Does CBT Help if I Have Real Problems?

CBT is one of the best researched, most effective therapy techniques. But how can it help if your problems are REAL?
This is a question I receive a lot from viewers, so decided to do a video to help explain how CBT can help even if your problems are real, and also point out the limitations of cognitive behavioral therapy.
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This video was created by Barbara Heffernan, LCSW for educational purposes only. These videos are not diagnostic and provide no individual consultation. Consumption of these materials is for your own education and any medical, psychological, or professional care decisions should be made between you and your primary care doctor or another provider that you are engaged with. Barbara Heffernan is not available for individual consultation via KZbin, social media, or email, and provides services only in the manner mentioned above.

[@qwerty9797]

CBT really puts the cart before the horse. It's not the negative thoughts that are resulting in me always getting left out in my friend groups; it's my lack of childhood socialization and inability to form meaningful interpersonal relations. What I need is to gain some social skills and a more sensible friend group. Not CBT where I get told that only if I change my thinking my problem would get resolved. My thinking about being a social outcast *came after and not before* I realized I was getting left behind.

[@dajonsson]

As i understood it is mostly about changing behaviour, not thoughts, she often repeats thst it is not easy to change thoughts. But if you change behaviour and go out to places unusual for you so you might find a new circle of people with other temper or interests. Or you can experiment with changing behavour in talking / listening proportion for 1 month, it is another example.

[@dajonsson]

kzbin.info/www/bejne/aYesfWSClN6jg8ksi=36DJMa1AcOV4JOm3

[@Ogulcan13]

CBT is just focusing on thoughts and this makes me sick. They say it is evident-based but no. It is all about earning money from people who are desperate. I hope one day Dr. Burns will lose everything he has and someone will say to him "JuSt ReFrAme YoUr ThOugHts to feel good"

[@ishathakor]

i have depression, (generalized) anxiety, adhd, and ptsd. i did cbt for about 3 months (weekly). then i switched therapists (my first one was terrible) and did cbt again for 2 months. i would say cbt is a complete waste of time for anyone whose problems are more complex than "sometimes i have negative emotions" and "sometimes i feel bad". explaining the way cbt treatment was going to work made me feel like my therapists were telling me i don't have any "real" problems. the way cbt was explained to me (though i also get this impression from googling) is that you're just assuming all my problems are self-created and if i think and act differently, i will un-create them. this is not the case for me and many other people. in my case, i have trauma from my childhood and i've been dealing with depression and anxiety since i was 11-12 ish years old. i had even tried to explain to both my therapists that i already TRIED the power of positive thinking and behaviour change (i am 24, so it's been a while) and it didn't do anything for me. i was dismissed. when i told them that their cbt strategies weren't working for me even though i was altering my behaviour and conscious thoughts just like they said, they would tell me i'm not doing it right. in reality i don't think it was that i wasn't "doing it right". i think the problem is that i have issues that are much harder to fix than just doing affirmations and deep breathing. the idea that some thoughts are "irrational" was also not helpful for me. i was told that i was being "irrational" thinking that i was going to fail my next college semester. this was an insane and wrong thing to say to me because i had failed every single class in the previous semester. yet my therapists insisted that it was an irrational thought. it was based in fact. if anything, it was more rational than thinking i wouldn't fail. i said that i'm bad at time management. i was told this is irrational too, when it's not. i don't start on any of my work unless it's due in a few hours. i am objectively terrible at time management and pretending otherwise would be delusional. my abuser told me she wished i had killed myself. when i relayed this to my therapist she said i was being irrational and she clearly loved me. this one was just plain gaslighting but i think its symptomatic of how far this concept can be taken. i also think "there's only a reason to worry when we can identify something that we can do something about" is the wrong philosophy to have. sometimes you really can't do anything and you're already reacting in the best way possible given your situation eg. i'm currently living with my abusers out of necessity. i can't do anything about it but that doesn't mean it's not something to worry about. it's just that in most situations where people are really suffering, just changing your thoughts or behaviours doesn't do anything. from about age 16 to age 21, i was coasting on the power of positive thinking. it literally did not do anything for me. my stress and anxiety levels got so high that my resting heart rate climbed to 110 at age 19, with no underlying health issues (i wore a fitbit around 24/7 for 2 weeks to confirm this. it hovered around the high 90s when i was asleep). i thought i was going to die. if i were old enough to drink, i would've easily developed a drinking habit. i attempted suicide a number of times when i was 20-21, AFTER i had spent several years convincing myself i didn't want to die. there was little to fix in my life at the time. i had good friends, i was a straight b student, and i wasn't living with my abusers. i had unknowingly been using the exact same techniques my therapists were teaching me for years and none of them had worked for me because my issues are deep seated. it was definitely a case of bad therapist too but the experiences overall left me with medical trauma on top of my childhood trauma.

[@ami5marion]

cbt therapist once said to me that i should be grateful my abuse made me who i am and i overcame it 🥰, other two therapists hit a dead end when i told them my family was abusive. cbt is not for people with real problems like abuse or poverty

[@skylinefever]

This is why I saw CBT as motivational bullshit slogans plugs gaslighting.

[@arielnecessary1615]

I have depression and severe anxiety from my very abusive childhood, and I found that CBT did more harm than good. Blaming me for my problems just reinforced my scapegoat status in childhood. Blaming me for my trauma just made the trauma worse. Dismissing my anxiety with statements like, "Yeah, we know that that's the way you are", has increased my anxiety disorder to terrible proportions. Telling me to do things that I, as an autistic person, cannot do, and blaming me for not being able to do them, increased my depression and hopelessness. I will never do CBT again, no matter how much pain I'm in.

[@bdml77]

It's new age nonsense

[@jenny-wk9cu]

Hey I urge you to seek out self compassion exercises and your own book on cbt so you can apply what is relevant to you. I too am neurodivergent and found I felt misunderstood by neurotypical mental health professionals.

[@anynamebutmyrealone]

You are completely right! I have the exact same experience.

[@breannapiscitelli3941]

I will be honest I was very hopeful that cognitive behavioral therapy would work for me. My entire life I’ve been struggling. It’s basically like I was not made for this planet. I never understood why I didn’t fit in and why I dealt with so many issues mentally. For years, I was missed diagnosed with an array of mental illnesses. That never really made sense to me. I actually had someone suggest that maybe I have autism and I looked into it and turns out yep that’s exactly what was wrong. The only reason I post this is because cognitive behavioral therapy does not work for people who are Neuro divergent. Our thought process is not the same as a Neurotypical’s. This is definitely something that should be stated. My problems are no more real or not real than the average person but the way that I experienced them is very different than a Neurotypical person. I am not trying to diminish the effects of cognitive behavioral therapy for a NeuroTypical person. But I do think it should go without even saying that it’s OK that cognitive behavioral therapy does not work for every single person. The other issue is it is so heavily thrown on every single person that goes through the mental health system, that situations like mine happen constantly. I was born in 1994 and at the time I’m pretty sure autism was just discovered and it was not possible, apparently , for females to have it. I also have parents that were pretty close minded about the entire mental health system, let alone their daughter being someone who could be considered the R-word. I think a lot more research needs to be done on autism itself, as well as how we can actually help a person with autism. Our brains work very differently, and the lack of understanding about it is very frustrating.

[@BarbaraHeffernan]

I totally agree that more research is needed on autism, and thank you for pointing out how this is often missed (yes, particularly in females!) and how our mental health systems need to be more flexible to include neurodiversity.

[@DavidLombardo]

My symptoms are purely neurological. The mental anxiety, anger, and strange mysterious mood issues are part of the symptoms, not the cause. My cardiologist suggested I get a workup for pheochromocytoma. My metanephrines, AST/ALT/CK, and aldolase were all elevated. Enough to be diagnostic, no - but it was truly actually more helpful to see how my body was malfunctioning, and not necessarily my thoughts. I've since learned that diet, sleep, exercise, and drug use (their timing and amount) has been very helpful. I'm still not perfect, but who is? The neurologist also found thoracic neurology changes, consistent with a history of Scheuermann's disease, which is like scoliosis. I have no pain, I look great, but no doubt the thoracic nerves in the trunk of that area control the sympathetic nervous system. It's actually bewildering that many people don't know this. Look up a surgery called ets. My doctor said hey I would never recommend it because it's so risky, but in terms of people who have a lot of physical symptoms and anxiety with no known mental anxiety, this could be very much the reason. I sweat, flush, and get agitated pretty easily. And I have my entire life. Perhaps most curious of all, the stimulants seem to help quite a bit.... which is indicative of nervous system dysfunction, the amphetamine, for example helps nerve impulses communicate, paradoxically calming down the nervous system as opposed to ramping up. Anyway, this is just to say that talk therapy isn't necessarily unhelpful, or even critical, but it is to say that it is just one actor on a very big stage. You can't have a movie with just one actor, you need the whole cast and crew to make it a story. As is the case with so much of life's most critical decisions, only you know what the real answer is, and sometimes it might take a while before you discover it. But it's worth the journey. If you still don't feel right, don't give up looking for the solution. As Peppy Hare reminds the ace pilot in all of us - the number one priority, no matter what situation a pilot finds themselves in, is to simply KEEP THE AIRCRAFT FLYING. In the heat of the dogfight, "TRUST YOUR INSTINCTS!" The priority of the flight deck, from WWII bomber pilots to a modern day Airbus landing in Baltimore, is very simple: Aviate, navigate, communicate. Such is the mantra of the aviator, and so to in life... First and foremost, keep your aircraft flying. Best of luck to you

[@michaelshannon9169]

CBT is ideal for the lesser complex, lesser self aware types. We all know the types, no introspection, just a doer. The more introspective and self aware you are the lesser impact it can have.

[@travelwell6049]

My feeling has been that CBT might work for someone who went through a difficult time, and now wants to get back to how they were. Rather than someone like me who's suffered with mental health issues for 30 years.

[@skylinefever]

I called it something for people near the top of Maslow's Pyramid, needing a boost to the top. For the rest of us, Maslow's Pyramid is covered with grease and we get mocked for not successfully climbing.

[@SSJKamui]

My experience. The more real the problem is, the less helpful CBT is. I think there are 2 components here. (Maybe 3) 1. Many CBT therapists have the assumption that your problems are caused by your thoughts and that by changing them you solve your problem. Sometimes that is the case. But often its not. It is not completely wrong. Your brain is highly capable of autosuggestive thinking. 2. A lot of cbt therapists have a highly unethical approach to the topic of happyness which result in an approach of "replace the unrealist thoughts which make you sad with unrealist thoughts you enjoy". And many CBT therapists do not understand the purpose of replacement behaviors and Think in a shallow minded was of "Patient does X offen, so x Brings him happyness." Not true. 3. They often see any negative thoughts as unjustified. Some negative thoughts can be very justified and there is a difference between "I should not have done x , that was stupid" and "I am doing x so I am a bad person"

[@cw5437]

Your videos have really helped me through this extremely tough month, especially this video and your rumination video. I have insomnia right now due to stress and grief and watching these videos helps me so much. Thank you so much for sharing your knowledge. I've never accessed counseling before due to a variety of reasons but these videos have really refocused my negative thinking patterns by giving me some tools to try which have really worked well for me.

[@BarbaraHeffernan]

I'm so pleased to hear how much these videos are helping. I wish you health and healing,

[@JulietMcArthur]

"There's only a reason to worry when we can identify something that we can do something about" about is my issue with CBT. Just because there's no solution or immediate available course if action doesn't poof away the worry, but that's where CBT always falls flat for me.

[@skylinefever]

I always saw it useless because it weas like "Yeah. I know this thought is irrational. I always knew it was irrational. Saying shot because it's irrational just makes me more miserable about having a thought that is irrational. Give me a mute button for my brain."

[@JulietMcArthur]

@@skylinefever exactly!

[@dakine4238]

I feel like my therapist is also dismissive.

[@BarbaraHeffernan]

Sorry to hear that....

[@7domo7]

Many such 'therapists' are box-tickers who have totally swallowed (introjected?) the CBT ideology and do not integrate the psychodynamic and humanistic wisdom that came before. And the only thing that matters to them is your PHQ-9 score...

[@addysaw]

Wow your video answered questions that I've had for a long time! Especially illustrating the grief case. Thank you so much!

[@BarbaraHeffernan]

So wonderful to hear that this was so helpful!

[@hanaamr3685]

Thanks so much. Lots of love, gratitude and prayers from Egypt

[@franciscordon9230]

Thanks, very helpful!

[@BarbaraHeffernan]

Glad it was helpful!

[@stephencaudill2422]

The problem with how CBT is taught in grad school, and thus how it is implemented in practice, is that the thinking is way overemphasized. In many cases of real problems changing the behavior is key...

[@stanmil5495]

Doesnt work for me all i have ptsd, ocd and depression. How on earth do stop flash backs in my sleep or when in expecting them? This causes the deppression. In life threating situations we ere taught aggression. Civilians woulďnt unstand it it kniòw what is give me 7:30 meds

[@hagartarek8303]

I can’t see the link it is not in the description may you please kindly attach it 🙏🙏🙏

[@BarbaraHeffernan]

Here you are:awakenjoy.lpages.co/negative-core-beliefs-pdf/ Make sure to check your download folder - sometimes it goes right in there. And I fixed the comments under the video - thanks for the heads up - I'd missed that! 🙏😃

[@TheBrighteyesrn]

Very good description of CBT and how it can intervene in the vicious cycle

[@BarbaraHeffernan]

So pleased it resonated.

[@tiffanymartin729]

Any recommendation for a cbt therapist for me. I'm uninsured.

[@tiffanymartin729]

Thank you

[@alleikat01]

Can’t feels dismissive

[@anynamebutmyrealone]

It can be very harmful and contribute to a sense of depersonalisation and detachment. Pretending traumatised behaviour is not “normal” is awful and dehumanising. Steve will make the right decision and take the right action once he heals, you as a therapist are incapable of making the right suggestions as there is no “normal” or right.

[@mariav.s.9324]

When people doesn't are enrolling in the program and they unsubscribe few times, not necessary to send material to their emails. People can check the videos if they are interested.

[@BarbaraHeffernan]

Hi Maria: the emails are automated, and it is very easy to unsubscribe - there is a link at the bottom of every email! I do appreciate when people unsubscribe when not interested. Wishing you all the best!

[@olivemugo7973]

I have never gotten that pdf

[@BarbaraHeffernan]

Hi: The download often goes directly into people's download file. Can you double check your download file? The link is working, and it truly is being delivered..... LMK!

[@Gar96229]

Honest question: What if we are unintelligent, and as a result, are unable to hold a decent paying job, or we are unable to get a qualification? I feel as though I’m destined for a life of poverty and sadness

[@BarbaraHeffernan]

I'm so sorry to hear you feel this way. There are many types of intelligence and many types of skills. Academic performance is not always a good marker of intelligence nor future performance! I wonder if beginning to focus on the strengths you do have could change your perspective?

[@JoshDTech]

Well, some intelligences pay more financially than others.

[@blushworthyspeaks]

Sooooooo you admit that it doesn't, then.

[@deborahwatson2730]

I turned off after the first 5 minutes…what on earth is she rambling about.

[@sue8370]

Might not be Steve, might be a crappy boss