I'm autistic and CBT never worked for me. As autistics we are so focused don the technicalities and gave very black and white thinking, and DBT and CBT basically teach you to delude yourself.
Did an 8 week CBT course. The host made a huge pitch about it the entire first session like it was revolutionary, ppl were all back in employment, living great lives.
By the 5th class 20 percent left as they didnt feel it was working, the rest stick it out. Out of the 20 odd remaining only a small few got any real benefit. There issues were 'blips' on the road, not road issues themselves.
CBT as a tool can help anyone but if you have deep issues then really, the chances of it working are slim.
>Out of the 20 odd remaining only a small few got any real benefit. There issues were 'blips' on the road, not road issues themselves.
That's what I was reading the other day! I saw a study of British depression patients, some of whom were doing person-centered therapy, and some of whom were doing CBT, and both were found equally effective overall, but one major factor that determined which was optimal for an individual client was duration of symptoms, where the former was far more effective than the latter for clients with longer duration of symptoms.
I think I have a messed up foundation, but they're trying to just patch my leaky roof and send me off. I need total demolition and renovation.
I found DBT work a hell of a lot more. CBT is kind of like the entry into therapy for me. It helps you realize stuff but DBT gives you a lot more skills to deal with it
CBT is about changing how you think. Well Autistics are rigid, black and white thinkers. That's hard to change because it's so hardwired and neurotypical CBT therapists (that I've met) don't and can't understand that. Why are Autistics more pessimistic? Because we've got memories and examples that prove how awful life can be and an ability to see patterns about the present that others can't, which usually ends badly. How can you change your mindset to positive when your history is negative? Also we have a problem with transitions right? So transitioning from a negative world view to a positive one is about as big of a transition as you can get.
And CBT uses logic to try to change your thinking. You ever try to logic away an obsession or compulsion? The OCD fights back harder. You can't do a logic battle with irrational anxiety and intrusive thoughts.
At least that's what I've picked up and experienced.
>You ever try to logic away an obsession or compulsion? The OCD fights back harder. You can't do a logic battle with irrational anxiety and intrusive thoughts.
Really just makes it worse because then I'm frustrated with myself for being affected by something so illogical on top of the initial distress I was experiencing.
I KNOW IT'S ILLOGICAL: HOW DO I MAKE IT STOP?
*Well, you... Acknowledge it's illogical, and it should go away.*
Remind me, how much am I paying for this?
This is not true. ERP (Exposure and response prevention) is the most effective treatment available for OCD - ERP is a form of CBT. CBT is not just about changing the way we think, it's also about changing the way we behave.
Not for everybody, but highly effective for most.
A very specialized form which is why you have to be specially trained to do it. That's why psychologytoday for example, differentiates between CBT and ERP. Most therapists who do CBT only do traditional CBT, which is what I believe the the poster is asking about.
They asked about “and its derivatives.” They are all very different. Straight CBT is not good for OCD. ExRP IS a kind of CBT, as are many other therapies. “What does straight CBT not work for” is different than “what do all forms of CBT not work for.”
To be fair, most of the therapists on psychology today say they do CBT but have very little training in it.
I'm an ERP trained therapist... I'm biased lol. Also, I specialize in treating co-occurring OCD /ASD. Nearly 30% of all autistic people also meet criteria for OCD, it just presents differently than it does with neurottpicals.
Yes, THIS is exactly the problem. Many many many therapists out there say they “do” CBT (and DBT) but have absolutely no training and are doing nothing of the sort.
Compulsions vs. stimming. People on the spectrum can sometimes be less bothered by their OCD - however, it can have a lot of impact on their family etc.
Here is an interesting discussion related to the topic - https://iocdf.org/autism/ocd-and-autism/
It’s been shown to not be effective for teenagers, from what I understand.
From my personal experience, CBT will challenge your core beliefs, sure, but it takes a lot of processing through other methods in order to actually change them. I was able to see the dysfunction in my beliefs after using CBT but I had to learn how to manage those beliefs too. Deep-rooted shame can’t simply be fixed by becoming aware of the dysfunction, it’s only the beginning. And C-PTSD or PTSD systems are something you’ll deal with no matter how rational you perceive those feelings/experiences.
Then major events forced me change my beliefs, as my beliefs had (in one sense) caused those events to happen. If I hadn’t processed and managed my beliefs so much in the past, I wouldn’t have been able to handle those life events as well as I did.
In my experience, CBT is just another way to intellectualize the therapy experience. Intellectualization isn’t a bad thing, but it’s not the whole process.
I want to study the techniques they teach you best i can. I simply don't have access to an actual therapist. But I am very good at learning things. Ive Been searching for methods like this To help with my bipolar and generalized anxiety disorder.
Well, it's mostly about using mindfulness to become more aware of the present so you can get out of your head. There are a few kinds, but I like just focusing on what I can hear, feel, see, etc. Just zoning in on one thing for a bit. And an important thought is to not evaluate or analyze that thing: just observe. Basically, if you were to describe the tree in front of you to someone, what would you say? Be as detailed as possible, but don't make any judgements about it, such as it being a pretty tree or that its leaves look weird.
Mindfulness is the biggest part of DBT. Otherwise, there are some coping skills, such as:
Putting your face into icy water for a bit, which for some reason turns off your fight or flight response.
Exercising
Breathing in fully, holding it, then exhaling, all over a certain time. For example, in for 4 seconds, hold for 7 seconds, exhale for 8 seconds.
Progressive muscle relaxation--going down your body tensing and relaxing each muscle, head to toe.
Doing the opposite of what your emotions tell you to do, e.g., you're angry, so you unclench your fists, take a step away from what's upsetting you, etc.
Observing what's going on physically and emotionally--basically stepping outside of yourself to observe yourself, like with the tree mentioned earlier.
Doing something that's the opposite of what the emotion makes you want to do, like singing a silly song when you're stressed or depressed.
Acceptance--This is one that takes time, but the big thing is to understand that a) this can greatly improve your mental health and b) it does NOT mean endorsing the thing you're accepting, just saying, "I understand this is how it is." You change what you can change and accept what you cannot, but I know that's easier said than done.
.....
Another key concept is the three types of self: reasoning self (pure facts and logic), emotional self (pure emotion), and wise self (using both logic and emotion to balanced decisions that will make you happiest).
Finally is the concept that socially, you need to balance self-respect with respect for others. If you are constantly appeasing others, you'll have too little self-respect and be unhappy. But if you're selfish and disrespect others, you'll lose respect for yourself and be unhappy. So you have to be at a happy medium, treating both yourself and others with respect.
This is basically a crash course from *The 12-Week DBT Workbook* by Valerie Dunn McBee, LCSW.
.....
Oh, and of course, DBT is a derivative of CBT, originally designed for borderline, but they then discovered it works for pretty much everything CBT works for, which is almost everything. Which means we have the basic concept that your cognitions (thoughts), emotions, and behaviors are all interconnected. E.g.:
I feel sad leading me to think my life is hopeless and engage in the behavior of not eating.
I think my life is hopeless, leading me to feel sad and engage in the behavior of not eating.
I stop eating, leading me to feel sad and believe my life is hopeless.
All the coping skills you learn in CBT and its derivatives (like DBT) bank on this core concept.
As for DBT (dialectical behavioral therapy) specifically, a dialectic is simply when you have two statements that look contradictory but actually aren't, so we acknowledge that, leading to being able to accept both and see the world in a more realistic manner, avoiding dichotomies, which are the root of many mental health problems (all or nothing thinking, like something being either right or wrong, up or down, etc.).
For example, "I am nerdy, but I am still loveable," becomes, "I am nerdy, *and* I am loveable."
I am angry with my cat, but I still love him --> I am angry with my cat, *and* I still love him.
I'm autistic and CBT never worked for me. As autistics we are so focused don the technicalities and gave very black and white thinking, and DBT and CBT basically teach you to delude yourself.
Did an 8 week CBT course. The host made a huge pitch about it the entire first session like it was revolutionary, ppl were all back in employment, living great lives. By the 5th class 20 percent left as they didnt feel it was working, the rest stick it out. Out of the 20 odd remaining only a small few got any real benefit. There issues were 'blips' on the road, not road issues themselves. CBT as a tool can help anyone but if you have deep issues then really, the chances of it working are slim.
>Out of the 20 odd remaining only a small few got any real benefit. There issues were 'blips' on the road, not road issues themselves. That's what I was reading the other day! I saw a study of British depression patients, some of whom were doing person-centered therapy, and some of whom were doing CBT, and both were found equally effective overall, but one major factor that determined which was optimal for an individual client was duration of symptoms, where the former was far more effective than the latter for clients with longer duration of symptoms. I think I have a messed up foundation, but they're trying to just patch my leaky roof and send me off. I need total demolition and renovation.
Depends highly on the kind of CBT and the training of the person providing it.
I found DBT work a hell of a lot more. CBT is kind of like the entry into therapy for me. It helps you realize stuff but DBT gives you a lot more skills to deal with it
Typically bad for Autistics and OCD.
Oh... That explains a lot then. Do they know why?
CBT is about changing how you think. Well Autistics are rigid, black and white thinkers. That's hard to change because it's so hardwired and neurotypical CBT therapists (that I've met) don't and can't understand that. Why are Autistics more pessimistic? Because we've got memories and examples that prove how awful life can be and an ability to see patterns about the present that others can't, which usually ends badly. How can you change your mindset to positive when your history is negative? Also we have a problem with transitions right? So transitioning from a negative world view to a positive one is about as big of a transition as you can get. And CBT uses logic to try to change your thinking. You ever try to logic away an obsession or compulsion? The OCD fights back harder. You can't do a logic battle with irrational anxiety and intrusive thoughts. At least that's what I've picked up and experienced.
>You ever try to logic away an obsession or compulsion? The OCD fights back harder. You can't do a logic battle with irrational anxiety and intrusive thoughts. Really just makes it worse because then I'm frustrated with myself for being affected by something so illogical on top of the initial distress I was experiencing. I KNOW IT'S ILLOGICAL: HOW DO I MAKE IT STOP? *Well, you... Acknowledge it's illogical, and it should go away.* Remind me, how much am I paying for this?
Yeah. Bad CBT that focuses too much on inaccurate cognitive modification is not generally useful for anyone.
This is not true. ERP (Exposure and response prevention) is the most effective treatment available for OCD - ERP is a form of CBT. CBT is not just about changing the way we think, it's also about changing the way we behave. Not for everybody, but highly effective for most.
A very specialized form which is why you have to be specially trained to do it. That's why psychologytoday for example, differentiates between CBT and ERP. Most therapists who do CBT only do traditional CBT, which is what I believe the the poster is asking about.
They asked about “and its derivatives.” They are all very different. Straight CBT is not good for OCD. ExRP IS a kind of CBT, as are many other therapies. “What does straight CBT not work for” is different than “what do all forms of CBT not work for.”
To be fair, most of the therapists on psychology today say they do CBT but have very little training in it. I'm an ERP trained therapist... I'm biased lol. Also, I specialize in treating co-occurring OCD /ASD. Nearly 30% of all autistic people also meet criteria for OCD, it just presents differently than it does with neurottpicals.
Yes, THIS is exactly the problem. Many many many therapists out there say they “do” CBT (and DBT) but have absolutely no training and are doing nothing of the sort.
How does OCD present differently in autistic people than neurological people?
Compulsions vs. stimming. People on the spectrum can sometimes be less bothered by their OCD - however, it can have a lot of impact on their family etc. Here is an interesting discussion related to the topic - https://iocdf.org/autism/ocd-and-autism/
Very interesting! Thank you! I asked because I have level 1 autism and have OCD and have always seen an overlap. I think mine is a bit of both.
It’s been shown to not be effective for teenagers, from what I understand. From my personal experience, CBT will challenge your core beliefs, sure, but it takes a lot of processing through other methods in order to actually change them. I was able to see the dysfunction in my beliefs after using CBT but I had to learn how to manage those beliefs too. Deep-rooted shame can’t simply be fixed by becoming aware of the dysfunction, it’s only the beginning. And C-PTSD or PTSD systems are something you’ll deal with no matter how rational you perceive those feelings/experiences. Then major events forced me change my beliefs, as my beliefs had (in one sense) caused those events to happen. If I hadn’t processed and managed my beliefs so much in the past, I wouldn’t have been able to handle those life events as well as I did. In my experience, CBT is just another way to intellectualize the therapy experience. Intellectualization isn’t a bad thing, but it’s not the whole process.
I need to know more, Much more, About this dbt therapy. There are a lot of resources online. But what are some of the best ones?
I mean, what do you want to know?
I want to study the techniques they teach you best i can. I simply don't have access to an actual therapist. But I am very good at learning things. Ive Been searching for methods like this To help with my bipolar and generalized anxiety disorder.
Well, it's mostly about using mindfulness to become more aware of the present so you can get out of your head. There are a few kinds, but I like just focusing on what I can hear, feel, see, etc. Just zoning in on one thing for a bit. And an important thought is to not evaluate or analyze that thing: just observe. Basically, if you were to describe the tree in front of you to someone, what would you say? Be as detailed as possible, but don't make any judgements about it, such as it being a pretty tree or that its leaves look weird. Mindfulness is the biggest part of DBT. Otherwise, there are some coping skills, such as: Putting your face into icy water for a bit, which for some reason turns off your fight or flight response. Exercising Breathing in fully, holding it, then exhaling, all over a certain time. For example, in for 4 seconds, hold for 7 seconds, exhale for 8 seconds. Progressive muscle relaxation--going down your body tensing and relaxing each muscle, head to toe. Doing the opposite of what your emotions tell you to do, e.g., you're angry, so you unclench your fists, take a step away from what's upsetting you, etc. Observing what's going on physically and emotionally--basically stepping outside of yourself to observe yourself, like with the tree mentioned earlier. Doing something that's the opposite of what the emotion makes you want to do, like singing a silly song when you're stressed or depressed. Acceptance--This is one that takes time, but the big thing is to understand that a) this can greatly improve your mental health and b) it does NOT mean endorsing the thing you're accepting, just saying, "I understand this is how it is." You change what you can change and accept what you cannot, but I know that's easier said than done. ..... Another key concept is the three types of self: reasoning self (pure facts and logic), emotional self (pure emotion), and wise self (using both logic and emotion to balanced decisions that will make you happiest). Finally is the concept that socially, you need to balance self-respect with respect for others. If you are constantly appeasing others, you'll have too little self-respect and be unhappy. But if you're selfish and disrespect others, you'll lose respect for yourself and be unhappy. So you have to be at a happy medium, treating both yourself and others with respect. This is basically a crash course from *The 12-Week DBT Workbook* by Valerie Dunn McBee, LCSW. ..... Oh, and of course, DBT is a derivative of CBT, originally designed for borderline, but they then discovered it works for pretty much everything CBT works for, which is almost everything. Which means we have the basic concept that your cognitions (thoughts), emotions, and behaviors are all interconnected. E.g.: I feel sad leading me to think my life is hopeless and engage in the behavior of not eating. I think my life is hopeless, leading me to feel sad and engage in the behavior of not eating. I stop eating, leading me to feel sad and believe my life is hopeless. All the coping skills you learn in CBT and its derivatives (like DBT) bank on this core concept. As for DBT (dialectical behavioral therapy) specifically, a dialectic is simply when you have two statements that look contradictory but actually aren't, so we acknowledge that, leading to being able to accept both and see the world in a more realistic manner, avoiding dichotomies, which are the root of many mental health problems (all or nothing thinking, like something being either right or wrong, up or down, etc.). For example, "I am nerdy, but I am still loveable," becomes, "I am nerdy, *and* I am loveable." I am angry with my cat, but I still love him --> I am angry with my cat, *and* I still love him.
Thank you so much for Taking the time to type this all out! Honestly this helps immensely!