What type of therapy worked for you, and for what problem?

February 3, 2022 3:37 PM

You had therapy which helped with an issue you were struggling with. What was the issue, and what style of therapy helped you with it? Bonus questions: How long did it take? How did you work through the difficulty? What about this mode of therapy did you most appreciate? What would your Before and After situations look like? What was really good about your actual therapist? Which other styles of therapy didn’t work for this problem in the past?
posted by d288478 to Health & Fitness (18 answers total)

CBT didn't work for me. I know it can be amazing for others but it was completely unhelpful and even frustrating to basically hear "just try harder!" and "there's no reason you shouldn't love yourself because you're amazing!" Obviously, that was in part due to the therapist-patient dynamic not being a match but I found it wasn't for me. That said, a year of seeing that therapist helped prepare me for my next therapist who was amazing. She was queer like me, which felt important at first but ultimately we were very different; the latter therapist is straight but very aware and understanding in part due to her own life experience and professional work.

EMDR was great: we did a few sessions of actual EMDR methods spread over two years because I was dealing with a lot. It took time for me to build trust as well as process things and deal with some stuff that was going on in my life that kept reactivating past trauma. I met with her once a week and we talked and that was helpful, too, because she's insightful and smart. I also took a super low dose of SSRI prescribed by a psychiatrist, whom I sometimes check in with; I will go on and off the medicine as needed.

I then moved away and stopped therapy but recently restarted seeing my therapist once a month for a check in. It feels so good, which is nice because most of those three years of therapy felt awful to just OK. The before was emotional dysregulation among other things; the after was feeling healed from trauma and resilient when it comes to new challenges. I feel seen and heard and am self-aware. I understand how my brain works, namely my mild OCD, and my mild PTSD rarely affects me in daily life anymore. I like and accept myself, strengths and weaknesses, while before I was outwardly successful but inwardly had a lot of self-loathing. I have healthier friendships and more happiness with my life in general; I have good boundaries and better relationships with family. The only downside is that dating has become perhaps harder because I have worked so hard to become this healthy, happy version of myself whereas a lot of people are not quite there yet themselves. I don't blame them because I used to be there and the work it takes can be excruciating!

For me the biggest thing, even more than the modality, is the therapist-client relationship. It took me many tries to find a great match and there were some truly awful therapists along the way, although it was even 20 years ago and therapy is more mainstream as are therapists more inclusive and aware.
posted by smorgasbord at 3:49 PM on February 3, 2022 [3 favorites]

Internal family systems (IFS) worked/s (still in therapy) for me. I went for help with my adhd, stayed for the help with the (lowercase t) trauma and attachment issues I didn’t know I had. My therapist does a mix of styles, but she said IFS is great for trauma. This was the first time I was able to really sit and feel my feelings in my body, instead of understanding them at a cognitive level. It’s really helped me understand what I’m feeling moment to moment.

In the past I had therapists try CBT and talk therapy. I usually didn’t stick around long enough to truly feel like I’ve “tried” those, but bailing was an indication that I felt like it wasn’t doing anything.
posted by bluloo at 4:17 PM on February 3, 2022 [3 favorites]

Oh, and to not abuse the edit window: I’ve been in therapy for a year now, and my therapist (now former, since I’m moving out of state *sob*) says that it often takes several years to truly feel “better”. I can feel it helping, probably from around the 3 month mark, but there’s also a feeling of there being so much more to unpack and work on. My therapist would say that things often feel worse before getting better; it’s like digging out an infected wound before you can start to heal it.
posted by bluloo at 4:20 PM on February 3, 2022

My principle problem was unrealistic expectations about life (ie, "love, marriage, baby carriage"). I came to understand, through therapy, that none of these things were for me, due to issues with my early childhood development. Confronting these things meant getting out of my comfort zone and trying new activities. The activities stripped the "glamor" from socializing and dating and allowed me to accept that these were things that I could "fake" my way through, but never truly enjoy.

All told, it took about 18 years for me to give up my long-cherished beliefs about what life "owed" me, and to accept that the life I have is about the best I could hope for, given my childhood. (According to my therapist, most folks with my early life experience either end up in prison or in a mental hospital. I'm lucky to have made it out alive.)

Aside from personal therapy, I participated in group therapy a few times (ie, several months in three different groups). I can't actually say it helped me. Likewise, the pharmaceutical approach did nothing for me. Looking back, I believe my therapist just threw everything she could think of at my problems and what worked, stuck.
posted by SPrintF at 4:38 PM on February 3, 2022 [2 favorites]

Group therapy from a psychodynamic perspective was highly effective for me. The issue that brought me to therapy was an existential crisis of meaning after letting go of all religious beliefs. Group therapy allowed me to find new meaning in my connections with other people. I believe my therapist was quite skilled in redirecting when the group got too off track, but for the most part did not direct the process. This was useful for my particular situation because I was definitely not looking for a "wise guru" to tell me the answers.
posted by hworth at 4:44 PM on February 3, 2022

Group systems therapy helped me recognize my own issues and default settings very quickly, though it didn't do much to change them at an essential level, but I might not have stuck with it long enough.

Regular ol' talk therapy has been helpful as an escape valve for various issues over the years, but I tend to confront my edges better, faster through experiential approaches (as above) because I quickly intellectualize things rather than attend to how I am.

CBT helped my insomnia more than any pill, though I have to periodically "re-mind" myself to do it.
posted by cocoagirl at 5:21 PM on February 3, 2022

I have only a very short experience so far. CBT for a cycle of panic attacks. It has been... not what I expected therapy to be like?
Mostly: here is the situation. It has these aspects. Let's work to identify what comes first, and then here are some techniques to interrupt that loop. Here are some things that probably seem helpful, but are not. Don't do those.

It has been quick to work, and quite simple in concept, but miserable in practice. Pushing through the miserable part has shown real changes!

I'm still stuck with some parts. It seems like panic attacks that wake me up are going to be trickier than daytime ones, but I think medication is helping me to endure until I can get those more under control, too.

For this, I could start applying techniques after one session (and seeing results that same week).
posted by Acari at 6:28 PM on February 3, 2022 [2 favorites]

CBT helped me learn how to cope with flare-ups of extreme depression and anxiety.

Regular old talk therapy helped me understand that I have a trauma disorder that led me to have regular flare ups of depression and anxiety.

DBT has helped me learn how to stay present with the uncomfortable feelings I had trained myself to avoid, and therefore reduce said flare ups.
posted by pazazygeek at 10:57 PM on February 3, 2022 [1 favorite]

My therapist advertises herself as using Psychodynamic theory, cognitive behavioural therapy (CBT), Eye-Movement Desensitization and Reprocessing (EMDR) and mindfulness as well as BrainWorking Recursive Therapy (BWRT).

The issues I'm dealing with are anxiety and depression, with related insomnia exacerbated by my mental health issues. I've had a mixed experience with therapy. The CBT (or more specifically for me, ACT approach) was helpful in some ways, but not so much in others. It helped when I had specific irrational thought patterns that needed to be challenged, but it sometimes exacerbated my tendency to ruminate.

I found CBT extremely helpful for my insomnia, as I was getting to that place where anxiety over not sleeping was causing me not to sleep. Logically unpacking the problem and challenging my irrational thoughts helped relax about the situaiton. Now, my sleep is a lot better and the lack of it doesn't really cause me anxiety any more. Which is a huge relief.

EMDR seemed to help me a lot with some specific anxiety producing problems I'm having with my family although I was hugely sceptical that it would work. It seems to have worked all the same. After just a few sessions I'm able to step away from patterns of behaviour and thinking that I've had all my life. Not solved, but so much better. I find that I'm able to switch from feeling overwhelmed by a problem, to seeing it as a challenge that I can deal with.

I got a bit frustrated with her use of BRT (Brain Recursive Therapy) because while it did seem to help my anxiety a bit, it started feeling like a "if your only tool is a hammer, everything looks like a nail" situation where there didn't seem to be space, in the therapy session, for the idea that my fear, depression and anxiety might not be caused by a specific event, but have their roots in my brain chemistry and hormones. Which is what I am increasingly sure of now that I am on an SSRI. BRT deals very much with certain traumatic memories, and I don't really have many of those, certainly not ones that are directly responsible for my anxiety and depression.

My therapist never said anything against using medication but I got strong vibes from her that she did not think it was the correct solution for me, or did not quite know how to talk about the fact that my mental health issues might be caused by hormonal or phisical issues like menopause. I'm not sure if I'm fair in saying this because she never SAID anything but it was a matter of joining the dots for me, of all the things she didn't say. At times I think I allowed her view to warp my own experience - for example overemphasizing the importance of some past event on my present mental health. Not sure of that, though.

For a while I found being in therapy to be not such a great thing for my mental health because it caused me to hyperfocus so much on my internal world. I tend to ruminate and hey, here is a whole new universe of internal stuff to get stuck on. I found myself getting sucked into constantly wondering what I would say to my therapist in my next session. Realising that, and making an effort to change this mental habit helped a lot.

Overall I would say that just the experience of having a kind, compassionate person dedicate their time to listen to me, and occasionally challenge my assumptions, was the main benefit of the therapy. Getting into the habit of kindly challenging my own thoughts and becoming more self aware.

Before I started therapy I was unable leave the house without severe anxiety. I worried constantly that I might hear or see something that would set off my fear to the point that I avoided being with friends, reading books, or watching movies except for the safest kinds. I could not read the news. I felt out of control and desperate.
Therapy brought me to a place where I could fairly quickly resume normal life (do the shopping, walk with friends etc) although I was still hugely anxious while doing it. I still felt the fear, but it was not ruling my life.
It's been about a year and a half since I first started therapy.
At the moment, I am not seeing my therapist as I got to a place where I felt I needed to figure things out for myself for a bit.
posted by Zumbador at 1:08 AM on February 4, 2022

I saw a counsellor who offered... I forget the exact term, but something like whole person counselling? We chatted, she validated my feelings and reassured me that the problems I was having and the experiences I'd had were and had been objectively hard, and most importantly, she also pointed out that I seem to be autistic, which has helped me to reframe a lot and (ultimately) to feel considerably better about myself. I'm not broken! I'm reacting in a perfectly understandable way to a world that isn't optimised for my kind of brain!

I went in just looking for... help; I'd been flailing around miserably for my entire adult life, anxious and panicky with occasional bouts of depression for good measure, and it had reached the point where work was no longer willing to put up with it. (Work being the actual direct cause of a good deal of my distress, this strikes me as ironic. "Please could you stop hurting me?" "No! Get therapy!") I didn't really know what to ask for. I had actually concluded that I was most likely beyond help. I'd investigated what the NHS had to offer, and learned that the go-to treatment for anxiety in my area is CBT. I'd tried that twice previously, once at university and again a few years later, and both times it had made matters worse, so that felt like a dead end; when the best hope for treating anxiety not only doesn't work on you but exacerbates the problem, it's hard not to feel like a lost cause.

I saw her weekly for about three months, and then we discovered a conflict of interest (small world problem) and stopped. She gave me some names of other people to try, and I may follow up on that eventually, but I decided I wanted to take some time to process everything first, and we're up to about nine months at this point.

Caveat: I am at present living in a bubble, thanks to the pandemic, and I don't know how much my new perspective on myself will help if I ever emerge from that bubble again. I haven't had to deal with certain stressors over the last two years, although goodness knows there've been plenty of new ones to fill the vacuum.
posted by ManyLeggedCreature at 1:15 AM on February 4, 2022

i hate CBT. it is not for me.

i do like ACT. it helped me A LOT about a decade ago with severe agoraphobia.

during that same time, i figured fuck it and tried a group art therapy class. it was fine, the people were fine. but every week it was a stretch about the inner reasons you created the thing you did. dude, i drew an owl because an owl looked cool and met the assignment. we don't have to delve into my psyche for more than that.
posted by misanthropicsarah at 6:25 AM on February 4, 2022

I have never, ever been able to respond to CBT. My brain just laughs it off. The only approach that has ever had anything close to a positive effect on me was a form of gestalt therapy. It was amazing.
posted by Thorzdad at 6:49 AM on February 4, 2022

I was going through a number of personal issues when I tried CBT - the main thing it did for me was help me stop catastrophizing. Once I stopped doing that, a lot of my other issues either went away, or got minimized enough that I could handle them.
My wife really needs to feel connected to her therapist, but I didn't feel that way at all. I don't know what his politics are, I don't know what TV shows he watches, I only wanted him to help me with my catastrophizing, and he did a good enough job that he suggested we stop the sessions, unless I had something else I wanted to work through.
posted by Furnace of Doubt at 10:20 AM on February 4, 2022 [1 favorite]

In my opinion, and I say this with kind intention, styles of therapy are an illusion. In my experience the relationship you have with your therapist is what really matters. Because in a good therapy relationship, you and your therapist will work together to find a way of doing therapy that helps you. There's a lot of trial and error in the process, because it's not a medical procedure, it's a relationship.

This perspective can make things hard because we're used to thinking of comparison shopping based on features, and it seems like the style of therapy is the important feature. But the real feature that matters is the relationship.
posted by medusa at 11:39 AM on February 4, 2022 [3 favorites]

ERP for OCD saved my life.
posted by chaiyai at 11:55 AM on February 4, 2022

I did EMDR to deal with intrusive memories from a bad postpartum depression. (2 months super helpful.)

Family systems therapy to deal with some childhood stuff and the actual PPD (4 years. Super helpful for the first three but probably kept going longer than necessary.)

CBT-I for life long insomnia (1 month but likely to continue for 3. Incredible! Feels like witchcraft. Wish I’d done it years ago.)

For me, the type of therapy has mattered a lot and needed to match the issue that I was trying to address. But as people have said in previous responses the match with the therapist was also critical.
posted by jeszac at 8:19 AM on February 5, 2022

CBT is not for me. I'm an overthinker and it just feeds that. Somatic therapies are my jam. EMDR and sensorimotor psychotherapy are great approaches that incorporate the body. I've seen someone for general talk therapy because I needed to vent and cope with a lot of present life stress but it wasn't really therapy for specific goals at that time. I did CPT but it was not helpful because of the cognitive angle. I found DBT to be really... I dunno, I can see the value of the skills but don't want to spend an hour going over something I can do out of a workbook on my own.

Currently seeing someone for Brainspotting (another trauma therapy, not somatic exactly but not cognitive either so I like it) and... I don't know if there is a name for the other model we are using. It's not Internal Family Systems but it is "family systems" for the parts in my head. Parts working through their conflicts with each other and learning to see the positive in each other's behaviors.

While I agree the therapy relationship is hugely important, and in most cases matters more for the perceived success than most other factors, there are situations where the person really does need to know a specific model. ERP for OCD is an example. Purely psychodynamic therapy for ADHD would probably not be helpful (though helpful for the self esteem baggage that can come with ADHD). And in my situation, I sought someone specifically for parts work, and it would not be going very well if they didn't know the model they are using. IFS would not have been a good fit. I also get on well with them but the model matters a lot for some conditions.

I also don't really need the relationship to be ... something. I just need to feel safe with them. I see my therapist like a surgeon. They have the skills needed for the specialty changes I want. But I have severe attachment trauma so probably most people would care.
posted by crunchy potato at 11:25 PM on February 5, 2022 [1 favorite]

I have seen many therapists.. maybe.. 10? plus more for couples counseling? I've always had varieties of depression, sadness, existential distress, and also a lot of very murky childhood issues that I couln't quite name but which impact my behaviors and emotions. The therapists I've seen have had a variety of orientations and training modalities. Having said that, they basically all came off pretty similar in their actual practice and did not vary widely in the techniques they used.

Right now I am seeing a therapist who is using a lot of IFS practices and some EMDR practices (more tapping than eye movements). This definitely creates a different kind of session than previous therapists I've seen as both of these modalities have specific practices and framings associated with them that we use. I am feeling more transformed and more relieved of suffering with my current therapist than I have with previous therapists. I think this is due to three factors, in this order of importance:
1) I am older, my parents are gone, I feel more ready and able to be open to a transformative exploration and daily practice
2) This is an extremely skilled and experienced therapist with excellent intuition and who is highly attuned to me and skilled enough to recognize what interventions might work best for me
3) The modalities we're using
So in short, I'd say a lot of what's happening now is internal to me and about the specific skill set and fit of the therapist, but we're helped by having some specific tools that resonate for me.
posted by latkes at 4:26 PM on February 8, 2022