CBT- a hill too steep?

[Guest Pootle]

Hi guys,

I wondered if any of you could help me, I have recently started CBT- a branch called Schema therapy- and I must admit it is a lot harder than anticipated. My Psychologist had asked me to tick a list of catastrophic thoughts I identified with- out of approx 20-25 I ticked a good 90% of them. So, there is alot to work to do.

The first week was ok, we worked through 2 "scripts", one for each negative thought. I was to recite these, commit to memory and do this every day. One of them is a lot better, the other less so. The next time i saw her we did another 3. So, in total I have 5 scripts I should be re-writing, memorising, practising. Now, hands up, I havent done much of my homework and i know this is vital. Ignoring that for a moment though- I am finding it really hard, too hard I think.

In one session she wanted to do "I am going to choke" which as some of you know is my biggie. I freaked - burst in to tears, just couldnt contemplate it. Felt like a right eejit I did. So we had to abandon that one for later. Anyway, in the last session I just couldnt pick one to work on that felt do-able.

I have been left feeling a bit defeated and deflated as ALL my hopes are pinned on this and I am paying a FORTUNE. Psych has now decided to abandon CBT for a while and concentrate on the "schema" stuff- she thinks my OCD revolves around a perception of vulnerability caused by childhood so that is now what we are working on. However, I have left my NHS group therpay to PAY for CBT to help for the here and now- it seems I am not strong enough to do that now so where does that leave me?

I cant believe it is that hard, yes its entrenched in my thought processes but I am not in my 50s- I am 27 and so surely it cant be THAT entrenched?? I wonder whether it is all down to the fact I havent done as much homework as I should have done?

I am not weak- why is this this happenning? Any help/ experiences would be very much appreciated as at the moment i am feeling very disappointed.

[Ashley]

Hi Pootle,

I have not really heard of that type of CBT before, maybe someone else can advise. But for me, I have always seen the best results with CBT by a therapist who gets the patient to start with the small exposures first and build up to the difficult ones.

I have two ladies in my Nottingham Support Group, two different therapists and both use this method and both ladies are quickly to the point where one is almost back at work and ready to come off meds and the other is doing superb and been OCD better for months now, promotion at work too.

I think CBT will only ever work, if you feel 100% comfortable with what is going to happen and a good therapist will get you feeling comfortable.

[Guest PrincessJenna]

Pootle,

I am so sorry it seems to be going so rough with your therapy.

I have been working with my therapist on some of my "schema" and it is well :censored:ish to say the least.

These are thoughts so enmeshed in our being that they are as real as, the grass is green and water is wet. Trying to change that is like the world crashing down around us.

It is time consuming and emotionally exhausting. My therapist is of the school that OCD is nature and nurture and that abuse and neglect in my childhood is what triggered me off so badly.

Her approach is a sort of one week on, one week off way that helps me. One week we tackle something and the next we have talk therapy.

I know that you say you are "only" 27 how enmeshed can they be? 27 years worth!! Give yourself a break hon, this is the hardest thing to change in anyone. And the homework is the hardest part... I have to confess I am not always good with it either.

But I have real hopes that this is going to help me change my OCD thinking. I am keeping you in my thoughts and if you need some extra support, you know where to find me....

Right here! :hug:

~jenna

[Guest twoshoes]

Small steps seem to work best in m personal experience. When you begin to conquer the small things you build your strength and confidence to start tackling the bigger problems.

I am 27 and I am unable to remember a time before OCD, I was 16 when it took over and 19 before I had a name for it. I think that OCD and I are about as bound together as we can be. I do beleive the longer yu live with it the harder it is to treat but if yur OCD started as early as mine then by 8 I was to far gone.

My parents are wonderful understanding and generous people, (they pay for my treatment even though I work) but the oCD they saw in my childhood was only what peeked out, and all kids play counting games and have irrational fears and we were completely ignorant until I was finally diagnosed.

My hypnotherapist gives me homework and when I don't do it I tell him, he understands, he calls it resistance. My conscious mind wants to get better but my subconscious mind doesn't want the hassle so I don't do the homework and OCD wins. I don't feel guilty we just look at different ways of approaching things so the resistance is reduced.

My CBT guy was all for throwing me in at the deep end as a result I felt too overwhelmed and gave up...result :dry:

Take care

Kerry

[Guest shjames]

Hi,

Don't feel bad for not achieving as much as you wanted to in the first round. OCD is tough, but you've survived it for 27 years, so you're tougher :original: .

For my daughter, who had intensive CBT treatment, it was exactly as Ashley mentioned. The Dr had her list all her compulsions and obsessions, then she graded them according to a "fear number," with 1 being the easiest and 10 being the hardest. She started with the easiest and built up her confidence by enduring small amounts of anxiety. At first the CBT caused a spike in compulsions which her Dr called an extinction burst. The same principle apllies when you tell a child "no," at first they throw a tantrum until they realize you're serious, then they stop. But as she practiced her resistance to compulsions, she was able to tackle harder and harder compulsions until she completed all of them.

It sounds as if your therapist started you off too quickly and didn't give you a chance to build yourself up slowly over time. Don't give up on CBT yet! Although it's tough, it's wonderful when it works. You have the most important criteria for success--you want to overcome OCD and you're willing to try.

Good luck,

Shelly

[Guest idntw]

I've had something similar and I think there is a certain sense to it. I think it's well recognised by psychologists that some of us have stronger underlying beliefs as well as OCD, beliefs that something like schema therapy addresses, and when that's the case it does seem to be best if that's looked at first, before the less deeply entrenched anxiety issues like OCD. However, I do agree that it's quite difficult if the therapist isn't looking at the day to day OCD stuff as well - I've found that too. Why not say to her that you'd like to spend at least a little of the time each session addressing that, or perhaps at least report back to her each week on which basic OCD things are worst for you that particular week so she can advise on some temporary things to try? I think the thing is that if you really do have the sorts of entrenched issues that schema therapy or similar is needed for, then the 'basic' CBT for OCD really might not work as well as it would if those things are sorted out a bit first. As I understand it, provided you make progress with the schema stuff you'll probably end up with a better eventual anti-OCD result if you go at it in that order.

[Caramoole]

Like Ashley, I haven't heard of this therapy. It does sound a little bit fancy and complex maybe. As Ashley and shjames describe, CBT generally works by grading the particular problems you have and facing the fears one by one from the least difficult upwards and challenging the faulty thinking associated with them.

It is generally held that a pyschotheraputical based response isn't the best for OCD.

CBT shouldn't be a hill too steep, you don't start by aiming for the top of the hill, you might start by aiming to reach the first lamp post. If you were aiming to enter a marathon you wouldn't start by running 26 miles the first day, you'd maybe do some work in the gym and running a mile and then build on that, CBT works in a similar way.

Therapy and therapists fall into a huge range, in both training and style, just as a point of interest, what is your therapists qualification?

Feeling at ease with a therapist and having confidence in them is a very important factor in your progress, if you don't feel their style is working for you, don't stick with them out of politeness. At the end of the day this is about you and you alone.

Caramoole