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Re: Positive experiences with cognitive therapy » Mark H.

Posted by MattDDS on July 9, 2002, at 22:58:37

In reply to Re: Positive experiences with cognitive therapy, posted by Mark H. on July 9, 2002, at 16:17:43

Hi Mark,

Wow! I really enjoyed reading your well articulated post on how CBT has benefitted you.
It helps to know that other people have been helped as much as I have by this.

What you said about anger was really interesting. You mentioned that you would tell
yourself that people 'should' do this or that. It is easy to see how these thoughts
and beliefs would lead to the corresponding behavior you described (e.g. road rage, etc.).
Amazing how subtle shifts in attitude lead to profound changes in mood and behavior!

I think I can relate to your situation during the acute depression. During those times
it is indeed quite difficult to muster up the motivation necessary to complete the CBT
exercises. You are quite fortunate to have responded well to an antidepressant. I think
I probably tried around the same number of medications, but I did not have any luck with
any of them. I should say, however, that benzodiazepines were quite helpful during the
worst parts, as anxiety is probably an even bigger problem for me than depression.

I also had a lot of physical manifestations. I had pseudo-neurological symptoms (my right
arm felt subjectively weak and tingly), high cortisol and catecholamines, and a constant
feeling of malaise. However, I think that everyone has some 'breakthrough' days, even
when severely depressed. I used these days to work hard on the CBT exercises, and built
some momentum. I used the behavioral techniques to prevent my life from falling apart.

You hit it right on the head with what you said about being 'right'. This was a huge
realization for me. I used to have thoughts like "with all the bad things happening,
how can I possibly be happy, life sucks!". This has some truth to it. There *are* a
lot of bad things that happen. One day I decided to do a cost-benefit analysis of this
belief. I had the following realization: It is neither appropriate nor beneficial for
me to allow [X bad event] to keep me from being happy. Better yet, this is an irresponsible
and sadistic way to treat myself!

You asked about which techniques I used. Are you familiar with David Burns' work? I got
a lot of techniques from his books, Feeling Good, and the Feeling Good Handbook. I used
the daily mood log every night, for at least 1/2 hr. I would identify the thoughts that
most bothered me or would recur and apply lots of different techniques on them. I used
the semantic method, the socratic method, thinking shades of gray, the downward arrow
technique among others.

I also suffered from panic attacks, and did exposure exercises for this. This entailed
inducing physical arousal by drinking a lot of caffeine! There are lots of other things
you can do, such as hyperventilating, running up stairs and staring into a mirror to
induce derealization. This sounds crazy, but I really wanted to face up to these
attacks. I have not had a panic attack since! I still get the symptoms of arousal, but
now it does not escalate to full blown panic as it used to. Basically I stopped running
away from them and the fear went away! Educating myself about panic helped too, serving
to demystify the symptoms and realize that they are harmless. Now I say, BRING IT ON!!!

In sum, you get out of CBT what you put in. That is what I like so much about it. I
recently read a scientific study that showed large causal effects of completing CBT
homework assignments on recovery from depression. This is exciting to me, and parallels
my own experience.

Take care,

Matt


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