Any CBT therapists help me understand something?

[Small Clone]

Hi,

I am a learning how to manage my OCD, I have had some very good therapy and have been largely able to get myself to a position where I have a good quality of life. That was however before I watched a video on the internet by an OCD expert and CBT therapist - which has made me halt in my progress.

Basically it is surrounding a small excerpt - of which I have no idea of what he is saying and it has raised massive doubt and anxiety in me to the point where the things I am thinking about are causing me much distress.

I know that deep at the heart of this OCD is at play however I just don't understand what this statement means (or I do, it's just my OCD is pulling me in a doubting direction).

Trust me to say that what I fear it might be saying I can't imagine any therapist in the world would say!

I am no longer in touch with my original therapist so what I am asking is if any CBT therapist out there would consider via personal message or email trying to help me understand what it is saying so that I can get on with the CBT that was helping me so much before...

Many thanks for reading this.

Regards

SC

 

[Daniel E.]

I'm not a therapist, but in my experience having OCD, it seems safe to agree with you on this point:

I know that deep at the heart of this OCD is at play

On a possibly related note:
http://forum.psychlinks.ca/obsessiv...lest-obsession-obsessing-about-obsessing.html

 

[David Baxter PhD]

Which video did you watch and which part worried you?

 

[Small Clone]

Thanks David - I will collect my thoughts as I am a bit of an OCD style panic over this, I want to put my concern, interpretation and where I think I am thinking irrationally about this over as I am so worried someone is going to confirm that which I am fearing.

Would you prefer me to post here or put it in Personal Message, I am worried to post this as I would not want anyone else who has OCD to think along the same lines as I am.

I really appreciate you taking the time to help me, I cannot tell you the depths of despair that I have felt over this, if you can help you will be doing me a huge favor.

 

[cbtish]

It looks like you answered this yourself in a previous thread when you wrote: "I think I need to go see a respected psychologist about this..."

The CBT you have had seems to have failed. Instead of working with your core beliefs and fixing the root cause of your problems once and for all, you are still having to manage your problems on a day-to-day basis. CBT is intended to be a therapy, not a way of life.

 

[Small Clone]

cbtish,

Thanks for your comment, but I am afraid you are not correct. The CBT therapy worked wonders for me, I have been free of H-OCD and P-OCD for about 8 months due to the wonderful dedication of my therapist and the hard work that I had put in, and by the way I still am on top of these...

After getting an understand of my OCD and learning how to manage it I turned on to wanting to improve my life. I then subsequently stumbled over a video that has made me fear something, basically I feel it is telling me that I am not allowed or shouldn't do something. That is nothing to do with my previous CBT but is a reaction to something that has put fear into me - and I think that I have misinterpreted it, that is where the OCD has kicked in on this for me as I have been remunerating about it.

I feel if someone could help me understand this video or confirm that what I suspect it actually means it does, I feel I could move on with my life again and pick up the bits of CBT that had up until I got a large doubt about this. I know where you are coming from as I have let OCD creep into this but I don't see it is failure of my CBT, just part of the learning curve of OCD.

Thanks

SC

 

[Meg]

I agree that it isn't a failure of CBT. In therapy you get to spend time learning how to apply specific strategies that help you change your thinking patterns. While these strategies are generalisable to other unhelpful thinking patterns not necessarily targeted in therapy, sometimes it takes a bit of practise to get used to a 'new' worry. The key here, it seems to me, is to get back to your CBT basics. If you need some help to do this at first, that's ok.

 

[Small Clone]

I agree that it isn't a failure of CBT. In therapy you get to spend time learning how to apply specific strategies that help you change your thinking patterns. While these strategies are generalisable to other unhelpful thinking patterns not necessarily targeted in therapy, sometimes it takes a bit of practise to get used to a 'new' worry. The key here, it seems to me, is to get back to your CBT basics. If you need some help to do this at first, that's ok.

Meg spot on,

I think sometimes people get a reaction, that something had failed when really all they are experiencing is a set back.... that is what this is. If you had seen how many times in my CBT I failed (my CBT was not massively lengthy by the way), it would have been easy to give up, but I learnt from these times and it got me to the position where I am now, basically in control of the OCD elements that plagued me before, but up against something that has caused me anxiety.

Basically I can akin my current situation to this, I play guitar - if I had made a decision that I would follow this route to becoming a better guitar player really passionately believed that I was right, felt there was enough evidence that it would be the right thing to do, invested so much into etc then I watched a Video by a guitar expert that said - if you follow that way you'll be resigned to be a rubbish guitar player.... Even thought I knew either he was wrong or that I had misunderstood, that would cause most people some upset, and that is guitar playing not mental health. Now I feel I am in the same situation with an OCD video, and it really is getting in the way!

Meg, I can so see the CBT way of thinking myself out of this current problem, however it has got latched and is feeding to OCD levels.... I don't think it's wrong to ask for help on this either...

Thanks

 

[David Baxter PhD]

Thanks David - I will collect my thoughts as I am a bit of an OCD style panic over this, I want to put my concern, interpretation and where I think I am thinking irrationally about this over as I am so worried someone is going to confirm that which I am fearing.

Would you prefer me to post here or put it in Personal Message, I am worried to post this as I would not want anyone else who has OCD to think along the same lines as I am.

I really appreciate you taking the time to help me, I cannot tell you the depths of despair that I have felt over this, if you can help you will be doing me a huge favor.

I would suggest that you post it here. It can always be edited for content if necessary and what you post may be helpful for other members too.

 

[David Baxter PhD]

The CBT you have had seems to have failed. Instead of working with your core beliefs and fixing the root cause of your problems once and for all, you are still having to manage your problems on a day-to-day basis. CBT is intended to be a therapy, not a way of life.

Actually, one could argue that it's intended to be a way of life, a skill one learns not only to deal with a current crisis but to practice and apply to future situations.

 

[Small Clone]

By the way just to clarify I am not asking for help with a Guitar Video, in case anyone misunderstood me!

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I would suggest that you post it here. It can always be edited for content if necessary and what you post may be helpful for other members too.

Thanks David, I shall post it later as it important to me and I want to get it right.

Actually, one could argue that it's intended to be a way of life, a skill one learns not only to deal with a current crisis but to practice and apply to future situations.

I agree, CBT most of the time is just common sense thinking, identifying where you are being irrational and adjusting. I think if people view it like a rule book, or being a 'cult' or even a 'religion' that is quite different, CBT is common sense, unfortunately for some OCD suffers not always as common as we'd like.

 

[cbtish]

Actually, one could argue that it's intended to be a way of life, a skill one learns not only to deal with a current crisis but to practice and apply to future situations.

A set of skills that you can apply in future when needed, yes, but that is not the same as a way of life. When someone has to 'manage' symptoms continuously, and when even that breaks down after just months, it strongly suggests to me that the original therapist failed to deal with core beliefs.

What might be happening here is that maladaptive beliefs were causing OCD symptoms. Those symptoms are now being suppressed. So the original unresolved problem is causing a new set of symptoms. In my opinion this should be assessed by an experienced clinician, just as Small Clone suggested in that other thread.

 

[David Baxter PhD]

In my experience, everyone, repeat everyone with OCD has to manage those symptoms continuously. OCD flares up during times of stress and subsides when life is fairly stable, calm, and predictable but it is always there as a background. In part, this is because it's part of the personality structure. In part, it's because of the physiological-neurochemical basis of OCD. And in part, it's characteristic of all anxiety-based disorders.

Frankly, cbtish, I think your analysis is overly simplistic and unhelpful.

 

[Small Clone]

A set of skills that you can apply in future when needed, yes, but that is not the same as a way of life. When someone has to 'manage' symptoms continuously, and when even that breaks down after just months, it strongly suggests to me that the original therapist failed to deal with core beliefs.

What might be happening here is that maladaptive beliefs were causing OCD symptoms. Those symptoms are now being suppressed. So the original unresolved problem is causing a new set of symptoms. In my opinion this should be assessed by an experienced clinician, just as Small Clone suggested in that other thread.

cbtish, thanks again but I feel you are still not right.

I don't need to be assessed (again) by anyone I have been through all of that and I got better, 8 months without H and P-OCD is testament to that. You are right this is a maladaptive belief, that had been identified by myself and by my therapist, one in which I had trouble seeing the irrationality of what I am 'allowed' to do or think, this had been treated and I have had massive sucess with this - however this video has triggered this again, and as the video is by someone who is highly regarded in the treatment of OCD, I have attatched fear to it, to the point where it has developed into anxiety.

Unfortunately when you have OCD you have to be mindful of it coming back from time to time, just because it does doesn't mean that it has either failed or you need to get reassessed - it just means another opportunity to but CBT into practice and to gain a little more understanding about your condition, thats they way I like to look at it.

I will be post my concern later, still working on it.

Thanks

SC

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First of all,

Thank you for taking the time to read this. David I want to thank you for taking the time to look at my problem. And sorry that this is quite a long post.

Well here goes...

Difficult typing this as on one hand I know how bizarre this sounds on the other I?m racked with terror that what I fear will be actually told is true.

Well it is around a video I watched by a well thought of therapist Dr Stephen Philipson, the Video can be found on his website, I advise anyone with OCD that on one hand the video is really helpful, however on the other I found one passage alarming?

This is how the passage goes

One of my clients yesterday said to me ?I know why I am a Pure-O I know why I?m an OCD it?s because I have never liked myself? and she said that if she liked herself then her obsessive thoughts about am I a person of my age equal to all other people my age or am I less; that obsessive question if she felt like she liked herself then she would never have to worry about whether she was ok or a failure or better than anyone else, and I suggested to her that 99% of the population doesn?t like themselves so that?s not necessarily where it comes from. But if you fool around with the concept of self worth if you decide to dabble in the idea that maybe you can one day like yourself as an obsessional thinker you set yourself up to maintain the problem. I would propose to you that any effort whether it be obsessional or self-esteem to improve your adequacy to improve your self like sets you up for a never ending life of esteem misery or worthlessness, but that?s a whole another lecture.

After watching this and listening to those words I got massively alarmed?. To the point where I have spent nights awake worrying about this, tried to do research on the internet to find out if my fears were true.

Basically I am thinking that he is telling me that liking yourself is wrong, or trying to change you thinking and feeling better about your life is wrong, I don?t have massive low self-esteem but I want to fell better about myself, to feel that I am valid to take some of the negative thinking that I have about myself and in CBT practice, change it to support my life. So much of the CBT I did was changing negative perception and thought patterns

For example

If I was sitting on a bus and the seat next to me was free and an attractive girl, walked past it I would say to myself ?there is conclusive proof that you are ugly and a bit of a freak?, through CBT I changed that to just thinking ?People tend not to sit next to each other if there are free seats etc, it has no meaning at all ? she probably has even seen you anyway? etc etc.

Or

If someone criticised my opinion or said that my idea was wrong or not workable I would think ?There you go proof that you are worthless? through CBT I adapted this to think ?Not everyone can agree on everything, just because someone does like your suggestion doesn?t mean it?s wrong or not valid and it certainly doesn?t mean that you are invalid?

Part of what I found on the internet were books called ?The Myth of Self-Esteem? and videos on Youtube called ?The Sickness of Self-Esteem? and this didn?t help, then it dawned on me ? all the people writing these Books and producing these Videos were linked to the teachings of Albert Ellis, who founded REBT if I am correct, who didn?t like the term Self-esteem, as I think he thought that it meant Trying to make yourself feel better by raising your accomplishments and the way others view you, and the preferred term in REBT and CBT for that matter is self-acceptance, seeing yourself as worthwhile because you are human and unconditionally. The trouble was that my idea (and a lot of peoples I imagine) of Self-Esteem, was actually the same as Self-Acceptance, it was just a matter of semantics, so you can see why seeing a video called the ?sickness? and a book entitles ?myth? of self-esteem I panicked an thought that I couldn?t ever feel better about myself due to not being allowed to self esteem. I should point out now that this ?allow? term is central to some of the negative core beliefs I held and through CBT I have found ways to tackle this as the irrational thought process that I had been going through. At points my head was like a dictator telling me what I was and wasn?t allowed to do, this my CBT therapist helped me out with and stayed pretty much dormant until I saw that video.

Now I think that as Dr Philipson is a CBT therapist who has probably studied Alert Ellis etc that what he is referring to in this video is that process, where if you keep challenging yourself, am I worthwhile in comparison to this person, have I achieved enough etc etc?. then I agree, that is a dangerous path, one which I do not want to go down, but I do want to feel better about myself not by comparing myself with others but by caring about myself, being kind to myself loving myself basically . What is the point of therapy or treatment if you can?t feel better about yourself? But I have latched on him saying that

But if you fool around with the concept of self worth if you decide to dabble in the idea that maybe you can one day like yourself as an obsessional thinker you set yourself up to maintain the problem

That as I?m an obsessional thinker I can never try to change my feelings about myself, never change the negative thought processes that have kept me chained before, I?m not allowed to raise my self-esteem (self-acceptance, or whatever you want to term it as) ? I?m not allowed to see myself as positive or if I have feelings that I like myself I am going to end up maintaining my worthlessness.

God I know this sounds bizarre as I am typing this, but I still fearful that someone is going to say ?he is right? you can?t think good things about yourself (how un-CBT would that be!) instead of saying yes your right ?it?s the constant comparing yourself to others, and trying to compete in an obsessional way, trying to value yourself in terms of where you stand with others?

I am confused and I know that it is my own making but surly just because I am an obsessive thinker I am allowed to like myself, and work on liking (accepting) myself ? otherwise what recovery is there?

Thanks again

SC

 

[David Baxter PhD]

Well, first I disagree with the quoted passage. It is possible that he meant it as a caution against unrealistic expectations, since by definition if your self-expectations are unrealistic then it follows that they are probably not achievable and therefore you are setting yourself up for disappointment.

On the other hand, Albert Ellis aside, most psychologists and psychotherapists would agree that there is no doubt that low self-esteem is a very real entity. Efforts to improve your self-esteem are neither misguided nor pathological nor doomed to failure.

They key is indeed to avoid unrealistic comparisons either with other people or with unachievable ideals. The aim, accoprding to Carl Rogers, is to move toward a state where you are not reliant upon comparisons with or feedback from others for your self-esteem and self-concept. Rogers calls this the "organismic valuing process", a characteristic of the "fully functioning person"; basically, it means that you are able to measure yourself against your own realistic goals and self-expectations and to use that self-generated information to determine self-esteem and self-worth.

I'm tired this morning, so I hope this answers your questions rather than confusing the picture further.

 

[Small Clone]

Well, first I disagree with the quoted passage. It is possible that he meant it as a caution against unrealistic expectations, since by definition if your self-expectations are unrealistic then it follows that they are probably not achievable and therefore you are setting yourself up for disappointment.

David just having somebody say they are able to disagree with that who is a therapist is an amazing event for me, I suppose this is elements of my OCD that I tried to 'prove' his (or my interpretation) point - you know work through it. I know what I have done is what I call my OCD trap, I have interacted with the thought, I have fed it, over analyzed it, got myself into an anxious OCD state - then because I am emotional and full of 'feeling' I have associated that these feels must be an indicator that it is true.

I actually didn't agree with it when I heard it as therapy that doesn't address negativity towards the self as a major issue, raising the persons well feeling
about themselves and their confidence so that they can have a normal life is not great. To me how I feel about myself is so important to coping with this condition, and with my previous CBT had been working wonders.

I'm going to get back on the horse.

Thanks for looking at it, maybe at a later date I can pick your brains again. I have looked a lot on this site and I see your name so often - I want to thank you for the time you put into this site for free, you are a very kind and decent man.

Thanks, you have helped!

SC

 

[Charity]

It seems to me (as a NON-therapist!) that like everything else, it's a matter of finding the right balance. It's important to believe in one's own worth and inherent value-- just not to the point where you think you don't need any more improving!

 

[Meg]

I looked up some of these clips on you tube and had a listen to what they said. If I may, I'd like to make a few observations.

Firstly, it doesn't really matter what term you use to refer to the idea that you accept yourself no matter what. Just because Albert Ellis called it 'Self Acceptance' doesn't mean that you can't think of it as self esteem if that's what's helpful to you. His point is not that you should not think well of yourself at all, but that it is best if you can think well of yourself at all times, no matter what. He argues that if you only think well of yourself under a set of rules (e.g. I will only think well of myself when I'm getting on well with my family, when I'm on top of my workload, when my hair looks nice, etc.) you're setting yourself up to feel bad when you're not meeting the rules. He says it's best if you've done something that you're not happy about, it's ok to question and change that behaviour if necessary, but you can still think well of yourself as a person at the same time. You are certainly allowed to feel better about yourself

Secondly, I watched Stephen Phillipson's video (well, up to the point you quoted, anyway!). I, too, had to listen to that part a couple of times, because the first time it just didn't quite compute. I found myself a bit confused by what he was trying to say. Honestly, I wondered if he got a little sidetracked at that point and didn't explain himself well. After giving it some thought I wondered whether perhaps what he was trying to say was that if you're constantly trying to improve your self-esteem instead of liking yourself for who you are right now, you're possibly going to be pursuing a better version of yourself indefinitely and never liking where you're at. That was the conclusion that I arrived at, anyway. So, it's ok to improve yourself and want to like yourself more, but it's best if you're doing it from a position from accepting and liking yourself for who you are at present.

I hope that's not confusing!

 

[Small Clone]

Firstly, it doesn't really matter what term you use to refer to the idea that you accept yourself no matter what. Just because Albert Ellis called it 'Self Acceptance' doesn't mean that you can't think of it as self esteem if that's what's helpful to you. His point is not that you should not think well of yourself at all, but that it is best if you can think well of yourself at all times, no matter what. He argues that if you only think well of yourself under a set of rules (e.g. I will only think well of myself when I'm getting on well with my family, when I'm on top of my workload, when my hair looks nice, etc.) you're setting yourself up to feel bad when you're not meeting the rules.

I totally agree, which is why I thought that it was a little dubious to use the term the 'sickness' of self-esteem when I think that most people would regard feeling good about themselves as 'self-esteem', but I totally agree with the rules bit that is bad, loving yourself should not be conditional, and taking care of yourself (though not being selfish) is a good goal to have

Secondly, I watched Stephen Phillipson's video (well, up to the point you quoted, anyway!). I, too, had to listen to that part a couple of times, because the first time it just didn't quite compute. I found myself a bit confused by what he was trying to say. Honestly, I wondered if he got a little sidetracked at that point and didn't explain himself well. After giving it some thought I wondered whether perhaps what he was trying to say was that if you're constantly trying to improve your self-esteem instead of liking yourself for who you are right now, you're possibly going to be pursuing a better version of yourself indefinitely and never liking where you're at. That was the conclusion that I arrived at, anyway. So, it's ok to improve yourself and want to like yourself more, but it's best if you're doing it from a position from accepting and liking yourself for who you are at present.

I'm glad and not surprised that you had to listen to it a couple of times, I agree I think he was side tracked too. I can't think of anything wrong with trying to improve yourself, just not if you are judging yourself as rubbish and looking to feel better when you get 'there'. If I look at my guitar playing again (sorry but it does help me as it is useful in analogy, my poor thereapist had to put up with me explaining things in terms of guitar, ) I like the way I play, I do wish I could play like Jeff Beck and it is something I hope to achieve one day, however I do not feel bad about not being as good as Jeff (not many are) and certainly am not waiting to 'like' myself only if that moment arrives. However I do try to improve most days, some days I just enjoy where I am with it, a think how much better I am now, compared to a few years back.

Sorry Guitar and Jeff Beck, scribbling over.

Thanks Meg and thanks again David - I though I was going potty at one point on this.

SC

 

[Meg]

I think it's actually a good analogy!