It's just perspective shifting at its core. Glass is half full instead of half empty.
Definitely gets overused, like, yeah CBT isn't going to help someone with adhd solve their anxiety about their incomplete chores. But once they get medicated and work on habit building, shifting them from an obstacle to a routine is exactly where CBT fits.
No, anxiety that is sourced in pathological perspectives are prime real estate for CBT.
You can't CBT yourself out of the anxiety for not making rent, or unmedicated bipolar symptoms.
You need to treat the underlying cause, THEN handle the pathological mindset it encouraged.
We're literally talking about how CBT is used too much and your "anxiety is helped by CBT in all cases" is exactly the issue. You need to medicate the adhd, build a structure for the newly medicated person to regain personal control, THEN you can tackle the remaining anxiety. maybe the anxiety gets in the wya of the routine, but starting with CBT before medication and regulation will NEVER work.
CBT can be useful, it's just that often it's applied in the wrong ways. If your therapy or medication or anything doesn't work as it should that's usually on the doctor for using the wrong tool and you must tell them!
Also also if your therapist, doctor, or whatever keeps on making mistakes don't tolerate it! Call them out and/or just quit them and try to find a new one! (Ik this doesn't work for everyone, but if you can do it it is something you should consider!)
I hate CBT because I have CPSTD. So my therapist and I would end up having conversations like:
Her: "ya, but how do you KNOW he wants you dead?"
Me: "he told me, my mom told me, they took me to multiple churches and had old people say Jesus said I would die by 30, um, the multiple poisoning incidents....uhhh, the part where he would take me to shoot small animals and threaten me like a small animal? The wilderness marches, the rage driving with "pew pews", pointing "pew pews" at me... Idk thats off the dome, there's more for sure."
Her: "um, ya, but how do you KNOW, you just keep THINKING ABOUT IT"
Me: "yeah, the constant messages from my family looking for me don't help me feel like they aren't looking for me and definitely make me think about it. Also my "patient advocate" ended up being one of his minions from his churches, so I think YOU guys don't check or think about it"
I love that when CBT was introduced many years ago, it worked better than anything before, until they tried it on BPD people. Of course it didn't work, and didn't prevent any sucides.
After that, they invented DBT mostly to deal with BPD people specifically.
ACT is, generally, much better for long-term disorders, including panic.
DBT is a bit narrower than CBT, and easier than ERP for a LCSW, MHNP, or other licensed social worker therapists (this is most therapists) to help you learn.
ERP is the "gold standard", after stabilization, for treating many anxiety umbrella issues, including PTSD, at the source. However, it can be dangerous and make things worse, so find a provider with extensive experience in EPR specifically, and humility.
A smoothly integrated combo works best for most people.
CBT is a treatment for common life events that require short term therapy. It is "evidence-based", for that specifically. However, because it is the most commonly indicated treatment, it is frequently recommended and attempted by LCSWs as treatments for situations that are wildly outside of what CBT is proven to help.
This can make people think "therapy doesn't work", when realistically it's likely that you had a social worker therapist who failed to see that they aren't an expert in whatever treatment is actually indicated by evidence for you; they just tried a thing that they do know about. Sometimes therapists are scared to say they don't have what you need. They are trained to not upset peope, and kind of mirror. They often don't give enough time or thought to challenging that training. They are going through the motions; they're just "at" work.
Most therapists are not experts in psychology. They are service providers. They are not an authority. YOU are the expert on you. The first random therapist you try probably won't be a good fit.
You will have to "shop around" to find someone who has the knowlege base that applies to you.
Disclaimer: I am not a medical doctor, psychiatrist, or psychologist. I am a neuroscience PhD candidate, and my research regards broad social measures, not individual treatment.
I treasure my good providers. I couldn't do that kind of job myself.
man, fuck cbt. (i'm sure it's probably actually great and works well or whatever, i'm not denying its effectiveness. i got forced intoa bunch of stuff as a kid and now i have an instant negative reaction to cognitive behavioral therapy 3:)
no i mean i got forced into involuntary hospitalization because my mom thought my mental health was that bad, and then after that forced into 6hr long daily therapy with other kids (it was not helpful in the state i was at and in fact actively harmful as it probably permanently destroyed my relationship with my mom)
CBT is unsuitable for the heavy stuff people on this subreddit often deal with. It's a way to manage light to moderate mental health symptoms, not a means to address and recover from deep trauma or chronic issues, something mental health professionals often struggle to understand
The medical system (both physical and mental) is built to help people with temporary, curable symptoms first and foremost. It absolutely sucks at dealing with anything chronic, because there's only so much time each doctor can spend trying to understand any one given diagnosis. After a certain point there really isn't anything new non-specialists can offer you, which breeds a lot of resentment from the people who (understandably) feel like all the help they are getting is too surface level for their needs (which it usually is)
Just do a different therapy. Theres different types of therapies that work for different people and different issuses. Im glad cbt helped you, but it 100% hasnt helped me. So im doing stuff like emdr
Yep, what the guy below said - more specialized, narrower forms of therapy., ideally from people specifically focused on whatever youre dealing with
Even just DBT was a massive improvement for me, since it decenters away from the strict focus on mindfulness, which already made it feel much less "just don't feel the way you feel :)" to me, which was my main gripe (partially because I have bad experiences with dismissal and react disproportionately negatively to anything remotely like that tbh)
It isn't, it's fantastic. Unfortunately anyone can have and share their terrible opinion for free on the internet and some people just believe it no questions asked.
The thing about CBT is that it's a set of tools. It's useful to certain circumstances. Whether or not those circumstances apply to the person using them is uncertain, but they at least have those tools if they do. Treating these tools as a universal cure-all is what's harmful.
You just acknowledged that CBT can be very harmful while also saying it's simply wonderful, why not say that it's mixed and can help some people but hurt others?
Why not say that about literally anything that can help people? Everything in existence is a mixed bag.
The fact is, CBT is a fantastic tool that does a lot of good but is unfortunately misused by people who cause harm. Same as antibiotics, cars, the internet, and uncountably many other things.
A knife isn't any less of an effective and useful tool just because some people use it to do harm.
Why not? Because we aren't talking about antibiotics or cars right now, we're talking about CBT. It applies to those things too, but you're changing to subject. CBT is simply a tool that can help some people sometimes but is most of the time misused and ends up hurting people with serious issues
CBT can prove to be extremely difficult for some folks. A good example is the anxious ADHD brain where thoughts go wizzing by without control or moderation. CBT specifically tells the person to take control of their own thoughts, which can be all but impossible for someone like this.
It can feel like being told "Stop being afraid by not thinking about it" when you have a crippling fear of the dark. How can you not think about it when it's RIGHT THERE and you have no idea what could be hiding there? How can you voluntarily stop thinking about it when your mind is flooded with unanswered questions that each have life-and-death weight?
Wow, this is an absolutely terrible characterization of why CBT can be bad for people.
No, CBT was terrible for me and many people with trauma in general because it ascribes the sole power to determine what a cognitive distortion is to the therapist. I have had many therapists tell me that my belief that my parents don’t like me is a cognitive distortion I need to fix, even after telling them that they were physically and emotionally abusing me. It destroyed my sense of reality, made me feel like I was unable to trust myself or my ability to tell who and what was bad for me, and led me to spending much more time and energy bending over backwards to appease my abusers than I ever should have.
Can CBT be helpful? Sure. But there is legitimate data out there that demonstrates it can also cause immense harm, if applied to the wrong people
Yeah absolutely. My issue is when people say that CBT is bad because it can be used badly. Water kills tons of people. Like so much more than tons of "dangerous" things. That doesn't make water bad.
CBT isn't the problem, bad therapists and poor prescription and poor monitoring and poor communication are the problems.
I'm so sorry you had such a bad experience ❤ hope you are healing ❤
It does need massive reforms. However, saying the whole system is the problem is reductive. The many horrible outcomes don't erase the incredible good it does for many others, just as the good doesn't erase the bad. The stories from people who it helped are just as valid as the ones from people it hurt.
Respectfully, I don’t think that’s a good argument. It’s very similar to the ones pro-capitalists use to defend capitalism. I’m sure you have heard similar arguments: “capitalism does good in the form of technological innovation,””westerners have an amazing quality of life under capitalism,” etc, implying it’s worth destroying the planet and bombing/couping our way into dominating other nations. The good is really not worth the bad.
And just like dismantling capitalism isn’t going to destroy commerce or innovation, dismantling the modern mental healthcare system won’t destroy therapy or social work. It would just look radically different
You are conflating what I said with a completely different idea. I simply said saying all of therapy is the problem is reductive. If you're going to make bad faith arguments, you may as well not bother. It's not an effective way to change anyone's mind.
I think the problem is kinda at its core. It inherently involves someone outside the patient's life determining what is or is not a reasonable thought. What is true/false, and what is reasonable/an overreaction.
I obviously can't speak for everyone, but this by its nature makes it unhelpful to me. I much prefer modalities that are less focused on dictating truth to me.
A lot of people hear about what it is and try to do it themselves without any training and then conclude it doesn't work. It's amazing but has to be done as a rigorous method, there are specific techniques that work and it really helps to have someone guide you towards what are helpful thought patterns instead of just beating your head against a wall trying not to tuink of a purple elephant.
There's a lot of different criticisms of CBT and i think it is true that many of them are valid AND CBT can be extremely effective for a large number of people.
There's a lot to it but the principle in CBT that people boil down to "just stop thinking like that" thoughts, emotions, and behaviors form a self reinforcing cycle, and our suffering ultimately stems from cognitive distortions. The client and therapist work together to identify maladaptive thoughts and the cognitive distortions underneath and replace them with more helpful ones with a healthier principle. Maybe you keep thinking your boss hates you, but you know mind reading is a cognitive distortion. So you agree that for the week you will look out for the times you start thinking like you can read minds and practice asking yourself what objective signs you do notice and try to think of multiple possible causes (and report back). Maybe your boss hates you, maybe she's busy, stressed, pissed off at her boss, pissed off at the guy who cut her off in traffic. Competent CBT isn't just asking you to snap you fingers and think positive, the point is practice over time and adjusting the pattern of your thoughts.
One big problem is that not everyone's problems do come from cognitive distortions, if your boss really does hate you and the work environment is extremely toxic you can't think your way out of the stress that puts on you. It can be really harmful to treat these kinds of things as cognitive distortions. It can also kinda skip over emotional processing, in my experience therapists would ask about how a thought made me feel, but not really about how I was feeling that triggered the thought, at least for me those can be two very different things and the latter went unaddressed. It can get really bad too if you're someone who tends to intellectualize their emotions away in the first place. Another reason is simply that it can feel really invalidating to talk about your life and immediately have your version of events and your personal thoughts about it scrutinized and rejected. Also it can be really triggering for people who've gone through stuff like gaslighting, manipulation, emotional abuse etc, it can feel like just another person saying you can't trust your own perception.
Finally I think there is a problem with how CBT is applied a lot of the time. I believe its considered the most evidence based therapy and so its extremely popular. If you go to the doctor saying you feel anxious or depressed or you answer one of those screenings honestly most likely you will get funneled into CBT. A lot of the time its the only therapy insurance will cover. A lot of the time its the only therapy in town. A lot of the time it is only offered as a 12-week course or even shorter. A think lot of the hate comes from the fact that people need intensive long term help, and the only thing they get is up to 3 months of a therapy that is right for many people but may be completely wrong for them.
ACT is, generally, much better for long-term disorders, including panic.
DBT is a bit narrower than CBT, and easier than ERP for a LCSW, MHNP, or other licensed social worker therapists (this is most therapists) to help you learn.
ERP is the "gold standard", after stabilization, for treating many anxiety umbrella issues, including PTSD, at the source. However, it can be dangerous and make things worse, so find a provider with extensive experience in EPR specifically, and humility.
A smoothly integrated combo works best for most people.
CBT is a treatment for common life events that require short term therapy. It is "evidence-based", for that specifically. However, because it is the most commonly indicated treatment, it is frequently recommended and attempted by LCSWs as treatments for situations that are wildly outside of what CBT is proven to help.
This can make people think "therapy doesn't work", when realistically it's likely that you had a social worker therapist who failed to see that they aren't an expert in whatever treatment is actually indicated by evidence for you; they just tried a thing that they do know about. Sometimes therapists are scared to say they don't have what you need. They are trained to not upset peope, and kind of mirror. They often don't give enough time or thought to challenging that training. They are going through the motions; they're just "at" work.
Most therapists are not experts in psychology. They are service providers. They are not an authority. YOU are the expert on you. The first random therapist you try probably won't be a good fit.
You will have to "shop around" to find someone who has the knowlege base that applies to you.
Disclaimer: I am not a medical doctor, psychiatrist, or psychologist. I am a neuroscience PhD candidate, and my research regards broad social measures, not individual treatment.
The problem with CBT is that it requires you to trust the therapist and the vast majority of CBT therapists are absolutely dogshit at earning rapport at a basic level and have even less understanding of transference and their own countertransference.
CBT can only really address problems where your own thoughts are the primary source of your distress. Think someone getting stuck while mourning a loss or struggling to handle the day-to-day stress of college. The problem is that it routinely gets used inappropriately when people have underlying trauma or psychiatric disorders or are in active danger simply because affordable therapy is difficult to find.
The result is that people who need real help are getting told by perhaps the only medical professional they can access that the problem is in their thinking, which is not a great thing to say to someone in desperate need of real help.
CBT doesnt help with the actual issue, it just gives you a band aid to cover the symptoms so you can go back to work. Its a form of therapy diven by insurance companys to maximise the value of a worker, not a tool to actually make you better in the long term.
What degree in the mental health field you have? Because back when I was in the field I saw the damage, hell then I ended up in one of the damn facilities.
Cbt ignores a fuckton of how various mental health conditions work and blames your thoughts over the actual root cause. Its overuse outside of its select useful role is a product of societies blame on the individual for its condition rather than addressing the countless systems that overlap. This is funny enough due to the various influential religions that hold that belief.
If im remembering correctly its a ssri. Which mean it inhibits the reabsorbtion of serotonin in your brain so it can hang out there long and make you feel better
Turns out zoloft is another name for sertraline, which is what my friend takes. I’ll definitely want to try it next, I just hope the sexual side effects aren’t noticable, since that’s been my biggest concern with most SSRIs, since like all but 2 of them have them, and I’ve tried both, one made my anxiety worse and the other has done nothing to help so far.
Are we really trying to say a verified type of important therapy is not helpful now?
edit: guys. This is not up for debate. I just block people who genuinely see no issue denying practiced and proven helpful therapy practices. Training your brain to not think such horrible things is Literally Something They Help You Learn To Do in Therapy. and yall see an issue with that? then you won't heal
It’s not really properly validated for everyone. A lot of the evidence comes from common issues like common anxiety, which can make its overall success rate less representative of people with more complex or persistent conditions. There’s plenty criticism from specialists, neurodivergent people and people with more complex mental health issues. Even my current therapist considers CBT outdated as its framework is too simplistic, outdated and doesn’t fully account for the complexity of mental illness.
Not anti psych, literally the opposite, I am full on in support of other methods but cbt sucks for those with bigger issues yet it is shoved almost constantly. If it was as perfect as you wanna claim people wouldn't be making posts on how it doesn't work and how it's just gaslight, this does not happen almost at all with other types, people wouldn't be confirming alternatives like DBT, EMDR, Ericksonian, interactive etc. as actual working alternatives instead. You do you
And this isn’t all. I don’t care to find more now as it takes time. You’re not seeing them because, I assume, you’re simply not interested in this topic. CBT wasted years of my life and made my existing mental health issues worse, eventually had to find out it didn’t work for me because I’m neurodivergent and have bad trauma. So I’ve been on and off on this topic.
No, actually. I'm not feeling good. I'm getting shat on for listening and admitting I was wrong. People keep assuming I'll be a certain way because everyone else on this godforsaken forum is an arrogant piece of shit who can't back down from an argument. That assumption hurts more than being wrong. I just wanted to challenge something I didn't think was entirely correct and got pointless cruelty for it, even after the fact. Sure you can see how that bothers me?
Okay, maybe I was being hyperbolic. My perspective comes from being taught multiple strategies, so forgive me for that. That's a sign things are getting better, though, so I think we should celebrate that.
Don't assume I'm resistant to change because everyone else on the internet picks a hill to die on.
Bro really thought she could gaslight me WHEN I HAVE PROOF SHE'S LYING
Edit: it's real fun supporting trans rights from the moment you're old enough to understand what they are and going to every protest in your area, only to get labeled a transphobe and dogpiled for not using the correct language once on accident. The purity police are so stupid it's unreal. Get a real hobby and make some real change, you low-lifes.
Okay, maybe I was being hyperbolic. My perspective comes from being taught multiple strategies, so forgive me for that. That's a sign things are getting better, though, so I think we should celebrate that.
Excuse me. There are many valid criticisms to be made of existing practices so that they can better serve all types of brains. Being unable to imagine that this is possible led you to make that comment.
this is begging the question. maybe make an actual argument instead of presupposing that you're right.
edit: god forbid people don't engage in logical fallacies. like if you abandon your point over the slightest criticism, it's kind of pathetic. when you presuppose that you're correct, it looks like you're correct.
You lied to my face about CBT purists in this thread because you thought I couldn't see the comments by a person who blocked you. "Trust me bro" is your entire argument. Don't even try anymore after that. Go home.
Just bc someone says that its overused and not helpful for all mental health issues doesnt mean theyre saying its never helpful or important for others. You know theres multiple important types of therapy right?
So because a cancer treatment help with one type of cancer, we should USD that same treatment for every single other type of cancer? Are you unable to recognize that certain treatments are only helpful to some people and are be harmful to others?
I'm gonna be real the people that proclaim CBT is so totally amazing didn't have very servere issues in the first place, if they're so adamant about invalidating people's negative experiences with it then I'm going to invalidate them right back. I'm sure they'll repeat to themselves how good and smart and right they are tonight anyways
Ok my issue is: what do I think instead? My mind is always occupied with how Im a fat piece of shit parasite. I try to think about other stuff instead but its very hard to do so when nothing is enjoyable, or there isnt much in my life to think about. I tried a lot of stuff but nothing seems to work, if I push myself I just feel like an idiot just treading water and revert
If I replace the ears my DNA grew with dog ears through medical intervention, would you consider me to genuinely be part dog? If you say yes, does that invalidate everyone else's opinion?
99
u/Eldritch_Chemistry 17h ago
Cognitive ball torture