When CBT Fails

warning!!

I like cognitive behaviour therapy (CBT). It makes sense. It helps a lot with my anxiety and perfectionist tendencies. The idea is to change false automatic thoughts (cognitive distortions) and make them more realistic, constructive and positive. My favourite method of combating cognitive distortions is looking at reality. What are the facts? What information sustains my conclusion? What is the proof? For example, during the fall, I had my comprehensive exams for my Ph.D. I had to defend my research proposal among other things. I was being really hard on myself and feeling miserable. I was thinking that I was never going to be able to think of all the angles, the experts would find holes in my proposal and think I’m an idiot. The cognitive distortion here is mind reading. I’m assuming I know what the others are thinking and thus being hard on myself and making myself anxious. In reality, I can’t really know what they are thinking. The purpose of these exams is to solve any major problems in my theory before I get started. No one person can think of everything, that’s why there are four different experts coming to evaluate my idea. They probably wont think I’m an idiot either, I’m a student, my purpose is to learn. Besides, I can’t be the worst Ph.D. candidate there ever was. Here, I relied on logic to talk myself down from a situation that I was making myself sick over.

Circle chart colour

Sometimes though, logic isn’t enough, I wish it were.. Something can make all the sense in the world, but when you are depressed it doesn’t matter, logic is not enough to change the way you feel. When I try to apply CBT strategies to depression, it feels empty, like I am lying to myself. I know a lot of my problems come from low self-esteem. Is low self-esteem interchangeable with hating yourself? Right now I really hate myself. I hate myself so much I don’t know how to continue existing. I am overwhelmed with anger towards myself. My skin is crawling with hatred. I can’t bare to look in the mirror or hear my own voice. I hate the things I say and the thoughts I have. I’m too ashamed to go out in public and be seen by strangers, never mind people I actually know.

I know this hatred toward myself is irrational. I am not a bad person, most people say I am kind. I’m not on People magazine’s most beautiful people, but no one calls me ugly, except for myself. I’m not too fat or too thin, I wear the clothes that are right for me. I have friends and people who love me. I have the right number of achievements for someone my age. There is no reason for me to despise myself so, yet I do.

I don’t always hate myself. Sometimes I’m fine and I don’t think about how I feel about myself at all. Other times, this wave of loathing washes over me and all I can do is be angry and/or cry. My logical self knows the way I feel is irrational, so I don’t act on it. I know it will pass and I’ll go back to not thinking about it. I try to use CBT to undo my distorted view of myself, but it feels fake and is not changing the way I feel.Why isn’t the logic enough to make me feel differently?

I don’t know what to do with myself when this happens. I usually try to distract myself somehow. Sometimes it works, sometimes it doesn’t. Eventually, the day ends and I climb in to bed and hope that sleep takes me away from myself.

Do you ever feel this way? What do you do?

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16 Comments (+add yours?)

  1. Vicky
    May 24, 2014 @ 08:45:12

    I can really relate to this blog. Sometimes I feel that all the therapy I’ve had and all the work I’ve put in has only served to make me feel guilty. Guilty that I must’ve done something wrong, not worked hard enough, not made the most of the opportunities given to me.
    On good days I can reflect back and see that there have been some improvements in the way that I think, but nothing significant enough to change my way of thinking in the longer term. Like you when I put CBT practices into work I feel empty and fake, which in the long run only serves to make me feel worse.
    I find myself faking it more and more for people who care about me because I see it often as my responsibility to make them feel better about my illness. When I do that though I am transported in my mind to childhood like I am seeking praise and recognition for everything.

    I have a very good friend who understands all of these feelings, often the only person who I’m brave enough to speak honestly to. His advice is often just “Vicky, you’re playing for time right now” This lets me just be, not having to score myself or look for changes. It helps a bit.

    I always love your blogs but this one is particularly good, you have a real way of being honest and brave and so articulate at the same time.
    Thanks so much for sharing x

    Reply

    • somberscribbler
      May 27, 2014 @ 15:27:27

      Thanks for commenting! I feel guilty when I can’t make what I’ve learned work too. I always worry about what people think too much. I worry that they’ll think I’m not paying attention during my sessions or I’m not trying hard enough. I don’t want to be accused of wanting to be depressed or something like that. It’s comforting to know that someone else understands this. Thank you.

      Reply

  2. rosewiltshire
    May 24, 2014 @ 10:28:07

    Personally I’ve found CBT to be helpful with my anxiety and I will be trying some for my dermatillomania and OCD. I have found it to be less useful with depression which I find to be linked to my feelings of self efficacy.

    Apart from going on anti depressants I would try to make myself get up and keep busy either exercise, working on my business, reading, doing chores. It is very hard though. I have been depressed as well recently and haven’t left the house for several days except to vote and my place is a tip. Decided I’m going to tidy just 5 things today. My house will still be a mess but not quite so bad. I keep going by focussing on the little easy things that I can do.

    Sorry in case it’s not much help, but I hope you feel better soon.

    Rx

    Reply

    • somberscribbler
      May 27, 2014 @ 15:30:08

      I agree with you about the anxiety, CBT has helped me a lot there, but like you, it doesn’t do much for depression. I like your 5 things idea. Completing five simple goals during the day would probably make me feel better about myself and like less of a failure. Thank you.

      Reply

  3. christy barongan
    May 24, 2014 @ 10:37:07

    Sometimes CBT isn’t enough. Sometimes people know that they’re thoughts are irrational, and that just makes things worse. A lot of these forms of therapy have added a mindfulness component that also focuses on self-acceptance.

    Reply

    • somberscribbler
      May 27, 2014 @ 15:36:45

      Self acceptance is definitely something I should work on. I haven’t done much reading on mindfulness either. I should look into these practices. I’m overwhelming myself though. There are so many aspects of myself I want to work on, but I can never get to them because there are so many demands from life that I feel have to come before myself.

      Reply

  4. Jase @ FindingPostives.com
    May 24, 2014 @ 12:43:25

    I love your honesty and openness. That is a very positive thing when dealing with what you are going through. I have the same feelings you have from time to time and I think as long as you can remain honest to yourself, it goes a long way in handling the illness.

    I wasn’t fortunate enough to get full CBT, but I did get a course themed on it. I truly believe it is one of the most empowering lessons I have ever had in my life. Did it “fix” everything? Nope, but it did straighten out a lot of things to do with my anxiety and paranoia. It also helped me with my depression to a certain extent. Certainly gave me a better mindset to challenge it. I think where CBT can fall down and I know it has for some, is at which point of your illness you receive it (depends on how cynical you are feeling at the time) and also a major part is the actual delivery of it all. I went at it with a mindset of “I wanted help, and this is help. It’s scary, I’m not sure if it is right but I’m going trust them and give it a go. I’m going to try it again and again to see if it actually works – which in most cases it did for me.

    The important thing for me is those days when my depression hits hard is to know I have at least tried my best to combat it. I’m not going to beat myself up if the depression wins that day, but I am going to be upset if I’ve not even tried to shift it. I try various techniques, hitting the shower then going for a walk outside seems to have a good success rate for me. Sometimes just putting on a certain album or movie can shift my mood or making contact with special people in my life.

    We all have our dark days, even people who don’t suffer from depression. Life is not Walt Disney, but it is what we make of it. I used to hate myself a lot, for years. Two things helped me change that mindset, firstly I started to accept and believe any compliments that came my way – that was really hard at first but then I started to think how I want people to feel when I compliment them. Surely it should be the same for me?! Secondly, there are enough Muppets in this world to be nasty and horrible to me, why the heck should I be one of them?!

    Sometimes in life a leap of faith is required. Believe in yourself. Focus on all your accomplishments and transfer those skills to what you want to achieve within yourself. Take the confidence of what you have done in the past to empower yourself in the now. The most important mindset I believe is to learn from the past, look to the future but always live in the now.

    Reply

    • somberscribbler
      May 27, 2014 @ 15:45:28

      I’m glad to hear CBT worked for you. I do appreciate CBT for anxiety and perfectionism, it helps me a lot there. I want help for my depression and I wish CBT would work. I still try it when I am feeling bad, but it’s just empty. I have several things I try when I’m feeling bad, a lot of the time they don’t work and I have to wait it out. I think it is important to learn from your past. Taking confidence from past accomplishments is a good idea, but it’s just as easy to take criticism from equal failures of the past. It would be irrational to look at the accomplishments and ignore the failures.

      Reply

  5. emmyleigh
    May 24, 2014 @ 14:14:34

    Wow, sounds tough. I know I get times when I feel a little like that, but I’ve learned they usually happen when I’m tired or coming down with something, and going to bed early usually shakes it off. Otherwise it’s trying to get out and go somewhere, or just go for a walk. I’m struggling at the moment as I’ve injured my knee and so it’s tough to walk, let alone go for a run.
    Thank you for your honesty and openness in writing about how you feel.

    Reply

    • somberscribbler
      May 27, 2014 @ 15:47:19

      Thank for your comment. I usually try to sleep or go for a walk to shake it off too. Sometimes it works, sometimes not, but at least I try. I’m sorry to hear about your knee! I hope it heals quickly!

      Reply

  6. lababup
    May 24, 2014 @ 14:28:19

    I have felt the same with cbt. I feel like a fraud when I am telling myself the logical thing to think but I know that my irrational beliefs are too imbedded. I then feel guilty that I am not able to come up with a more balanced point of view. The words you try and tell yourself end up sounding hollow when you don’t believe them.

    Reply

    • somberscribbler
      May 27, 2014 @ 15:48:56

      That’s exactly it. Sometimes I think if I could figure out what caused my irrational beliefs, I could get over them, but there is no logical reason for them, they are just there.

      Reply

  7. dramallama85
    May 24, 2014 @ 14:43:28

    I’ve never had a proper course of CBT, but I’ve used a few books that used CBT techniques to cope with various things from anxiety to paranoia and voices etc. I’ve found it reasonably helpful with some of these, but not useful when it comes to issues at the core of my ‘being’ such as self loathing and how I view myself.

    I think that CBT can manage the ‘symptoms’ of our inner struggle to some extent and allow us some perspective. But if we have deeply entrenched feelings about ourselves, I don’t think it’s enough to try and ‘think differently’ as those feelings don’t really have a basis in thoughts that we are able to identify. We may have had those feelings for so long it’s hard to identify where they come from, what the thought processes are. I think that to overcome those feelings might require work that delves a little deeper into things.

    I don’t know what the solution is, it’s likely to be different for different people. I don’t think that it means that either you or CBT has ‘failed’ just that it wasn’t the right approach for this one aspect of your struggles, but right for others.

    I’m sorry you feel so badly about yourself. I can really relate to your description of hating everything you do and say.

    Reply

    • somberscribbler
      May 27, 2014 @ 15:53:26

      Thank you for your comment. I like what you said about there being no failure, it’s just not the right approach for me. That’s a much better way to look at it. Now if only I could find the right approach….

      Reply

  8. NotAPunkRocker
    May 24, 2014 @ 19:58:35

    I am sorry you are feeling this way. Unfortunately, I am not much better. I hope you find something that works soon. ((hugs))

    Reply

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