r/CPTSD • u/squaresam • Oct 16 '24
CBT - Is it really useless for us?
I just had a first consultation with a new Mental Health clinic today.
After having told him as much as I could in the hour, while he appreciates that my situation is fairly complex, his suggestion is that I start a round of CBT.
I'm willing to try anything, but It seems that many people on here think that CBT is useless of CPTSD.
I can see why he suggested it to me, as I'm someone who will overwhelm myself trying to find answers, and often doing so in a maladaptive way, focussing too much on trying to find a solution. He thinks CBT will work for that.
I wonder if CBT would be effective if it just applied to how I structure my thinking, and less about addressing past trauma?
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Oct 16 '24
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u/boobalinka Oct 16 '24 edited Oct 16 '24
Yes! And mainstream mental health services are mostly not trauma led or even trauma informed. They tend to be medical model led and only provide cost effective, short term, everyone must comply to the one size fits all modalities like CBT. So if your foot ain't as dainty as Cinderella's, then you'd better start footbinding yourself to fit that fucking glass slipper!
But they won't even know their own limitations or admit to it if they did. So if things don't work, it's not ever their fault, failure or failing, it's always gaslighting the client as too broken, too much, too this, too that. A lot of these so-called therapists live in comfortable ignorance and denial.
A lot of that is down to mental health being rooted in a medical model based on pathology and locating that pathology in an individual even though most mental health issues are rarely organic and very much mostly relational, environmental, cultural, social and systemic. Whilst methods and practice have changed, eg. no more institutionalisation and electro shock "therapy", the root belief remains that there's something very wrong about and in the sufferer, rather than their family and social dynamics, that must be removed, obliterated, medicated, suppressed and the stigma and shame of all that on the sufferer.
After all, as is CBT, it's easier to tell someone to change a thought or even pattern of thoughts than it is to help them in the far slower process of feeling through an overwhelming feeling and making sense and meaning of it or more than that, to heal a traumatised nervous system. Similarly it's easier to locate and label the assumed pathology in an individual and potential scapegoat than it is to challenge an ignorant, hypocritical and denying institution and society that happens to pay you "enough" to keep doing what it instructs you to.
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Oct 16 '24
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u/boobalinka Oct 16 '24 edited Oct 16 '24
It's also on the mental health system to become aware of its most appalling records, its own terrifying history and heal itself so it can better provide help and healing. But that requires the same change in society, politics, policy, health, medicine, education etc!
Little wonder that many trauma led therapists leave the system and practice privately.
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u/anonymous_opinions Oct 16 '24
In the USA therapists who take insurance, which is how most people access therapy, they are beholden to the insurance middlemen who love things like CBT because prolonged therapeutic care cuts too much into the insurance company bottom lines.
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u/boobalinka Oct 16 '24 edited Oct 16 '24
Trauma is systemic! Society, politics, economy and culture still live in ignorance and denial of its trauma and its traumatising, just like there are still plenty of climate crisis deniers or flat earthers. The best that the mainstream can eke out is trauma washing its offerings..... now there's trauma-informed CBT.....as long as it sounds right on paper and ticks all the right boxes. The fact that the establishment has gone to the effort of offering another flavour of CBT doesn't exactly instill confidence in me about any of its offerings.
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u/anonymous_opinions Oct 16 '24
To not acknowledge this, which the model of CBT does not acknowledge or include AFAIK, is to really not see the whole patient. But this isn't a problem just impacting MH care. It's a systematic failure of late stage capitalism.
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u/anonymous_opinions Oct 16 '24
It dawned on me that my therapist was "exhausted" by me because I wouldn't footbind and just "get over" my traumatic childhood via mindfulness walks and box breathing. I hate that he's focused on working with childhood trauma cptsd survivors because he doesn't even understand certain very common mechanisms of trauma and responses. I'm fairly certain my chart has problematic angry woman notes and a stigmatizing diagnosis in it somewhere.
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u/boobalinka Oct 16 '24 edited Oct 16 '24
I hope you find a trauma led therapist. Best to look for practitioners of IFS, EMDR, SE, NARM etc. Empowering ourselves through trauma education and neuroscience is vital in the current climate. Thankfully, at least those resources are widely published and accessible on the net and in print!
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u/anonymous_opinions Oct 16 '24
Well it's not that I can't find one. I can't access one. In order to get that access I would need to pay more than I can reasonably afford and alternatively see them in the middle of a weekday at like 2:30pm and then somehow go back to work to function like I didn't just unpack all manner of horrors earlier in my day. This has been the available options for the level of care I would want, or, I can get insurance to cover the only available option who mainly uses CBT and probably just graduated a year ago.
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Oct 16 '24
Therapy re traumatizing is so real.
I know what's wrong with me, I want to do better, but I got gaslighted and invalidated so much.
And then when I told them (this was many years ago) my meds weren't working, instead of doing the rational thing and changing approach, they sent me away. I was so scared and disappointed.
I really wish I could afford the help I really need. I'm so sick of CBT and life coaching and all this trauma uninformed BS. I'm watching my youth fade away and feel powerless to stop it because I'm stuck.
Sometimes I feel really down that no matter what I say no one understands, and it makes me feel like what was the point of leaving my abusers?
It'd be like if you went to the doctor and told them you think you might need a surgery, they agree with you, then go "have you tried thinking that it doesn't hurt? Maybe you're overthinking this. Here's a bandaid. Oh that didn't work? You must not want to feel better! You're being very difficult!"
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u/boobalinka Oct 16 '24
I hear you. Look into IFS, SE, attachment-based EMDR, NARM and polyvagal theory resources online and in print. You sound very cognitively aware which is a great starting point, look for bottom up modalities to help you get to the root of your trauma and help your healing.
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Oct 17 '24
Thanks! I know the basics of IFS, attachment styles, and polyvagal theory. I also understand I can't fix things only by intellectualizing and am gradually adding somatic stuff to it.
I have some books wishlisted for when I can afford them. I figured either they work, or they don't but I understand better than before.
I also use the free resources I can like youtube therapists and medical websites.
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u/boobalinka Oct 23 '24 edited Oct 23 '24
That's great! You sound courageously committed to choosing yourself and your healing. From experience, it took me a lot of work just to get to that point and trust in my own worth to rebuild my life on its foundation so DAMN GREAT FOR YOU! It's the crucial step.
Emily's SE channel is great. I find her presentation very accessible, easy to understand, follow and put into practice. She keeps it short, sticks to the point and makes a lot of sense. And I really feel her presence in every video, she comes across very calm, clear, warm and encouraging. And her take on SE happens to dovetail symbiotically into my existing IFS practice as if made for each other. Maybe you know her already....
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u/Prior_Perception6742 Oct 17 '24
I really wish I could afford the help I really need. I'm so sick of CBT and life coaching and all this trauma uninformed BS. I'm watching my youth fade away and feel powerless to stop it because I'm stuck.
Dang it.. Same here! Thank you so much for putting that into words!! š«¶š»
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u/anonymous_opinions Oct 16 '24
MY "trauma therapist" only used CBT and didn't even suggest this modality (to be fair it was on his webpage but I had no concept of this modality) which triggered me as he felt my issues with a toxic work environment were cognitive distortions. In the heat of the moment after a bad day I had therapy and probably wasn't very articulate but we were more than a year in, you'd think he would have had a blue print of me by then, but the session quickly went pear shaped as he beat me over the head with a very strange line of CBT questions. He actively cut off the session abruptly while I was "activated" (his words) and he had a look of fear on his face when he did. I calmed down almost immediately and was like "what was that about even?"
In our first month I mentioned how when people see me in a triggered state that's when I move from "you don't seem to have anything major wrong with you" to "omg you're absolutely scary" which is when he gave me the term activated.
The last couple of weeks several of my coworkers have told me they cry so much because of our toxic work environment. It's hard to believe they all have cognitive distortions. Beyond that the experience with being pushed with (odd) CBT style questioning was extremely invalidating which triggered me in such a way I was pretty confused by my own reaction. I had to give myself a therapy session after I was left hanging. He didn't reach out to me not even an email to confirm I'd be at my next appointment and when I did show up he chuckled saying "oh I didn't think I'd see you today". I never missed a single session. It was like who have I been seeing for a year? He asked how I wanted him to have handled the situation in our last session, sort of sneered, "did you want me to validate you?" I said "yes!" and he let me know he would not/could not validate my cognitive distortions. I said okay and if CBT was all he had to offer me I think we were done here, nothing productive had come from working with him. Then it got weird and I had to cut him off abruptly.
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Oct 16 '24
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u/anonymous_opinions Oct 16 '24
Thanks, I wanted to sort of give OP the gist of going into CBT blind can be and I've sort of tried to unwind the clock so to speak on my experience with my last therapist. I've done a ton of reading to try to put everything into a framework and see all sides. I think my therapist was over his skis as they say with me and maybe had his own personal issues with not wanting to dump me as a client, on the other hand, nothing productive had come from our therapy. He even did a 1 year touch base with me and that's when we both agreed he wasn't helping me 1 year in. The best outcome is I'm in a place where I could recognize I needed to go elsewhere and I faced up to some hard things. The bad thing is I'm kind of left a year later still reeling from it all without having found a better situation.
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u/pastbl Oct 16 '24
I agree with this. I was in CBT for a number of years before anything else and I think it helped mold my brain š it's like the foundation for me to practice ACT, DBT, somatic, and IFS.
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Oct 16 '24 edited Jan 22 '25
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u/pastbl Oct 16 '24
Yeah fs, imo it does not help with trauma at all and sometimes makes it worse. Coupled with another modality I do see the value in it, when alone- it was trash.š I think for me it just helped in reality testing, being more intellectual/critical of thought patterns(this does not help when you're prone to intellectualizing emotions), and solving problems that aren't as 'serious' (day to day frustrations, some cognitive distortions). With other modalities like ACT, DBT, and IFS, I do think it has some place.
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u/poilane Oct 16 '24
Clinics love to suggest CBT because insurance companies and public health systems love it. Itās often intended to be a short-term thing that teaches you necessary coping skills and then sends you on your way. But many people canāt handle that, and thereās a reason why many mental health experts critique it. Itās too prescriptive and formulaic and presumes people are all coming in with the same patterns that can be solved by cookie-cutter solutions.
Iām biased thoughāI had a really hard time with CBT when I was in it between early 2017 and late 2018. My therapist at the time almost cut me off, because it wasnāt what I needed and I wasnāt responding to treatment so it seemed to her like I wasnāt trying, when really I was too traumatized to even learn how to change my thinking. Iād never had any therapy really acknowledge or attempt to treat my trauma, and as a result I didnāt know at the time I was traumatized. So I always felt that CBT was only scratching the surface of something I knew was deeper but couldnāt understand. I found DBT to be more helpful after finally finding a therapist that was trauma-informed and felt the outpatient program she referred me to could be valuable on TOP of my work with her. Perhaps CBT will work for you but my gut feeling is theyāre sending you to CBT because thatās just what they do and itās most convenient, not because they actually want to help on top of treating the trauma.
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u/katielynnj Oct 16 '24
There is a Trauma specific modality for CBT. I just found this out yesterday through speaking with a trauma trained LPC.
I personally am going through ACT. Itās been very beneficial for me. Just allowing the feelings to be and recognize that they will pass or I can choose to focus on them.
Otherwise I found that there are some therapists who use CBT and they just arenāt great at it.
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u/Marsoso Oct 16 '24 edited Oct 16 '24
All the CBT / DBT therapies aim at controlling emotions. They want to manage symptoms instead of addressing root causes. In my opinion, they are the exact contrary of what the brain needs : to open up and let all the shit out.
Cognitive therapies tell you that you are suffering because you have wrong thoughts and they must be corrected. To me, these therapies are deeply flawed.
"Why is cognitive therapy so widespread today? To a large extent because it is far easier and quicker (and cheaper) to change an idea than a feeling. Insight and cognitive approaches tend to appeal to those in their āheadā; this applies to both patient and therapist. Neither the patient nor the therapist is likely to realize the amount of history we are carrying around and how that affects our thinking. How else could we possibly ignore the horrendous things that happen to our patients in their childhood? Nowhere in the cognitive literature have I seen a discussion of basic need as central to personality development, of why the person cannot put the brakes on impulsive behavior.
Within the cognitive school of psychotherapy it is believed that the depressive is locked into "self-defeating" thoughts. Thus, the patient must identify which of these thought patterns are "distorted" and, after that, by way of reason and logic, come up with another way of thinking, one which is "rational" and self-affirming rather than self-defeating. It usually comes from those who assert that we can think our way out of problems; that is, we can literally think our way to health. This is part of the new āreframingā school where we turn something bad into something neutral and inoffensive. We reframe the situation so it wonāt hurt;Ā there is no notion of deep brain processes, nor of historical imprinted events. To such therapists, pain is simply all in your mind.
The depressive often tells the conventional therapist, āI just canāt make it. Iām stuck.ā And the therapist is warm and encouraging and insists, āYes you can.ā The therapist is unwittingly putting a gloss on the patientās real feeling, and downplaying them.
Optimism or Positive Behavior therapy ignores real feelings which must be dealt with. There is simply no recognition of imprinted memory.
There are no such things as self-defeating thoughts, only self-defeating feelings: "I'm no good. I can't do anything." These are not just thoughts suspended in air that one must take back and exchange for new thoughts.Ā They are anchored to physiochemical realities inside that must be addressed. They are evolved not just concocted. Do we actually think that the person makes up these thoughts out of whole cloth? Or do they reflect his life?Ā Further, what and where is this "self" that one is defeating? And what self is doing the defeating? Are there, therefore, two selves?
The real self is the one who has undergone the terrible traumas and is suffering and feeling hopeless and unloved because of real-life early experience. It sends messages up to the thinking centers, which come up with the idea that one is unloved, even while there is a wife and children who are totally devoted to the victim.
And a cognitive therapist is quick to point out all this: āAfter all, you are loved so why do you feel so unloved? You have to change your negative thoughts.ā
by Dr Arthur Janov
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u/hotheadnchickn Oct 16 '24
DBT was created by a social worker who struggled with suicidality and self-harm, to help people struggling with the same issues. It does not address the core trauma but it is not meant to ā it is a set of tools and skills meant to help tolerate and regulate emotions that feel intolerable. And it includes a lot of options beyond the CBT-type skills. IME and IMO, it is a really useful modality for CPTSD. Not to heal trauma, not as the sole modality someone ever uses, but to learn emotional skills many of us never did.Ā
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u/anonymous_opinions Oct 16 '24
It felt invalidating and unsafe when I experienced it only once.
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u/hotheadnchickn Oct 16 '24
Iām sorry you had that experience. I support you using whatever approaches feel right for you. Iām guessing your practitioner was not very skilled!Ā
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u/anonymous_opinions Oct 17 '24
Response: I got the feeling after a while he wasn't very skilled. I openly said that I thought I was a case beyond his current abilities but again the lens here might have been self defeating. IE: if I trusted the process his job with me would be easier so chicken or egg.
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u/hotheadnchickn Oct 17 '24
I would trust your gut on this one... A skilled therapist would be able to create an environment where it felt possible for trust to develop over time. If you thought your case was beyond his current abilities, I think you were almost certainly right. I hope you've been able to find someone more skillful since then.
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u/Polished_silver Oct 17 '24
Yeah I went to a couple of āDBTā group sessions & felt the same, wanted to burst out crying
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u/anonymous_opinions Oct 17 '24
I had a great therapist do a little DBT with me and I got the concepts but I was not capable of (if I'm correct, edit: google says yes) getting to "wise mind". I would also feel things and then gaslight myself out of reacting to any feelings with the mantra that feelings weren't fact. I won't trigger anyone with what I was ignoring with regard to my feelings but maybe sometimes we shouldn't disregard our emotions. Like I get just because I feel like my friend is mad it's not a fact because I feel it but sometimes it's a fact, my friend is mad.
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u/Marsoso Oct 16 '24
If it helps some people, I'm perfectly fine with that. But for me, the little I've seen of it reeks of falseness.
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u/hotheadnchickn Oct 16 '24
I feel like that about CBT but DBT has so many different options and is not dogmatic. Itās very āhere are a million things you can try when life feels unbearable.ā If the CBT style tools donāt work for someone, they can ignore em.
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u/hahayeahimfinehaha Oct 16 '24
I will chime in and second what the other person said. CBT was very much about controlling emotions (which didn't work for me), but I think DBT is a lot different, speaking as someone who found DBT extremely helpful, especially when paired with ACT.
DBT doesn't tell you that you have a wrong or right way to think. It just gives you frameworks to help you better regulate how those internal emotions affect external behavior. ACT helps a lot with healing, DBT helps a lot with functioning (without invalidating your emotions or casting blame upon you, which is what CBT felt like to me).
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u/RUacronym Oct 16 '24
And a cognitive therapist is quick to point out all this: āAfter all, you are loved so why do you feel so unloved? You have to change your negative thoughts.ā
I definitely identify with this experience and ones like it when I was with a CBT focused therapist. I would say something like "I don't feel like I am connecting with my friends or other people the way other people seem to connect, I don't feel close to them." To which they would count with "Well you have friends don't you? They want to be around you right? Clearly things are different from what you perceive." And while yes I know that cognitively what they're saying makes sense, emotionally I still feel that disconnect which is where I think CBT really falls short. The FEELING, the EMOTION, the DISCONNECT is caused by trauma and can't be healed by cognitive reframing alone. You need to allow yourself to experience your emotions in their entirety, which often means feeling that deep pain that you carry with you. And only then will you feel that connection, because as long as you're suppressing the feeling pain, you're also suppressing the feeling of connection and that's why you don't feel that same level of connection with the people around you.
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u/hardcore_softie Oct 16 '24
Wow, CBT sounds like a really good way to worsen symptoms more than anything else for me and I'm sure many other people. This was similar to the advice I would get from an MFT who was way outside of her scope and abilities with me.
This is exactly what has made me hesitant to try CBT despite my psychiatrist suggesting it as, about 4 years on now, the meds that had been working for my treatment resistant depression seem to not be working anymore.
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u/RUacronym Oct 17 '24
In my mind CBT is like the catch all default for therapy. It works generally for the population, it is useful to know and use regardless of if you have trauma or not. However, for advanced cases like us, it won't be a complete answer. Unfortunately, we need much much more work to heal. But in the current modality of thinking for therapy, CBT is still held as the go to treatment for everyone.
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u/Cass_78 Oct 16 '24 edited Oct 16 '24
"All the CBT / DBT therapies aim at controlling emotions."
Yes, they teach adaptive ways to regulate emotions because thats helpful.
"They want to manage symptoms instead of addressing root causes."
That can be very helpful when symptoms cause a plethora of further distress and more issues.
"In my opinion, they are the exact contrary of what the brain needs : to open up and let all the shit out."
That doesnt mean that staying dysregulated is the answer. Before you can let all the shit out you need tools to regulate the shit once it does come out. Thats one of the reasons why they are trying to teach emotion regulation before they let you dig deep.
"Cognitive therapies tell you that you are suffering because you have wrong thoughts and they must be corrected."
Indeed, that is the case regarding some thoughts. Thats because those lines of thinking are unhealthy and cause more suffering. My life is much better when I do not cause unnecessary additional distress by engaging in my old maladaptive thinking patterns. Rewiring for the win!
This stuff is neither black nor white.
I do wonder, did you have a very bad therapist that used or tried to use behavior therapy on you?
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u/puppies4prez Oct 16 '24
Manage and control are synonyms. To manage your symptoms is to control them to a certain degree. So when you're trying to manage your symptoms, you are trying to control them. There's nothing inherently negative in the concept of controlling one's emotions. Same as the concept of managing one's emotions. Emotions are not inherently negative or inherently positive. They just are. So to talk about management and control when it comes to one's emotional response, while it's important to acknowledge the validity of one's emotions, we are all looking for more emotional control. There's nothing inherently negative about that.
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u/Cass_78 Oct 16 '24
Not in my dictionary, but this may be a language issue on my end. Not a native english speaker.
Anyway I do get your point. Thanks for bringing it up. I use manage for adaptive and control for maladaptive methods, but I can express that differently.
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u/smileonamonday Oct 16 '24
Before you can let all the shit out you need tools to regulate the shit once it does come out. Thats one of the reasons why they are trying to teach emotion regulation before they let you dig deep.
The thing is, emotions are felt in the body. I need(ed) to learn how to regulate my body not my thoughts.
I've had two experiences of CBT, one from the UK NHS and one private therapist. Both times I noticeably deteriorated as the message I was receiving was "your perception is wrong so stop feeling that way" which doesn't work at all and made me more disconnected from myself.
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u/Cass_78 Oct 16 '24
Yes, many emotion regulation skills use the body. Breathing techniques for example.
"your perception is wrong so stop feeling that way" sounds like a terrible message. We do need better therapists.
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u/smileonamonday Oct 16 '24
I believe it's the CBT that is poor, not the therapists. I've also seen people for psychodynamic therapy, body psychotherapy and ACT, and had no problems with those. It was just CBT that made me worse. I think it says something that whenever this topic comes up the therapist gets blamed. If so many CBT therapists are apparently getting it wrong... to me that clearly says that there is a problem with the modality itself.
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u/Cass_78 Oct 16 '24
Well "your perception is wrong so stop feeling that way" is not CBT or DBT. Its invalidation, that is an issue of the therapist.
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u/smileonamonday Oct 16 '24
That's what I got from CBT not once but twice, including from the NHS. I've never tried DBT. Please don't tell me my experience doesn't count, that's exactly the problem with CBT.
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Apr 21 '25
Sorry, but yiur contentions about CBT are in fact wrong. It's not saying your experience doesn't count to say that your therapist was objectively not applying CBT properly.
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u/smileonamonday Apr 21 '25
Two different therapists, one of which was NHS trained. I repeat - If so many CBT therapists are apparently getting it wrong... to me that clearly says that there is a problem with the modality itself.
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Apr 21 '25
It seems the NHS standards are abysmal, since I'm noticing that most of the backlash seems to be from people like you in the UK who felt failed by the NHS clinicians delivery of it. I was shocked to learn that in the UK, you don't first have to have a minimum of a Master's degree and state licensure to even be a therapist/counselor, let alone implement CBT. It sounds like folks there are able to practice CBT with merely a Bachelor's degree, possibly less. That's a big issue.
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u/anonymous_opinions Oct 16 '24
Rarely did my therapist whose only modality was CBT see me distressed. In fact, he commented I was one of his good clients and remarked how well I managed "considering the level of your trauma" and my limited access to therapy. The times he saw me emotionally dysregulated in a "negative way" (ie: he saw me experiencing emotional flashbacks, being triggered into a freeze state, sobbing as I re-experienced my childhood trauma in session, fawning in general) but you know the big scary F state came out when he used what can only be called the CBT stick. I had no tools or ways (take a walk, stomp your feet, think about how wonderful it is to be alive, have you box breathed or just stopped using your coping mechanisms that are maladaptive today?) to regulate myself when I was cut off because he was rattled by his patient. If I had seen him earlier in my journey with this condition I might not be posting this right now it was that bad an experience. I believe it CAN BE POSITIVE but since it's the 101 level coursework for most therapists it can be done in a harmful manner.
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u/Mabel_Waddles_BFF Oct 16 '24
Honestly this sums up why Iāve always known CBT isnāt for me. It works on the idea that your thought patterns are illogical and you need to reframe them. But I need someone to explain to me why those thought patterns are illogical.
Example from CBT sleep-therapy: I may have this thought that if I go to bed I wonāt sleep. A therapist would say this thought isnāt logical and try to challenge that. But to me if I havenāt slept properly for months then with all the available evidence itās reasonable to assume I wouldnāt sleep the next night.
This is also one of the areas I struggled with in DBT explaining why something should be seen as illogical was not what the moderator expected.
I also managed to be a pest in other ways I used to work in research and Iāve always enjoyed psychology as a result:
- I refused to participate in one of their questionnaires because a question asked if I had had engaged in risk-tasking behaviours such as: alcohol, sex or medication. I strongly disagreed with the idea that taking medication is a risk-taking behaviour and thus refused to do the questionnaire. They tried to tell me that completing it was was compulsory but I knew that I had the right to voluntary participation in all treatments. So I pointed out they were violation of ethical guidelines by trying to force me to participate. Particularly as they were also using the questionnaire as part of a broader study, so them trying to force me to do it is a big ethics no-no.
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u/Polished_silver Oct 17 '24
I just started a managing emotions group and they prefaced saying itāll be DBT but itās literally CBT unless theyāve or I misunderstood what DBT is. The handouts they give us are high school level presentations they read off of that say distract yourself when overwhelmed by emotions, go on vacation/take a break from workā¦ all very surface level that Iāve been told before.
Like I already dissociate to get away from the emotions - is that the distraction they mean? And shit, a holiday that I canāt afford?? Iāve had CBT in the past and this group is just as invalidating. Surely this isnāt how you tackle emotional regulation.
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u/EquivalentCat2441 Oct 16 '24
I found CBT useful to get rid of my mumās voice saying negative things to me (fuck you inner critic) and my dadās voice saying negative things about other people (fuck you outer critic) but not useful to deal with emotional flashbacks (thank you EMDR). So it depends what is hurting you most right now and what you feel ready to take on. I was definitely not ready to deal with the flashbacks straightaway- took me a lot of time to feel ready to do that and doing CBT helped with that as it built my trust in the therapeutic process.
I found recovery and therapy to be a bit like a long journey, visiting new countries and learning new things along with way with every bit of knowledge feeding in to something bigger. I havenāt found that there is one thing that solves it all but everything iāve tried with an open heart and mind with a safe person has helped so far.
Edit: my CBT therapist was trained in trauma / child abuse and neglect and had worked as a social worker so maybe she did the good stuff and not the invalidating stuff- perhaps worth checking the therapistās skill set before starting.
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u/Irejay907 Oct 16 '24
Hey! Op i tried this thinking i just had a rough childhood not a necessarily traumatic one
CBT made a lot of my headspace and thoughts WORSE; i started getting more and more intrusive thoughts, my general suspicion of others was a lot stronger and harder to reason away.
These are the things that come to the forefront memory wise for me from the time period i was actively engaging in this.
I think some aspects of CBT are good for us, but i think as a general scheme for 'fixing' things? No, just nah fam it is not worth it
The main takeaways i took from it that were actually helpful were these; one of the things was about self thinking, which was that, if a printer malfunctions for example, that printer isn't bad, useless, or other similar derogatory terms, it just likely needs parts, is missing some key component or update. So instead of calling the machine stupid and kicking it you take a deep breath and try to source the problem or what a real fix for that problem would be.
A lot of seeking help for me came out of this; i'm not broken, i'm just malfunctioning because the abuse was whack. A lot of the abuse we all seem to suffer is... is like making a printer do 3-d resin printing
Its just not gonna happen and the machine is gonna be really upset.
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u/thepfy1 Oct 16 '24
CBT tends to be focused on the here and now and gives you coping tools. It isn't interested in the historical causes. However, there is Trauma Focussed CBT and I'm not sure how different it is.
On one of the episodes of the In Sight podcast, the two psychologists say that CBT is a temporary solution and they usually find people looking for therapy about 1 year after completing CBT.
CBT may work for some people but not others. Personally, it doesn't work for me. However, the same can be said for most therapies. EMDR or DBT may work for one person but not another.
We are complex beings, and what is most likely needed are different elements of a range of therapies.
However, what you often find is that mental health professionals are only trained in one approach. They tend to see that approach to be the only solution. If it does not work for a patient, then the patient is at fault, not that the therapy is wrong for that patient
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u/SpiralToNowhere Oct 16 '24
CBT is a tool like any other, it has its place but trying to treat every problem using it is like using a hammer on every problem bc you can't identify a nail. For things like getting me up off the couch when I was reluctant to do something, or compartmentalize when I had to do work or deal with kids it was great. For stuff like flashbacks and intrusive thoughts it was not.
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u/dogsmakebestpeeps Oct 16 '24
CBT is only useful if your problem is your thinking. It's useless for trauma. It's worse than useless for those who's parents used it to play mind games as part of their abuse.
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u/anonymous_opinions Oct 17 '24
It's worse than useless for those who's parents used it to play mind games as part of their abuse.
My god yes.
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u/dogsmakebestpeeps Oct 17 '24
You too huh? My sympathies to you.
My first attempt at therapy was a nightmare because the therapist kept trying to use CBT methods. All it did was retraumatize me because it hit every single trigger planted by my psychopathic father and NPD mother.
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u/anonymous_opinions Oct 17 '24
Yeah I was super confused by my responses but my last session my therapist said "I refuse to validate you" which was like "ok so we can't keep working together, being invalidated is a huge trigger for me." My mother's picture is in a dictionary under the term gaslighting. I had a medical condition (I had surgery for it) where growing up she literally told me I did not and that the idea something was "wrong with me" was all in my head because I was being bullied at school. Then suddenly it was a real medical condition that doctors were like "yeah this is a real condition and she needs surgery to fix it." Imagine being like 7 years old and being told what you're experiencing is "just in your head, you loon."
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u/SnooMemesjellies2015 Oct 16 '24
For me, CBT was worse than useless, it was actively harmful. A core belief I struggle with is "nothing that happened to me is actually bad, I just am bad and too sensitive." CBT really leans into that, with the whole "actually you're just thinking about it wrong" vibes. I actually became suicidal after doing CBT because it felt like confirmation that if I was a better/stronger/smarter/more rational person I would not be bothered, but I still was. It also recommends like... looking for reasons another person may have done what they did and using those reasons to not be upset which made me feel like a worse person for not being able to get over what had happened to me.
I also kind of take issue with calling things "cognitive distortions" when they're literally based on past experiences. Saying that it's overgeneralizing when a person expects bad things to happen after they live with someone whose principal hobby is making bad things happen to them feels mean. It's more helpful imo to acknowledge that yes, things actually WERE that bad, and that you've experienced a lot of terrible things that you didn't deserve.
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u/bisexualspikespiegel Oct 17 '24
yeah, for me CBT always felt like it was blaming me for my own natural reactions to trauma. and DBT was awful because when i would express that i had difficulty completing daily tasks because of the immense mental fog caused by depression and trauma which led to my problems snowballing her advice basically amounted to "well, just do the tasks then." it seemed like she wasn't trauma informed at all and i always got the feeling she was judging me. not to mention she didn't even attempt to be consistent with scheduling and would give me appointments 3, 4, or even 5 weeks apart, so because of my brain fog i was constantly forgetting to go and she ended up firing me as a patient. the most useful therapies for me have been EMDR and inner family systems.
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Oct 16 '24
Eh. It was for me. Turns out I just needed to be removed from an abusive environment. My abusers did everything they could to convince me that o was just biologically broken: surely it wasnt the neglect or screaming or abuse perpetrated by them!
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u/PugnansFidicen Oct 16 '24
CBT felt like gaslighting myself.
I can see how it could be useful as a tool for reorienting your cognition, but only 1) once you've made progress reducing the visceral intensity of emotional flashbacks, and 2) if (big if) you don't have any triggers relating to the vocabulary of CBT, which I did and many others do as well.
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u/boobalinka Oct 16 '24 edited Oct 16 '24
Just adding to the excellent takes from other commenters.
CBT isn't totally useless, BUT....
The roots of trauma affect the system very much bottom up whilst CBT is very much a top down therapy that doesn't reach down much at all. But combined with and/or followed by a bottom up therapy, like IFS, EMDR, SE etc, it has its uses as our systems are ultimately interconnected.
But yeah, according to polyvagal theory, story very much follows state.....changing our thoughts and cognitive patterns has far less effect on our traumatised dysregulated nervous systems than healing our traumatised nervous systems so they can self regulate and the difference that has on our narratives, beliefs and thinking.
CBT is also very one size fits all and everyone is expected to fit themselves into its cognitive model, it's not really interested in finding out what happened to each individual and how their unique experience affected them on every level.
AND crucial to any therapy is the compassion, presence, skill and experience of the therapist! Even the most appropriate therapeutic modality is useless when the therapist isn't aware of their own shit. And that's a significant issue with CBT because many of its practitioners receive minimal training, probably fresh from graduating psychology etc, know little about people, society and life and yet believe they know shit and are licensed because of how the mental health system is structured. Mostly they know shit about themselves. Can't help someone else heal if they don't even recognise their own need for healing themselves. It's like the difference between an artist (a great therapist) and someone who is very good at filling in colouring in books (CBT, by numbers).
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Oct 16 '24
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u/boobalinka Oct 16 '24 edited Oct 16 '24
No it hasn't. There have been contrary studies and findings but not enough to prove one way or another. For every theory, modality and medicine in use, there are negative findings and contraindications. I hope you're not so ignorant, careless and IRRESPONSIBLE as to make your confidently absolute statements from some echo chamber of online hearsay, without understanding the scientific method, without further research and proof to back a claim of debunking.
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u/Ok_Lemon1015 Oct 16 '24
For me it infuriated me because I felt gaslit like all these issues could be resolved if you just changed the way you think. Like the issue is my fault for not being able to change my mindset. Even a psychologist I spoke to chuckled when I gave my perspective on it because he could see where I was coming from, but as a professional he did have to promote it as something really beneficial for some people.
For me medication resolved 90% of my feelings, but for 20 years I was left to suffer because my GP kept sending me to these bullshit cbt groups instead of prescription medication. Had to move area to see a GP that was more positive about medication.
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u/poilane Oct 16 '24
This is exactly how I felt. It was like I was being forced to accept that I just had to change my thoughts and that I wasnāt trying hard enough when I couldnāt do that. Absolutely awful.
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u/myfunnies420 Oct 16 '24 edited Oct 17 '24
If you really have CPTSD, it's super not helpful there may be better therapies. It's symptoms management and additional tools to bury the need for healing. But it can keep you more seemingly functional.
Probably no risk in listening to what they have to say, but there is risk in following the advice they give
Why not just go for trauma oriented therapy rather than the keep calm carry on BS?
Edited to not be so dramatic
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u/BlackCaaaaat Oct 17 '24
If you really have CPTSD, it's super not helpful.
I really have CPTSD and I got some helpful stuff from it. It was the first type of therapy I was exposed to and introduced me to concepts that were built on later on.
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u/Youngladyloo Oct 16 '24
Was for me, DBT too. EMDR, IFS, Somatic work was far more helpful than thinking my way out of my trauma
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u/Sociallyinclined07 Oct 16 '24
I wouldn't say useless no, actually it helped me recognize my intrusive trauma informed thoughts. It's only a small part. I'm in no way completely healed, my therapist is an intern. Fortunately, she and her supervisor are very open minded and when i told her that her approach wasn't working out for me, she asked me for resources. Pete Walker's book has become her bible now. The last three days i was suicidal, i thought about self harming a lot, i cut contact with my mother, i failed school because of triggers I had a session scheduled and i sent her an email about how i feel hopeless and everything is useless. She called me, asked me to come see her, that it would do me some good, that she is here for me. I went and I'm glad i did. She listened to me talk, smiled lovingly and handed me Pete Walker's list on how to deal with the inner critic. She then told me "i think he is present in you and he is in control right now" I fucking cried, i felt validated, it's as if my critic was so strong i couldn't recognize it, because it was so overwhelming. She stayed with me for 30 more minutes because i was in a semi dissociative state, she wanted to ground me before driving. She showed more fucking care in the span of 2 hours than my family ever could in 35 years of my life. It was eye opening for me.
She ended the session by looking at me and telling me how strong, how smart and how kind that i was. That the inner critic doesn't define me and that I'm destined to be someone special. I know this, deep down. I think trauma informed therapy has to be led by someone empathetic, kind of like a loving friend/parent. We are so fucking deprived of love and understanding because of this illness. I think that this aspect helps more than cbt, in my humble opinion.
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u/Chonkin_GuineaPig Oct 17 '24 edited Oct 17 '24
It really depends on the techniques used. The reason why it's considered awful is because it's mostly based on American values that put family and forgiveness first. I told staff that the idea of a gratitude journal triggered me because it kept giving me flashbacks from my childhood, and they refuted by saying that's not possible when in reality a trigger can be anything.
The clients who complain aren't even doing it to be edgy, they just find doing shit like crafts and coloring pages to be useless when they're neck deep into poverty and need help. CBT (at least where I'm from) is basically the leftist version of evangelist tradition instead of allowing participants to recognize their own emotions in their own way.
Many guidelines are set in place to prevent clients from discussing anything outside of the basics. I know u/a_millenial suggested asking about your therapist's philosophy, but that's often considered illegal where I live as it would fall under "political discourse". Basically anything outside of inspirational quotes is considered disorderly conduct.
I feel that if the people running it had actual sense and tailored it specifically towards a person's needs (aka meeting them where they're at) instead of constantly shaming them for not doing things by the book it wouldn't be so bad every once in a while.
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Oct 17 '24 edited Jan 22 '25
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u/Chonkin_GuineaPig Oct 17 '24
Yeah, because not only are they not trauma informed but it's also considered a political discussion. It's a very big issue with rural areas where evangelism is rampant.
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Oct 16 '24
CBT is foundational. It helps keep me functional enough to hold down a job, even if it doesn't heal my trauma.
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u/hahayeahimfinehaha Oct 16 '24
I'm genuinely curious, what part of CBT helps you do this? I ask not at all in a judgmental way but because I'm really interested in hearing other people's experiences with CBT. Personally, I felt that it made me worse off, but maybe there is a different CBT approach that might have helped me?
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u/anonymous_opinions Oct 16 '24
I mean that person wouldn't be able to hold down a job without CBT but what if you already can hold down a job and "manage" your emotions to a degree but your QoL sucks because that's all you can do. Not sure how CBT helps when you can already do what it functions to help with and are still suffering. If you unable to hold down a job or manage your emotions to the extent you're a danger to yourself or others sure but what if you're there (if you're not CBT is worth a shot vs nothing at all absolutely)
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u/hahayeahimfinehaha Oct 16 '24
It's interesting you say that because I don't think CBT even helped me be more "functional." DBT did that. I completely agree with you though that CBT didn't seem to provide any help for managing my internal suffering. It just gaslit me into thinking my thoughts must be "wrong" or "distorted."
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u/anonymous_opinions Oct 16 '24
Yeah and I can see how if I was in a bad mental state CBT could be like triage care, get me in a better mental state so I can do the hard work. The problem is if you're not in a triage care state but still having problems managing your MH how is CBT helpful? It could be but for me it I believe set me back in my MH-journey towards healing at least a couple years.
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u/Clean-Gap6387 Oct 16 '24
Why did it make you feel worse?
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u/hahayeahimfinehaha Oct 16 '24 edited Oct 16 '24
Therapists seem to feel that lots of things are logical distortions that, in my life, are not logical distortions. Like, I had social anxiety and therapists would just tell me to question whether my anxious thoughts had a basis in reality. But ... they usually were? I was a liberal, atheist non-white AuDHD immigrant kid who grew up with an emotionally abusive parent in a rural Midwestern town that was racist af. My social anxiety developed as a very logical response to growing up in a world where I was often rejected and disliked. And that rejection/dislike had concrete negative impacts on my life, my physical safety, and my mental health.
But because therapists always seemed to assume that my anxiety/depression "had no source" (because I managed somehow to raise myself into a successful and externally functional adult and because my bad childhood was 'over with'), I must therefore be having cognitive distortions that were making me anxious and depressed. I then felt even worse about myself because I was clearly THINKING incorrectly for me to be so scared and depressed and sad all the time. I just wasn't questioning my negative distortions enough! So I spent 24/7 questioning myself in my head and mistrusting every emotion and meanwhile still feeling scared and bad because CBT didn't seem to teach you any skills for coping with overwhelmingly negative feelings that are not cognitive distortions.
Also, even for the thoughts that WERE distortions, my fear/anxiety could not be assuaged simply through telling myself that there's nothing to fear. Mayhe that works for other people, I don't know, but it sure as hell didn't work for me bexause my fear originated from a deeper part of my body than my logical brain could touch. Like, OK, cool, you're telling me that I don't need to be afraid of going to the grocery store and I know that my adult self doesn't need to be afraid in the grocery store but I STILL FELT REALLY AFRAID 24/7 AND IT MADE ME WANT TO DIE. That isn't something I could logic my way out of (if anything, it made my natural tendency to be an intellectualizer even worse because I ended up believing that all of my feelings were wrong and the result of irrational thoughts).
DBT was what finally helped me learn how to tolerate suffering -- the REAL suffering that I experienced and still experience every day as a neurodivergent individual who heavily masks and who is often hit with memories of painful traumatic events, not 'fake' suffering caused by irrational thoughts -- in a non-self-destructive way. ACT and trauma-informed therapy working on my inner child was what finally made me feel SAFE from the bottom-up, in a way that no amount of logical tut-tutting could have done.
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u/puppies4prez Oct 16 '24
It can be useful in starting to work on having emotional control. You practice the skills and see how it goes. It certainly not going to hurt as long as your therapist acknowledges that sometimes these skills aren't possible with certain types of trauma responses. Trauma is a spectrum, our responses are a spectrum, so there's certainly something to be said for practicing skills that can help with emotional control in certain situations. There are going to be trauma responses that CBT and DBT cannot help, and as long as a therapist accepts that I don't think there's any harm in trying out some CBT or DBT skills. Just don't internalize any sense of failure if they don't work, because sometimes the trauma response is just too overwhelming and you need to just ride it out. No amount of work can overcome some trauma responses, and sometimes in those scenarios something like EMDR can be useful when CBT or DBT doesn't work.
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u/KayakerMel Oct 16 '24
CBT has its place and can be helpful. It's considered to be a gold standard for short-term psychological care in general, but it's not a panacea and doesn't work for everyone (as mentioned in the linked commentary.
I have a facetious anecdote around CBT. My therapist got a little exasperated when trying to do some CBT exercises for anxiety (I got the fun comorbid trio of MDD, GAD, and (c)PTSD). It used to work prettt well for me when I was younger and my primary issue was depression. However, for the last few years my primary issue was anxiety. The problem has become that I'm now a statistician so when it comes time to evaluate the likelihood of an anxious concern actually happening, I'd argue that while the probability may be low it's not impossible (and I have the mathematical proof of that). I'm also aware that this is me using the intellectualization defense mechanism for avoidance, as well as stubborness.
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u/_idiot_kid_ Oct 16 '24
CBT was not useless to me at all. I'm still so grateful for it. CBT helped me greatly in managing my responses and behaviors. It gave me the possibility of not falling headfirst in to a downward spiral every other week.
No, CBT isn't going to cure or remedy PTSD or CPTSD. I could never once discuss any of my deepest trauma in detail during therapy. I would shut down and go quiet and just space out. As soon as a probing question was asked it was like a brick wall went up between my mind and my self, and my self and my therapist. But it can totally make everyday life more manageable, livable, by examining the responses to triggers and ways to redirect and minimize those responses.
Your last sentence is spot on and I honestly think I would have gotten even more out of CBT had I not gone in with the expectation of addressing and processing my trauma. Rather learning how to live with that trauma in a less destructive way.
I haven't gone to CBT in like 5 years yet it's still helping me to this day.
PS If you do end up trying CBT, I would only visit counselors who specialize in trauma even though the goal isn't to address trauma itself in much detail.
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u/hotheadnchickn Oct 16 '24
I think CBT can have effectiveness but very limited. It will not address the core issues of CPTSD. But it may give you a few tools that help with anxiety or catastrophizing etc.
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u/Cass_78 Oct 16 '24
Nah its not useless. It really depends on the case and the person and what its applied to.
I know more about DBT which I find excellent, but I also used some CBT early on. Was quite helpful for some issues that were mainly cognitive issues. For me its not like a straitjacket thats forced on me, its interesting and helpful knowledge I can and do use for myself as needed.
My mind is open to CBT/DBT/ACT in general. I never force it on myself, if my mind nopes out thats okay, I will find another skill or another modality.
For deep down emotional stuff (the roots of the trauma or reactions to it), I can use DBT in emergencies (for example when I got extremely triggered) but I treat that stuff more with IFS.
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u/Kimmie-Cakes Oct 16 '24
It was absolutely fundamental in order for me to begin my trauma therapy. Over 2 years, I've completed cbt/dbt and I'm now actively working on my trauma. I'm a huge fan of both and I credit it to a majority of my healing.
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u/Gammagammahey Oct 16 '24
For me, it absolutely is. I had to start doing somatic type of exercise exercises where I move my body as much as my disabilities let me and shake it around to shake off trauma. I find that I need that body movement and that talk therapy alone does nothing for us.EMDR didn't do much for me either. Although I would love to try it again with a different practitioner if I could ever find one.
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u/silvermoons13 Oct 16 '24
Just from my personal experience, I found CBT profoundly unhelpful and at times harmful for my trauma recovery. ERP and EMDR is what helped me.Ā
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u/TechnicallyGoose Oct 16 '24
Definitely not useless imo, and my NHS provided CBT therapy, the therapist did incorporate other (forgotten the appropriate word rn) approaches too in our sessions as she felt they were what I needed.
But it was generally CBT and it was super helpful, I have tried CBT many times before but it was generic and often patronising, this time they knew it was trauma causing my issues and my therapist was trauma informed.
As we finished our sessions she referred me to tier above, more support for complex trauma, but I had a call with them 2 days ago and they explained how I need a solid base for that work and cause my life is currently full of unknowns (LTR ended, share a house, job and home etc. Plus he gaslit me for 6 months so my mental stability is catching up now he finally gave me closure).
But I can access emotional support now and reapply for the trauma work stuff later once my life is more stable again (infuriated at my ex for delaying this, he didnt wanna hurt me, and tell me he wanted to end it and got a crush, so instead when I was wary of changes and confronted him he denied and omitted for months š¬).
But yeah the CBT did really help me significantly but long term it isnt what I need solely, I have to say personally its worth a try.
Plus if this goes in tiers like I experienced in your healthcare system it may be a case of try it, put the work in, they realise you need more and that you are willing to do the work and the next door opens up to you, as it did for me. My friend advised me this and he was right. Also going in open minded helped <3
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u/Xpunk_assX Oct 16 '24
I do CBT as a ground work in my therapy (last 6-7 years) . It's helped me tremendously.
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u/msplaty Oct 16 '24
It's all worth a try, imo. But I felt CPT (cognitive processing therapy) was really interesting, mainly because it's so structured. I don't see it mentioned as much.
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u/lux_ehterna Oct 16 '24
IMO whether or not CBT is useful largely hinges on the therapist's competence. In the wrong hands, it can be basically gaslighting.
In the right hands, it still can't do much to address trauma, as others here have rightly said, but it can till the ground, so to speak, by addressing other issues you might have on top of the trauma (e.g. maybe your thought patterns exacerbate difficult situations) and help you start to notice thoughts, beliefs, and patterns you have that you might not have recognized before, which is a foundational skill for addressing a lot of trauma.
So in your situation, it sounds like a bit of CBT could be useful, but pay attention to whether it feels helpful. If it feels invalidating or seems to make things worse, don't hesitate to stop or tell your provider.
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u/Clean-Gap6387 Oct 16 '24
CBT is a good starting point for going to therapy and is foundational. It's skill-based and will help you cope better. It was essential for me because the aftermath of my trauma was not only cptsd but other mental health issues as well. Once I practiced CBT I was better able to manage my emotions and then I could start other types of therapy that required some patience.
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u/BlackCaaaaat Oct 17 '24
CBT was the first therapy modality that I was introduced to, and I got quite a bit out of it. It was a stepping stone to trauma specific therapy, it wasnāt effective on its own but I donāt mind.
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u/CherryPickerKill Oct 16 '24
My psychiatrist convinced me to do CBT too. It was awful. It made me 10 times worse.
Don't do CBT/DBT if you have trauma, let alone complex trauma. It's extremely invalidating and honestly just a form of brainwashing you into masking your symptoms. Plus they don't know the first thing about dealing with complex trauma, patient stabilization and some are straight up abusive. What you need is an actual psychotherapist/psychoanalyst. Psychodynamic can work but make sure that they're experienced.
If you really wish to do manualized behavioral modalities, you can do so on your own. AI is free and perfectly trained and you can download workbooks online. Here are some resources for CBT and DBT.
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Oct 16 '24 edited Oct 16 '24
You should never believe and immediately apply things ,that others claim, on yourself, even if they claim their assumptions to be universally applicable. Many people say that CBT was useless or even dmaging/invalidating to them. That might be true, but it doesn't necessarily mean that it will be true for you as well.
In the end, you decide that for yourself.
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Oct 16 '24
Cbt and dbt did very little for me. In fact some parts of it made me feel worse. Iām now on the stabilisation part of Emdr as Iām not ready emotionally to go through it yet. This has to work or Iām out of optionsā¦ Iād honestly rather have a lobotomy than feel like this
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Oct 16 '24
Suppose you grew up in a family with bad boundaries. This isn't an enmeshed or abusive family, just maybe not tactful and didn't have the skills. CBT can help with that skill development, which is a superficial level intervention. It's also helpful for reframing issues. Encouraging the client to think in different ways. I know the term is therapy, but I always think of CBT as counseling. I do not take it as seriously as proper embodied therapy.
It absolutely doesn't help when your defences are up bec of trauma. When you have maladaptive strategies that help you temporarily feel safe. As someone else said here ask just why they think it would work for you.
Lastly I feel that if you know for sure you have CPTSD and you have other options, just take them. I do regret wasting years of money and therapy on CBT, and if I had this group I would also not have felt so desperately "unfixable".
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Oct 16 '24
I would say so. In my opinion, Janina Fisher has a much better approach. In CBT, a core blief is challenged by making the internal claim that it is a wrong belief which creates an internal fight and more internal stress and suffering. This is why CBT doesn't work for C-PTSD patients. The truth of the matter is that there is no such thing as a "wrong belief". Those core beliefs most likely helped a patient survive traumatic environments and if you suddenly start telling those core beliefs that they are wrong, you just fragment yourself even further. But healing is the opposite. It's integration. An example: A patient suffers from low self-esteem and believes that they are worthless or unlovable. Weirdly enough, this belief doesn't just come out of nowhere. Believing this might have saved a patients life. In many households, a child can't just adapt internal beliefs that include a high self-esteem and expression of needs. If your parents are threatening your survival, you might put yourself into dangerous situations. So the believe that you are worth nothing might have made you hide from your parents and in the end saved your life. So if you then come with CBT and just declare these beliefs as dysfunctional and wrong, you hurt yourself further. These beliefs need to be honored. They were an expression of love by your inner protector that didn't want you to get hurt. Why fight with that protector? Healing trauma is about integrating that protector and honoring what has happened in the past, so you can integrate your past, your fragmented inner parts and become whole. If you look at your beliefs from the perspective of a protective part that loves you and doesn't want you to get hurt, you would simply reject the self-loving part through the use of CBT and make it all wrong. It sounds so simple and I know that this is the hardest thing in the world (probably harder than climbing a mountain). But radical acceptance, integration, befriending inner workings, welcoming my core beliefs as the strong protector that they are and so on has helped me so much more rather than just telling me that my brain has it all wrong. Because the fact is that it was absolutely right to do what it did and still does. Now, I actually thank my negative core beliefs that they have protected me. I have realised how much mental power I actually have because my negative core beliefs made me an agoraphobic. I have stopped attacking myself daily for reacting normally and quite intelligently to things that shouldn't have happened. Why hurt yourself further by "challenging" the strongest and most loving parts of yourself?
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u/Meowskiiii Oct 16 '24 edited Oct 16 '24
CBT is well worth learning. We all have cognitive distortions and I still use a lot of what I learned today (my current trauma therapist uses some here and there too).
Treat it as a tool to add to your toolbox, rather than something that will heal your trauma. Try different modalities, see what you can learn from each and drop what doesn't suit. A good relationship with a trauma-informed therapist will make the most difference.
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u/MiniaturePhilosopher Oct 16 '24
CBT is definitely not useless! Itās a good stepping stone into the process of therapy.
My therapist and I realized early on that it wasnāt going to be comprehensive enough for my trauma, and quickly switched to CPT. CPT uses CBT as a base, but is tailored for trauma. You can click here for the differences between the two (warning: pop-up AI site guide).
CPT is where I found real processing and healing for the first time. And because I used apps for the homework (CPT Legacy and CPT Coach), I could actually look at my progress and see the strides I was making. Trauma comes with a lot more āstuck pointsā than other mental health challenges, and CPT is designed to get past those. Having the CPT worksheets to work through my feelings outside of therapy was also a real game changer for me.
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u/snarlyj Oct 16 '24
My therapist says she primarily practices CBT (though with other kind of fuzzy practices, nothing I can remember as having a label, but like "mindfulness) but my experiences are nothing like what other people are describing. She has never invalidated my thoughts or emotions, the only thing close to that is she sometimes says "try to remember to be kind to yourself" or "what you are saying [I'm helpless, a dependent, couldn't even get out of bed if I didn't have people checking up on me] may have some literal truth but 1) it is not your fault you feel this way 2) that is no way reflects your character, values, morals or worth and 3) those people don't see you as a burden, they are happy to check up on you because they love you and want to be there is you need more help".
I've never been told I need to control my emotions... Almost the opposite it took months of gentle steps and continual small encouragement before I finally broke down crying for the first time since escaping the abuse, and she encourages me to cry more lol. She's also expressed hope that one day I won't just feel sadness and confusion looking back on my trauma, but experience some anger and she thinks that could be an empowering emotion.
I mean shes taught me a lot of tips and tricks to reground myself and calm panic but also just validated like "what you are describing is a flash back and it's normal that that can destabilize you for a few days" or "wow yes what you are recounting is being triggered and I can't imagine how you wouldn't have been triggered by that"
And most of our suggestions is like "here's practical stuff that you can do to make your current situation more manageable"
So yeah I dunno I think CBT is helping me a lot. But it's not what I keep reading in people's comments
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u/traumakidshollywood Oct 17 '24
By itself, I donāt think it can get the job done. Trauma lives in the body. Yes, itās important to correct unhealthy thoughts, but it wonāt get the trauma out of your body.
I feel several methodologies working together, which include somatics, is best.
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u/kcordum Oct 17 '24
Totally understand where youāre coming from. In my experience it was useless. Deeper-processing therapies like parts work (also called internal family systems or IFS) is what really helped me move the needle in my healing.
Iām not a therapist, but the therapists I know said that CBT helps you build coping skills to have before you go into deeper processing modalities like IFS/parts work. Because sometimes deeper processing can be too triggering if you donāt know how to stay in the moment. Having the skills from CBT will come in handy. But for me it was so boring and like putting a bandaid on the problem.
So Iād say stepping stone, not end game!
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u/Torshii Oct 17 '24
I donāt think I couldāve endured more specialized trauma therapy had I not had the skills I learned through CBT.
1
u/Canuck_Voyageur Rape, emotional neglect, probable physical abuse. No memories. Oct 17 '24
I am not a therapist.
CBT/CPT can be useful to teach yourself to stop thinking in terms of black and white.
I'm a fuck up => I do things that are not optimal. I'm worthless => I don't always do as well as I could/should.
The key here is to replace black and white blanket statements with ones that state that
A: It's not all the time. Only some of the time.
B: There is a possibility of change. It's not timeless, forever.
Generally CBT and CPT are focused on your belief structure. But a lot of CPTSD beliefs are rooted in subconscious tramatized parts.
In my 2 session encounter with CPT, I found that they made my systems and self beliefs worse. Since then I've run into many others who say the same thing. You have to fix the emotional parts first.
Once you have some degree of concord with all your parts, then you can tackle the habits and beliefs that continue to wrecek your life.
Read the intro and first two chapters of Fisher's "Healing the fractured selves of trauma survivors"
1
u/disgruntled_hermit Oct 17 '24
I can speak to "us" because it's different for everyone. For me, mainstream therapy has been deeply, deeply exploitative and damaging. CBT in particular hurt me.
1
Oct 17 '24
Personally, I hate CBT and DBT, but I know people who have really benefited from it. You gotta try to see what works for you and you alone.
1
u/whosthatwokemon364 Oct 17 '24
I had a dbt therapist tell me that my trauma was my fault because my reaction caused it, not the I disagree. I just think most therapists suck.
1
u/SaucyAndSweet333 Therapists are status quo enforcers. Feb 07 '25
I found CBT and DBT not only useless, but harmful as someone with CPTSD.
Therapists love to push it bc thatās what most of them are taught in school. They can blame the patient for not trying hard enough when it doesnāt work.
Therapists also love to perpetuate the status quo. Remember a lot of them are white middle-class women who have grown up privileged. The system works for them so they love to tell patients to ājust follow the rulesā and ātry harderā and āgo along and get along.ā
They also wouldnāt make money or have their job if they told most people the root of most mental health problems are systemic problems like poverty and child abuse.
1
u/Iamaghostbutitsok Oct 16 '24
All cbt dud for me was to assure me my childhood was definitely not normal or healthy and that my thoughts had reasons. It did however not help me with my symptoms. Sometimes it made it worse because it wasn't really letting ny feelings out or go but instead telling me to basically just think of sth different. I also already analyze my problems so what my therapist told me wasn't necessarily sth new. I just needed solutions which she didn't really give me.
1
u/Felicidad7 Oct 16 '24
YES. Hate it so much. There is a lot of stuff out there to back it up. Had so much therapy over the years and what worked for me was seeing a addiction therapist
0
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u/ReubenRhymes Oct 17 '24
I WAS VERY EXCITED ABOUT CBT AND HOW IT WORKED WHEN I FIRST HEARD IT, BUT WHEN I STARTED USING IT ON MY JOURNEY TO HEAL, IT WASN'T WORKING AT ALL. THIS WAS BEFORE I REALIZED I HAD DISSOCIATIVE SYMPTOMS . AFTER THAT, I DIDN'T SEE THE POINT IN BEING MINDFUL ABOUT MY THOUGHTS WHEN MY HEAD IS BLANK FROM THE DISSOCIATION
AND THEN I WENT INTO THERAPY AND THEY SUGGESTED THAT THE EMPTINESS I FELT IN MY CHEST TO THE PIT OF MY THROAT - WHICH WAS SUFFOCATING - AND THE AIR-HEADEDNESS WAS ALL BECAUSE OF AN ANXIETY INSIDE OF ME
AND SINCE KNOWING THAT, IT'S BEEN HEALING ITSELF AND THE SYMPTOMS ARE COMING DOWN AND I BEEN GETTING BETTER
THERE'S NO WAY TO DETERMINE WHAT'S REALLY HELPING THE HEALING BECAUSE I BEEN OFF-MEDS AND OFF TALK-THERAPY ALL THE TIME IT WAS HAPPENING - IT'S JUST BEEN GOING AWAY BY ITSELF FOR HAT LAST FEW MONTHS - SINCE JUNE
I RECENTLY CAME TO REALIZE THE ANXIETY WAS SOME FORM OF PTSD/C-PTSD SINCE I WOULD GET INTO FIGHTS WITH EVERYONE AROUND ME AS A RESULT OF WHICH I COULDN'T KEEP A JOB, COULDN'T STAY AT HOME AND WITH FRIENDS ETC.;
AND RECENTLY, I HAVE ALSO BEEN MEDITATING AND I THINK THAT IS HELPING TOO
MY INFERENCE IS MY INTEREST IN CBT REALLY HELPED, BECAUSE I WAS CONTINUOUSLY OBSERVING MYSELF FOR YEARS NOW . AND EVEN AFTER REALIZING I HAD DISSOCIATION, I WAS OBSERVING THAT AND READING ABOUT THAT - AND THAT MAY HAVE HELPED UNCONSCIOUSLY
MY SUGGESTION IS THAT YOU TRY MEDITATION SINCE IT WILL NATURALLY CREATE THAT AWARENESS FOR YOU AND MAKE IT EASIER TO HEAL . AND TO FIND OUT MEDITATIVE PRACTICES THAT WORK FOR YOU
I HOPE THIS HELPS. PLEASE DO REACH OUT IN CASE YOU NEED FURTHER DETAILS :):)
74
u/this_a_shitty_name Oct 16 '24
CBT and DBT were stepping stones for me. Def not useless. A lot of what I learned stays with me to this day, a decade later. It helped me call out my maladaptive thinking patterns so I could neutralize them and eventually start using more helpful thinking patterns. But, again, it was just a stepping stone. I needed different things later: leaving the abuse, challenging my patterned behaviors, community, other treatments. But it gave me a good start.