Discussion Is it just me or is CBT kind of bullshit?

[qualityOV3Rquantity]

I don't mean that I think CBT is useless, and I don't deny that many people have been helped by it. But it seem like it has obvious limits that many mental health professionals aren't willing to recognize.

I have IBS, which causes me pain every day and which has drastically changed every area of my life since I developed it. And I stopped seeing my previous therapist because it seemed like his whole idea was that the reason I'm depressed and suicidal isn't because of the actual pain of IBS or of the huge reduction in quality of life as a result of living with it, but because of my thoughts around having IBS. He always went on about how I need to change my thought patterns about IBS. Stuff like "you are not IBS, you are just a person living with IBS." I don't deny that mental health plays a large role in managing IBS and many chronic illnesses, but at the end of the day, IBS causes physical pain and dysfunction, and these things are unpleasant and make my life worse. Even if I never had 'bad' thoughts like "my life is over, all the happy times of the past are gone, my life is just pain until I die", I would still have IBS and experience pain. And it's ridiculous to think that pain doesn't affect your emotions unless you let it.

And now that I have tinnitus as well, there's no way in hell I'll ever return to that therapist, since I know that his approach would be the same - "it's not the tinnitus that is the problem, just your reaction to it." Is there any other problem besides negative emotions and physical symptoms that would be "treated" this way? Would a social worker tell a woman being beaten by her husband that the issue isn't the beating, it's her negative emotional reaction to it? Certainly not, they would advise her to try and make the cause stop, by leaving her husband.

It seems like in the face of intractable issues, CBT is not a real solution, but merely a ruse to hide the fact that there really is no help. If tinnitus had a cure then no therapist or doctors would ever talk about "overcoming your negative reaction to the noise". They would tell you to take this pill to make the ringing go away. The idea of somehow adapting to the ringing (or in my opinion, attempting to gaslight yourself into thinking the ringing isn't bad) would be laughable, because they would readily admit that the ringing is a problem and the solution is to make it go away. But because it doesn't have a cure, doctors and therapist instead need to try and convince you that you are the problem (your thoughts), not the problem itself.

Sorry if this doesn't make sense, I'm just miserable and my mind is a fucking mess. I want this pain to stop...

 

[aiyuxhan]

i totally agree with everything you said. I have chronic pain 24/7 and chronic illnesses. IBS is one of them that I have had for at least 10+ years and tinnitus as well. I also have Spondyloarthritis, Psoriatic Arthritis, OA in all my joints including neck and skull, fibromyalgia, occipital neuralgia, etc. I've also gone through failed botched surgery and medical injury. I'm in pain in several areas of my body every day.

I did therapy 2-3x a week and was told similar things like you. I feel like therapy may help people who have problems like a break up, an annoying boss, etc.

But, my problems are degenerative and progressive with no cures. Therapy isn't going to take the pain and suffering I live with everyday.

Sadly, I'm not approved for euthanasia (I'm not terminal aka dying in 6 months). So, I gotta do it myself

 

[wiggy]

I have no doubt that CBT can have positive outcomes in many cases, either as a coping mechanism or as a definitive resolution to some kind of mental anguish.

The fundamental problem, in my opinion, is not specific to CBT but to the field of mental health in general - it has an unfounded conclusion as a premise. That premise being that death is never a preferable outcome to any kind of suffering, an assertion so absurd it's comical when examined through a dispassionate lens like that of moral philosophy, where the topic of suicide is discussed with seriousness.

 

[EvisceratedJester]

I don't get how CBT would in any way treat your IBS since it is a medical condition. Some of the techniques might help with better coping with it, maybe, but people with chronic health issues need proper medical intervention, not someone saying shit like, "You are not your IBS".

I have heard other people talk about how their therapists told them that certain health conditions are linked to trauma and so on, so maybe he thought that addressing your IBS from a psychological angle would help with treating it, idk. I'd assume that IBS likely occurs more in those who have experienced past trauma as a result of epigenetic mechanisms which cannot be addressed through CBT. Basically, the stress that you experienced may have led to changes in your gene expression, causing you to become more at risk of developing IBS. Of course, I could be wrong here. I haven't done much research on this topic so I'm kind of just making a guess here based on my poor understanding of genetics. Anyways, (got a bit sidetracked there), I feel it shouldn't be that hard to understand that CBT won't do much in helping to actually treat that condition.

I don't get why therapists have such a weird boner for cock and ball torture, but I guess they are freaky like that.

 

[Ijustcantanymore]

I think CBT is more helpful the more mild/moderate your mental health issues are. I think the more severe, the less impactful it becomes when your symptoms can overpower the exercises.

 

[GhostInTheMachine]

I was not thinking that kinda of CBT, I'm so cooked

 

[Moniker]

Yeah, I generally feel like CBT isn't far off from gaslighting in a lot of cases. More accurately, it's someone teaching you how to gaslight yourself. I don't like it.

it has an unfounded conclusion as a premise. That premise being that death is never a preferable outcome to any kind of suffering

That's the main reason I don't take it very seriously. You aren't allowed to be honest about how you feel because the therapy relies on forcing you to feel a certain way. It's invalidating.

 

[WhatCouldHaveBeen32]

Someone from my family ended contact one day with me and said they don't want to talk aynmore, I gave them a call a week later and I asked calmly, I just want to know why you wish to not talk to me anymore and they said that they have no problem with me but that everytime we talk, I only say things as they are, I am too cynical and sometimes way too right on what I say and that they don't have the energy nor the time to think about these things nor do they want to. So either I only call them to talk about fluff or don't call them at all.

CBT exists so people like me don't inconvenience others with my way of thinking, it can go to shit for all I care.

 

[LigottiIsRight]

I was in cognitive therapy a few years ago because of my insomnia, and what happened there is basically the same that OP has told us. The 'treatment' consisted in trying to change my thought patterns about the lack of sleep, an attempt to brainwash myself into believing that a poor quality sleep is not as bad as I was seeing it. Meanwhile, the insomnia and its effects remained there, unchanged (still are). It's very difficult to operate that kind of brainwash when you can't stop noticing the issue that lead you to the psychologist office. Because that issue is the fucking primary problem, not the thoughts that we have regarding it, ones that in no few cases are perfectly adjusted to the magnitude of it. Those can worsen the situation, yes, but there's no way on earth for them to be the source of the suffering.

Cognitive therapy (more specifically, cognitive restructuring, which is a key component of DBT) is a fucking insult to intelligence. Nothing more than a pathetic aim of palliative care when nothing really useful can be done.

 

[aiyuxhan]

I was in cognitive therapy a few years ago because of my insomnia, and what happened there is basically the same that OP has told us. The 'treatment' consisted in trying to change my thought patterns about the lack of sleep, an attempt to brainwash myself into believing that a poor quality sleep is not as bad as I was seeing it. Meanwhile, the insomnia and its effects remained there, unchanged (still are). It's very difficult to operate that kind of brainwash when you can't stop noticing the issue that lead you to the psychologist office. Because that issue is the fucking primary problem, not the thoughts that we have regarding it, ones that in no few cases are perfectly adjusted to the magnitude of it. Those can worsen the situation, yes, but there's no way on earth for them to be the source of the suffering.

Cognitive therapy (more specifically, cognitive restructuring, which is a key component of DBT) is a fucking insult to intelligence. Nothing more than a pathetic aim of palliative care when nothing really useful can be done.

Yeah, this I have insomnia too because of chronic pain. I get 2-4 hours of sleep a night and often times, none at all.

I gaslight myself into thinking via CBT and toxic positivity that it's okay that I can't sleep even if the original issues causing insomnia will never resolve. :(

 

[GhostInTheMachine]

Yeah, I generally feel like CBT isn't far off from gaslighting in a lot of cases. More accurately, it's someone teaching you how to gaslight yourself. I don't like it.



That's the main reason I don't take it very seriously. You aren't allowed to be honest about how you feel because the therapy relies on forcing you to feel a certain way. It's invalidating.

 

[rs929]

I think depression and other mental health issues are the real gaslighters. Like, "I'll never get better" ."I'm a burden to everyone" . "I'm worthless" . It's all bullshit and CBT is actually right about that. I don't think any person in this forum is actually worthless, not a single one. Yet the 95% probably feels like that.
The problem is that CBT by itself isn't enough when you're in severe, deep emotional turmoil. You just can't see it the "rational" way. I agree with what has been said, it's more effective for mild/moderate conditions. I think other stuff, newer than classic CBT are better for severe mental health issues. (like DBT or schema therapy)

 

[GhostInTheMachine]

I think depression and other mental health issues are the real gaslighters. Like, "I'll never get better" ."I'm a burden to everyone" . "I'm worthless" . It's all bullshit and CBT is actually right about that. I don't think any person in this forum is actually worthless, not a single one. Yet the 95% probably feels like that.
The problem is that CBT by itself isn't enough when you're in severe, deep emotional turmoil. You just can't see it the "rational" way. I agree with what has been said, it's more effective for mild/moderate conditions. I think other stuff, newer than classic CBT are better for severe mental health issues. (like DBT or schema therapy)

Ask yourself why people may be experiencing "severe, deep emotional turmoil" and understand that for them, it's not just "I'm sad about life". It's usually closer to "I'm miserable because the circumstances of my life hinder me from attaining fulfillment and they can't be changed". CBT assumes that the people who seek it out are irrationally sad when often their misery is entirely rational. You can't CBT yourself out of having been abused/neglected. You can't CBT yourself out of being physically disabled.

Yes, there is a point in "mind over matter", but that has it's limits.

 

[WhiteRabbit]

Agreed, and this is why I've never been to a therapist for my chronic pain problems. I don't find "you are not your pain" helpful in any way.

 

[Darkover]

I agree it's like telling a depressed person to just cheer up
It's like, no amount of thought tracking is going to fix the fact that life still sucks in very real ways.

 

[Forveleth]

CBT assumes that the people who seek it out are irrationally sad when often their misery is entirely rational. You can't CBT yourself out of having been abused/neglected. You can't CBT yourself out of being physically disabled.

THIS THIS THIS THIS THIIIIIIIIIIIIS! One of several reasons I gave up on therapy/medication was this exact point. You can give someone all of the coping mechanisms in the world, but they can still be not enough for the bullshit someone is going through.

 

[peanutsandjelly]

I'm not in medicine, but I've read that the objective of CBT is to, in effect, get the patient to accept their issue. So it's not about finding a solution to a problem so much as it is about accepting that the issue is just a fact of life. I've read accounts of therapists who lament about how they wished they could just give their patients money because the only way to solve or mitigate the many issues they see is money.

... yeah.

I don't know what happened but in a blink of an eye, therapy got regard as like some of kind of panacea but it doesn't seem to be? I think there's a business side to it in that a lot of private equity money has been funneling into healthcare looking for novel opportunities for growth and returns, so it's probably the executives who decide to market therapy as such (eg. BetterHelp), and not the practitioners themselves.

 

[GhostInTheMachine]

Most people already accept their issues, but that doesn't exactly make them feel better about it. So at that point, what is CBT really even supposed to do?

 

[Forveleth]

I'm not in medicine, but I've read that the objective of CBT is to, in effect, get the patient to accept their issue.

Most people already accept their issues, but that doesn't exactly make them feel better about it. So at that point, what is CBT really even supposed to do?

I do not think that is the point of CBT. The point of CBT is to kick you out of the thought loop that can be formed, often with depression and anxiety. Your brain rewires itself to assume situations are bad or automatically make negative associations out of habit. It is not about "accepting" anything, it is about dissolving a completely false negative association.

The problem is, this method got put in a pedestal as a "cure all" for mental health issues. The world of psychology got caught up in the idea of dispelling this negative thought pattern without addressing how one gets into that thought pattern originally. Hence, what I said earlier. You can teach someone to cope with bullshit in a healthy manner, but humans can only handle so much bullshit until the healthy coping mechanisms are not enough.

I think it is a similar situation as those in physical medicine with chronic pain. A lot of shitty doctors prescribe pain meds but never investigate the actual cause. Pain meds can only do so much if the root cause is never addressed.

 

[peanutsandjelly]

My bad, okay not "accept", perhaps "live with".

My point was that I was surprised to find that providers sometimes felt just as stuck as the clients felt themselves, and the contrast between how therapy is marketed and regarded at large compared to what it really is, which is anything but a panacea.

 

[dontletthembribeyou]

I agree. I would go as far as to say that getting CBT when I was younger was actually harmful. It taught me not to trust my own senses and intuition