Posted by Ilene on September 15, 2004, at 20:06:25
In reply to Re: CBT or DBT?, posted by alexandra_k on September 15, 2004, at 19:33:41
> Invalidating. For people with an invalidating childhood CBT can be experienced as invalidating with its focus on 'if you change the way you think it will change the way you feel'. It may seem as though the message is that you are creating your own distress - and should just snap out of it. But with an invalidating childhood some people (the emotionally intense / sensitive ones) never learn how to regulate intense negative emotional states. Linehan considers it is like telling a person with no legs to get up and walk without providing crutches for her to walk on. The skills training is supposed to teach you HOW to regulate the distress in a doing way instead of focusing on rational refutation of faulty cognitions.
>Aha! Lightbulb clicks on!
> Yup. CBT focuses on a thoughts -> feelings -> behaviours model. The notion is that if you change your thoughts, this will result in a change in emotional state. There is some truth to that with respect to thoughts refiring emotions etc. But sometimes because of our physiology (both genetic and the way it matured via environmental influence) we get a state of intense physiological arousal - which tends to be experienced / interpreted as distressing. In that kind of case the negative emotion comes first and the 'faulty cognitions' are employed retrospectively as we attempt to rationally justify our distress to clinicians who insist on such a rational justification (before berating you for having faulty cognitions).
>I suppose there are people who react to the world differently than I do. There is a strong genetic component to my depression--at least half the members of my family on my mother's side have (or had) a psychiatric disorder, ranging from anxiety to personality disorder.
> When I did CBT I would get annoyed and would feel very misunderstood. I KNOW my emotions are irrational. I KNOW that if you insist that I attempt to rationally justify them then I will either misrepresent the world in an attempt to legitimate them or I will say something illogical. Then when I do this your eyes light up and you berate me for being irrational and causing my own distress. Thats where DBT can get around some of these problems with CBT that some people experience.
>It seems the height of rudeness to insist that a person's emotions be rational. Emotion is the opposite of rationality.
> > I don't know if I can change my mind. It makes sense that I could.
>
> Ok. My thought on that was that if DBT is being run as preached by Linehan then you would need to sign a contract to stay in therapy, work on the treatment hierarchy, go to group etc for x amount of time. Sure you can pike wheneva you like, but then if you change your mind back again you may be stood down from doing it again for a year.
>
>That could be. I don't know. The pdoc didn't promote psychotherapy too hard, outside of saying all their therapists were equally good (I bet they're all good-looking, too). So far she's let me push her around, but my basic suggestion (higher dose of meds) has made sense. At least I think so.
The other issue is whether the type of therapy really matters. From what I've read the therapist makes more of a difference.
poster:Ilene
thread:391101
URL: http://www.dr-bob.org/babble/psycho/20040911/msgs/391251.html