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Ann2011
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19 Sep 2011, 2:34 pm

I am currently undergoing CBT to help me deal with the social problems associated with Asperger's. I have mixed feelings about it. Today we did "exposure therapy" in which my counselor and I went in to a public area and asked people for the time. I think the idea is to get me to be more comfortable with talking to strangers and more trusting of them. This is good, but at the same time, it doesn't make me feel any more connected to people. I simply do what's expected of me like an actor.
I'm wondering if anyone else out there has had CBT and what you thought of it, good or bad.



nemorosa
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19 Sep 2011, 3:13 pm

I was offered CBT but declined to accept as I made repeated enquiries as to what exactly they would be attempting to "fix" with me without success. How could they expect me to put my faith in something without any idea of the agenda? I was made to feel like a trouble maker for pushing this line of questioning but I simply must have the facts before I commit to anything.

I would have made a go of it if the psychologists had been more open with me even though I am dubious that CBT has any value to me as I don't think I have issues with behaviour, but rather with perception and mental processing.



Willard
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19 Sep 2011, 3:22 pm

Ann2011 wrote:
I simply do what's expected of me like an actor.


Exactly. I think you can't rewire brain damage by applying psychological pressure.



btbnnyr
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19 Sep 2011, 3:29 pm

I think it can be useful for overcoming social anxiety, but I don't think it will help with the fundamental social difficulties of ASD.



Tadzio
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19 Sep 2011, 6:23 pm

Hi Ann2011,

I've been sent to the public area to ask people for the time too!! !

My counselor was a speech therapist using roughshod CBT in graduate level intern projects, while I was more interested in applying Skinnerian Behaviourism to my "third level" speech impairments. My CBT graduate speech therapist promoted such theraphy as asking random people in public places the time of day.

My "first level" speech impairments are from all the effects of neurological impairments grouped under "epilepsy". When I'm having an epileptic seizure, I often don't talk no matter what, and with the frequent effects of such as "Todd's Paralysis", by speech is somewhere between totally absent to slightly impaired, for up to a few minutes to hours after a strong seizure.

My "second level" speech impairments tend to be in a more vague area where physical impairments are not totally distinguishable from a priori categorizations satisfying criteria such as in the Asperger's Syndrome, and where my speech can sometimes be conditioned, and sometimes not, but this is definitely not a reliable "cusp-point" division.

My "third level" speech impairments tend to definitely respond to conditioning, as distinct from the first two levels of impairments.

Most practioners of CBT I have met do not clearly understand the differences between behaviourism's conceptual definitions and distinctions between "negative reinforcement" and "punishment". In conditioning, positive reinforcement works the best, negative reinforcement doesn't work nearly as well, and punishment is most often deterimental rather than beneficial. Being told what to do (ask people for the time of day), where to do it (in a public place), and how to do it (just "do it!! !") often doesn't result in positive reinforcements to a desired set of behaviours.

When desired results are not obtained, most practioners of CBT blame their therapy seeking client. Most neurologists, neuropsychiatrists, psychiatrists, psychologists, therapists, to "New Agers", follow the same line of blame.

As distinct from any general CBT, therapy based on Relational Frame Theory and into Acceptance and Commitment Thearapy (ACT) is often better based with Skinnerian Behaviourism, but ACT has a major fault at the "second level" of impairments involving the "cusp-point", where ACT hypothesizes a valid and objective distinction between "clean" impairments and "dirty" impairments, a division that is not valid nor objective and is often detrimental with no otherwise saving utility. Steven C. Hayes is one of the most frequently cited with mainstream ACT. Tony Attwood has a branch too.

Tadzio



Ann2011
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20 Sep 2011, 8:55 am

Thanks for your thoughts. I hadn't heard of Acceptance and Commitment Therapy before, but it sounds interesting.



MommyJones
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20 Sep 2011, 10:11 am

I'm NT, but I was EXTREMELY shy in high school and my early 20's. I was also in abusive relationships which also beat down my self esteem. I went to therapy for a long time. At the very beginning I was asked to do the same type of thing. I was asked next time I go out with my friends, to pick someone I don't know and find out 3 things about them. It was a long time before I was actually able to do that. Talking to people you do not know is hard when you have social deficits or shyness, but starting with asking for the time is simple, direct, a common practice and a good beginning. It's a way to help you start to get comfortable with approaching people. I'm sure as you grow your therapist will ask you to try to engage in more challenging interactions. I don't think it's to make you act like an actor or to change you in any way, but to start with something small in order to help you interact with more comfort and ease with people you don't know, or don't know very well. You don't have to have anything "wrong" with you to get CBT. It can be used to help you improve your quality of life in areas that give you difficulty.

At the time, asking someone 3 things about them was impossible, but I was over thinking it also because of my fear of rejection. It never dawned on me to just walk up to them and say "May I ask you a favor? I'm tasked with finding out 3 things about someone I don't know. What's your favorite color? What car do you drive? and Are you married?" That's kind of cheating, but hey! Boom...done. :wink:



ACT-KC
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20 Sep 2011, 4:20 pm

As both a fellow Aspie and practicioner of ACT, I agree that therapy will not change or cure an Aspie (nor do we want that from therapists). A therapist HAS to have an understanding of Aspergers. The therapy should be focused on positive motivators to build social skills or foster acceptance of self (as we can be down on ourselves due to negative comments from NT's). Therapy does have benefits if the therapist knows what they are doing and who they are helping.


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25 Sep 2011, 8:10 am

I had CBT a few years ago, to try to help depression caused by a lack of social interaction.

I did not find that it had any real effect on my mood, or gave any improvement to my social interaction.

Most of the emphasis was on identifying "unhelpful" thoughts, and changing/correcting them. The problem that I found was that I wasn't able to change the thoughts as much as would have been necessary to have any beneficial effect. Converting "I will always be alone" to "it is highly likely that I will always be alone" did not help much. I also found that when I did increase my confidence a bit in the sessions, I then failed in reality destroying the positive thoughts.

I think it may have benefits for some people, but will depend a lot on the reasons for the persons problems, and the skills of the therapist.



ACT-KC
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25 Sep 2011, 8:29 am

That is why I do ACT instead of CBT. Instead of replacing negative thoughts with positive ones, acceptance and commitment therapy allows a person to practice mindfulness and acceptance. I also find it humiliating when I read books or hear fellow psychologists trying to promote curing Aspie's.


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