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future directed therapy - any experience ?


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Has anyone had any experience of the use of Future Directed Therapy ( FDT)  - as an adjunct to normal CBT etc  - it supports improvement in depression suffered alongside OCD? 

Seems to make some sense to me .. the Wikipedia entry  says it is based on the thinking of Melges who "proposed that the harmonization of future images, plans of action, and emotions restore a person's sense of hope and control over the future: "Thus, with hope, the personal future is not certain and fixed, but is viewed as being open, unfrozen, and full of opportunities." . 

Clinical trial results seem to say it has good outcomes  - better than CBT for those suffering with depression. Not found any trials for those with OCD and depression.    

Seems for those like my son who have an OCD that is all about fear of the future and having certainty (caused by things from the past )  -  when of course there is none - FDT might help  ... especially as courses of CBT and other therapies  haven't worked enough on their own to get him functioning normally - although they have helped improve  things for sure. .       

FDT seems to  package up lots of ways of looking at things that many TED talks and inspirational people talk about  ... most seem to  be  very future orientated and about making a future life they want  ( not what they don't want)  ..giving hope and light at the end of the tunnel ... something my son doesn't have too much of at the moment.      

Any thoughts/insight / experience  please?   

Many thanks 

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Hi there Littlefoot,

Future directed therapy is not a therapy that I know a lot about so hopefully you get a response from someone with experience in it :)

I know that goal setting is an important part of good CBT for OCD so I can see the advantages of directing your attention there. We know that at the moment the therapy shown to be the most effective for OCD is CBT but if your son finds that FDT helps him with his depression then that's great.

Gemma :)

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  • 1 month later...

I don't know about Future Directed Therapy but I wonder if this is related? All my posts this week are plugging OCD Conference recordings - and here I go again. I found this one from Mark Freeman so uplifting. He talks about the importance of goals and thinking about the vacuum that will need to be filled if you have success in recovering from OCD. Instead of focusing on getting rid of anxiety, having a focus on something positive ahead of you. It's a really positive joyful attitude to OCD recovery https://www.ocduk.org/conference/conference-map/main/walking-off-the-battlefield/ Hope that helps.

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  • 2 months later...

thank  you - sorry for delay - been somewhat distracted -work/ son's  OCD ! and now the fact  that he is completely  stuck - doesn't  believe  anything/ therapy  etc will help him . 

 

I was thinking of the Future Directed Therapy as with or without OCD he has zero goals - so hard to see how he can  move forward  at all .  mmmm.

 

the video looks helpful ....to me anyway!  x fingers something resonates with my son.  :)  

 

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I think it's become fashionable to give every idea it own acronym as if it was some kind of different therapy. But 'standard' CBT can focus on future goals and outlook if that's where the therapist and participant decide to go with it. :)

On 16/02/2021 at 18:16, 1Littlefoot said:

doesn't  believe  anything/ therapy  etc will help him . 

Totally typical of depression. :(You just have to keep chipping away at the negativity. Counter every negative statement with an equally true/equally likely positive statment. Don't let him 'wallow' and pull him up sharpish when he indulges in feeling sorry for himself.

Try to get him interested in hobbies/ doing practical things with his hands. Activity of any kind is better at stimulating the depressed brain than passive things (like watching TV.)

When he does do 'future therapy' make sure there are a range of goals. Lots of very small, easily achievable goals daily in the short term and one or two medium and long term goals/dreams/hopes. Tell him that it's ok to hope for something to come true in the future even if it seems impossible now; remind him it will become more possible as he progresses.

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On 18/02/2021 at 20:48, snowbear said:

I think it's become fashionable to give every idea it own acronym as if it was some kind of different therapy. But 'standard' CBT can focus on future goals and outlook if that's where the therapist and participant decide to go with it. :)

Totally typical of depression. :(You just have to keep chipping away at the negativity. Counter every negative statement with an equally true/equally likely positive statment. Don't let him 'wallow' and pull him up sharpish when he indulges in feeling sorry for himself.

Try to get him interested in hobbies/ doing practical things with his hands. Activity of any kind is better at stimulating the depressed brain than passive things (like watching TV.)

When he does do 'future therapy' make sure there are a range of goals. Lots of very small, easily achievable goals daily in the short term and one or two medium and long term goals/dreams/hopes. Tell him that it's ok to hope for something to come true in the future even if it seems impossible now; remind him it will become more possible as he progresses.

Thank you.  At the moment its hard to even get him out of bed until mid afternoon .......  ..  he's cut off even talking to his friends. So your ideas are a great reminder for how to encourage him .... 

I'm finding it pretty impossible  to talk to him  in terms of goals,  easy first steps  ...  ... and dreams and hopes conversations  get caught up in an OCD cycle  of stuckness  - ie questions around how does he know any choice he makes is the right choice    / doesn't  want to  get it wrong .... so he continues to do absolutely nothing.  he's so sad ....and his confidence is rock bottom. can't find a way of  breaking the cycle and now he has stopped unie he has nothing to get up for in his mind ..  urghh ,,,,,   😌

 

he's reached out to the psch ...( a good thing .. he did it himself) . ... so await a new appointment  - but the treatment will be review meds  and x fingers therapy - if psych and son thinks that is worth trying  - given past history unless son really wants  it then doubt the doctor will recommend.     

Sort of feel   I must leave him to find his  own  way out of this .... .... but know  depression doesn't make that possible so well  .. and if not careful will end in a high risk situation ( as has been before)   ...... ummm 😪

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20 hours ago, 1Littlefoot said:

dreams and hopes conversations  get caught up in an OCD cycle  of stuckness  - ie questions around how does he know any choice he makes is the right choice    / doesn't  want to  get it wrong .... so he continues to do absolutely nothing.

There's a brilliant book called 'Feel the Fear and Do It Anyway' by Susan Jeffers which addresses this way of thinking. It's a self-help book for those crippled by anxiety in general rather than for OCD, but I read it 30 plus years ago and the way she describes how 'it's impossible to make a wrong choice' has stayed with me ever since. Worth getting it out of the library and encourage him to give it a read? There's a new edition published 25 years after the first edition that I read, but I believe it's still as good, if not better. Highly recommend it.

20 hours ago, 1Littlefoot said:

Sort of feel   I must leave him to find his  own  way out of this ....

Helping someone with depression can be a thankless task, but if you possibly can just hang in there. It really will help him even when you feel like you're bashing your head on a brick wall. Inside his head he's being pulled equally in 2 directions - half wants to stay stuck and avoid leaving his comfort zone, the other half wants desperately to escape the prison of depression. Trouble is, the nature of depression saps your motivation entirely so you end up thinking endlessly about both options (stay stuck or fight free) and can't find the energy to do either one. That's where someone on the outside supporting you can make a difference. You say he can't find any reasons to get up - so give him some. Small responsibilities, easy tasks ('favours') that you can thank him for profusely like his help is really making your life easier. Ideally the taks have time limits/ deadlines so he has to actually put in a bit of motivation to get them done on time. That's a huge ask in the early stages, so keep the jobs very small, eg. help you to unload the washing machine or fold sheets, put the dry dishes away, lay the table while you cook lunch (reason to get out of bed before afternoon!) etc. As he becomes more engaged with life again you can make the jobs a bit bigger, always pushing him gently but firmly forwards so his confidence grows.

It's not easy, so remember to take time out for yourself, especially if you find you're getting frustrated or angry with him. Patience and firmness with immoveable bondaries is key to success, never allow him to give up on a task even if it's easier to do it yourself. Letting him leave something unfinished will sap his confidence again faster than anything. The point is to give him an ever-increasing list of achievements to look back on so he gradually regains his confidence and the desire to do more. Good luck!

 

 

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