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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Racer on March 26, 2004, at 10:19:37
I'm seeing a lot of references to a lot of different therapeutic models, here and elsewhere, and am wondering about them. I may understand the basics of some of them, like CBT, but am curious to understand them a little bit more. For instance, CBT -- based only on my limited understanding -- seems like a recipe for making me even more likely to suppress my emotions and experiences, thus making me sicker than I am. I'd like to find out more, to see what I'm missing.
I'm also in the process of trying to get out of my current "therapeutic" situation, so knowing something about what I think might help me would be very valuable right now. Do I want to look for an analyst, CBT, dynamic, what? So, if you have any resources to offer, or comments about what's worked for you, or anything else, please let me know.
Thanks!
Posted by lonelygirl on March 26, 2004, at 13:52:34
In reply to ??? about therapy models, posted by Racer on March 26, 2004, at 10:19:37
Coincidentally, I had a little chat with my CBT today about that. I will try to summarize how he explained "what he does." I’ll try not to mess it up :)
He said that we have reasons for doing everything, which include both conscious and unconscious motivators. When we do something that doesn't seem to make any sense, on some level, it does make sense, but we may not be aware of our "unconscious motivators." Sometimes our unconscious motivators are emotional, and emotions are not logical, so they may cause us to do things that do not seem to make any sense. Sometimes, these emotions are based on fear or shame, and then we might not be willing to admit that because we think it's wrong to feel that way. We may interpret those emotions as something else, such as being tired or angry, which can further confuse our logic.
His "philosophy," I guess, is that we need to figure out what our unconscious motivators are that cause us to do things that don't seem to make sense, and understand why we feel those emotions in order to deal with them constructively. So to answer your question, as I understand it CBT is not supposed to "suppress" your emotions or feelings at all; on the contrary, it is supposed to recognize and understand them.
I guess it depends somewhat on your preferences and what you want to get out of therapy. If there were one model that is definitively the best for everyone, all the schools would teach it and the other models would sort of die out. I personally feel better about CBT than some of the other stuff, because -- and please, please nobody be offended by what I am about to say, because it is only my opinion based on how I think my mind works -- some of the other things seem a little "quack"-ish to me (to reiterate my earlier statement, I know that some of these things work for some people, and that's what matters in the end, but I personally would have a hard time taking them seriously). CBT seems to be more logical rather than based on "magical" sorts of theories. I am generally a bit of a skeptic, and CBT is easier for me to swallow than, say, psychoanalysis, humanist, Gestalt, etc.
Anyway, I am obviously not an expert on psychology, so I can't really give a recommendation one way or another. I'm sure it also depends a lot on what you want to get out of therapy. Just in case you wanted to know, though, that is my take on CBT. Hope it helps in some way.
Posted by terrics on March 26, 2004, at 16:12:05
In reply to ??? about therapy models, posted by Racer on March 26, 2004, at 10:19:37
Hi Racer, psychoanalytical therapy does not work for me. I have tried it for years with different therapists, not realizing I had a choice of therapies. These therapists all want you to remember your past. WELL I DON'T. And I give up trying. All these therapists seem diappointed that I do not have gory stories to tell. As I have said on the board, I am starting DBT. I'll let you know what I think of it in a few weeks, and what it entails. terrics
Posted by DaisyM on March 26, 2004, at 17:28:58
In reply to Re: ??? about therapy models » Racer, posted by terrics on March 26, 2004, at 16:12:05
My Therapist has a psychoanalytic leaning with emphasis on attachment and self. (Read: Kohut)We do problem solve and he has tried reality testing with me (I hate that!). I don't know if CBT would work for me because I tend to look for "answers" and minimize my feelings already. I spend way too much time in my own head. I'm smart enough to see what I should do (let people help me more) and to see what I'm just have to learn to accept (my husband's illness). But being smart hasn't "fixed" this intense sadness, lonliness and emptiness I've felt for awhile.
My therapy, as I am experiencing it, offers me an attachment and support I've never had with no expectation that I will have "the" answer. I am learning to be "inter-dependent" and trust other people with my emotional needs. I have a long way to go.
On the flip side, my son used CBT to work on his anxiety. He used meds for awhile and also did a course of Biofeedback. He is now off meds and out of therapy. I think all these things combined gave him the tools he needed to manage his anxiety. He still has it, but it doesn't overwhelm him as often nor interfere as much with his life. I wish I had learned to calm myself at 12! Biofeedback taught him to center and breathe...just like I teach in childbirth ed. I think we should require this to be taught from kindergarten up!
Posted by gardenergirl on March 27, 2004, at 0:14:42
In reply to Re: ??? about therapy models, posted by DaisyM on March 26, 2004, at 17:28:58
Racer,
I feel a little sadistic recommending this, but there is a set of books that talk about specific therapy models out there that I found valuable recently. It's the "Comprehensive Handbook of Psychotherapy", edited by Florence Kaslow. One volume is all about Behavior-based therapies, one is all about psychodynamic therapies, one is humanistic/existential, and the fourth is integrative/eclectic. If you are one to head to the library and research til the doors are locked and the cows come home you might find something in there that makes sense. But it's very detailed in the different models. If you want more of a broad overview, I'm not sure of a good text off of the top of my head.Either way, you can always ask a T or potential T to explain their preferred model. If they say "eclectic" ask them how they conceptualize clients, i.e. how do they view problems, personality, history, the present environment, feelings, and thoughts as contributing to the problem.
Hope this helps,
gg
Posted by Racer on March 27, 2004, at 14:53:29
In reply to ??? about therapy models, posted by Racer on March 26, 2004, at 10:19:37
These days, language is not my friend. It's really hard to get the energy up to explain what I mean, so I'm using a sort of shorthand. I think what I said about CBT looking like a recipe for making me sicker wasn't very clear, so I'd like to try to explain what I meant a little more. If it's still not clear, oh well.
I'm very, very good at coming up with reasons not to say what I'm feeling, talking myself into denying my feelings, saying to myself, "Well, you shouldn't feel this way, or think this way, so think this other way instead." That's not healthy for me, because it does lead me to bottling things up even more inside myself. Telling me to look at something from another perspective just isn't very helpful for me, because I can and do already look at almost everything from all sorts of perspectives -- because that allows me to repress what I'm actually experiencing.
My understanding of CBT is that it tries to teach patients how to stop the negative cognitions, in order to arrest the negative behaviors. You know, "you're in a negative thought rut, so break out of it and explore a more positive way of thinking, in order to behavior in a healthier way." That's great -- when it works for a particular patient.
It's also something I try to teach my riding students when I'm teaching. Stop thinking about the Might Be and start thinking about the What Is. It really and honestly does work, and is very, very valuable.
Where it becomes a problem for me, is that I spend so much time and effort using that as a coping strategy, I lose my feelings and experiences entirely. I know that I feel great distress about my father's death, for example; I know a great deal about why, but I can't process it and move on. What I need right now isn't someone to help point out other ways to look at my experiences, I need someone to help me reopen old wounds and let them heal. The more it's about specific here-and-now behaviors, the less I get what I really need in order to move on. Here and Now are bad enough, but they're filled with bushels of old pain that can't be set out on the curb to be hauled to the dump. They're blocking my way outside of this prison.
So, if I'm looking for someone who can help me pack up that rubbish and get it carted away, is there any model of therapy that I should be looking towards? (And, yes, I know that it means finding a good therapist, rather than just going by the model they use. That's a whole 'nother subject, though.)
Thanks, and I hope that's clearer.
Posted by Ilene on March 27, 2004, at 15:17:37
In reply to Clarification of what I meant about CBT, posted by Racer on March 27, 2004, at 14:53:29
I know that I feel great distress about my father's death, for example; I know a great deal about why, but I can't process it and move on. What I need right now isn't someone to help point out other ways to look at my experiences, I need someone to help me reopen old wounds and let them heal. The more it's about specific here-and-now behaviors, the less I get what I really need in order to move on. Here and Now are bad enough, but they're filled with bushels of old pain that can't be set out on the curb to be hauled to the dump. They're blocking my way outside of this prison.
>
> So, if I'm looking for someone who can help me pack up that rubbish and get it carted away, is there any model of therapy that I should be looking towards? (And, yes, I know that it means finding a good therapist, rather than just going by the model they use. That's a whole 'nother subject, though.)
>
> Thanks, and I hope that's clearer.
You've hit on something I have questions about: the here-and-now vs. the painful past. I wonder if thinking about the past just allows it to continue being painful, whereas if we work on what's going on right now we might feel better.I have a lot of doubts about CBT, also. Right now I want to investigate DBT (dialectical behavior therapy) because it deals with emotion dysregulation. There seems to be an underlying assumption w/ CBT that once you recognize your dysfunctional thoughts, your dysfunctional emotions will straighten themselves out. I don't find that to be true.
On the other hand, I'm all too aware of the painful past and I wonder if opening up old wounds to let them heal is a false analogy.
Mostly I want to function in a reasonably normal fashion. I think therapy may be too ambitious a project for me until I get meds that actually work. I am full of doubts.
Posted by lonelygirl on March 27, 2004, at 15:51:29
In reply to Clarification of what I meant about CBT, posted by Racer on March 27, 2004, at 14:53:29
Sorry... I didn't mean to insult you or anything :-( I'm just an idiot so don't mind me ok. Sorry.
Posted by Racer on March 27, 2004, at 20:10:10
In reply to Re: Clarification of what I meant about CBT » Racer, posted by lonelygirl on March 27, 2004, at 15:51:29
Posted by Karen_kay on March 27, 2004, at 21:41:44
In reply to CBT, as I understand it » Racer, posted by lonelygirl on March 26, 2004, at 13:52:34
If I may... If you ever, ever, ever ever EVER!!! question your intelligence, why not take a look back at the post where you explain you and your therapist's interpretation of CBT. That sounds rather intelligent to a numbskull (is that how you spell it?) like me! I wouldn't even be able to remember past the first few words, let alone understand what he was talking about. Please don't keep telling yourself such harsh things. Believe me, after a while, you begin to believe it! You are very smart. Reread that post, you'll understand what I'm talking about. Give yourself some credit! :)
Posted by Racer on March 28, 2004, at 7:14:16
In reply to And lonelygirl...., posted by Karen_kay on March 27, 2004, at 21:41:44
Karen_kay is absolutely right. You are anything but an idiot, and I appreciate what you said. I posted my clarification because I thought people had misunderstood me when I said that CBT struck me as a way to make me sicker, not because your response to it was in any way less than intelligent and insightful.
Just on a personal note, when I read your posts, my heart always goes out to you. You sound a good deal like me 20 years ago in so many ways, and I'd do anything to help relieve your distress. Your posts are always interesting, and generally pretty insightful. The only thing I think you miss is the part about friendship: you deserve friends, and the potential friends who haven't met you yet are missing out. If I could, I'd be your friend -- and that's saying a lot, coming from me.
Best luck, and I'm sorry if your feelings were hurt by anything I posted.
Posted by fallsfall on March 28, 2004, at 8:51:28
In reply to Clarification of what I meant about CBT, posted by Racer on March 27, 2004, at 14:53:29
My brain is a bit muddled right now, but it sounds to me like you would like my therapist. He is Psychodynamic (likes Kohut - Psychology of the Self). One thing that I did was find a bunch of books at the University library that had case studies in them. I read case studies from different therapy orientations. That gave me a better idea of how each orientation deals with things. Good luck.
Posted by gardenergirl on March 28, 2004, at 11:27:56
In reply to Re: Clarification of what I meant about CBT » Racer, posted by fallsfall on March 28, 2004, at 8:51:28
Ooh, good idea!
Posted by antigua on March 30, 2004, at 15:57:38
In reply to Clarification of what I meant about CBT, posted by Racer on March 27, 2004, at 14:53:29
Sorry, I've been away for a while so I just read this post. You have such a way w/words. You explained CBT very well, IMO, because you explained the inherent problem I have had w/it. I used CBT to change some bad habits and to understand how I use negative thoughts about myself to hurt myself. Once taught these negative thoughts, I now recognize that my feelings about things can be changed if I zero in on why I behave the way I do. For me, however, it's the deep underlying issues (abuse and abandonment) that drive everything I do. In my current life I can use CBT to help me out, but my life will not heal until I heal the underlying pain. So I use a combination of therapy. My T is definitely psychodynamic and everything always refers back to the original "sin," but I want to get over the original trauma. I will never be whole until I do so.
For me, letting go of the anger and actually experiencing it is what is holding me back. I don't trust anyone else or myself enough to let go, but I know that once I let go I will really be on the road to healing fully.
Sorry for the rant, but IMO there are benefits to both therapies, and if I want to change my very nature I have to go back to the original trauma, which for me is being healed with psychodynamic therapy. That said, CBT helps me get through every day.
antigua
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