My quintessential CBT experience or that time I got kicked out of therapy

I have lots to say about the topic of CBT (Cognitive Behavioural Therapy) which is why I’ve procrastinated in talking about it because of spoons & getting stuck on what the best way is.

But I thought I’d make my first post about the experience which symbolizes CBT to me. This post will be in a couple of parts. I’ll do the intro & invite you to reflect on something & then follow up with the rest of the story.

Ok so for background, a couple years ago I was in a partial hospital program for mood and anxiety disorders where we had like 5 hours of “psycho-education” / group therapy per day. Each hour we had 2 or 3 choices of therapy modules we could pick from that covered different therapy techniques like CBT, DBT, ACT and more.

Now I already knew I didn’t like CBT much but one day I had no choice but to attend a CBT class because the other session was full. Now the way these classes were generally structured were the therapist would give us all a handout & then we’d discuss it. So we’ll do something like that on this post here today. Here’s a version of the handout we got during this fateful CBT class. I will ask you to please read page 12 and only page 12 of this handout before proceeding. Because you’ll need that to understand what came next. I’ll copy the relevant part below as well:

Listening to Your Self-Talk

Have you ever said to yourself, “This is the worst possible thing that could have happened?” Or, have you ever heard yourself saying, “I can handle this situation; I know I can.” These are examples of negative and positive self-talk. In order to master the art of cognitive restructuring you need to become aware of your negative self-talk and substitute a more realistic, or positive, alternative.

Most people don’t even realize how often their self-talk is negative. Your brain thinks much faster than you or anybody else can talk and thus it rapidly inserts pessimistic ideas and judgments so quickly you’re often not even aware of it.

Self-talk doesn’t have to be negative.

Self-talk can be rational or irrational. Rational (neutral or positive) self-talk correctly guides and inspires you. It gives you confidence. Irrational (overly negative) self-talk can undermine your self- esteem and cause you to feel angry, frustrated, or depressed.

Becoming aware of your self-talk is the first step toward mastering it. For example, let’s say you’ve had problems with a certain vendor who “never returns your phone calls.”This problem is in quotes because the statement is a highly inaccurate interpretation. In point of fact, the vendor takes longer than you would like to return your phone calls. But eventually, he always gets back to you. This may sound like splitting hairs, but you’ll see in a moment why this distinction is important.

You’ve spoken to this vendor about his tardy replies and he has said he will make an effort to get back to you promptly. He has promised to call you back that afternoon with a price on a printing job that you need to get out in a hurry.

When he hasn’t called by the end of the day your negative self-talk kicks into high gear. Why didn’t that so-and-so call me back? He never returns my calls! There must be something wrong with that guy! Doesn’t he want my business? He must think we’re too small an account and he doesn’t care.

Your self-talk makes you furious.

You finally call him at 4:45 PM and discover he’s already left for the day. Now you’re really furious. “I can’t believe he left without giving me a call. He’s an imbecile.” You ask for his voice mail and leave him an angry message telling him you wish to terminate your relationship.

You try to calm yourself with positive self-talk, but the damage is done. As you tidy your desk to go home you find a note your assistant left that was hidden under a pile of papers. Your vendor had called back with the prices you requested. You slam your fist down in frustration as you realize that these prices are by far the lowest of the three vendors who bid on the job.

Your negative self- talk distorted your thinking, causing you to make inaccurate conclusions and faulty judgments. Transforming distorted, irrational self-talk into rational and clear self-talk is the goal of the next exercise.

The Thinking Person’s Stress Management Workbook [https://institute.welcoa.org/wp/wp-content/uploads/2016/02/thinking-persons-wb.pdf]

Ok. Pause.

Read all that? Good

Now I want to ask, am I the only one who thought that example was bullshit?

Well, I was certainly the only one to speak up in class and say I disagreed with the handout.

So what happened was that I said I think the person in the story made the right decision based on prior evidence. To which the therapist responded by telling me to focus on what happened that day. And I kept saying, you can’t just ignore prior history. This is a vendor with a history of being late, and the lowest bid doesn’t always mean the best bid. Cost is not the only consideration used to hire vendors. By choosing not to go with a vendor with a history of being unreliable, she probably saved herself future stress.

Now this all sounds very nice & calm but boy did that therapist not like being challenged. At this point, we’d spent a bunch of time arguing about this and the other patients were starting to get restless too. So she uh…offered that I could leave the class. Which thank goodness, because I didn’t wanna be there in the first place but the way these programs are designed, if you don’t participate, it’s taken as evidence of “non compliance” which can have some pretty bad consequences. I took the “offer” aka got kicked out of class.

The fun part, which is completely on script for my life, was that after the class, other patients came up to me and told me they agreed with me but didn’t want to speak up and get in trouble 🙃

I later read the handout to my mom without telling her the story and she had the same reaction as me. So clearly it wasn’t just me.

I have tons more to write, as I mentioned above, about the idea of CBT as glorified gaslighting but I love the above handout because it so succinctly illustrates how CBT does mental gymnastics to deny context, prior information, anything to convince you you’re thinking about a situation wrong & not that the situation or other people are the problem.

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