Posted by Dinah on December 26, 2003, at 23:28:44
In reply to Re: You know what might be interesting? » Dinah, posted by mattdds on December 26, 2003, at 20:01:24
Ok, here's another one. This one doesn't use the relationship.
I report that I have been upset this week because I discovered my dog is dying. I break my thoughts down with my CBT therapist and, while they contain a certain amount of realistic grief, there are also some dysfunctional thoughts. My dog is dying. I will be bereft and suicidal when he dies. I won't be able to stand the pain. I will never again know the love that I have known with this dog. It's not fair! He shouldn't be dying! I'm fortunetelling, catastrophizing, overgeneralizing, guilty of emotional reasoning, and believing that the world should always be fair. My CBT therapist could pull out his blackboard again, point out the myriad flaws in my thinking, have me question each thought, and come up with counterthoughts for each of them.
Now at this point, I'd probably be ready to break the whiteboard in two and storm out. And my therapist (if he were a particularly unwise CBT therapist) might be asking me if I want to keep feeling this way, what is my secondary gain. And then I would storm out. But that's just me. :)
My therapist would reflect that my dog obviously meant a lot to me. And I might tell him funny stories from his life, and how he makes me feel. He might guide me to point out the needs I have met by the dog. I might tell him about previous grieving experiences I had, where I did feel the things I was now afraid of feeling. We might talk about how we could spend our remaining time together. He'd guide the conversation to the points he wanted to make, while not rushing it.
Again, the presentation would be less didactic, more experiential. But the result would be the same. I would come to a more reasoned view of what was happening and how I would react. Yes, it would hurt, but yes, I could live through it. I had lived through grief in the past, however much it hurt. He might let me remain angry that the world wasn't fair, even as I accepted the truth of it.
You might say that this isn't a general enough tool. That I wasn't taught the wider concept of challenging all my thoughts, not just this one. I wasn't sent home with a split journal to write the dysfunctional thoughts of the week and my counterthoughts. And that's true enough. And for those who do well with the teaching approach of CBT, it would certainly save time to start with the global and apply it to the specific. But you get to the same end starting with the specific too. After you've gone through the process enough times, you start to internalize it (or so the theory goes, and I have noticed it to be true). You begin to have an internalized therapist, who guides you through the steps that your real therapist would have.
poster:Dinah
thread:293462
URL: http://www.dr-bob.org/babble/psycho/20031221/msgs/293660.html