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StuartN
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16 Jun 2010, 3:54 am

I went through some Cognitive Behavioural Therapy (CBT) before I was diagnosed with Asperger's syndrome and I found the experience extremely oppressive, like a verbal and emotional assault. All that I took away from the sessions was that I had "distorted thinking patterns", was "not trying", was "sabotaging my own recovery" (I was diagnosed with depression), that I was "undermining the psychiatric staff" and at one point I was asked to sign a "pledge of loyalty" (which was when the therapy ended, because I did not sign). I ended up feeling very bad about myself, because I seem to be antisocial, uncivil and untreatable.

Now I am going through a bad patch of anxiety and fear of other people, and lack of enjoyment in life, and might be offered more therapy. Really I just feel like I would like to be left completely alone to pursue things that interest me, with other people who have the same interests - but real life is getting in the way.

Have other people with ASD found that CBT can be an unpleasant and unhelpful therapy? Is it perhaps different if you have been diagnosed, and the "failures" have an explanation?

Is there some kind of therapy that people with ASD have found very helpful?



Danielismyname
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16 Jun 2010, 4:06 am

Yeah.

ASDs aren't due to erroneous thoughts. Now, treating something that's possibly comorbid, but it's not the primary disorder (ASD), like social anxiety, which is based on irrational thoughts, is prudent if you want to socialize and the social anxiety is stopping you from doing such.



ouinon
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16 Jun 2010, 4:28 am

Wow! Finally another person with the same reaction to CBT! :D :lol

Actually I didn't react to CBT like that to begin with; it took me 8 years ( from the very first weekend course to the day that I felt as if I psychically "vomited it" all up ), to realise that I had been walking around with the equivalent of Big Brother in my head, a "living" 1984, an oppressive "presence" that said that it was all my fault if I didn't make the effort to patrol my thoughts, 24h/24h, throwing out the "false" ones, putting the "don't knows" on ice, and only accepting the "trues".

Apparently there is a new(er) form of CBT, called "Mindfulness Based Cognitive Therapy", MBCT, which also, like CBT, concentrates on teaching one how to notice/become aware of/"see" our constant background flow of beliefs/thoughts but only so that can then simply "ignore/disinvest" or "let go" of ( all of ) them more easily, rather than meticulously, like an inquisition, categorising them as "true", "false", or "don't know", a process which if anything seems to *add* value to the beliefs/thoughts, increase one's attachment to them. I think that MBCT sounds a lot less oppressive.

I think that the big mistake that trad CBT makes is that it emphasises an already oppressive/exhausting tendency in many people, particularly AS perhaps, ( and yes, it certainly didn't help that I didn't know about my neurodivergency/AS at that time, and thought that my "failures" were evidence of "not doing the work" ), to believe in ( some sort of absolute objective ) "truth". It encourages the illusion that if make enough effort one will be able to weed out all the "bad", limiting, self-destructive thoughts/beliefs, leaving only the theoretically "good", "true", enabling ones.

MBCT on the other hand teaches that all beliefs/models are to some extent "false", ( monkey chatter ), and that we might be unable to avoid using them, but that by becoming aware of them/recognising their presence, seeing them clearly, "affirming" them almost rather than instantly denying/spurning them, ( however unpleasant/negative/unwelcome/irritating/"obviously" "stupid" or "obviously" unrealistic ), we can free ourselves of them.

The thoughts/beliefs ( or "mindtalk", as the CBT-based courses I went on called them ), may be really idiotic, obviously pathetic thoughts/beliefs, but they are ours, and therefore "true" for us, ( so long as we still think them ), but trad CBT has us examining them for some sort of ( supposedly ) "objective" truth, measuring "our truth" by rules that it has devised, eg. all statements about the future are "don't knows"; almost all statements involving absolutes are "false", etc.

Interestingly though the CBT-course's creed of "It works, if you do the work" ended up having an effect on me like a zen koan; it got me wondering exactly who or what it was that decided to "do the work" ... and a couple of years after "violently" liberating myself from the CBT training/principles etc I no longer believe in free will! :D ... I suspect that MBCT would have been less painful though.
.



Last edited by ouinon on 16 Jun 2010, 4:56 am, edited 8 times in total.

MotownDangerPants
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16 Jun 2010, 4:33 am

Is this like DBT? I was referred to this when I got DXd with BPD a long time ago. I'm almost positive I don't have BPD, and I think therapy like this can really only be good for problems one develops in childhood, assuming the person has an otherwise "normal" brain. I knew it wouldn't be good for me because I've been through LOTS of therapy and nothing was ever "revealed", you know? I had a messed up childhood but I got over it, and there was no one big thing that explained all my problems, nothing I could work on.

If your brain is just different than I don't think this kind of therapy could help at all, ASD's just need therapy that focuses on their current issues and teaches coping skills.



MotownDangerPants
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16 Jun 2010, 4:38 am

ouinon wrote:
Wow! Finally another person with the same reaction to CBT! :D :lol

Actually I didn't react to CBT like that to begin with; it took me 8 years ( from the very first weekend course to the day that I felt as if I psychically vomited it all up ), to realise that I had been walking around with the equivalent of Big Brother in my head, a "living" 1984, an oppressive "presence" that said that it was all my fault if I didn't make the effort to patrol my thoughts, 24h/24h, throwing out the "false" ones, putting the "don't knows" on ice, and only accepting the "trues".

Apparently there is a new(er) form of CBT, called "Mindfulness Based Cognitive Therapy", MBCT, which concentrates on teaching one how to notice/become aware of the constant background flow of beliefs/thoughts and then, rather than categorising them as true, false, or don't know, to simply "ignore/dismiss" or "let go" of them. I think that sounds a lot less oppressive.

I think that the big mistake that trad CBT makes is that it emphasises an already oppressive/exhausting tendency in many people, perhaps especially AS, to believe in "truth". It reinforces belief in absolute truth, and encourages the illusion that if make enough effort one will be able to weed out all the "bad" thoughts/beliefs, leaving only the "good", true ones.

MBCT on the other hand teaches that all beliefs/models are to some extent "false", that we might be unable to avoid using them, but that by becoming aware of them/recognising their presence, seeing them clearly, "affirming" them almost rather than instantmy denying/spurning them, ( however unpleasant/negative/unwelcome/irritating/"obviously" "stupid" or "obviously" unrealistic ), we can free ourselves of them.

The thoughts/beliefs ( or "mindtalk", as the CBT-based courses I went on called them ), may be really idiotic, obviously pathetic thoughts/beliefs, but they are ours, and therefore "true" for us, ( so long as we still think them ), but trad CBT has us examining them for some sort of ( supposedly ) "objective" truth, measuring "our truth" by rules that it has devised, eg. all statements about th future are "don't knows"; almost all statemants involving absolutes are false, etc.

Interestingly though the CBT-course's creed of "It works, if you do the work" ended up having an effect on me like a zen koan; it got me wondering exactly who or what it was that decided to "do the work" ... and a couple of years after "violently" liberating myself from the CBT training/principles etc I no longer believe in free will! :D ... I suspect that MBCT would have been less painful though.

.


This sounds awful, this is like teaching an ASD brain to work against itself. I bet this drives people mad.



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16 Jun 2010, 5:31 am

I agree. I had CBT before, and that was the worst therapy experience I've ever had...
I hate that therapist...she looked at me and talked to me like "just think this way instead of that way, you idiot." totally hate her.


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StuartN
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16 Jun 2010, 5:39 am

MotownDangerPants wrote:
ouinon wrote:
Wow! Finally another person with the same reaction to CBT! :D :lol
...
Apparently there is a new(er) form of CBT, called "Mindfulness Based Cognitive Therapy", MBCT, which concentrates on teaching one how to notice/become aware of the constant background flow of beliefs/thoughts and then, rather than categorising them as true, false, or don't know, to simply "ignore/dismiss" or "let go" of them. I think that sounds a lot less oppressive.


This sounds awful, this is like teaching an ASD brain to work against itself. I bet this drives people mad.


Yes, exactly - the black and white thinking, obsessive thoughts, unsocial behaviour etc that are defining characteristics of my identity are all pathologized, so that being who you are is being a disease.

Ouinon, I did some Mindfulness after I was diagnosed and it was indeed useful, but somehow I seem to be unable to apply my intelligence to understanding therapy, so it was slow and frustrating (for the therapist and for me). I didn't realise it was CBT because it was more like meditation and learning acceptance - the monkey chatter will go on, whether you pay attention or not, so why not accept it as a background and carry on doing something else than just listening to it.

At the moment I am trapped in between caring for my children (school run, cooking and so on - I love my kids and enjoy interacting with them, so they aren't a problem) and doing a job where I am almost paralyzed by the need to do it exactly right, to the point I am getting nothing done - and dealing with the people who I have to deal with (other parents, contractors etc) saps so much energy that I feel drained afterwards.



marshall
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16 Jun 2010, 11:20 am

ouinon wrote:
Interestingly though the CBT-course's creed of "It works, if you do the work" ended up having an effect on me like a zen koan; it got me wondering exactly who or what it was that decided to "do the work" ... and a couple of years after "violently" liberating myself from the CBT training/principles etc I no longer believe in free will! :D ... I suspect that MBCT would have been less painful though.
.

My guess is the therapist you had sucked. "It works, if you do the work" sounds like a cop-out for their failure to me. If you're dealing with a "mental" disorder you can always just blame the patient for the failed therapy. It must be nice for psychiatrists to always have a back door exit.



ooOoOoOAnaOoOoOoo
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16 Jun 2010, 11:28 am

A therapist tried to get me to try CBT and sent me to a bookstore for a copy of The Feeling Good Handbook, but I was very skeptical.

She must have thought I was depressed, or why would she recommend that book? I tried to trudge through the pages, but I didn't want to read what the author was saying, that my thoughts were causing my depression. I thought other people's reactions to me was causing it, not my thoughts.

It drove me to tears.

I gave up on it.

What I wanted to talk about was being disrespected on a daily basis and the effect it was having on my psyche. I didn't think I could ever put my own spin on it so my mind would be convinced I wasn't really being insulted. I am more capable of doing that now and ignoring the disprespect, while running for the shelter of my car or home where I can turn on cable television and completely zone out or cook a rewarding meal of chicken breast, green onions, garlic, carrots and chopped greens. Health food helps me recuperate

I used to long for the tabula rasa, that I could just erase everything and start from scratch., but it's not possible. Maybe one day it could be, if someone events a machine., but not now. :idea:



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16 Jun 2010, 11:29 am

Sounds evil and sadistic.



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16 Jun 2010, 12:20 pm

I think, only when badly done.

I've no experience with, well, with seeing a therapist for anything at all, but I have some experience with CBT techniques, using them on my own. Doing it that way, it's not at all oppressive, because I'm in control. I use those techniques that work for me.

But I can totally see how doing CBT with a therapist who thinks CBT will make you into a normal thinking person would be oppressive. Yuk.

I think some people on the spectrum can benefit from CBT, either using the techniques on their own, or with a therapist who respects their autistic differences. But it can't and shouldn't be used to try to make someone normal.


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StuartN
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16 Jun 2010, 12:57 pm

ooOoOoOAnaOoOoOoo wrote:
She must have thought I was depressed, or why would she recommend that book?


This is apparently very common with Asperger's because there is a strong link between Asperger's and depression (maybe in the therapists' mind more than in reality) and also because Asperger's is misdiagnosed as depression. So, for instance, the therapist might be judging progress by the change in affect, and it is just normal to lack affect. Or assume that the perfectionist standards are going to disappear, and they don't. The poor patient is simply bound to fail.

ooOoOoOAnaOoOoOoo wrote:
What I wanted to talk about was being disrespected on a daily basis and the effect it was having on my psyche.


When I go out, I feel like people are looking at me as if I have faeces on my hands, with a kind of snarled up look of disgust ("like a bulldog licking the piss off a nettle"). I know rationally that part of that is in my mind, but it doesn't help me get out the door and go deal with real life chores.



marshall
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16 Jun 2010, 2:12 pm

From my understanding of CBT the objective isn't to discount certain thoughts as "irrational" and try to "combat" them. That doesn't really work because it's often not possible to demonstrate that negative thoughts are irrational and trying to "combat" them is always counterproductive. The more you try to combat negative thoughts the more emphasis you put on them where the goal should be the opposite. The better strategy is to accept negative thoughts and work on ways to gradually de-emphasize them.

Anyways. I don't think CBT is effective for treating clinical depression if anxiety isn't the causative agent. It's much better for dealing with anxiety or phobias that might be causing depression by creating barriers to self-improvement. Major clinical depression by itself is a much harder nut to crack.



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16 Jun 2010, 2:44 pm

I've had bad experiences with CBT, which is in fact about changing how you think. (I even read the book by Beck, who originated it, and I found it insulting.) I don't think that there's anything wrong with my thinking. I just have trouble dealing with some situations, so I want to better understand how other people are and why they act and think the way they do, I don't want to change how I think.

I've had to tell my current therapist that I don't want "therapy" of any kind, I just want to gain some insight. Therapy in general is about tricking the patient into changing what they believe and giving the patient the illusion that he/she came up with those new beliefs on his/her own. It doesn't work with people who have intelligence and strong sense of self, because they will not be duped successfully.

And of course AS makes it all even worse, because how we are isn't going to be changed by changing our beliefs, nor through some lame reassurances, which is what some of my former therapists were always trying to foist on me. ("Of course you're fine at talking to people; look. you're talking to me..." That sort of thing.) I have seen 12 different therapists over 20+ years, so I am speaking from some experience.



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16 Jun 2010, 4:23 pm

Mysty wrote:
I think, only when badly done.

I've no experience with, well, with seeing a therapist for anything at all, but I have some experience with CBT techniques, using them on my own. Doing it that way, it's not at all oppressive, because I'm in control. I use those techniques that work for me.

But I can totally see how doing CBT with a therapist who thinks CBT will make you into a normal thinking person would be oppressive. Yuk.

I think some people on the spectrum can benefit from CBT, either using the techniques on their own, or with a therapist who respects their autistic differences. But it can't and shouldn't be used to try to make someone normal.


Let me add, those CBT techniques that I've used on my own have been very helpful for me with emotional stuff. Basically, learning CBT techniques has been, for me, learning skills for dealing emotions. And, included with that, relationships -- the relationships that bring out emotions, that is. And, while emotional issues are not technically a part of autism, they can often be an issue for those on the spectrum, because due to our social difficulties and/or differences in thinking, we don't learn skills from others they way most people would.

Yes, using CBT techniques changes my thinking, but, first, only in the realm of emotional stuff, and, second, only when and if I choose to use it.

It's actually a lot of use of rational thinking, and self talk with that, in the realm of emotional issues. And rational thinking we tend to be good with.


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16 Jun 2010, 4:25 pm

I hope that I'll never have to go through it.


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