r/CBT

Basically I have been using David Burns CBT for over 15 years now and it has pulled me out of the greatest pits of mental despair. However, I will say I have found the "walls" so to speak. Meaning, there are some problems I keep running in circles around with Burns CBT. I have heard on this sub "acceptance therapy" being mentioned frequently. Are there any books that you recommend that explores this version of CBT?

So I've been working on a scene for like 8 years now. You would think the scene was me surviving a plane crash or something. But no, it's just a situation where I accidentally made someone angry and they SLIGHTLY raised their voice at me. Not even anger really, just an increase in tone.

CBT brothers and sisters, I have been twisted up in a pretzel of guilt and shame over this for eight years. And JUST RECENTLY I've been able to even come up with the beliefs that were happening during those few seconds.

Well I'm grateful to be making some progress at all, but still it's difficult to not hold some resentment to myself that I couldn't figure this out earlier.

I struggle getting things done. I have spend years researching how to be motivated or disciplined. I always thought that something was wrong with me for not completed my task. I also take wellbutrin which increase motivation. Wellbutrin helps a little with motivation and productivity but I still cannot thing completed anything I set my goals to and still procrastinate. After self reflecting, I realize it is not that I was born different or not motivated, it is because I am hugely afraid of pain/discomfort. If I sense a micro dose of discomfort, my natural urge is to run away and hide. I tried to power through my discomfort but on the third day, I felt a wall of resistance. I need advice. Do I reframe my thoughts, keep a journal and rate my discomfort before and after, or visualize my pain and discomfort in a relax state to desensitize it?

I have my 6th session coming up and I am extremely anxious about it. Last session I was ungodly anxious but able to tell my therapist about my SI. It's hard for me to be vulnerable to anyone and I am so embarrassed and ashamed and scared for my next session Tuesday. I hate talking about myself and bringing attention to myself and regret telling anyone. What can I expect for my next session? Will I be questioned about further SI thoughts?

Mostly around how CBT do not use "needs" anywhere. If you google needs and CBT you get zero result. Most people can say what they feel but most can't name any other need than the most basic Maslov needs.

For some reason, CBT think that it works like this:

Thoughts <-> Behavior <-> Emotions but in a circle.

Or just thought -> emotion -> behavior.

When in reality it is elementary to include need into the equation.

Unmet need -> thought -> emotion -> behavior.

If you do not include needs in anyway, that is like removing 50% of the sequence.

Unsafe -> I feel bad -> scared -> run away.

Whenever you feel something there is ALWAYS related to a need. Always. Emotions and needs interact 100%. You can not have an emotion without a related need being met or unmet and they are often connected to the same proxy of emotions and needs in each end.

So my question is, how in the world is needs not included in CBT or just in psychiatry overall? When I speak with psychiatrists (i am not even a psych), they are like "Huh, that is actually true".

I am absolutely flabbergasted because this is so fundamental to understanding how humans work. Not only that, but for the people you help. And I mean psychiatry and CBT is so well established and I can not find anything about needs.

This is honestly not just about CBT but for psychiatry and psychiatrists as a whole. I recently watched a video where a popular psych said "This is the most important about psychology" and did not even mention needs. How is that possible!?

So for the past 4 years I have this fear that I could die in my sleep. The most annoying part of this fear is realizing that if I die I won't know if Im dead. Where do you think this fear comes from and why does the not knowing part annoys me the most? Can cbt take this obsession away from my head? And how?

I have no health issues, I do check ups often. This fear has stuck in my head when I read that many people are afraid of dying in their sleep. Actually what scared me back then is not being able to sleep because of this fear, which in a way it happened at the end.

Hi everyone. I'm 21F and I've been in CBT with the same therapist ever since I was 16.

Initially I got into therapy because I had a very hard time asking for help and was struggling in school because of it. One day I was crying in the laundry room because of how anxious I was because I couldn't do my schoolwork, my mom found me, argued with me and then got me a therapist.

Continuing with the trend of struggling to ask for help, I truly wasn't able to open up at first in therapy. I was able to get better in some aspects of my anxiety, especially the bad social anxiety I had, but it took a few years for me to get truly comfortable with my therapist to tell her about deeper things about me.

When I was 19 I had an argument with my dad where he told me I was too sensitive, took everything personally and couldn't take criticism. I had heard similar things in the past. I brought that up in therapy and my therapist told me she didn't think that of me. But a couple of years have passed and honestly, I think my dad was right. The context of our argument was a situation where I truly wasn't in the wrong, but it is true that I have a hard time dealing with criticism.

This year I went through a huge fight with my entire friend group. My friend group was toxic and my friends had their own issues, but I was partially responsible for everything that happened too.

My therapist validated me so much in the entire situation. She didn't exactly defend my poor actions but she didn't focus on them either, she focused more on how I was wronged.

She constantly tells me I blame myself too much, but I feel like she just lets me off the hook too easily.

Ever since that situation with my friends I began feeling exhausted because every interaction I have is filtered through some thoughts - "am I being a good person? Am I being fair? Am I being mature? Am I distorting everything and making me the good guy when I'm actually in the wrong?"

I keep on replaying all my conversations, reanalyzing everything, posting on r/AITAH...

Today I was talking to my therapist about a situation where I upset my sister and how sad I was I had hurt her (though I had apologized etc etc), and my therapist once again told me I was feeling guilty for something I didn't have to feel guilty about. But I did something that upset my sister (she was upset she couldn't fit all the projects she wanted to be a part of because of her part-time job, and I told her I was happy I could organize all my schedule, so it sounded like I was rubbing on her face I could do all I wanted and she couldn't though that wasn't my intention...).

Anyway, I truly worry she is being way too validating of me. That she's not calling me out when needed. She has a few times but it's not possible that other people are more in the wrong than me. I worry she's being too validating and that means I'll never grow and I'll be an awful person who hurts people.

It's being really exhausting. I don't know what I should do. I like my therapist and since I have a hard time trusting people and opening up I don't know if I'd feel okay changing therapists... I just need some advice

I've been suffering from public speaking anxiety for 20 years after a stressful class presentation in college. I've been in all kinds of therapy (EMDR, CBT, talk therapy) and am currently prescribed 40mg propranolol for job related public speaking (plus 0.5mg Xanax for especially high stakes moments). Even though they take the worst physical symptoms away, I still just don't feel relaxed. I know the goal isn't perfection but I just see other people saying that this kind of medication just take the anxiety away like a magic wand and I feel jealous. My current therapist who uses a combination of CBT and talk therapy suggest I look into CPT. Has anyone tried it? I know it's primarily for PTSD, but I guess since a lot of mine goes back to that one moment, it's potentially useful.

I am looking for some resources for my son who is 18. He has a diagnosis of anxiety which runs both i  my family and his dad’s. When he was a kid, he would ruminate over an asteroid hitting the earth or his parents having a car accident. But he was also usually a happy functioning kid with activities, interests, etc

Now he has had a collapse about climate and this is hard because it is absolutely real and genuinely terrifying. The headlines are filled with forest fires, extreme weather, etc.

His doctor recommended CBT and I am looking at workbooks and resources. There seems to be a serious gap in the material. 

I am finding that materials are either:

1. focused on climate anxiety for people with “normal” social responses: “take action, write letters, join a group, research the issue, read all the things, talk to your family and friends, etc”. These are toolkits for otherwise well functioning people. They note that it is healthy to take the odd break, but they mostly want the reader to do more.

or

2. Manuals focused on GAD, OCD or panic disorder that assume the worry is exaggerated or focused on improbable dangers.

We are left stranded between two unsuitable messages:

“Your fear is irrational; challenge the thought.” His fear is not irrational. 

and

“Your fear is valid! Become active and engaged!” He is too exhausted and desperate. 

Neither addresses: The threat is real but you have become totally incapacitated.

Are there some CBT resources that are founded on managing worry about real and genuinely overwhelming concerns?

I found a manual called What to Do When Worries Ring True that recognizes that standard manuals often mishandle realistic dangers. But it is guidance for therapists, not patients.

I need something that acknowledges climate science (or other valid and terrifying fears) while treating the symptoms of anxiety: constant rumination, compulsive research, repeated reassurance-seeking (is there hope?) combined with constant searching for confirmation of fears (there don’t seem to be enough insects, the lake seems warmer, those trees are dead, the fires in bc are unprecedented, our city is engulfed in smoke, the rhine is at its lowest level, etc), panic, inability to sleep, —before discussing activism. I need to get him back to his baseline so he can make it to tomorrow, next week, next month.

Any ideas about resources? Anyone working on this? Some psychologist who has contemplated what seems like a very obvious problem? Or someone else in the environmental or health world who could point me in the right direction? 

I’m an RMN with 2 years’ post‑qualifying experience, currently on long‑term sick leave, and I’m exploring realistic ways to return to psychological therapy work once I’m able. HI CBT trainee roles feel too intensive for me at the moment, so I’m considering the PWP route as a structured, lower‑intensity step before progressing to HI CBT later on.

For anyone who has worked in IAPT/CBT services: how common is the RMN → PWP → HI CBT pathway, and does prior nursing experience tend to help or hinder when moving into CBT roles? I’m also starting an MSc Psychology and wondering whether that background is useful when transitioning into CBT training.

I’d appreciate experiences or insights from PWPs, HI CBT trainees, or supervisors familiar with this progression.

Hey! I've been going to a therapist and i feel severe nausea. My throat dries up, I feel a lot discomfort in my chest, my limbs feel suddenly heavy, I feel super sleepy, I can't feel good at all.

And this happens every single time.

I usually have my sessions once every two/three weeks at about 3 PM and all of the above starts happening the second I wake up in the morning at about 10/11 AM or 12 PM.

Is it the same for you guys too? How can I stop feeling this way? It is wrecking me and I am so tired of dealing with this every single time.

I'm currently in therapy. When I started in early June, I expressed my desire to try CBT but was open to whatever my therapist thought would be best for my constant overthinking/low self-worth feelings. More specifically, my ex-wife cheated on my and said some really terrible things and gave me some sort of PTSD from it. While I've healed 80%, I still struggle with the fear my new spouse will cheat (but not all the time). I told her in the past I've had the most success with action-oriented therapy, meaning, if you give me homework, I will implement it, whereas, when I do traditional talk therapy, I feel better after talking about my feelings, but it feels short-lived.

2 months later, I feel like I'm just doing talk therapy. There was a couple of weeks where she taught me the breathing techniques and the see 5 things, hear 4 things, feel 3 things, etc. But other than that, I feel like we're just talking about my past.

Part of the problem is I'm not going through anything specific right now. Like I said, my fear is oddly situational. Some things trigger my thoughts, but it's usually random. So while my biggest focus is my fear of being cheated on, I'd rather use CBT in all situations where my mind runs amuck.

Is it possible that my therapist is trying to figure out what exactly is the root cause of my anxiety (inner child work) before moving forward to the specific CBT tasks? She did warn me in the beginning that it can take a long time to see improvement, so this part wouldn't be a surprise.

Thanks for your help and guidance. I'm a little on the spectrum and don't always know the best way to approach these types of situations or if expectations are wrong.

>Metacognitive Therapy (MCT) is a type of psychotherapy created by Adrian Wells that focuses on how you think rather than the content of your thoughts. Instead of challenging negative ideas like in traditional CBT, MCT teaches you to stop excessive worrying, rumination, and fixed attention patterns, changing your core beliefs about your own thoughts

I feel like rumination is my biggest problem. Does anyone have any experience with this?

I’m reading a book on CBT and it asked me to write down a ranked list of activities, 1 being less scary, 10 being terrifying. But then it goes on to say ‘…repeating each until… it doesn’t happen’. But my lived experience is why I have that anxiety, repeatedly. I’m worried because I do know the likelihood of shit happening.

There’s also a worry tree but it’s extremely unhelpful to read “can you do something about it?” And the answer being no, and being told to let it go then. I’m disabled and I can’t let go that there are other factors going into why I can’t but still need something!

I’m thinking of scrapping the CBT for now and focusing on ACT. I find myself a bit irritated when the logical answer to each is a problem I’ve already exhausted the options of what I can do to address.

I (27, non-binary, any pronouns) have never dated anyone or so much as held hands with someone in a romantic context. I'm autistic and was bullied pretty relentlessly in school, so I missed out on exploring any of that stuff in my teens/early adulthood.

I feel too old to be completely inexperienced, and like there's no easy "entry point" to romance/sex. If I'd never learnt to swim as a child, I could go to a local pool and start in the shallow end, hire a teacher or just look up videos of people teaching swimming to learn how. But I can't do that here.

All the advice I seem to find is just like "put yourself out there" and "be yourself", but that's not useful because I don't know *how*. Making friends is already a struggle for me, but at least I know how to make small talk and have conversations with people. Even if I don't make friends with them, I can usually carry on a conversation with someone, while being reasonably sure I won't offend them or make them uncomfortable. I don't know how to do that with romance/sex. I don't even know how I'm supposed to tell another person might be interested/receptive. I've only ever been flirted with twice (once where the other person made a transphobic joke, possibly trying to determine if I had a dick or not; and the other was someone who approached me at work and started asking "why are you single?" and generally making me uncomfortable), so I don't have any real life examples to pull from for what flirting can/does look like.

I know I can't wait around expecting someone to flirt with *me*, but the idea of making the first move is petrifying.

I've tried dating apps, but everyone I see on there seems so much more experienced and like they know exactly what they want, and I *really* don't.

Bars/nightclubs aren't a good option either because I don't really drink/don't get drunk, being around drunk people makes me uncomfortable, and with being autistic, the loud music is both overstimulating and means I wouldn't be able to hear what anyone was saying anyway.

The one local meet up group for queer people is small, and focused around friendship and community building, and I'm new to the group. I don't want to test anything out there because I don't want to weird anyone out or make them uncomfortable, or lose the only community I have access to if something went wrong and I felt like I couldn't go back.

I've asked for advice in other places, but just get a lot of "just throw spaghetti at the wall and see what sticks", which I find really unhelpful. Like I don't know how to make spaghetti, never mind how to throw it. I need some actual pointers and not just "get out there, champ".

I've found bog-standard CBT very unhelpful in the past, and had TfCBT recommended to me because of trauma from being bullied and undiagnosed autism. When I've tried to look into it, none of the information I found really explained how the two are different, other than TfCBT being "trauma informed".

Are the techniques/methodology meaningfully different, or is it just CBT with like. Some acknowledgement that trauma exists. (In which case, why isn't *all* CBT trauma informed?)

Any suggestions on how I should start?!🤔

(27 non-binary, any pronouns, autistic)

When I try and fail at things I care about/have put a lot of effort into (making friends, dating, drawing, etc.) I feel a lot worse than if I just don't try.

The phrase "at least you can say you tried your best" doesn't make any sense to me, because if I tried my best and still failed, that means my best wasn't good enough. At least if I don't try I can say I didn't try, and that's why it didn't work out. Not trying saves my feelings.

The thing is, I *know* this frame of mind is ruining my life and stopping me from trying things and learning, but I feel so awful when I fail at things it sends me into really severe depressive episodes, or at least end up crying for hours. When I didn't get the grades for my first choice university I sobbed almost non-stop for days (in retrospect I'm glad I went to the university I did go to, but at the time I was devastated). When I tried to make small talk in college and it went badly I couldn't concentrate on classes for the rest of the day and barely slept for a week. When I made a concerted effort at uni to make friends and then got bullied by the people I thought I was getting along with, I had a depressive episode so bad I had to repeat the year. When I had to do a job fair at the job centre the only mini-interview I did went so badly I sat down in the corner and cried until my job coach came over and let me look for jobs on the online system for the rest of the job fair. Trying really hard with a drawing only for it to look terrible has made me so frustrated and upset in the past that I broke a pen and hit myself in the head with my hands. I get incredibly frustrated and upset with myself if I fail at games too, especially if I've really tried and still failed, not just made a stupid mistake (with games, I feel less bad if I at least feel like I've learnt something by failing, which often isn't the case in real life. you can't simply try the same "challenge" over and over again in identical circumstances irl).

I don't know how to deal with this because I *know* it isn't helpful, I *know* failing at these things doesn't make me less worthy as a person, but feeling like I've failed just hurts too much and has me reeling for days, if not depressed for weeks (depending on how big the failure is).

Since a teenager I have suffered with health anxiety - it would come and go.

For a few years now (I’m 54 ) I have been in distress every day, mental worries about certain symptoms and daily compulsions to check for lumps and bumps on skin. Checking stool etc etc.

Even when doctors have told me I’m okay, I wake up and think, well something might of changed over night. It’s daily and it’s never ending.

My brain tells me, “just check one last time, just in case you’ve missed something”
Does this sound familiar to anyone?