Depression and what it's really like

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Late Great, if CBT works for you, go forth and enjoy CBT. But please, just stop trying to tell me why it's my fault it didn't work for me. It isn't. The end.

My current therapist is great! I have NO IDEA if she would work for Spacecadet, or indeed, for anyone else. Person is not currently available on the NHS, though, and I'm bankrupting myself to continue seeing her, because I (and my loved ones) have noted that something seems to be working, and I do indeed seem to be operating more easily in the world.

Person practices a mix of Jungian analysis and Existential therapy and "whatever the hell I keep my eye out for, that I know will Branwell will probably respond to, because I've got to know person really well."

Person listens to what per clients need, and responds to what they tell per, and tailors therapy to what the client responds to best. Person sometimes even asks me "What was that book, or website that you mentioned, because I'm going to recommend that to another client, it sounds like what they need right now." Person listens to, and responds to, and works with per clients, and together, we come up with what the therapy is going to be, and what actions I am going to take in the next week. Person has taught me that I know myself better than any of the people around me, and I'm the only person who can work out how to fix me. *I* am the only person that gets to define my narrative. CBT and the whole "THIS MUST WORK ON YOU OR GTFO" was just one more external narrative that other people imposed on me. How the fuck was that ever going to work, for a person like me?

The irony is, I've spent much of the past decade going "Therapy is worse than useless, therapists are useless charlatans, don't waste your time or your energy" and I certainly understand why people are projecting that narrative onto me still. But my current therapist is the first therapist I have *ever* had (and I've had shrinks of one kind or another since 1982) who has made me go "Therapy is great! Therapy is so amazing and life-changing and everybody I know should get therapy!" I am now 100% therapy-positive, because of this person, and their *bothering* to try to find something that works for me, instead of just imposing one more narrative on me, whether that's CBT or whatever.

Keep looking till you find what *you* need, Spacecadet. It might not be "comfortable" but it will feel *right*.

Branwell Bell, Wednesday, 8 January 2014 21:25 (ten years ago) link

Medication worked for me. Therapy did not work for me without the medication. It was like conversations with my mom when I was a teenager.

sarahell, Wednesday, 8 January 2014 21:28 (ten years ago) link

xp i'm not talking about *you* bb, i'm talking about CBT. i never said it was your fault it wasn't working for you.

the late great, Wednesday, 8 January 2014 21:28 (ten years ago) link

i do think it would be a shame if you scared anybody away from the most clinically effective treatment for depression

the late great, Wednesday, 8 January 2014 21:30 (ten years ago) link

I think it would be a shame if anyone else was scared it was their own fault if this magic therapy didn't work for them. Good to hear both sides.

kinder, Wednesday, 8 January 2014 21:32 (ten years ago) link

Now that my brain feels more "normal" -- those teenage conversations with mom make sense and seem relevant. Am I just rambling to myself?

sarahell, Wednesday, 8 January 2014 21:32 (ten years ago) link

Kinder OTM.

Branwell Bell, Wednesday, 8 January 2014 21:34 (ten years ago) link

but it's not a "magic therapy". it's a hell of a lot of work, kind of like a diet + exercise regimen for the brain and lifestyle. so if it's not working, there is a good chance it IS down to you, though i would hate to use such a loaded term as "fault".

the late great, Wednesday, 8 January 2014 21:35 (ten years ago) link

BB, Existential Therapy is a close relative to CBT ... cognitive therapy was born in large part out of existential philosophy (at least Albert Ellis and his REBT are). so if that's working for you then there has to be some parts of CBT that'd be cool by you, depending on what type of CBT you've done. there are lots of kinds ... Aaron Beck/David Burns (which seems to be the most popular), Albert Ellis' REBT (which I think is the most interesting, and has more of the existential elements to it), etc. plus you have different therapists and what they bring to it, etc. CBT just isn't one method, it's a huge field with lots of different types of practices, people involved, etc.

Spectrum, Wednesday, 8 January 2014 21:37 (ten years ago) link

kind of like a diet + exercise regimen for the brain and lifestyle

I think that's a good analogy.

sarahell, Wednesday, 8 January 2014 21:38 (ten years ago) link

Maybe you could work some of your CBT thinking on why you keep turning my "If it works for you, fantastic! If it doesn't work for you, it's not necessarily your fault" into "scaring people away from the best therapy" - that might be a start. The moment you compare things to "diet & exercise regimes" you have to "work real hard at" - which HEY YOU KNOW WHAT DON'T WORK FOR EVERYONE EITHER - you have lost my attention. Now good day, to you, sir.

Branwell Bell, Wednesday, 8 January 2014 21:39 (ten years ago) link

yo i wasn't even talking to you i was talking to kinder

the late great, Wednesday, 8 January 2014 21:40 (ten years ago) link

eh I have some mental blocks against putting the effort in, but there are definitely aspects of CBT I think may be promising (also some I find kind of shallow and unconvincing or just impossible though)

plus I've also had non-CBT counselling, just talking and no homework, and got nowhere too. Actually those were strangely frustrating to me, cz even though in CBT I feel like I'm enjoying the play-acting thing and being listened to more than actually working out steps to solutions, without that pretence it was like, why am I here at all?

What are the current CBT alternatives? Mindfulness is kind of in vogue I guess. I've heard of DBT for borderline personality disorder - I don't think I'm borderline but I def. have some abandonment/splitting/anger issues so maybe the techniques could be helpful. Haven't heard of Existential psychotherapy as mentioned by BB, will look into that now.

not a player-hater i just hate a lot (a passing spacecadet), Wednesday, 8 January 2014 21:40 (ten years ago) link

so which parts do you find shallow and unconvincing?

the late great, Wednesday, 8 January 2014 21:45 (ten years ago) link

my therapist does a combination of CBT and psychodynamic therapy, psychodynamic therapy might be something to look in to. it's basically a lot of "hmm, based on what you're saying to me to sounds like you do X when you feel Y because Z happened to you in your past and you never got over it". i find it useful.

the late great, Wednesday, 8 January 2014 21:50 (ten years ago) link

Spacecadet, it's totally worth investigating and checking out many different flavours, and reading up on them, and feeling through which one instinctively feels right, and which one smells "omg no, this is bullshit."

Because the best therapist is really someone who will work with you, and is willing to mix and match the bits that you find helpful, rather than - and I'm going by the NHS dudes I had here - someone who turns up with a workbook and photocopied worksheets that you will take home and do, because that is what the NHS has recommended, regardless of whether it has anything to do with you. I mean, hey, if you enjoy worksheets, by all means, do more worksheets. But I just found the expectation of "This is the book, you have to do it page by page, whether or not it is relevant" was just so... no. Effort is necessary, but effort directed in the wrong direction will not move the heavy object, it will just break your leg.

But I really do believe that it is the therapist as much as the therapy. A lot of people really resist that idea, because it's not Scientific!!!!11. Science and Medicine should just *work*, regardless of who it is administering the cure. And mind-brain stuff is... it's just different. It really does matter who administers the cure, and whether *you* feel listened to is hugely Urgent and Key.

Branwell Bell, Wednesday, 8 January 2014 21:58 (ten years ago) link

xp I know I'm lucky here but I don't have any particularly traumatic childhood events to blame for my feelings. Wonder if my therapist does that too because she accidentally gave me the wrong 5-column thought record today before noticing and getting the right one, and column 5 in the other one was something about "past event this reminds me of: who said this to me? when?"

I uh... I just find the "what other ways are there to look at things?" bits awkward, because the blurb I was given said it wouldn't help if you didn't believe them. Well, I can make up other explanations for things all day, but no, I don't believe any of them. Things like that.

(this is kind of vague, there are other things too but tbh we haven't been doing much CBTing for the past month, partly because of the holidays and partly because I guess I was starting to flake and she was going easy on me)

not a player-hater i just hate a lot (a passing spacecadet), Wednesday, 8 January 2014 22:00 (ten years ago) link

yeah i always struggled with that too ... it's easy for me to come up with positive affirmations but i find it hard to internalize them.

it has gotten easier over time ...

the late great, Wednesday, 8 January 2014 22:07 (ten years ago) link

aps don't have anything but i hope you find whatever method is out there to help you

lj. 'hoover' egads (darraghmac), Wednesday, 8 January 2014 22:09 (ten years ago) link

xp

that's where the habit and repetition comes in, no? part of why i mistrusted the idea of CBT was because i cdn't see the route to internalization but now i feel like worrying about how stuff happens is counterproductive, for me.

Emilia Fabbo (Noodle Vague), Wednesday, 8 January 2014 22:11 (ten years ago) link

which is perfectly sensical if you believe that you didn't acquire your self-destructive thinking habits in a couple of days

Emilia Fabbo (Noodle Vague), Wednesday, 8 January 2014 22:12 (ten years ago) link

otm

the late great, Wednesday, 8 January 2014 22:15 (ten years ago) link

TS: therapists that tell you to pull yourself together vs. therapists that tell you to accept yourself as you are.

mohel hell (Bob Six), Wednesday, 8 January 2014 22:26 (ten years ago) link

accept who you want to be and work toward it imo

mh, Wednesday, 8 January 2014 22:42 (ten years ago) link

I'm going back to therapy starting this saturday and I am going to try to take the CBT exercises really seriously this time. I think tangibly changing my habits would be empowering, and is necessary for me to actually accept myself.

tɹi.ʃɪp (Treeship), Thursday, 9 January 2014 02:40 (ten years ago) link

Thanks for this conversation. It's been really helpful for me, both in terms of solidifying my understanding of why CBT didn't work for me, and also the basis of my mistrust of the use of it as an NHS panacea.

Any time a person, or a method starts disregarding the variety of human beings, and starts insisting "This method will work for everyone, if the method doesn't work, it is the fault of the person not working hard enough, not the fault of the method" - that is not science, that is cult-like thinking.

And that analogy - it's like a diet and exercise regime - that was the moment that the realisation snapped into my head. I have heard this *exact* argument before. Many, many times. "Diet and exercise regimes work for everyone, and if you are not losing weight, you're just not working hard enough!" Thank goodness there are movements like HAES and Body Acceptance that have said, quietly compared to prevailing culture, but often enough for the message to reach me: "that is bullshit." It's empowering to stop blaming myself for failure which is not my fault, and look for something that just helps me be more healthy.

Even in the realm of more physical medicine, after the advent of "wonder drugs" which really did save the lives of billions of people, penicillin and the like, there was the slow realisation that 1) some people (including myself) have penicillin allergies, and the drugs will harm them more than help them and 2) that there are such things as penicillin-resistant strains of disease.

I'm putting CBT firmly into the category of "penicillin" - works great for many people, not so great for others. But I'm putting people who continue to advocate CBT as the "best treatment" in the face of the many people it does not help, into the realm of "dangerous, cult-like thinkers" to be avoided the same way I avoid the "OMG death-fatties" crowd.

Branwell Bell, Thursday, 9 January 2014 10:48 (ten years ago) link

Thanks for the reassurances upthread BB. :)

poor fishless bastard (Zora), Thursday, 9 January 2014 11:08 (ten years ago) link

I agree with BB, but also see how people who think they are benefiting from CBT would get defensive at the suggestion that it's not 100% effective for 100% of people. Having faith in whatever therapeutic model you are using is probably an important factor in whether or not that model is effective. This connects to a larger issue I have where I think my skepticism -- or "objectivity" -- about things can be self-defeating. To get results in anything, I am slowly realizing, you have to look down and follow some sort of plan while blocking out distractions and uncertainties. This is hard for me, and I don't even find it appealing as a personality trait or whatever, but I think it's necessary sometimes, and a thing CBT tries to help people do with its emphasis on "productive" rather than "open-ended, infinitely regressive" thinking. People who are fitness fanatics, or really defensive about whatever habits they've cultivated, are probably just scared of looking up, recognizing they don't know everything, and losing the motivation to keep doing the thing that's working for them.

tɹi.ʃɪp (Treeship), Thursday, 9 January 2014 17:59 (ten years ago) link

I'm not excusing people who have close minded, prescriptive attitudes about mental health and certainly not excusing the NHS, obviously. Again, BB otm, and people should learn to separate what's best for them from what's best for other people.

tɹi.ʃɪp (Treeship), Thursday, 9 January 2014 18:06 (ten years ago) link

wtf is this talk about fitness fanatics?

the late great, Thursday, 9 January 2014 18:11 (ten years ago) link

doing a thing you find helpful is great and it makes sense you'd be a believer and evangelist for it, but it's not everyone's path

is wtf this talk is about, i think.

yeah okay but i've hardly been an evangelist for it, nor have i tried to push it on anybody

the late great, Thursday, 9 January 2014 18:21 (ten years ago) link

Talking like people who decide to follow a regimen are blinkered, self-deluding cultists is a pretty high level of condescending, we could probably have more or less the same conversation by allowing that sometimes you have to focus your efforts in order to fulfill your expectations for a thing.

Horreur! What are this disassociated lumps of (in orbit), Thursday, 9 January 2014 18:24 (ten years ago) link

fair point!

I never said that people who decide to follow a regimen are blinkered self-deluding cultists.

I said that people who decide that *their* regimen is the *only* answer, and is applicable to everyone, regardless of other people's self-reported evidence that it is not, are blinkered self-deluding cultists.

If no one in the thread has said the latter, then we do not have an argument on this thread. But both of these things have been said to me, in many contexts, and I do not find it a stretch to equate the two attitudes.

And condescension is in the eye of the beholder. I mean that in many different senses, all of them applicable.

Branwell Bell, Friday, 10 January 2014 10:32 (ten years ago) link

Are you taking an ilx break or not taking an ilx break, BB?

quincie, Friday, 10 January 2014 12:15 (ten years ago) link

I took a break from ILX last night, because I had just come from a difficult therapy session. It was good to take time and rethink and get a clear head for the evening. Sorry if you didn't catch that.

Branwell Bell, Friday, 10 January 2014 12:17 (ten years ago) link

spost I mean duh clearly not, but when people say they are going to go away in an effort to support their mental health, and then do not, well. . . oh well never mind what CBT may have to say about that, right?

quincie, Friday, 10 January 2014 12:18 (ten years ago) link

Here's the thing: I have long valued this thread for its honest insights as to what it is like to suffer from depression; from its sincere support for those who are suffering; and for providing a thoughtful place to consider all of the issues surrounding depression.

Your heavy-handed, bull-in-china-shop presence here is not one I, for one, find valuable.

quincie, Friday, 10 January 2014 12:27 (ten years ago) link

Thanks for your opinion. I will not comment on whether I find it valuable.

Branwell Bell, Friday, 10 January 2014 12:43 (ten years ago) link

If you don't find it valuable, than stfu. If you do, try to be respectful of others.

quincie, Friday, 10 January 2014 14:16 (ten years ago) link

*then*

quincie, Friday, 10 January 2014 14:17 (ten years ago) link

"STFU"

"respectful."

Wow. Just... wow. Good day to you, Quincie.

Branwell Bell, Friday, 10 January 2014 14:40 (ten years ago) link

I'm not sure if I'm just drunk, or if you're being kind of an ass, quincie. Either way, everyone else on this thread without this horrible arguing.

badgers moved the goalposts (dowd), Friday, 10 January 2014 18:57 (ten years ago) link

say what?

the late great, Friday, 10 January 2014 18:58 (ten years ago) link

"everyone else on this thread *feels terrible enough* without this horrible arguing"

badgers moved the goalposts (dowd), Friday, 10 January 2014 18:59 (ten years ago) link

ah, true

the late great, Friday, 10 January 2014 19:00 (ten years ago) link

surely depression is one of the foulest demons ever to crawl into a human !!

Brian Eno's Mother (Latham Green), Friday, 10 January 2014 21:02 (ten years ago) link

https://www.youtube.com/watch?v=XU1MAokrrUk

j., Friday, 10 January 2014 23:55 (ten years ago) link


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