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Side effects of Cognitive-Behavioral Therapy (CBT)

pauldonato — Sat, 04 Jul 2009 12:31:51 -0800

Are there really no side effects to cognitive-behavioral therapy? Has anybody had a bad outcome or weird experience? The reason I ask is that I discovered CBT in 2004. Rather than forking over money to a therapist, I just read how it worked and tried applying it to myself. I found that it made me over-think my anxieties and in one case, aided me in putting blinders on myself in a situation, thereby making it worse.

Fast forward to now, and I can see that there are many many studies showing that CBT is effective. I'm using computerized CBT, and I've been reading a lot about how it works (literature I couldn't find five years ago). Needless to say, I think I'm excited about it, and think that I won't run into the same abuses and mis-applications that I had before.

However, after a few initial sessions this time around, I did notice some anxieties crop up. For example, one of my "warped thoughts" is "I can't relax otherwise I'll get screwed up." I went through the process of disputing that, and afterwards I started to relax but I also felt nervous about my relaxation. It almost reminded me of how I feel when taking Xanax. It's like, "this feels good, I'm relaxed. Oh wait, relaxed means danger!"

So my question is, are there any bad side effects to CBT? Are there any ways to abuse it?

Is there a therapist who can get past my mom's suspicions?

Nattie — Wed, 22 Oct 2008 11:30:50 -0800

Recommendations for a cognitive behavioral therapist in the Houston area for my mother? He/she is going to have to deal with a lot, especially because she is irrational and suspicious. I need to be sure that the therapist is good because my mom has a lot of issues that need to be addressed, but she tends to be suspicious of anyone who tries, or else she has a nervous breakdown and starts crying.

If it matters, she's in her mid-50s.

- My father died less than a year ago. She has said she might need to get therapy for dealing with this but, to my knowledge, has made no moves yet, so I'm hoping to steer her in the right direction. She understandably feels some anger about his death too, since he died from the Digitek tablets that were mistakenly twice the listed dosage.

- I'm not even sure how to put this except bluntly. For at least five or six years now, she has read a website that has lead her to believe all of the following: the government puts microchips in people's brains to program them, but people can be "deprogrammed" if they do the right things; reptile shapeshifter people exist that look just like normal human beings; the husband of the couple who runs the website has been abducted and informed by various different species of aliens of all this stuff; etc. They often take news stories and twist them into evidence of their claims. They post other things daily, like aliens landed here but it's been covered up, or the numerology of this and that means some outrageous thing, and so on.

It is extremely delusional and paranoid, but you can't disagree with her because she just thinks anyone who denies it does so because they're programmed to. If pressed on the more ridiculous stuff sometimes she will say she doesn't take it very seriously, but trust me, she does. It's very awkward to watch TV with her and have her say she thinks someone is a reptile, or for her to talk about someone being rude to her at work and attributing it to their programming or something.

The website also told her that California is going to physically break off from the United States apparently within our lifetime, and uses this as a reason why I should not move there with my husband who recently got a job there. She became very upset and started crying when we tried to explain to her that land masses take much longer than that to break off, if it's going to break off at all. Things like that make it very upsetting to be around her now. She is trying to influence the direction of my life based on completely out-there, untrue claims.

If I hadn't seen the website for myself I would think she'd developed some sort of mental illness, but she's always just been very impressionable and superstitious. Since she holds a lot of irrational beliefs, apparently because they make her feel better on some level (i.e. to believe she's deprogrammed and everyone else isn't), I think CBT would be best for her, but I think (I hope I'm wrong) this is probably more difficult to deal with than your typical patient.

- On a similar note, she will make stuff up and then believe it 100%. It's disturbing. For example, another one of her arguments against our moving to California was that the rent was three times higher there. When we told her we were only paying a couple hundred dollars a month more than we were in Austin, she would move on to another irrational argument, then come back to the "three times higher" argument again.

- More irrationality: she's maybe $100,000 in debt but she won't even compile her financial data to find out. When I asked her why, she admitted it was because then she'd have to deal with it, and she was scared. I pointed out that she was paying all the bills anyway so it doesn't make a difference, and that the only way she can make things better is to look at it. She doesn't even know what interest rate her credit cards are, for example, so she's paying way more than she needs to; she has a card that's 30% interest rate with a balance on it that she could entirely transfer to a 20% interest rate card. She won't do it. I have offered to do it for her and she just says she'll think about it.

This is going to turn out very badly if she doesn't get help soon.

- She is extremely judgmental. She was completely anti-racist as I was growing up, until about high school when she started hating Hispanic people because we lived in a Hispanic ghetto, and then after Hurricane Katrina she started hating black people because crime rates in Houston went up. This has gotten progressively worse and it's quite upsetting. I can't have a conversation with her anymore without racist stuff coming up, even in the oddest places. (It would be more bearable for me if I could just avoid certain topics, but it doesn't work that way.) It makes her feel better on some level to believe that she's better than minorities and that they're the cause of her problems, so I think CBT might help with that.

- She worries about everyone, for mostly irrational reasons. She has always been this way, even since she was a child. The 24/7 worrying makes her an emotional mess, and in the past has had a lot to do with why she cries and has nervous breakdowns. I don't see how this can continue and I don't like seeing her get worse.

- This has started to affect our relationship negatively. She loves me more than anything and can't deal with my moving out of the state, especially after my dad has died. I understand that. But the ways in which it comes out lately have been very upsetting. She is negative and resentful of anything that makes me happy or I am excited about. She sighs about how different I am from her and calls me weird for normal things like being an introvert, which makes me feel very unaccepted. (I'm not a "weird" introvert either; I go out a lot and have normal friends. She calls me weird for being tired by social interaction.)

I try to see her more often to make her feel better, and because I used to have so much fun with her, but the last few times I have visited her she has been so negative and unaccepting of me that I've been entirely unhappy and just want to leave. I can't just go fake it either, because it's gotten to the point where I have nothing I can safely talk to her about. I point out how I'm feeling about specific things, like when I told her to quit being negative about California, but just that made her cry. I think if I told her that her behavior was pushing me away, instead of making me want to see her more, it would absolutely destroy her. Normally I would agree that telling her how I feel is the best solution, but I think it's well past the point where such a thing would be safe and I don't think I'm qualified to deal with the extent of her problems.

I'm hoping if I can recommend a cognitive behavioral therapist and say it's to help her deal with losing my father and my moving away, especially because she already expressed some interest in it, maybe the other stuff will get slowly dealt with too.

I'm not the only one affected by this either.

Sorry for the long explanation, but I partly wanted to vent and partly wanted to show how important it is that the therapist really know what he/she is doing. I think it would be difficult for any therapist to deal with my mom thinking they're trying to steer her wrong because they have a chip in their head, for example, and she's going to cry and deny things a lot.

One other caveat: I would prefer someone who's not going to drug her. I realize such a thing might be necessary but I would rather that conclusion be reached after a significant amount of sessions. She tends to have bad reactions to medications, too (runs on her side of the family, it seems) so that's a concern.

Thanks for reading all this and any suggestions you might have.

St. Louis Cognitive Behavioral Therapist Referral?

gd779 — Tue, 20 May 2008 07:18:35 -0800

St. Louis CBT Therapist Referral: I am looking for a referral to great a cognitive behavioral therapist in the St. Louis metro area to deal with depression and anxiety issues. Suggestions?

Fix my brain: CBT in Cambridge, MA?

waxbanks — Wed, 07 May 2008 21:24:39 -0800

Cognitive behavioral therapist in Cambridge/Somerville/Boston, MA - for a geeky/creative sort? Hey all. Can you recommend a cognitive behavioral therapist in Cambridge, MA? I'm willing to schlep over to Somerville/Boston but would prefer something in the Central/Harvard/Inman area. I'm a geeky type and a writer by trade, if that sort of information is germane to choosing a headshrinker, and - for better or worse - would respond a lot better to a male therapist.

Thanks much in advance, folks.

A cognitive behavioral therapist and/or a psychiatrist in Northern NJ or NYC?

Anonymous — Tue, 23 Oct 2007 11:46:47 -0800

A cognitive behavioral therapist and/or a psychiatrist in Northern NJ or NYC? I know a similar question was posted in April, but I think a lot of the replies were emailed directly to the poster. I would like to try cognitive behavioral therapy and the possibility of going on an anti-depressant / anti-anxiety / anti-being-frustrated-and-grumpy-and-pissy-all-the-time-regardless-of-the-situation type of medication. Does anyone have a recommendation for a doc/therapist near me? I'm in Fort Lee, NJ, which is just over the George Washington Bridge from Manhattan. It would be a bonus if he/she takes my insurance (Horizon Blue Cross Blue Shield of NJ), but I'm willing to pay out of pocket if that's what it takes to get someone great. There are plenty of directories of psychiatrists and therapists on the web, including the one on my health insurance's website, but I would really like personal recommendations. If you're really feeling ambitious, you can go to the Horizon Blue Cross Blue Shield of New Jersey provider directory. My plan is "Horizon EPO/EPO Plus" and my zip code is 07024. Northern New Jersey and The Upper West Side of Manhattan are both optimal but, again, I'm willing to go a bit out of my way for the right person.

Thanks everyone. You can email me directly at asknonymous at gmail dot com.

Did CBT work for you?

Anonymous — Sat, 28 Oct 2006 20:22:51 -0800

I have recently been diagnosed with depression. I am taking 40mg of Prozac a day. I have also been advised to persevere with a course of Cognitive behavioural therapy. I am worried that CBT isnt relevant to me. Has anyone else had or currently having success with it? I have been trying to cure myself of depression scince about June. Despite the fact that I have been taking the drugs for nine weeks I feel I am getting worse not better. I feel increasingly angry. I have lost the ability to cry. I have been cutting myself. My suicidal thoughts are developing structure and intent.

As far as I understand CBT it is based on the premise that negative thought patterns are part of a self fullfilling vicious cycle. Negative thoughts are not necessarily true. Carefully examining them will therefore help reveal this. This will help breakdown the individual's self hatred and improve his or her self esteem and coping ability.

CBT also seems to assume that depression or lack of self belief is commonly founded in the inividual's life experience. (I dont feel that anything has happened to me to explain the way I now feel.)

Intellectually this makes perfect sense. I can totally see how this may be the case for lots of people. But I fear that it is not the case for me. It seems to me that the things I believe about myself are not only negative but absolutely true. Therefore examing them is a waste of time and could potentially make me feel worse.

Are these feelings another symptom of the illness? Did anyone else face this hurdle at the beggining of CBT? How did you overcome it? Did it take long? What hope do you now have for the future?

I would be gratefull for any experience or wisdom that anyone could offer. Im trying to be brave but I dont think that I actually have the strenght to overcome this.

With thanks in anticipation.

How do I help my friend get help?

twiggy — Fri, 31 Mar 2006 19:21:59 -0800

I have a friend (seriously) who has serious problems with social anxiety, to the point she is sometimes paralyzed with fear or depression. She cannot hold a job because of it, and therefore has no insurance for medical attention - what can she do? I'm no doctor, but based on all of the reading I've done and her descriptions of problems she's had, I imagine she would benefit greatly from cognitive behavioral therapy. She has been on anti depressants in the past, when she had a job and insurance, but they were only minimally helpful.

Are there financial assistance programs for someone in this situation? She is located in central Illinois, if that matters.

I feel so terribly for her that I would try to help pay for the medical expenses myself if I could afford it - but I absolutely can't handle that kind of expense at this point in my life.

She currently lives with her parents, one of whom does not work, the other of whom gets a modest disability check that supports them all due to a job injury. She's too old to be claimed as a dependent on her parents insurance.

She seems so stuck in a downward spiral due to the catch-22 she's in, and I'm at a total loss for what to do to help her other than be a supportive friend. I thought maybe the wizards of AskMeFi might know something I don't about how she may be able to find affordable help.