Not liking CBT / unsure what to do.

Mental health
1

So I’ve recently started CBT, and I really wanted to be positive about it and go in with high spirits and trust and openness... but I really hate it, every minute of it. The first phone conversation I had with my therapist went pretty good and I was quite excited before the first session (which was meant more as an assessment and not an actual CBT session). My GP even said at one point, about this first initial assessment “let’s see what the expert says”, meaning the therapist (aka Wellbeing Practitioner). But when I actually got there and as we started talking I soon started to feel really uncomfortable sharing things, and I hated her responses, they felt so rehearsed and weird. It felt condescending the way she was talking to me and I just didn’t feel “safe”. I still did my best to try and share as much as I could and be honest but there are lots of things I didn’t mention even tho I had planned to tell her. Anyway I’ve now had one session of what they’re calling “guided self-help” (basically CTB type therapy) and it’s beyond a doubt the most ridiculous thing I’ve ever tried. The conversation felt totally scripted (just that I never got my lines), no seriously a few time I said something and she didn’t know how to respond, it was little talking to a fish! And she’s barely older than me, probably fresh out of training (and most definitely not an “expert” as my GP assumed).

I’m not sure what to do now, I have another appointment on Wednesday but I really don’t want to go. I really want to back out and say this isn’t for me but my GP really hasn’t got anything else to offer me (I don’t think) and I don’t want it to look like I’m unwilling to get better or like I’m throwing the only thing I agreed to back in his face (as I said I didn’t really want any meds yet). Any suggestions? Should I just stick it out a few more sessions? If I decide to quit, should I tell my GP that I’ve done that, should I go talk to him first about wanting to stop with the CBT before I tell my therapist anything? I really don’t know what to do.

My GP also doesn’t really have the full story of how bad it’s gotten, mainly because it’s just been getting worse and worse. The first time I saw him it really wasn’t so bad but then in the weeks following that first appointment everything got just so much harder for me. Should I tell him? I’m so bad at telling him stuff, I only get 10 min long appointments and I get so nervous because of the time limit. Last time I saw him I was shivering and was in physical pain the whole time (and I didn’t actually tell him why I was really there... just a major fail altogether). Later that day I had what I assume might have been my first real panic attack (maybe) I’ve been dealing with anxiety for a while and I was really depressed for a while a few years ago, but I don’t think I’ve ever had an actual panic attack (if that’s what it was). I don’t know what to do. I don’t want to make another appointment and then not say what I mean to (I have written letters in the past but I really don’t want to do that again either) I feel like he’s so sick of me, or not sick of me; I think he’s frustrated because there’s so little he can do for me. I’m just so confused right now and don’t know what to do.

Sorry for the ridiculously long post. And (for those who got this far) thanks for reading it!

All the best,

Anya

2

Hi Anya

Sounds like you have a lot going on for you. With regards to the CBT - I would try and go to another few sessions with an open mind and then re-assess how you feel about it?

I know you said you've written letters in the past, but if you are struggling to verbalise how you feel to your GP in the apt, maybe writing it down and showing the GP is a good idea?

Do you have any grounding techniques for the anxiety and panic attacks?

Your GP will not be "fed up" of you - it is their job, and what they are paid to do. 

hang on in there xx

3

Not sure if CBT is the same everywhere but in my NHS trust you have 3 guided self help sessions with one practitioner and following these you agree whether to move forward to formal CBT. In my trust if you go for formal CBT you get a new practitioner. I hated the 3 self help sessions, found them quite patronising and useless but having moved into formal CBT it has been much more helpful. Might be worth trying to find out if you get a different practitioner for formal CBT in your trust? 

4

Hi Lisa, thank you for the lovely reply.

I could try I guess, it's just that I find it so difficult to be honest because of how judged and uncomfortable she makes me feel and I realised this is mainly due to my own insecurities but still, it’s just really hard.

I don't even know if there's any point to me seeing my GP again, he'll just look at me in this "I wish I could help but I don't know what to do" kind of way, like he did last time when he could obviously see I was struggling but I think mental health is just a little out of his depth.

I think I'll leave my GP alone for a while but yes I guess I'll try and give the "CBT" (I don't even know if it's really proper CTB) another chance, at least the sessions are only half an hour long.

Thanks and all the best xx

5

Hi Anya, 

No problem at all, happy to try and help. 

Would you feel comfortable telling the CBT therapist that you feel uncomfortable? Maybe they don't realise and there is something they can do to ease the situation for you?

Also, there are self help CBT books that may be benefitial and some CBT websites 

xxx

6

Oh, I’m not sure… I don’t think anything was said about things changing after 3 sessions, I think the plan is that I get 3 guided self help sessions and then we evaluate how it’s going (this, for experience I’m assuming, is basically where she asks if I think it’s useful and doesn’t do an evaluation herself). And then I think I can only get more of what we’ve just been from those 3 sessions. I don’t think I could get a different therapist because this is the therapist that works with my GP practice so she’s here twice a week and I’m pretty sure she’s the only one. But I could try and look into it, who do you think would be the best person to contact about this? (if you don’t mind me asking – obviously if you’re not sure either that’s fine) : )

Oh and yes “patronising and useless” is exactly how I’d describe my experience of guided self help.

Thanks for the info, I really hope it works the same here! I also wouldn’t mind trying some talking therapies but there’s not much available through the NHS and I just can’t afford to pay for it on my own right now.

7

Oh your NHS trust is definitely different to mine. Ours is a centralised service shared by all GP practises. Might be worth ring the Drs and asking for advice, maybe the Practise Manager? Getting along with you therapist will be key to how well the therapy works in my opinion!

8

Hi anya I was the same first time I did It I loved it ! My anxiety went second time around I hated it I didn't like my worker so much either she even told me she didn't think I was ready for it .

Try to do a couple more if it isn't for you don't go again cancel it because it doesn't work for everyone I learnt a lot from it but after quitting from my own experience I had more confident after quiott

9

Posted too early ...anyway after I left I got more confidence from quitting because I had learnt a little and started doing it in my own way I still ain't cured but my cbt started making me more anxiouse because I was dreading it but just try a few more if not try to teach yourself it's definitely not for everyone xx

10

Cbt isn't always suitable for everyone, I hated it too. There are other forms of therapy, I'm in CAT which is much better,cbt for me was a total waste of everyone's time

11

I mean it is a centralised service but I think they have specific therapists assigned to each GP practice. But I'm not really sure, I'll try looking into it.

Thanks

12

I'm not sure if CBT is the right thing for me at all but I'll give it a go for a while longer and see what happens.

I want to say I'd be able to talk to her about it but realistically looking someone in the face and telling them I'm not comfortable with them is probably not "manageable" for me. (She likes to ask, in a very patronizing way, "does that seem manageable?" about things I need to do. Of course I say yes but then yesterday I didn't actually manage to do any of the things I said were manageable.)

xx

13

Oooh, what's CAT? (I can obviously just google it if it requires a long winded explanation) : )

14

Thanks for this glad I'm not alone (not that I thought I was, but still always nice to hear people have had similar experiences), yeah I think I'll try the Wednesday session and then if I feel as awful during and after it as I did this week I'll probably quit.

15

Hi Anya

My GP recommended CBT for me. I had one session with someone I now know was not a qualified CBT therapist. This was guided self help. I went home and told my husband "this isn't for me." She didn't even grasp that one of issues was overwork and wanted to send me to evening classes to fill my time! My husband pushed me into phoning the office which set up the appointment. It took courage. I said I wanted this to work for me and had felt on the first session that the therapist didn't grasp my situation and kept yawning. I was then transferred to a guy who I now know was the only qualified therapist on the team and what a difference. I had 10 sessions which changed my life. You need to ensure that you see a qualified therapist not someone who reads it all from a paper. I know the organisation of mental health services is different in every area. I was under a system where I could phone the local MIND office and speak to the head of the therapy department. In that situation there were about 10 guided self help people and only one qualified therapist. If I hadn't have taken my courage in both hands and phoned the office I would have either given up or endured the seesions and got absolutely nothing from them. If you have the option of speaking to the person who organises the CBT therapy in your area I strongly encourage you to give it a go.

Best wishes

Eileen

16

Oh thank you so, so much for sharing that. I just did some research and yes there's "Psychological Wellbeing Practitioners" - who I'm seeing, and "Psychological Therapists" but I think the Wellbeing Practitioners are the ones who can refer me to the Therapists, after at least 3 sessions if they feel you need it. But I'm just finding it so difficult to be open with her, I think there's a high possibility she won't realise I qualify (if I do, I'm not even sure).

Oh I don't know what to do... or who to contact, I hate calling people up, I hate talking to people I don't know about this. I think I will just end up going to see my GP again and talk to him about it.

Thanks and best wishes,

Anya

17

Hi Anya, From what you have just said re the therapist making the referral to the other kind of therapy, I really feel you might be better talking to them rather than your GP. If you feel you can't do this verbally why don't you write them a polite letter explaining why you feel CBT won't work for you and explaining why you feel the other therapy will be more beneficial, and give this to them at your next session. You may still need to complete these three sessions before they can refer you. They may want to discuss the letter further with you but at least you will have made your feelings clear at the outset. Good luck. 

18

Hi Anya Rose,

CBT will seem scripted, mainly because it is, just the same as NLP would be or hypnotherapy. CBT relies on learning where you are making the wrong emotional attachment to an event that causes you to act in a specific way. If you lie or don't be open your therapist can't get a handle on you to enable them to pinpoint where the problem area is. Think of tv lie detectors, they always start by asking simple questions with known answers, this sets the base line to work off. You say your therapist is the same age as you, then use that as a bond, next time you see her ask her if she can tell you a bit about herself so you can build that bond. Don't give up, even if you go through the whole process and get nothing out of it you didn't quit. You are strong and most mental health self help is just that guided do it yourSELF help. Hope this helps

David 🙏❤️😀

19

It's Cognitive Analytical Therapy,it allows more room for dealing with the root issues in the past,to then resolve the issues which cause anxiety in the present. cBT is all about now,it doesn't allow for dealing with he past - that works for some, but definitely not all.

20

Dear Anya, I had some difficult experiences with CBT too.

Where I live there is a local NHS based service called "Healthy Minds" which is mostly CBT.  Patients can refer themselves, or the GP can refer them. I had my doubts about it, because I had been through CBT years ago, and it was very rigid, all about fitting people into boxes.  I didn't fit into any of them.

But I tried this new service, and I was lucky, because the counsellor was really flexible and willing to listen to my experience.  Once she realised I knew a lot about CBT, she spent the time helping me find ways to make it work for me.

Then she referred me on to a "Mindfulness course".  This is very popular now -- it is based on some techniques used in Buddhist meditation but the NHS has decided it's a good thing.  I had done some meditation and knew a bit about it, so thought I would try it out.

Unfortunately, the course was really all about standard CBT, and the trainer was not "mindful" at all!  She just got us doing some silly exercises, and kept saying everyone had anxious thoughts while doing routine jobs at work, or driving to work -- even though it was a daytime course, and most of us were not employed!  "Everyone" was supposed to have standard anxiety symptoms, and when I said mine were a bit different, she didn't want to know.  Boxes, again.

I contacted my original counsellor who was very helpful. I wrote a letter about the mindfulness course, and she said she would pass it on to the people organising it.  So maybe something will change...eventually.

Anya, please carry on writing letters, and don't be embarassed about telling the GP it isn't working for you.  Find out whether they do DBT which might work better for you.  Ask to see another therapist.  Whatever.  This is about your life, not about what the GP thinks of you. 

I think CBT can be useful, but it's quite simplistic, and you need to find someone who can practise it in a flexible way and figure out how it applies to you, not "everyone".