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Dr. Bob is Robert Hsiung, MD,
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Posted by melinda on August 21, 2002, at 15:23:13
I have paranoid schizophrenia and have been going to CBT sessions for a couple of months. I'm amazed at the results so far!
I'm wondering if anyone else has used CBT, in addition to medication, to treat delusions and hallucinations?-melinda
Posted by judy1 on August 21, 2002, at 16:13:59
In reply to CBT and Schizophrenia, posted by melinda on August 21, 2002, at 15:23:13
Hi Melinda,
My therapist uses a variety of therapies- CBT, DBT and analytical to treat all aspects of my disorder(s) including hallucinations. Back in the 1970s Dr. Loren Mosher, who was then head of the NIMH schizophrenia dept. started something called the Soteria project. It involved group home situations where people diagnosed with schizophrenia (paranoid being the most common sub-type) were given love and inderstanding and no medications. The project was an immense success- something like 80% of the clients greatly improved w/o medications. He was fired by the NIMH and his funding cut, and the APA buried his studies at the bequest of the big pharmaceutical companies who were making billions off of AP drugs. So, it does not surprise me at all that you are improving with therapy and if you find the right psychiatrist- you may find you don't need medications. By the way, this is all documented in the book called Mad in America by Robert Whitaker. I spoke to Dr. Mosher 2+ years ago, I was on 6 psychotropic meds and no one would help me get off, he kindly spoke to me for over an hour and recommended 2 shrinks- one of whom I go to and who shares his philosophy. I'm delighted you are doing so well- do a search on Google and read about Dr. Mosher and especially his letter of resignation to the American Psychiatric Assn. Take care, judy
Posted by xjs7 on August 22, 2002, at 1:57:51
In reply to CBT and Schizophrenia, posted by melinda on August 21, 2002, at 15:23:13
Hi Melinda,
First of all I am glad you are doing so well. I have been diagnosed with schizophrenia and know how terrible this illness can be. I hope you continue to see results from your therapy.
I would really appreciate more information about your sessions and how they have decreased your symptoms of psychosis. Could you reply with some examples of the progress you have made? What does your therapist talk about?
I have never had any therapy besides medication therapy and am interested in trying it out. Thanks!
xjs7
Posted by melinda on August 22, 2002, at 14:09:14
In reply to Re: CBT and Schizophrenia » melinda, posted by xjs7 on August 22, 2002, at 1:57:51
Hi xjs7,
(This is kinda long so bear with me.)Here's my take on the CBT. When you experience something, such as hear voices or have ideas of reference, there are thoughts that automatically pop into your head...automatic thoughts. The automatic thoughts elicit emotions and the emotions cause certain behavior. It's like a cycle...experience, automatic thoughts, emotions, behavior. From what I understand, the goal of the therapy is to actually change the automatic thoughts, which will cause a ripple effect and ultimately change behavior.
Each time I notice my mood change, like I get anxious of scared, I record it. I write the situation, my automatic thoughts, my feeling or emotion, the cognitive distortions I made, and the evidence I found for and against my experience. With this information I'll be able to decide whether I should believe my experience.
An example
Situation: "I'm reading the Wall Street Journal. The (Bill) Gates Foundation has donated a lot of money to Eli Lilly."
Automatic thought: "Bill is still watching me."
Emotion or feeling: "anxiety".
Cognitive distortions: "personalization, mind-reading, and maybe a mental-filter".
Evidence for: "The article was meant for me. Eli Lilly makes Zyprexa and I take Zyprexa".
Evidence against: "Why would Bill care that I take Zyprexa? Why would he watch me (of all people)? The Foundation also donated to other pharmecuetical companies. Why would the Wall Street Journal print and article just for me? It would have been easier just to send an email."Well, based on my evidence, I decided that it wasn't very likely that the article was meant just for me. I also decided that Bill probably isn't still watching me. As a result, the delusion became more of a passing thought that caused me to become slightly anxious. In the past it would have runined my day.
In the sessions we sometimes talk about a particular experience I recorded. Other times it seems more like a patient education session. That is, we talk about schizophrenia and voices. Basically he's teaching me how to do this stuff on my own.
The one thing I find creepy about schizophrenia is that I don't feel like I can trust what my brain is telling me. "Normal" people take this for granted...they trust all their perceptions. I don't trust my perceptions. The CBT has given me a way to determine whether I should trust my experience. It also makes me feel like I'm in control of my experience instead of my experiences controlling me.
I hope this helps answer your questions.
-melinda
Posted by melinda on August 22, 2002, at 14:22:10
In reply to Re: CBT and Schizophrenia » melinda, posted by judy1 on August 21, 2002, at 16:13:59
Hi judy1,
I'm not familiar with DBT.
I did a search on google and found lots of information about Mosher. Very interesting.
Fortunately, my doctor takes a minimalist view on medication. I take only one medication and he went through the effort of finding the smallest dose possible. He feels it's necessary for me to take the medication, but he also feels there are ways that I can deal with the symptoms so that I don't have to take so much medication. He's been very supportive of the CBT.
I'm glad to hear that you found a doctor who shares you philosophies.
-melinda.
Posted by judy1 on August 22, 2002, at 17:48:45
In reply to Re: CBT and Schizophrenia » judy1, posted by melinda on August 22, 2002, at 14:22:10
Dear Melinda,
Your psychiatrist sounds wonderful, that he was receptive to CBT and keeps your AP at a low dose is both rare and progressive. DBT or Dialectical Behavioral Therapy was developed by Marsha Linehan. It's basic philosophy is 1. A person's behavior affects both self and others; and the opposite is true. 2. The fundamental nature of reality is change and process- nothing is static. 3. Developing a 'wise mind'- emotional experience plus logical analysis plus intuitive knowing=wise mind. 4. to develope mindfulness skills for achieving wise mind. To be mindful is to be aware of the present moment and to accept it without judgement. You may recognize some facets of CBT in this- this is a structured program (one year usually). I do well with this type of therapy because I self-injure and this stresses being in the present and works to prevent me from dissociating. Take care, judy
Posted by xjs7 on August 22, 2002, at 20:18:30
In reply to Re: CBT and Schizophrenia, posted by melinda on August 22, 2002, at 14:09:14
Hi Melinda,
Thank you for sharing your experiences. I think gaining control over your beliefs and thoughts is an extremely valuable skill, one which I have yet to learn.
I can really identify with your example. I used to have automatic thoughts when I was acutely ill, usually related to violent themes (such as, "They are going to kill me"). However, with medication I have far fewer such thoughts. I might do even better with therapy.
Your message has inspired me to look into CBT--it sounds like a great thing, even for those of us with psychotic symptoms. Thanks again for posting.
xjs7
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