Is Cognitive Behavioural Therapy a bad idea for me?

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Bloodheart
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30 Dec 2013, 10:40 pm

I'm supposed to be going for CBT, but I'm really uncertain about it...

I'm going for CBT because of general anxiety, this anxiety has come along with worsening autism symptoms as a result of long-term unemployment - I honestly believe that the only thing that will help me get back to normal is to be working again, however while my autism and associated problems like anxiety have worsened getting another job seems impossible.

I've had bad experienced with therapy as a child. I wasn't diagnosed as autistic until adulthood so my school put me into therapy due to my unusual characteristics, although the therapists figured out I was autistic they weren't trained in how to deal with autistic children and also didn't know I was being abused at the time. They seemed to expect me to know what to say when they asked me questions, if I didn't answer as they wanted me to they'd tell me they couldn't help me unless I did, as if I chose not to answer them correctly and it was on me to figure out what they wanted me to say. I never understood why they didn't realise that a person with communication problems might struggle with talking therapy, why it never occurs to them to try different strategies to get people to talk or try talking via email.

This time round I had hoped for a male therapist with autism training, I've gotten two female therapists with no autism training - I hate talking to female therapists, and how can they help if they don't understand autism-specific problems? I'm also VERY secretive, I don't mean to be but even with the most mundane things I really struggle not to hide things, opening up to people is really hard as I'm very guarded, so I don't know how they expect to get the information needed out of me. I don't think that I will be able to tell them any of what I've written here either to explain to them my problems with the therapy. They've sent me a form to fill in, asking me to explain my problems and things such as my daily life, but I can't even fill that in...I'm getting anxious, angry, and upset just thinking about it.

I don't even know what makes me anxious - I've only been able to identify anxiety in the past few years, hell for all I know half of what I think is anxiety may not be anxiety at all, and I'm not sure what makes my anxious. My understanding is that with CBT they expect you to identify the cause of your anxiety and get you to consider why it makes you anxious, but how can I do that if I don't know what makes me anxious or why?! If I can't tell them what makes me anxious, and they can't find a way to figure it out, then it's a no-go.

It also seems that they slowly force you to deal with things that make you anxious, I'm not sure I understand the logic of forcing someone to do something that makes them anxious, I don't see any benefit in forcing me into a meltdown...that could leave me barely able to function for days and potentially make my autism worse long-term. It seems to me that CBT could be as harmful as it could be helpful.

Is CBT even going to be helpful for me?


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JSBACHlover
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30 Dec 2013, 11:57 pm

CBT works excellently for Aspies. As long as you have a therapist who understands AS, you'll make great progress.

Now, if you do not feel comfortable with your therapist, I advise you to get another one. And make certain that it is someone who has dealt with adult autism. Good luck!



EzraS
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31 Dec 2013, 12:18 am

I had therapy for self harm, anger and depression and it helped me very much.
I am at 135 days now with no self harm.
Mine is a therapist who works with kids with asd.



goldfish21
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31 Dec 2013, 12:28 am

It's a good idea for anyone.

I did self administered written CBT for a couple months 2 Summers ago.

while it didn't have it's intended result, I learned a lot and it was still highly valuable.

The fact that it wasn't working & my Burns Depression Checklist scores kept getting worse and worse was frustrating at first, but in the end it was highly valuable because I knew that something was making me worse and worse and after a lot of research finally figured out that it was a sensitivity to salicylate acids & that they'd been building up from everything I had been eating, drinking, and putting on my skin. I detoxed them and thought and felt worlds better. The worst depression of my life that had lasted 5+ months was nearly completely lifted within the first 5 days of avoiding all sa's & using epsom salts on my skin to absorb the magnesium sulphate in order to detox the acids via urination. I've read that 70% of us are salicylate sensitive.

Even though it didn't work for me directly, it was still very well worth doing because it gave me a quantifiable result to track and realize that something must be making me worse and that I had to figure out what it was and deal with it. Further, the techniques I learned to deal with depression, anxiety, perfectionism, procrastination etc are all valuable tools that I can use at any time for the rest of my life.

I did all of this by reading the book "Feeling Good," by Doctor David Burns. If you haven't read it, consider it. It's about 700 pages but will give you a lot of tools that will help make talk therapy CBT that much more effective for you.


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Sare
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31 Dec 2013, 12:32 am

Are you able to insist that you see someone who has had Autism training? Are you able to print out what you've written here to show your therapist?

I can understand your frustration with CBT. When I went to see my female external supervisor for my residual anxiety issues she insisted on CBT. This approach made no-sense to me, since I no longer experience running thoughts through my head (my mind is completely silent). I even tried to explain this to her, but she seemed to be skeptical and not in a good way (close-mindedness). I can say that my body does still experiences 'anxiety'. However, I later learned that what I thought was 'anxiety' was actually distress (an accumulated response to experiencing many stressors). My nervous system/body becomes distressed due to over-arousal (the stress response is activated). So, this is one reason why I have found reading up on somatic issues and somatic (trauma) therapy as more useful than psycho-therapeutic approaches like CBT - which require you to be able to name your feelings (and the thoughts associated with it). So, when you experience trauma, particularly at a young age, it can remain unprocessed and stuck in your body, and will keep reactivating until you are able to process it through to completion.



AardvarkGoodSwimmer
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31 Dec 2013, 12:41 am

I'm sorry you had bad experiences with therapy while in school. I've also had generally bad experiences with therapy and counseling, including this clown who didn't take my father's violence seriously while I was in high school.

The therapist should certainly have a good understanding of autism. And cognitive-behavior therapy should be used as just one tool, and not as a religion.

A good therapist should also be able to talk about feelings and experiences which may or may not be anxiety, and be able to do so in a nonjudgmental way.

Good luck with the job hunting. With this economy, it can definitely take quite a while.



AardvarkGoodSwimmer
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31 Dec 2013, 4:28 pm

Bloodheart wrote:
I've had bad experienced with therapy as a child. I wasn't diagnosed as autistic until adulthood so my school put me into therapy due to my unusual characteristics, although the therapists figured out I was autistic they weren't trained in how to deal with autistic children and also didn't know I was being abused at the time. They seemed to expect me to know what to say when they asked me questions, if I didn't answer as they wanted me to they'd tell me they couldn't help me unless I did, as if I chose not to answer them correctly and it was on me to figure out what they wanted me to say. I never understood why they didn't realise that a person with communication problems might struggle with talking therapy, why it never occurs to them to try different strategies to get people to talk or try talking via email.

I am sorry you were being abused. And I'm sorry the therapists or maybe even a teacher or trusted adult did not pick up on this and try to help in a practical way.

These therapists almost sound like they are high-pressured sales people, that they know one method and that's all they know. Contrast this to an experienced tutor. Okay, if a student is struggling with, for example, calculus and taking a derivative in one way, the experienced tutor probably has about five or six other ways to explain the same material.

I think it's fine to be middle-of-the-road with how much personal and private information you reveal. You kind of need to see if the counselor is going to be, one, competent and knowledgeable, and two, respectful to you as the unique human being you are.

As far as cognitive-behavioral therapy exposing you to something which causes anxiety, here's an analogy I've heard as explained by a young psychiatrist in training. Let's suppose a person is afraid of dogs. You want to avoid the dual mistakes of going way overboard and avoiding dogs from even two blocks away, and the other mistake of taking a big angry growling dog and putting your face right in there. Instead, here's this small, friendly happy dog. Maybe you'd like to pet him and maybe you don't. And even way is okay. And that's kind of the key, this zen place where it's okay to approach something which has caused anxiety in the past, and it's okay not to. And it's your choice. And that's crucial. Someone should not attempt to pressure you regarding this.

Now, if a therapist only has one method, they might try and pressure you. And this is where it helps to have something brief prepared, almost like a mantra. "It's my personal decision." And repeat that as necessary. Be prepared to sit there and not say anything. If the counselor switches the topic, also be prepared to graciously accept that. And be prepared to stand up and put one foot in front of the other and walk out of the room. Just because the therapist gets stuck, doesn't mean you have to. Of course all this is easier said than done. But as a fallback position, this might be good to have.

And if you do get pressured, try and be a little easy on yourself. All kinds of people get pressured by slick sales people.

Offhand, I'd say about 30% of therapists are just plain lousy, perhaps 20% of them are really good. And the rest? Well, they're kind of in the broad middle of sometimes being helpful and sometimes not.



Last edited by AardvarkGoodSwimmer on 31 Dec 2013, 4:38 pm, edited 1 time in total.

bumble
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31 Dec 2013, 4:38 pm

JSBACHlover wrote:
CBT works excellently for Aspies. As long as you have a therapist who understands AS, you'll make great progress.

Now, if you do not feel comfortable with your therapist, I advise you to get another one. And make certain that it is someone who has dealt with adult autism. Good luck!


I find CBT to be oversimplified psychobabble kybosh.

Things are far more complicated than CBT makes out they are.

Thoughs affect feelings but feeling affect thoughts as does how much sleep you had, what you have eaten, whether you have the flu, the people around you, your environment....

Nothing is black and white, it is all relative.

Plus it replaces on assumption with another. This is pointless, it is better to stick to facts and not make any assumptions at all. If someone does not speak to you when you are out do not jump to any conclusion or assume anything..just ask them politely in a friendly manner what happened. Making assumptions or jumping to conclusions is pointless.

Oversimplified psyhcobabble rubbish.

Also CBT is for those people with certain belief systems. If you are logicl or practical it won't really be relevant for you.

It is absolute rubbish (in the most part).



ECJ
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31 Dec 2013, 4:53 pm

bumble wrote:
JSBACHlover wrote:
CBT works excellently for Aspies. As long as you have a therapist who understands AS, you'll make great progress.

Now, if you do not feel comfortable with your therapist, I advise you to get another one. And make certain that it is someone who has dealt with adult autism. Good luck!


I find CBT to be oversimplified psychobabble kybosh.

Things are far more complicated than CBT makes out they are.

Thoughs affect feelings but feeling affect thoughts as does how much sleep you had, what you have eaten, whether you have the flu, the people around you, your environment....

Nothing is black and white, it is all relative.

Plus it replaces on assumption with another. This is pointless, it is better to stick to facts and not make any assumptions at all. If someone does not speak to you when you are out do not jump to any conclusion or assume anything..just ask them politely in a friendly manner what happened. Making assumptions or jumping to conclusions is pointless.

Oversimplified psyhcobabble rubbish.

Also CBT is for those people with certain belief systems. If you are logicl or practical it won't really be relevant for you.

It is absolute rubbish (in the most part).


^this.
I had CBT for years and found it insulting and not very helpful at all. It also made me feel worse as I was constantly being told my thinking was "wrong." It didn't address the cause of my problems at all.



Bloodheart
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31 Dec 2013, 5:56 pm

ECJ wrote:
bumble wrote:
JSBACHlover wrote:
CBT works excellently for Aspies. As long as you have a therapist who understands AS, you'll make great progress.

Now, if you do not feel comfortable with your therapist, I advise you to get another one. And make certain that it is someone who has dealt with adult autism. Good luck!


I find CBT to be oversimplified psychobabble kybosh.

Things are far more complicated than CBT makes out they are.

Thoughs affect feelings but feeling affect thoughts as does how much sleep you had, what you have eaten, whether you have the flu, the people around you, your environment....

Nothing is black and white, it is all relative.

Plus it replaces on assumption with another. This is pointless, it is better to stick to facts and not make any assumptions at all. If someone does not speak to you when you are out do not jump to any conclusion or assume anything..just ask them politely in a friendly manner what happened. Making assumptions or jumping to conclusions is pointless.

Oversimplified psyhcobabble rubbish.

Also CBT is for those people with certain belief systems. If you are logicl or practical it won't really be relevant for you.

It is absolute rubbish (in the most part).


^this.
I had CBT for years and found it insulting and not very helpful at all. It also made me feel worse as I was constantly being told my thinking was "wrong." It didn't address the cause of my problems at all.


Yes, this is a concern of mine. With being ASD obviously I'm going to think differently to an NT therapist, if they don't understand why I think the way that I do then there's the potential of them just telling me how I think it wrong, because it isn't how they think...because they don't understand why I think the way I do. A major cause of anxiety for me is my executive functioning problems, trying to plan a simple trip to the shops or planning days in advance, I'd be hard-pressed to explain my thought process at all let alone explain it in such a way that a NT person who has never had executive functioning problems could ever understand. Then there are times when those of us on the spectrum do things but can't really explain why we do them, if we can't explain this then therapists may well just dismiss our thoughts/behaviour as being unnecessary or part of the problem, rather than this behaviour or way of thinking is useful to us.

If they don't understand the thought process, how can they know that what I think doesn't make sense - you know?


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bumble
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31 Dec 2013, 6:13 pm

Please don't take this offensively but honestly, in my experience. therapists are not very bright (there are a few exceptions but not many).

I wouldn't worry if they don't understand your way of thinking. They may not be able to.

sorry if this offends anyone but this has been my experience.