Feminist opinions on CBT and mindfulness

[PenguinB]

Does anyone have any links to feminist opinion or analysis, or opinions of their own on CBT or mindfulness?

I left a DV situation and am now on the waiting list for counselling (non CBT). Every time I speak to my GP other professional they immediately offer CBT group or individual therapy or mindfulness with a CBT component. I know these are preferred by the NHS.

I am getting quite skilled at firmly but politely explaining I don’t want CBT. The reason for this is because having spent years disassociating, I struggle to remember events or form new memories.

The forms of therapy offered seem to be about not looking at things with a negative perspective (CBT) or not looking at things outside of the present moment (mindfulness), neither of which either allow me to acknowledge what has actually happened.

This all sounds very personal, but I would really be interested in hearing anyone’s perspective on going through therapy, attending self help groups etc.

What an interesting question. The question of whether talking therapies as a whole are feminist is unfashionable but relevant, but I hadn't considered whether particular modalities are more feminist than others.

Gross generalisations notwithstanding, CBT and mindfulness both locate the 'problem' in the individual. You're thinking the wrong way or too much or you're identifying with your thoughts. And they both give you tools to correct your 'problem'.

Trauma informed therapy on the other hand, locates the problem in what happened to you and foregrounds a validation of your experience by allowing you to explore and make meaning out of your thoughts, feelings, body sensations. That sounds like a feminist project to me.

That is where some recent criticism of mindfulness has come from Dido.

So long as one has a good teacher, it shouldn't be about solving the problem by focusing on the self - it should be, if taught properly, about learning how to handle our response to the 'problem', to enable us to get to a place where we can more calmly consider our options, and better take measures to resolve any issues, process trauma, etc. Mindful awareness is a part of the process, not the entirety of it.

I think that learning to observe our habitual responses (not judging them as 'the problem') can be very empowering and healing, if done properly - and definitely can work well alongside other therapies.

I guess ideally every person's situation would be approached in an individualised and responsive way, using a little bit of various therapies/treatments according to what is needed at the time, and adjusting as we go.

Not sure I can add much more that has been eloquently said already, apart from my own personal experience. As a childhood abuse survivor, I have been in for counselling on the NHS over the years, as well as at University, and it was worse than useless, actually detrimental to my well-being as it seemed to deny my experience of life. I was always offered the 6 week course, as well as having anti-depressants thrown at me, which I never took for very long as even I had enough self-awareness to know that wasn't going to solve any of my ongoing issues. From my experience depression wasn't taken very seriously, and I believe this is because I'm female. At my worst I was literally suicidal and was going to hang myself, but was still only offered the 6 weeks counselling and given citalopram, which made me ten times worse and prepared to kill myself. I rang up in this state and was referred for an appointment with the mental health team. Without a proper diagnostic process, but from only answering a multiple choice, short questionnaire with the nurse, I was then told I have BPD and was referred to have some group 'distress management' talking therapy. Although I believed I had BPD myself at the time (and probably have/had some traits) a lot didn't ring true. The report from the questionnaire said I was histrionic, which couldn't be further from the truth, I have had to hide my feelings from everyone for most of my life - as a child to avoid being abused, and to hide the abuse from others, habits which continue to this day. I also wouldn't know how to manipulate someone to save my life, but have been on the receiving end of bullies and manipulators on countless occasions due to people pleasing, again as a result of abuse. I felt gaslit by mental health services, it was re-traumatising. I refused to go to the therapy, as I couldn't think of anything worse than being in a room full of people with BPD. I continued to make bad choices after therapy sessions I had, because I didn't understand myself, and so would be back again a few years later with another breakdown and new problems. I believe I have CPTSD and would benefit from longer-term talking therapy, and that this is the only thing that would help me to unpick the coping mechanisms I learned from an early age which helped me as a child, but are detrimental to me now. It's a false economy to keep sending someone back with the wrong type of therapy again and again every few years, like banging my head up against a brick wall. I manage today without the same level of depression as before but certainly stunted and not living to my potential, having mainly helped myself through reading on the subject. I'm not in the UK now, but if I was I don't know if I could put myself through the process of trying to find a suitable counsellor for trauma, trying to convince a doctor that I'm worth helping.

Hey
I teach mindfulness and other forms of meditation as well as emotional resilience techniques. I personally never take on anyone recovering from severe trauma as I don't feel qualified to deal with these issues. Mindfulness is great but it's not a panacea. That said, I got into all of this to empower myself, so here are my personal thoughts. Not all meditations are equal, if you follow guided meditations you will gain the benefit of reducing your stress without allowing difficult thoughts to come up. The same can be said for mantra meditation also, which is my preferred method for deep relaxation. Different types of meditation activate different parts of the brain and they are great for reducing amgydala activity which can lead to hyper vigilance. I have personally experienced cognitive dissonance from an emotionally abusive friendship, with someone suffering from histrionic personality disorder. What has been really helpful for me is journal therapy, it allows you to put things into a perspective where you can look at them rationally and within the narrative of your life not just that one experience. Also I've found radical acceptance practices really helpful, where you purposely expose yourself to difficult thoughts whilst calm and prepared and allow them to come up without judgement, this is more MBCT based. I hope you find some peace and healing. Good luck on your journey. 🙏❤

There’s some great comments on this thread. I can’t offer any particular recommendations, but I’ve had CBT twice and it was completely unhelpful. I felt angry with myself for being useless at it. I later learned it’s well known for not working on people with ASDs who don’t think in words/concepts.

It makes me cross that it’s pushed for being effective at a population level, implication being that the neurodiverse and traumatised people who end up harmed by it are acceptable collateral damage as it passes utilitarian medical ethics.

OP, I wish you the best for the future and hope you find someone/something that helps you.

I think diagnosis' are also worthy of critique. I have a condition (allegedly) which 75%+ of its sufferers are female. I argue that this shows a clear sexism in diagnosing as there is an element in the disorder of showing excess emotion. I can't imagine men being told their emotions are incorrect... I bet they'd get a PTSD diagnosis.

upfield .

purple I agree. There is an inherent sexism.

And also a medicalisation of the normal trauma and distress response women who've experienced abuse, violence other trauma, through a BPD diagnosis which in my opinion is victim-blaming. Rather than a caring acknowledgement of what that person has been through, how awful it's been.

"Don't ask what's wrong with me, ask what's happened to me."

A doctor told a friend of mine that CPtsd was a "popular fad" amongst women, that says it all really

Male doctor I'm assuming

Popular fad? What a horrible thing to say.

Upfield, I'm so sorry to hear of your history. It's just the worst when we ask for help and aren't given it. I hope you continue to find ways to improve your situation and heal.

I think the NHS - especially at the moment - is just barely equipped to deal with mental health issues. Short term-ism, and a pretty poor state of affairs. These short courses just don't seem adequate.

Yeah male physiatrist!

This isn’t feminist specifically but you might find reading Alice Millers work useful to help articulate what you find unhelpful about cbt approach. I avoided both cbt & mindfulness for the same reasons you are listing (although decades later i find mindfulness somewhat useful, but I know I wouldn’t have with regards to ptsd) and opted to go private. Sometimes charities will have other therapeutic options, free or cheap, some private therapists will do concession prices and sometime visiting university lectures are a useful option to check out as they might have experience of things like mentalisation therapy that’s not common here. Emdr is also accessible on the nhs, although that may depend on area, and the people I know who accessed this also did cbt along side it.

Oh, also, my personal concern with cbt- which can apply to any for of therapy but I feel is more evident in cbt- is the clients need to ‘please’ the therapist and be a good person in recovery. This imo is a greater risk with female patients as we are socialised to people please more. Cbt imo is very results focused that this increases the risk of this dynamic, and being a truama survivor increases the risk again. Any therapy that doesn’t take into account the risk of this dynamic and doesn’t address rewriting that conditioning won’t be any help to a truama survivor.

The most important thing is always the relationship between the therapist and patient though, and not all therapists will ascribe to their approach. I saw a psychodynamic therapist, whose background was truama, dissociation as well as supporting voice hearers (which I wasn’t) and when I tracked him down I read his books, and asked his view of many I had read, as well as explaining my worries about cbt type therapies. He explained his training but said the main thing was to work with emotions and I felt reassured by this and his views on the books I brought up. (I also sought out a man, which I appreciate is unusual with female trauma survivors, but for me the manipulation of my mother and her gas lighting around the abuse she handed me over for was my biggest issue- I wanted to explain this as I realise saying ‘he’ about a trauma therapist for a woman seems strange).

I also found online and in person support groups very helpful, and I used these until I felt up to trying therapy. That might be an option to try? These also helped me articulate what I was looking for from therapy.

Sorry you are stuck dealing with this.

Sorry, I didn't mean to make this thread all about me, just wanted to add that I found the BPD diagnosis was reached very quickly, without even undergoing a meeting with a psychiatrist, in fact, and only meeting with the nurse. Once you're tarred with that brush it's very difficult to get anyone to listen to you, as everything is presumed to be a lie, exaggeration or manipulation, treatment which is obviously extremely dangerous for someone already suicidal (and yes, it was a male doctor who decided I was BPD). I wanted to add that meeting with the group leader first sounds like a good idea so you can raise any concerns. I'd formerly take the attitude that any help offered is to be taken, but now I'd say to trust your instincts, as I really do believe the wrong sort of therapy does more harm than good. I didn't want to sound harsh against those with BPD either, only the last place I needed to be was in a room full of people who are known for being histrionic and emotionally manipulative, when I'd had a lifetime of trying to deal with that already.

I haven’t read this, has anyone else? It sounded very interesting when I heard it discussed on Radio 4...
amazon.co.uk/Good-Reasons-Bad-Feelings-Evolutionary/dp/0241291089/ref=smi_www_rco2_go_smi_8682124849?_encoding=UTF8&%2AVersion%2A=1&%2Aentries%2A=0&ie=UTF8]]

I am not an expert in this at all, but a couple of people I know have found EMDR very helpful in dealing with trauma and removing some of the terror, which can then make other forms of therapy more accessible - if indeed you need them after that.

I have had a couple of goes at CBT and it is a load of old cobblers if you ask me. It was trying to deal with intense medical anxiety and the therapist kept asking, but what's the worst thing that could happen? 'Well, I could die.' I think it's only good when - as other people have reported above - you end up in a therapeutic relationship anyway.

However, I have found mindfulness helpful, just in my life in general. It might help not to look at it as a cure or treatment, just something you can do, like exercising, which helps you cope a bit better.

There's lots of EMDR videos on youtube, you can learn that yourself for free, I would say. I have found it quite helpful as a kind of emergency calming measure!

And I agree, artisan, that physical exercise is a good analogy for mindfulness, generally. Maybe with therapy being surgery, unless that's carrying the metaphor too far?! Both can complement each other but aren't always needed/appropriate.

Good mindfulness/meditation teachers will always recommend someone seek out qualified and expert help for trauma/mental health issues. That might cover medication, therapy or lifestyle changes, or all of these things.

CAT may be more useful. You may have to pay for CAT ( www.acat.me.uk ) but some NHS trusts or IAPTs offer it.
Good person centred counselling will be worth waiting for as well but probably one or the other for now.
Sometimes we need different therapies at different points with periods of assimilation between to fully reach our optimal place. Apologies if you know this already.

My sister had cbt but it doesnt sound like the above, it was 2 years with one session a week 1:1 and a group session each week. She found it helpful but it was tough.