Posted by Iansf on January 16, 2004, at 13:03:21
In reply to Re: CBT versus drugs » Ame Sans Vie, posted by zeugma on January 15, 2004, at 16:38:08
> > Obviously a propensity toward avoidance makes for a very difficult time adhering to the principles put forth in cognitive behavioral therapy (not to mention even getting out of the house and going to your therapist in the first place!).
>
>
> I believe I have avoidant personality disorder, and I was not helped by CBT. I found it too focused on the 'consequences' of social interactions, as if my fears of interacting with others were somehow founded on some kind of risk-benefit calculation, with the avoidance triggered by a fear of 'adverse' consequences. But I found (and still find) that social interaction unsettles me, regardless of the objectively determined outcome.
>
I put a huge amount of effort into cognitive therapy, to virtually no avail. In fact, in some respects I ended up feeling worse because when I failed to improve my therapist insisted I wasn't trying hard enough. Even though I knew she was wrong to criticize me, it still hurt.I can hardly imagine anyone trying any harder than I did. I pushed myself into social situation after social situation (and still do), and I wrote and wrote and wrote in my exercise book. But nothing changed, either externally or internally. Mixing has NEVER become easier for me emotionally, and I have NEVER become smoother at it.
Never, that is, except with the right medication.
I agree that CBT focuses too strongly on consequences and risk-benefit analysis. Whatever unsettles me in social situations is not the potential consequences -- it's something much deeper, something that is, apparently, immune to rational analysis.
There's also seems to be an expectation in CBT that rewarding yourself for making an effort to should be equivalent to reaching the goal. "OK so you still can't function in social settings. Give yourself credit for trying." Well, what good does credit do? I credit myself all the time, but I'm often still painfully lonely.
It's like telling a starving man to pat himself on the back for going all out to find food even if he never finds any and ends up still starving. Self-congratulation cannot fill an empty stomach and nourish the body. Nor can it fill a social void and nourish the heart.
poster:Iansf
thread:300957
URL: http://www.dr-bob.org/babble/20040114/msgs/301636.html