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CBT - Do you find it helpful


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Hi all,

I have recently started CBT and had two or three sessions so far and I'm not 100% sure that it will help me, I know it is the beginning stages but the fact that is all over the phone makes it even more anxiety inducing to me. I already have horrible intrusions that my phone is being tapped and will store this information to be used against me.

How did you all find CBT if you have done it or what else helps you for your OCD?

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Hi Real

Have you been set homework and are you managing to do it?  One of the problems with CBT/therapy is that we often attend, listen, take it in but don't always actually do the things that are suggested.  The same is true of other therapies like physiotherapy.  It must be doubly difficult taking it all in over the phone.

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Hi Real

I have seen four clinical psychologists who use CBT. Two were excellent, one was  middle ranking and one was exceedingly poor. Yes CBT works ( it helped me) but therapists vary in their capacity. Just like any other occupation from plumbers to surgeons. I try to see one GP for my mental health and another GP for minor operations. People have skill sets.

In my experience the best therapists video record their sessions and ask their clients to make their own recording so that after each session the recordings are played back. We tend to forget what is said. Client and therapist recordings are good in my opinion.
 

I have never had telephone therapy it must be difficult I think video therapy would be better. It is recognised that telephone therapy is more difficult. The government has provided money for research to improve IAPT (improved access to psychological therapy). The universities of Cambridge, York, Sheffield and Manchester are involved. Preliminary findings are already published. A lot of work is done through telephone therapy especially during the pandemic so it is a important research initiative.

A lot of people worry about describing their experiences during therapy. It is a trust issue. I am sure that it is more difficult in telephone therapy. I would be open with your therapist about your feelings.

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Just a reference for IAPT:  ‘Telephone delivery of NHS’s IAPT service providing low intensity psychological treatment for anxiety and depression disorders’ by Paul Drew and Annie Irvine is a brief non technical paper written for PWP (personal well being practitioners) therapists to supplement their training. It is available at ResearchGate. Loads of good ideas especially on building up a picture of the cognitive side of therapy. For this, in my therapy, the cognitive picture/model was co constructed on a white board. Useful to reference and to get people to refer to.

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It worked for me but it wasn’t immediate. At the time I thought that it wouldn’t help but that’s mainly because as soon as I left the room I was going back to my old ways and not putting what I was taught into practice. The more sessions I had the better I got at it and eventually something just clicked with it and I still use those techniques as best I can to this day. Therapist was good also which helps I suppose. I had one before that who kept trying to reassure me which is the worst thing they could do.

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  • 3 weeks later...
On 17/02/2021 at 18:29, Caramoole said:

Hi Real

Have you been set homework and are you managing to do it?  One of the problems with CBT/therapy is that we often attend, listen, take it in but don't always actually do the things that are suggested.  The same is true of other therapies like physiotherapy.  It must be doubly difficult taking it all in over the phone.

Hi Caramoole,

 

I have been set homework since I put out this post. Though it is slow progression, it is starting to help. It is a struggle to stay on top of it whilst also doing my degree.

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On 18/02/2021 at 09:21, Angst said:

Just a reference for IAPT:  ‘Telephone delivery of NHS’s IAPT service providing low intensity psychological treatment for anxiety and depression disorders’ by Paul Drew and Annie Irvine is a brief non technical paper written for PWP (personal well being practitioners) therapists to supplement their training. It is available at ResearchGate. Loads of good ideas especially on building up a picture of the cognitive side of therapy. For this, in my therapy, the cognitive picture/model was co constructed on a white board. Useful to reference and to get people to refer to.

Hi Angst,

 

Thank you for this, I will definitely take a look at it! As well as for sharing your experience, I am making slow progress which is better than none. 

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On 19/02/2021 at 11:25, Lennon841 said:

It worked for me but it wasn’t immediate. At the time I thought that it wouldn’t help but that’s mainly because as soon as I left the room I was going back to my old ways and not putting what I was taught into practice. The more sessions I had the better I got at it and eventually something just clicked with it and I still use those techniques as best I can to this day. Therapist was good also which helps I suppose. I had one before that who kept trying to reassure me which is the worst thing they could do.

Hi Lennon,

 

Thank you for sharing. My thoughts are the same about it, though now I am starting to make small progress and they have helped me to pick out other compulsions that I was not aware of before. Still, small progress is better than none!

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Yes, CBT did help me, but like some of the others here, it took time. I paid a lot of attention to what was being said, thought that I understood it all, but didn't put it into practice. It took a while for me to start implementing the advice that they were giving me and challenging myself. Once I started doing that, I also started to see results. I agree it is challening over the phone, rather than in person. If you commit to it and actually put the advice into practice, you should see results.

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Hi Real,

Having had quite a few therapists over the years, I feel there is a kind of goldilocks zone with therapists & self help and ERP.

Some therapists kind of walk on eggshells in the way they did CBT, & at the other extreme, one therapist I saw triggered me to the extreme causing a massive setback.

The same applies to self help and ERP! Too little, & you wont get anywhere, and doing too much can flood you into massive setbacks.

It is basically all about getting the right balance.   

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Having CBT over the phone sounds like it would be really hard. I am currently getting CBT therapy over video calls which is okay, but I really miss being able to see my therapist in person as I do think it makes it easier.

I have been having therapy now for over a year and a half. I have found it very helpful and it has made a huge difference to my life. Personally I found it took quite a while before I noticed a difference, but that may have been because I was very depressed at the time as well. It took several months for me to notice a real impact, but it did happen so if things are slow please keep trying.

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23 hours ago, malina said:

Yes, CBT did help me, but like some of the others here, it took time. I paid a lot of attention to what was being said, thought that I understood it all, but didn't put it into practice. It took a while for me to start implementing the advice that they were giving me and challenging myself. Once I started doing that, I also started to see results. I agree it is challening over the phone, rather than in person. If you commit to it and actually put the advice into practice, you should see results.

Thank you for sharing Malina,

 

I totally agree, I am doing my best to juggle implementing the advice alongside finishing my final year degree. I'm hopeful I will see further progress in the coming months!

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23 hours ago, felix4 said:

Hi Real,

Having had quite a few therapists over the years, I feel there is a kind of goldilocks zone with therapists & self help and ERP.

Some therapists kind of walk on eggshells in the way they did CBT, & at the other extreme, one therapist I saw triggered me to the extreme causing a massive setback.

The same applies to self help and ERP! Too little, & you wont get anywhere, and doing too much can flood you into massive setbacks.

It is basically all about getting the right balance.   

Hi Felix,

Thank you for sharing that, I hope you are doing well now. I feel grateful that my therapist is very nice and helpful despite doing it all over the phone. Though I couldn't imagine how you must have felt in that situation.

 

I have minor 'setbacks' if you will but that is mainly my own doing with the homework being set and wanting to challenge myself further.

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2 hours ago, Agrippina said:

Having CBT over the phone sounds like it would be really hard. I am currently getting CBT therapy over video calls which is okay, but I really miss being able to see my therapist in person as I do think it makes it easier.

I have been having therapy now for over a year and a half. I have found it very helpful and it has made a huge difference to my life. Personally I found it took quite a while before I noticed a difference, but that may have been because I was very depressed at the time as well. It took several months for me to notice a real impact, but it did happen so if things are slow please keep trying.

How do you find the video calls? 

I think we are on a similar page now, I'm starting to see the usefulness of it as I can see myself before and understand that I was in a negative headspace. I still have setbacks from challenging myself a little too hard with the assignments but I'm hopeful. 

I hope your therapy is going well for you still remotely.

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CBT isn't for everybody. Regardless of there being evidence claims saying things like "CBT is effective for OCD", which I'm not doubting are true, we also can't escape the fact that we are all extremely unique individuals and respond to different things in different ways, and we have to find what works for us best. So it's worth trying CBT, particularly in the UK where that's probably the only thing you'll end up getting offered on the NHS. But you might find that it's not for you, and that's okay. It doesn't mean you are wrong or failing at doing it properly, it probably just means that the particularly mode of doing things in CBT just isn't your bag.  It's normally the only talking-treatment style offered on the NHS for OCD, which can lead to patients thinking there is this expectation that it is the thing that you "MUST" do, but as I say, it isn't for everyone, and we all have unique ways of responding to stuff. 

I personally hated CBT and have been seeing a psychotherapist (privately), which is a more open-ended kind of talking treatment. I find this enormously helpful and much more my style than the CBT homework-style approach. I'm lucky to be able to do this privately - some places to offer low cost options if it's something you are interested in (Google "low cost therapy"). 

That's not to say that therapies other than CBT are completely painless. All therapy is hard work and challenging. 

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Codrot, I don't buy that CBT isn't for everyone and I don't buy that there are alternatives that have the same outcomes.

I have been here for about seven years. I've talked to many people who've tried other therapies, like EMDR, hypnosis, psychotherapy, memory regression, ACT, and so on. The results were universally dismal.

Recovery from OCD requires two conditions to be met. The sufferer must change the way they percieve their obsessons and the sufferer must change the way they behave as a result of their obsessions (in short, stopping compulsions). 

CBT is a combination of two therapies. Cognitive therapy is about changing thinking. Behavioral therapy is about changing behavior. CBT meets the requirements as set out above.

If other therapies meet these requirements, then really they have CBT components. Without these requirements being met, whatever therapy is being used will be completely worthless as far as recovery from OCD is concerned.

 

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1 hour ago, PolarBear said:

Codrot, I don't buy that CBT isn't for everyone and I don't buy that there are alternatives that have the same outcomes.

I have been here for about seven years. I've talked to many people who've tried other therapies, like EMDR, hypnosis, psychotherapy, memory regression, ACT, and so on. The results were universally dismal.

Recovery from OCD requires two conditions to be met. The sufferer must change the way they percieve their obsessons and the sufferer must change the way they behave as a result of their obsessions (in short, stopping compulsions). 

CBT is a combination of two therapies. Cognitive therapy is about changing thinking. Behavioral therapy is about changing behavior. CBT meets the requirements as set out above.

If other therapies meet these requirements, then really they have CBT components. Without these requirements being met, whatever therapy is being used will be completely worthless as far as recovery from OCD is concerned.

 

It sounds as if we have wildly different positions so happy to leave it here. I respectfully disagree with your position. My view is that sufferers are the experts on what it means to be them and how they feel. Cbt for a lot of people is useful which is fantastic. I think it's quite a violent and authoritarian act however, to force people to do it as "the only way" and to tell them they any other way is insufficient . If an ocd suffer finds another way and reports that they feel better about it (eg me saying now i found psychotherapy much better *for me*) then you have to take my word for it since you do not know me better than I do.You're making assumptions about what it is like to be everyone. You are only the expert on what works best for you. 

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Look, if blowing bubbles changes the way you think about obsessions and causes you to stop doing compulsions, then clearly blowing bubbles was the right remedy for you.

Psychotherapy is a wonderful therapy that I have partaken in. I wouldn't advise it for OCD, at all.

If you are participating in psychotherapy and you are changing the way you think and behave, good for you. But then that psychotherapy must include a CBT component.

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