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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 34. Go back in thread:
Posted by cecilia on July 15, 2006, at 13:30:48
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 8:14:41
Well, ok, I know I shouldn't have put this rant in any board. But it still hurts so much. No med, with even the most horrible horrible side effects (Effexor. Parnate. Nardil. Emsam) has had side effects anywhere near as bad as therapy. Cecilia
Posted by SLS on July 15, 2006, at 13:30:48
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 8:38:39
> Well, ok, I know I shouldn't have put this rant in any board.
I'm glad you did. It helped to remind me that I have my own paths to forge and remain true to.
> But it still hurts so much.
I wish I could write something clever to make the hurt go away forever.
> No med, with even the most horrible horrible side effects (Effexor. Parnate. Nardil. Emsam) has had side effects anywhere near as bad as therapy.
How is your self-esteem? Mine took a wicked hit this past month when Wellbutrin acted to exacerbate the biological counterpart to my depression.
Self-esteem is a precious commodity. It is gained with such effort, but lost so easily. Depression tends to reduce one's sense of self-esteem, which then reinforces the depression, which in turn acts to further reduce self-esteem. It is a downward spiral. CBT can help to change one's core beliefs and raise self-esteem. You don't even need a therapist to practice it.
- Scott
Posted by cecilia on July 15, 2006, at 13:30:48
In reply to Re: Can't Get Over It, posted by SLS on July 15, 2006, at 8:55:53
My self esteem is non existent. Reading the CBT books just makes me mad, I can't make myself believe any of the thoughts I'm supposed to believe and I'm certainly not going to do the shame reducing exercises. I have more than enough shame already without deliberately increasing it. I hate David Burns and his smug "guaranteed to work" claims. He makes me think of a TV evangelicist. Believe what I believe and you will be saved (from depression). Choose not to believe, well it's your fault you're depressed. Doesn't matter whether it's true, all you've got to do is BELIEVE (and do your homework). Write down the "rational" thoughts you don't believe 500 times until you're willing to admit you believe them.
7:29 am. I've got to figure out a way to program my computer so I can't use it at night. Another night without sleep. I take 10 mg Ambien and lie sleeplessly for hours stewing over one thing or another and finally take another 5 mg and tell myself I'll just go on the computer for half an hour until it takes effect and then of course hours pass. Cecilia
Posted by Phillipa on July 15, 2006, at 13:30:48
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 9:36:43
Yup the computer is addicting and I too have low self-esteem and Scott is right it fuels the depression. Love Phillipa
Posted by SLS on July 15, 2006, at 13:30:48
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 9:36:43
> My self esteem is non existent.
That was the impression I was left with from the first post along this thread.
> Reading the CBT books just makes me mad...
OK. I guess that's one path to be less travelled.
:-)
> I hate David Burns and his smug "guaranteed to work" claims. He makes me think of a TV evangelicist.
I hate that sort of self-promotion. It makes me think that it's not really good enough to sell itself on its own merits. Why does it have to be sold at all?
> Believe what I believe and you will be saved (from depression). Choose not to believe, well it's your fault you're depressed.
Perhaps it has not been made clear to you exactly what CBT can and cannot do. You may have had unrealistic expectations of what CBT could do for you. Perhaps the books exaggerate the effectiveness and generalizability of the CBT approach to treating mental illness. I haven't read any of the popular CBT books. CBT is a powerful tool for accomplishing some things in some peope, but not for others.
CBT is not a good match for everone. Burns is not a good match for everyone. How about forgetting Burns and his entire program along with the homework and keeping the CBT concept? Just recognize:
1. Automatic thoughts
2. Cognitive distortions
3. Core beliefsThat's all you need to know. You really don't have to "do" anything. Just a thought. It might not work for you. Keep the best and throw out the rest. Use the insight into how the mind works to figure out your own strategies as to how to best attack your inefficiencies.
> Doesn't matter whether it's true
For me, it really does matter whether it's true. If I don't believe it, the whole thing doesn't work.
> all you've got to do is BELIEVE (and do your homework). Write down the "rational" thoughts you don't believe 500 times until you're willing to admit you believe them.
For me, CBT works because logic works. The approach I take doesn't utilize such repetitive pounding of thoughts. Such forceful use of rote has never worked to change my belief system. Logic has worked. I think it is important to be kind and merciful with yourself throughout any recovery process. However, there are times when I treat myself in an Albert Ellis sort of way. I sometimes need a good kick in the *ss.
- Scott
Posted by pseudoname on July 15, 2006, at 13:30:49
In reply to Can't Get Over It, posted by cecilia on July 15, 2006, at 8:10:02
That's really too bad, Cecilia. I wish I could get back the tens of thousands I paid to my main therapist, who told me after I'd been with him for over a year that he had no goal of making me better whatsoever. When I screamed that that's what I was in therapy FOR, he would just grin and lie back and say "We don't know why you're in therapy." Desperate moron that I was, I stayed for several more years of frustration.
This would be another good reason to consider the use of therapy progress evaluation forms (see this thread http://www.dr-bob.org/babble/psycho/20060703/msgs/666624.html).
But yours sounds like one of the worst experiences I've heard. I'm really sorry about it.
Posted by pseudoname on July 15, 2006, at 13:30:49
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 9:36:43
> I hate David Burns and his smug "guaranteed to work" claims.
Burns is a moody fellow who seems very bitter that people think differently than he. He used to have a web site where he answered emails and would get *very* upset and fixated with people, apparently forgetting all of his books' techniques. He has reportedly claimed at his professional seminars that he permanently cures patients' depression in one day and has had only 10 patients relapse in his entire career! He has called psychiatric medication "horse$#*". In his most recent NYT interview, he was openly bitter and carping, apparently oblivious to the irony of HIM publicly being that way about mental health issues.
Albert Ellis seems a lot more personally consistent than Burns, but Ellis also makes a lot of promises in his books that the techniques can solve almost any mental problem if YOU just keep doing them long enough. Which can make you feel just lazy & bad if you ever give up on one. I wish ALL therapists & authors would acknowledge the limits of what they offer more explicitly right upfront.
Like Scott, I too use Ellis to kick-start myself sometimes. I call it "Ellisizing" a situation and ask myself, with Ellis's snarl, "WHYYY should ___ be/do ___?" But like other CBT techniques, for me, it only works sometimes. I'm trying hard to get better at recognizing which techniques I've found or invented are likely to help FOR ME in which situations. But for sure they are no magic bullet.
I hope you don't feel alone about these things, Cecilia. Best wishes.
Posted by bassman on July 15, 2006, at 13:30:49
In reply to Can't Get Over It, posted by cecilia on July 15, 2006, at 8:10:02
Somewhere, Dr. Freud is laughing. Your therapist basically said "you want to be depressed; you're incompetent"-when the case in reality, it would seem to me, was more like your therapist was incompetent (and mean and nasty). Projection, anyone? It's especially difficult when someone you trust/need to trust screws over you. It's a relationship, and like all relationships, things can happen and you get hurt, sometimes, badly. But that's what your T was trained to know. Please don't blame yourself-and being deadly realistic, you're so much better off without her-even though it was an expensive lesson. There have been many, many posts on the low percentage of good therapists available. Lucky you, you got a stinker. :>} Please take care.
Posted by mayzee on July 15, 2006, at 13:30:49
In reply to Re: Can't Get Over It, posted by cecilia on July 15, 2006, at 9:36:43
I really empathize with you Cecelia. I too obsess about a pdoc I did therapy with for years, spent tons of money on, and let go on way too long, just getting worse. I usually blame myself for not getting out sooner, but now I'm learning to be angry at him --he shouldn't have let me suffer so long. (hey better angry at him than at myself, right?) Yours sounds so much worse -incompetent & brutal. I'm so sorry.
CBT really appealed to me logically, but it didn't help me. I tried it with various therapists, including a year at the Beck Institute. Tried some of the books... Feel Good, Reinventing Your Life, etc. They didn't turn me off; I just was too depressed to do the exercises. But my main problem with CBT was that my negative thoughts are so deeply engrained that I couldn't even notice them. They just felt to be *me*.
What is helping me is "mindfulness" training. A few years ago I took an 8-week course that taught mindfulness meditation --based on Jon Kabat Zinn's program (see "Full Catastrophe Living" or one of his other books). It is really helping me to learn to pay attention to and be aware of my thoughts, feelings, reactions. It's very gentle; very accepting. It's also got me onto a path of studying tibetan buddhist philosophy/psychology which is very supportive. You can look for mindfulness training in your area by going to http://www.umassmed.edu/cfm/mbsr/
I am still in therapy, and it's now becoming much more effective as I get better at being mindful and being present; starting to be able to see reality vs. my own little (ugly) world in my head. I think if I did CBT now it would work better for me.
The glitch in this plan for me is that I'm often too depressed to do the sitting meditation practice on a regular basis. But even without that it's definitely helping.
Anyway, I just wondered if this might be something for you to consider. Mindfulness Meditation. Or one of the therapies that incorporated mindfulness: DBT or ACT. I myself want to look into ACT (Acceptance & Commitment Therapy) because it incorporates a focus on values and what's important to *you*. http://www.acceptanceandcommitmenttherapy.com/
I just noticed that there's a thread on the psychology board where people are working through the DBT skills training together. Maybe you could check that out: http://www.dr-bob.org/babble/psycho/20060312/msgs/624046.html#followups
Hope I'm not butting in and offering unsolicited advice. Just offering a possibility in case you haven't already looked into it.
Best wishes,
mayzee
Posted by pseudoname on July 15, 2006, at 15:03:14
In reply to Can't Get Over It, posted by cecilia on July 15, 2006, at 8:10:02
Posted by Phillipa on July 15, 2006, at 18:41:40
In reply to Re: Can't Get Over It - tried mindfulness?, posted by mayzee on July 15, 2006, at 13:23:36
Everytime I find a therapist she is either too booked or works only at the hospital. Very frustrating. Cause I've only found one who understood me and she worked for the pdoc and he decided he wanted to do the theraphy too. What a disaster. Love Phillipa
Posted by Declan on July 15, 2006, at 18:43:37
In reply to deluded therapists » cecilia, posted by pseudoname on July 15, 2006, at 11:59:02
I spent all this time saying that I came to see my T for *her* benefit. She would regard me quizzically. Naturally I wasn't talking about the money (That only occurs to me now). I didn't know what I was talking about, but I had some idea that I was in her and she in me, or somesuch thingo, playing tennis from the wrong end of the court.
Posted by Declan on July 15, 2006, at 18:47:22
In reply to on Burns, Ellis, and CBT » cecilia, posted by pseudoname on July 15, 2006, at 12:32:00
You want some distinction in your therapists. Harry Stack Sullivan was pretty cool.
CBT? I dunno how people maintain interest. Probably because it works, it could only be that, there's not much else. And Albert Ellis? Yeah.
Declan
Posted by Declan on July 15, 2006, at 19:06:03
In reply to Re: Can't Get Over It - tried mindfulness?, posted by mayzee on July 15, 2006, at 13:23:36
I was watching a Goddard film from 1962, "Vivre la Vie" (I think, certainly not that M. Scott Peck thing), and in it the main character says to the one who wants to escape to the tropics (noone wants to escape to the tropics these days. Why not?) 'You just have to take an interest in life. Life is life, a man is man, a plate is a plate', and then she breaks out laughing. I was impressed. Mindfulness comes from a tradition.
Declan
Posted by Jost on July 15, 2006, at 19:40:08
In reply to Can't Get Over It, posted by cecilia on July 15, 2006, at 8:10:02
Hi, Cecilia.
I don't want to ignore your pain. But I'd like to hope that it's not totally intractable. Even if it seems that way, even if you feel that you've given up hope, or don't want any because your hopes have betrayed you in the past.I'd like to ask what happened with your ex-T and whether and how you can find a way to redeem your life from whatever happened with her, and with other people before her.
But I don't want to put you through going into that, because it sounds like it torments you. But I wish she hadn't been so (what sounds like) vulnerable, and unable to keep hold of her own sense of self with you.
There are a lot of confused, naive, or overwhelmed Ts out there-- but they aren't all that way. Despite what's happened, I truly believe you need to find another T some day-- maybe someone unusual who can communicate in a way that's strong and subtle enough for you to feel safe, over time, that he or she is really there for you.
When you've had a traumatic relationship, you need some other relationship that can help repair the trauma. Maybe this isn't something you can do now, but I really hope that you can someday. Because I think if you got some really good referrals and interviewed a number of people, you might be able to find someone whom you could feel was worth trying with.
I've seen a lot of Ts since I was a teenager, and many of them were well-intentioned and helped a little, and a few of them were incompetent, and some did significant damage-- but eventually, I did find someone-- and while it hasn't been and still isn't easy, it's so much better than it used to be.
I'm going to hope that can happen for you, even though you don't believe in that right now for yourself.
I know this isn't thinkable now, but maybe someday you can try to forgive your old T-- I have a feeling your pain was hurting her too much-- which isn't your fault, but also maybe isn't exactly hers. Of course I don't know, but I don't think it was only about money. Maybe she just didn't know what to do, and did the wrong thing.
That's tragic, esp. in its effects on you--but however awful, it's not utterly heartless, which is worse.
Jost
Posted by pseudoname on July 15, 2006, at 20:54:18
In reply to Re: on Burns, Ellis, and CBT, posted by Declan on July 15, 2006, at 18:47:22
> I dunno how people maintain interest. [ ] And Albert Ellis? Yeah.
Do you mean to say Albert Ellis is boring?
Posted by pseudoname on July 15, 2006, at 21:04:23
In reply to Re: Can't Get Over It, posted by SLS on July 15, 2006, at 11:50:17
When I said Burns was moody and bitter, etc. I didn't mean to be knocking CBT techniques or even Burns's books ("Feeling Good" & "The Feeling Good Handbook"), which are I think the best presentations of CBT theory & technique, howevermuch he oversells it.
All schools of psychotherapy oversell their results and promote themselves as uniquely true and insightful. Even the "Client-Directed" group that thinks all schools of therapy are equal: they're smug that only *they* realize this.
Posted by pseudoname on July 15, 2006, at 21:32:59
In reply to Re: Can't Get Over It - tried mindfulness?, posted by mayzee on July 15, 2006, at 13:23:36
I wanted to throw in with mayzee (Have we met?) about mindfulness, too. As I'm finally officially not depressed AND I'm trying to rejoin life (two separate things, it turns out), I'm finding that every day is full of "MacGyver"-type mental health challenges, and I have to put it together with stuff from everywhere: medication, insight, "restructuring" automatic thoughts, Baby Steps, behavioral activation, little self-tricks, more insight, rinse, and repeat.
But it seems more and more that all of it comes to a common pathway of mindfulness paying attention and acceptance of what comes up inside me. But that path isn't direct or visible. There is no way (I'm thinking) to charge straight at acceptance. I think I'm finding that it's just the bottom line that I look for in every attempt at therapeutic change: something to embrace when it's offered. Bit by bit.
Hayes and Kabat Zinn and the other mindfulness folk like all psychotherapy schools, I think, overfocus and oversell. But I try to keep their ideas in the front of my head because I have no better tools.
Posted by Declan on July 15, 2006, at 21:37:17
In reply to Re: on Ellis » Declan, posted by pseudoname on July 15, 2006, at 20:54:18
I don't know that much about him to have an opinion worth listening to, but having said that, sure.
Posted by Declan on July 15, 2006, at 22:10:15
In reply to Re: on Ellis » pseudoname, posted by Declan on July 15, 2006, at 21:37:17
I've got a lot of sympathy for psychoanalysis even with its success rate, until someone like Nabokov or Edmund White comes along saying it is simply vulgar, and then I think that too. I just like to feel superior. Why am I posting this?
Declan
Posted by pseudoname on July 16, 2006, at 11:52:45
In reply to Re: on Ellis, posted by Declan on July 15, 2006, at 22:10:15
> I've got a lot of sympathy for psychoanalysis even with its success rate
That's the spirit. ;-)
> until someone like Nabokov or Edmund White comes along saying it is simply vulgar
I'm glad you posted that because that "vulgar" claim has really hooked me. I blurt: (a) How could it possibly be true? and (b) I don't know what would be wrong with that.
I *really* have to read White's book now. ("My Lives")
> I just like to feel superior.
Not so depleted, then. (Joke!)
> Why am I posting this?
I read a thing this morning that friendship in America is not what it used to be, in America or ancient Greece. It used to be closer to the relationship in a well-made marriage: about knowing somebody deeply and being known. I think psychoanalysis and other therapies can be like that.
And while I think broad knowledge (like of trivia) can be vulgar, could deep knowledge ever be vulgar?
I think the catches are that in psychoanalysis the deep-knowing is only in one direction, the relationship is constrained by "boundaries" and treatment rules beyond the tolerance of ordinary human needs in human relationships, and the whole collaboration hangs by a thread (payment, diagnosis, etc) that can be permanently severed at any time for reasons that would seem to destroy the entire pretense of the feelings & "reality" of the relationship. Those constraints could seem "vulgar" (used derisively) in comparison to a "real" friendship that is two-way and flexible and organic and risky, free to grow and be wounded in whatever channels it may.
I guess psychoanalysis *commodifies* the deep-knowing relationship, removing a lot of the best parts of it but making it available to anyone, whether they have a bohemian heart or not. I guess that's vulgar like packaged tours or foie gras McNuggets.
Maybe a constrained relationship would be better than none, like a packaged tour might be better than never going at all. But that's not an endorsement: psychoanalysis is costly in many ways, not just money, and it is by no means the only option. As scientifically inadequate and unsatisfactory as psychotherapy doggedly remains, there are nevertheless in it other more promising, honest, and generalizable options for being known deeply. They're scarier or harder, maybe; but I guess that's the distinction of sophisticated, higher-class learning, whether it's sailing or books or whatever: openness and less protection but a whole new level of awareness and power.
So yeah, I guess it's true, if I understand this: psychoanalysis is vulgar (in these ways).
Posted by Declan on July 16, 2006, at 15:32:14
In reply to Is psychoanalysis vulgar? » Declan, posted by pseudoname on July 16, 2006, at 11:52:45
I would love to be able to find the quote from My Lives but have unfortunately lent it out. From memory cathexis was in there, but the translations are arbitrary and subject to vulgarisation and mockery (naturally). "The Psychoanalytic Movement The Cunning of Unreason." by Ernest Gellner looks at psychoanalysis from an interesting perspective. He admits the insights and denies the efficacy, and suggests that psychoanalysis is really just domesticated Nietzche for the middle classes (cultural decline!), which I thought was pretty cool. But as long as it casts a pleasing aura of mystyfication I'm reasonably happy....object relations, Margaret Mahler etc etc. Maybe the serious point is that there is mystery and suffering in our hearts; you have to be careful talking about vulgarity...someone may reply "Using the language of the bereavement card, Declan etc etc"
Posted by Declan on July 16, 2006, at 15:36:28
In reply to Re: Is psychoanalysis vulgar? » pseudoname, posted by Declan on July 16, 2006, at 15:32:14
Maybe this is an excuse to read "Lolita" again. The passages on poular culture were a delight.
Posted by canadagirl on July 16, 2006, at 16:06:22
In reply to Is psychoanalysis vulgar? » Declan, posted by pseudoname on July 16, 2006, at 11:52:45
Posted by canadagirl on July 16, 2006, at 16:07:12
In reply to Is psychoanalysis vulgar? » Declan, posted by pseudoname on July 16, 2006, at 11:52:45
Wow what a great description!
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