It's takes time and effort. It teaches you to change how you think about things.

When it works it gets a natural "glass half empty" person to think like a "glass half full" person.

I hated CBT. Patronising twaddle. Didn't help me at all. I got counselling and got much better, alongside mindfulness (which I got off the internet myself).

It works for some, doesn’t for others.

It did nothing for me either.

I saw a programme with another therapist saying that CBT is offered on the NHS as it’s the cheapest option but, for many, psychotherapy would be more beneficial.

I found CBT really helpful for drawing attention to all sorts of disordered thinking patterns I had without realising. A lot of things that used to cause me distress or anxiety were entirely in my head. Learning how to control them and be more rational and less unproductively emotional was so helpful.

It definitely doesn't work for everyone, but I do also know people who claim it doesn't work at all for them, whilst being noticeably calmer, happier, more rational, easier to interact with etc. So sometimes its impact can sneak up on you.

@TheCatfordCat I'd love to know why you found it patronising.

Kain Ramsay runs Udemy courses on CBT (amongst over subjects) and has written a book which I loved - Responsibility Rebellion.

This is a quote of his I've just seen

It differs so much between people - perhaps due to the quality of the therapist but maybe due to different personalities and mental health issues.

I found it utterly ridiculous and very patronising - I still get quite furious about how unhelpful it was!

On the other hand EMDR changed my life - my problems were not cognitive, my thinking was not the issue and so I needed a different kind of help x

My CBT included a section on mindfulness

Thank you all...I guess it's largely down to the individual, I'll persevere and see how I go.

What I found made a difference was a therapist who actually guided me through the thinking in the session- eg I'd talk about how I was feeling, she would ask the prompting questions, I would answer, she'd follow up. We did this for several sessions then she explained the model and asked me to try it at home.

That was much more useful than the guy who just explained the model and sent me off to do it as homework. I felt like never actually got to talk things through with him

DBT is a version of CBT which is recommended for neurodivergent women. CBT is thought to be inappropriate in this specific instance. You don’t mention a diagnosis OP, but it might be worth considering, especially if you have a history of anxiety and depression.

I (was) an NHS trained CBT therapist working under the IAPT system.
It has a 50% success rate, compared to 'watchful waiting'. You can train yourself to think more 'helpfully' about your difficulties but they will still be there. I left as I felt that the IAPT system was very inadequate & left some clients feeling that any lack of improvement was their fault.

Unhelpful thinking is about identifying when you're thinking about things the wrong way and being negative when you don't need to
This. But it only works if your thinking is disordered and needs to be corrected. If your thinking is correct and accurate, and everything really IS as shit as you think it is, then CBT can’t help.

I am a therapist and primarily practice CBT. It's a brilliant modality however it is certainly not right for every person or every situation so I adapt and use what works for the client individually. I wonder how clearly your therapist has explained her rationale to you about the homework etc. I always check out my clients' understanding when giving tasks to try at home. It's ok to ask your therapist for a different explanation or approach, after all it's your time really. For any therapy to work you need to put some work in yourself, so make sure it's work you understand doing.

It was hopeless for me (I am neurodivergent). I got into a panic because I couldn't understand the exercises. What annoyed me was that after leaving me in a worse state than I started, the NHS couldn't offer anything else.

Sorry to hear you had such a disappointing experience. I work with neurodivergent clients as I myself am neurodivergent too. CBT can definitely work for this but it needs to be done with the neurodivergence in mind first and foremost. NHS are so strapped for cash with mental health, and there's a tendency to train up nurses in CBT which doesn't always help. Your best best really is to find a private therapist if you want to work further on your mental health, this might mean finding local charities or saving up and paying for your own sessions with someone who understands neurodivergence properly.

I'm ND and just finished 9 sessions of CBT with an NHS therapist. It took a few sessions before I felt the benefit and I did feel like it was going to be a waste of time for a while but I'm happy to say I was entirely wrong and it's really worked for me. My therapist was amazing though and I realise it's likely they're not all that good. How many sessions in are you OP?

CBT helped me so much with anxiety. Before it I couldn't walk around a supermarket without feeling as if I was going to have a panic attack - there were times Id have to abandon my shopping trolley and leave the shop. That never happens anymore. I use the techniques that I learned in many situations and they're very helpful.

I was quite sceptical at first but I persevered with it and am glad that I did. I had 12 weeks of CBT.