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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Kevin Davis on March 2, 2003, at 19:13:33
Hello, I am a sufferer of depression and Social Anxiety disorder. I have recently been informed that I should consider taking nardil and seeing a doctor who practices cognitive/behavioral therapy. I haven't had any luck with doctors in the Ann Arbor Michigan area. They seem to want to focus on my past and they have not provided good strategies for dealing with my problem. I have taken many different SSRI drugs but none of them seem to be worth dealing with the numbing side effects. Can someone please recommend some good doctors in the Ann Arbor area. Preferably one who practices cognitive therapy and participates with the perfered choices PPO.
Thanks.
Posted by Phil on March 2, 2003, at 19:27:19
In reply to cognitive therapy, posted by Kevin Davis on March 2, 2003, at 19:13:33
Kevin: I think I found a great link for you.
http://www.aabt.org/CLINICAL/MI.htm
Phil
Posted by ace on March 2, 2003, at 21:45:27
In reply to cognitive therapy, posted by Kevin Davis on March 2, 2003, at 19:13:33
Posted by Phil on March 2, 2003, at 23:15:58
In reply to I PERSONALLY wouldn't waste time on 'CBT' (nm) » Kevin Davis, posted by ace on March 2, 2003, at 21:45:27
Posted by Rainee on March 2, 2003, at 23:30:20
In reply to I PERSONALLY wouldn't waste time on 'CBT' (nm) » Kevin Davis, posted by ace on March 2, 2003, at 21:45:27
I also didn't know I was soft bi-polar either until a med kicked it in. I suffer from anxiety first and foremost. A nice even keel is what I want. Because the crash is too much to handle.
I feel bad when I see someone is manic and they think there under control. CBT is great.Best wishes
Posted by KrissyP on March 3, 2003, at 1:02:54
In reply to When I was hypomanic I didn't think I needed CBT., posted by Rainee on March 2, 2003, at 23:30:20
CBT helped me. I still wish it would have helped a little better though
> I also didn't know I was soft bi-polar either until a med kicked it in. I suffer from anxiety first and foremost. A nice even keel is what I want. Because the crash is too much to handle.
> I feel bad when I see someone is manic and they think there under control. CBT is great.
>
> Best wishes
Posted by NikkiT2 on March 3, 2003, at 7:29:17
In reply to Re: When I was hypomanic I didn't think I needed CBT., posted by KrissyP on March 3, 2003, at 1:02:54
CBT has helped me enormously with regards to social anxiety and panic attacks.. really has been great.
Nikki
Posted by mattdds on March 3, 2003, at 7:58:23
In reply to cognitive therapy, posted by Kevin Davis on March 2, 2003, at 19:13:33
Kevin,
CBT is great, but it requires a lot of work on your part. I got about 80% of my relief from anxiety and nearly all of my depression from CBT. Certainly, the behavioral aspects of both of those disorders were helped tremendously (i.e. I was able to continue functioning at a high-level during bad anxiety thanks to CBT training)
I disagree that it is a waste of time. CBT is becoming the standard of care (according to many) for panic, social anxiety, OCD and depression. It targets specific complaints and upsetting ideas and beliefs, rather than blindly groping around your "childhood" for some possibly related traumatic event, like the older therapies often do.
Also, CBT can change your brain, literally. A commonly used biological marker to show remission of OCD is reduced glucose metabolism in the caudate nucleus. A study done at UCLA in '92 showed that people who responded to CBT showed the same changes in caudate glucose metabolism as those who responded to SSRI therapy. Reference below:
Baxter, L.R., Schwartz, J.M., & Bergman, K.S., et al. Caudate glucose metabolic rate changes with both drug and behavioral therapy for obsessive-compulsive disorders. Archives of General Psychiatry, 49, 681-689
I strongly recommend CBT. It can't hurt and can only help. There are also (presumably) no side effects (others would jokingly say a "pain in the ass", though.), and you can raise the "dose" as high as you want.
CBT is not a panacea, and I'm sure I'll take some flak for posting this, but my experience has been really good.
Keep in mind that CBT and meds need not be mutually exclusive. I take a (very) small dose of Klonopin, which is usually frowned upon by most behavioral idealists. But this is what works for me. Between the CBT and the Klonopin, I consider myself 100% recovered, sometimes perhaps better than before I was ever sick! Also, when I feel myself slipping or getting flare-ups of my old symptoms, they last about an hour now. CBT is great, and well researched, for relapse prevention.
Best of luck,
Matt
Posted by laurarn on March 3, 2003, at 10:49:28
In reply to Re: cognitive therapy » Kevin Davis, posted by mattdds on March 3, 2003, at 7:58:23
Thanks Matt. I like the way you expressed my own experience.
Posted by TommyTommy on March 3, 2003, at 12:07:43
In reply to Re: cognitive therapy » mattdds, posted by laurarn on March 3, 2003, at 10:49:28
Where does CBT differ from "ordinary" Pyschology? It seems like so many pyschologists I've seen don't want to dwell deep into things and they just want to give "seemingly worthless" examples that any idiot could come up with. Basically what I'm saying is that too many pyschologists just want to spend the hour session treading the water with examples of positive thinking instead of going down deep into the water and addressing the true problems. Do you guys feel that CBT is a totally different experience? Are all pyschologists trained to do CBT?
Thanks,Tommy
Posted by ace on March 3, 2003, at 19:22:54
In reply to Re: No one has asked you to. (nm) » ace, posted by Phil on March 2, 2003, at 23:15:58
Posted by Maximus on March 3, 2003, at 21:37:03
In reply to I PERSONALLY wouldn't waste time on 'CBT' (nm) » Kevin Davis, posted by ace on March 2, 2003, at 21:45:27
Posted by KrissyP on March 3, 2003, at 21:48:44
In reply to Re: cognitive therapy » Kevin Davis, posted by mattdds on March 3, 2003, at 7:58:23
I agree, CBT is much more sensible often, I say, rather than blindly groping around your "childhood" for some possibly related traumatic event, like the older therapies often do. Thanks for sharing Matt. Did any of your CBT training include deep breathing? A therapist not too long ago taught me that and I really get the concept now-and it helps! I did CBT for a while when I first went into therapy. It WAS tough AKA "a pain in the ass" LOL BUT, it sure helps with how you think (cognitively) and how you choose your behavior (Behavioral) LOL I am not seeing a therapist right now-I did 6 years of it and I woulodn't be where I'm at today if CBT wasn't part of my treatment-It's great.
Just my opinion........
Kristen:-)----------------------------------------------------------------------------------------
I disagree that it is a waste of time. CBT is becoming the standard of care (according to many) for panic, social anxiety, OCD and depression. It targets specific complaints and upsetting ideas and beliefs, rather than blindly groping around your "childhood" for some possibly related traumatic event, like the older therapies often do.
Also, CBT can change your brain, literally. A commonly used biological marker to show remission of OCD is reduced glucose metabolism in the caudate nucleus. A study done at UCLA in '92 showed that people who responded to CBT showed the same changes in caudate glucose metabolism as those who responded to SSRI therapy. Reference below:
Baxter, L.R., Schwartz, J.M., & Bergman, K.S., et al. Caudate glucose metabolic rate changes with both drug and behavioral therapy for obsessive-compulsive disorders. Archives of General Psychiatry, 49, 681-689
I strongly recommend CBT. It can't hurt and can only help. There are also (presumably) no side effects (others would jokingly say a "pain in the ass", though.), and you can raise the "dose" as high as you want.
CBT is not a panacea, and I'm sure I'll take some flak for posting this, but my experience has been really good.
Keep in mind that CBT and meds need not be mutually exclusive. I take a (very) small dose of Klonopin, which is usually frowned upon by most behavioral idealists. But this is what works for me. Between the CBT and the Klonopin, I consider myself 100% recovered, sometimes perhaps better than before I was ever sick! Also, when I feel myself slipping or getting flare-ups of my old symptoms, they last about an hour now. CBT is great, and well researched, for relapse prevention.
Best of luck,
Matt
Posted by mattdds on March 3, 2003, at 23:59:43
In reply to Re: cognitive therapy » mattdds, posted by KrissyP on March 3, 2003, at 21:48:44
Hi Kristen,
Thanks so much for your comments! It is great to hear others benefitting from CBT as well.
To be honest, I learned about CBT on my own, and have had little formal "therapy" sessions. I did, however, read a **lot** about the advanced techniques and also about the research and theory behind it. I read all the stuff by Aaron Beck, Adrian Wells, and David Burns is a favorite too.
In my opinion, once you learn the techniques that help you, you really don't need a therapist.
Also, I don't think most people that try CBT give it a fair trial. I mean, this stuff is work! Most people go to a CBT therapist for a few sessions, don't do any homework, and don't really do much outside the 1-hour weekly sessions. I think of CBT as reprogramming your brain, which takes a lot more work than 1-hour weekly sessions.
When I was in my worst period, I would spend hours on the exercises, and kept the "mood log" journal of cognitive distortions nightly. I also tracked my progress using the Beck anxiety and depression tests. This way, I could objectively measure my success. I really got into it, and watched my anxiety and depression scores plummet on an Excel graph! I'd be happy to detail all of this to you if you are interested.
So my point is, the CBT therapy sessions (like formal therapy) do very little other than teach you CBT, if that makes sense. If all you do is get once a week counseling, there is very little chance CBT will help, in my opinion. It is the *homework* that will really get you better. Another option is intensive therapy on an inpatient basis, as they do at Stanford University. You have to really get the attitude of kicking anxiety's (or depression's or OCD's) ass, and be diligent. I cannot stress the importance of the homework enough! This is, in my view, the ONLY way that CBT works, with tons of individual effort. It is incredibly hard work to rewire your thinking from the ground up, but it really pays off. For the first time, I feel like I have "fixed" the bulk of my anxiety disorder, though many here will doubt that.
As far as deep breathing training, I'm not sure that's considered CBT, technically. It could certainly be used as an adjunct, but I think the mainstays of CBT are cognitive restructuring and behavioral exercises. Are you familiar with those? I'd be happy to discuss this over at psychological babble (I'm sure this will get redirected) with those who are interested, but it seems that very few people here are interested in CBT. I tried to get a discussion going over there about CBT back in June of 2002, but even in psychological babble, people were yawning. To me, it's fascinating. I think CBT is the most underutilized and underrated tool in psychiatry. (I'll be ducking from all the flak I'll get for this comment!)
You're right, CBT is a pain in the ass! And there is really no way around that aspect. But for me, the return was infinitely worthwhile.
Having said all that, CBT is not a panacea, or miracle cure-all. It cerainly works for me, and I think it would for most people, at least to some degree. Going along with the cliche, YMMV.
Best wishes Kristen,Matt
Posted by KrissyP on March 4, 2003, at 0:50:49
In reply to Re: cognitive therapy » KrissyP, posted by mattdds on March 3, 2003, at 23:59:43
Your very welcome Matt. David Burns is awesome-I learned a lot from his writings. Isn't the goal of therapy to learn so you no longer need one?
:-)I'm glad that you can use CBT on your own now.
I think the therapist/patient relationship is a TEAM. What good is it going to do us if we don't do the "homework" etc. that we are paying the therapist to help us? Yes I am interested in your Beck and Excel graph-that is wonderful.
CBT IS work and anything worth getting is work-It's taking me a while to learn this. Better late than never though:-)Yes, I am familar with cognitive restructuring and behavioral exercises, I kept a journal for 2 years and noted everything, and I learned to see things differently-it helped a lot. Deep breathing certainly can be used as an adjunct to CBT-It really is helpful. The efforts one puts into CBT is well worth it! I'm glad that it has helped you and I am happy to hear you know a lot about it.
Keep in touch, By the way what do you mean by YMMV?
Please share.
Keep posting
All the best:-)
Kristen
-------------------------------------------------Hi Kristen,
Thanks so much for your comments! It is great to hear others benefitting from CBT as well.
In my opinion, once you learn the techniques that help you, you really don't need a therapist.
Also, I don't think most people that try CBT give it a fair trial. I mean, this stuff is work! Most people go to a CBT therapist for a few sessions, don't do any homework, and don't really do much outside the 1-hour weekly sessions. I think of CBT as reprogramming your brain, which takes a lot more work than 1-hour weekly sessions.
When I was in my worst period, I would spend hours on the exercises, and kept the "mood log" journal of cognitive distortions nightly. I also tracked my progress using the Beck anxiety and depression tests. This way, I could objectively measure my success. I really got into it, and watched my anxiety and depression scores plummet on an Excel graph! I'd be happy to detail all of this to you if you are interested.
So my point is, the CBT therapy sessions (like formal therapy) do very little other than teach you CBT, if that makes sense. If all you do is get once a week counseling, there is very little chance CBT will help, in my opinion. It is the *homework* that will really get you better. Another option is intensive therapy on an inpatient basis, as they do at Stanford University. You have to really get the attitude of kicking anxiety's (or depression's or OCD's) ass, and be diligent. I cannot stress the importance of the homework enough! This is, in my view, the ONLY way that CBT works, with tons of individual effort. It is incredibly hard work to rewire your thinking from the ground up, but it really pays off. For the first time, I feel like I have "fixed" the bulk of my anxiety disorder, though many here will doubt that.
>
> Best wishes Kristen,
>
> Matt
>
>
Posted by dave1 on March 4, 2003, at 11:55:23
In reply to cognitive therapy, posted by Kevin Davis on March 2, 2003, at 19:13:33
What exactly do they do in CBT sessions?
Dave
Posted by KrissyP on March 4, 2003, at 12:08:51
In reply to Re: cognitive therapy, posted by dave1 on March 4, 2003, at 11:55:23
Well.......when I did CBT, back in 1996, my therapist taught me how to see things differently AND behave differently. For example, I was going through extreme guilt because my dad had chosen to do drugs. I felt it was something I could change in my dad-to make him better. The therapist helped me to realize that even though I loved him, HE had chosen to do drugs and that probably 99% did not have anything to do with me, and I was NOT responsible. That was hard for me. I was taking it out on myself-hard, and she helped me to gain my power back by "thinking" about that and MANY situations differently. CBT is VERY intense, but it doesn't have to be if YOU are willing to do the work-AND work as a team with a therapist-something that took me 3 therapists later to realize. CBT is definately worth a try-for me it was anyway. Also, when I was asked a question-I often said "I don't know" when in reality I did know. My therapist said "everytime you say 'I don't know'-I'm going to put a dollar in a bottle and donate it to your least favorite charity"-She was awesome-my first therapist. There are many more things CBT involves and it depends on the psychologist's theory of practice and scope.
Hope this helped?
Kristen:-)
-------------------------------------------------What exactly do they do in CBT sessions?
Dave
Posted by KrissyP on March 4, 2003, at 12:27:02
In reply to Re: cognitive therapy, posted by TommyTommy on March 3, 2003, at 12:07:43
I hear ya! This is why I stopped therapy last March. And so far so good. There are many approaches that therapists take-and all depend upon the symptoms the patient approaches him/her with. Freud's theory is "childhood", Maslow's theory is "self-actualization", and so on.
CBT is about changing your thinking and behavior that maybe adding to your discomfort. Most psychologists do it, but some are tailored and trained to only do one or a few types of therapy.
Hope this helped a little?
Good luck, Kristen
-------------------------------------------------Where does CBT differ from "ordinary" Pyschology? It seems like so many pyschologists I've seen don't want to dwell deep into things and they just want to give "seemingly worthless" examples that any idiot could come up with. Basically what I'm saying is that too many pyschologists just want to spend the hour session treading the water with examples of positive thinking instead of going down deep into the water and addressing the true problems. Do you guys feel that CBT is a totally different experience? Are all pyschologists trained to do CBT?
Thanks,
Tommy
Posted by dave1 on March 4, 2003, at 13:12:22
In reply to Re: cognitive therapy » dave1, posted by KrissyP on March 4, 2003, at 12:08:51
HI,
I was wondering when you did the CBT, did it make you more self conscious about yourself. Once when I went to an OCD psychologist, he sent for social skills training. When I did that, I would basic practice socializing with the therapist and the therapist would teach me things like asking open ended questions. Unfortunately, it made me very self conscious and I became obsessed with myself and everything I said or did. I wouldn't want that to happen if I did CBT.
Dave
Posted by David Smith on March 4, 2003, at 16:08:50
In reply to Re: cognitive therapy » mattdds, posted by KrissyP on March 4, 2003, at 0:50:49
...By the way what do you mean by YMMV?
> Please share.
> Keep posting
> All the best:-)
> KristenDear Kristen,
Thank you for the tip on David Burns.
I would guess that YMMV stands for
"your mileage may vary."
Of course, I cannot speak for Matt.
What a great thread!!!
dave
Posted by KrissyP on March 4, 2003, at 18:59:09
In reply to Re: cognitive therapy » KrissyP, posted by dave1 on March 4, 2003, at 13:12:22
Hi Dave,
I remember when I did CBT- yes, I took what the therapist had taught me and thought A LOT about it. It did make me somewhat self-conscious but back then I was extremely self-conscious already. My advice, work with a therapist if you are interested in CBT and tell him/her your concern you state here. Empower yourself-maybe corny, BUT you are taking care of you and learning how to cope more effectively by your thought processes when you undertake CBT.
**About you feeling self-conscious, I understand what you are saying. Sometimes when we go into therapy, some of us think "Oh, I will be cured"-that isn't the case always--we put our emotions on the front line, and we become vulnerable-could that be how you are feeling rather than the self-conscious feeling you talk about here? Just a thoguht. Therapy in general is tough, BUT so worth it, IF you work as a team, as I said in an earlier post. I know it may feel uncomfortable for you, but realize that you can choose to give it a try, if it doesn't help, or you feel self-conscious-TELL the therapist that. You may get even more help than you were seeking in the first place.
I hoped this helped? Good luck!
Keep me posted:-)
Kristen
-------------------------------------------------
HI,
I was wondering when you did the CBT, did it make you more self conscious about yourself. Once when I went to an OCD psychologist, he sent for social skills training. When I did that, I would basic practice socializing with the therapist and the therapist would teach me things like asking open ended questions. Unfortunately, it made me very self conscious and I became obsessed with myself and everything I said or did. I wouldn't want that to happen if I did CBT.
Dave
Posted by KrissyP on March 4, 2003, at 19:25:40
In reply to Re: cognitive therapy, posted by David Smith on March 4, 2003, at 16:08:50
Thanks Dave got it LOL
"Your Milage May Vary" New to me.
Kristen
> ...By the way what do you mean by YMMV?
> > Please share.
> > Keep posting
> > All the best:-)
> > Kristen
>
> Dear Kristen,
> Thank you for the tip on David Burns.
> I would guess that YMMV stands for
> "your mileage may vary."
> Of course, I cannot speak for Matt.
> What a great thread!!!
> dave
Posted by mattdds on March 4, 2003, at 23:31:44
In reply to Re: cognitive therapy » David Smith, posted by KrissyP on March 4, 2003, at 19:25:40
YMMV. Sorry, should have just spelled it out. I don't think many people know about this except the old psycho-babble veterans! What a strange little world this is here, haha.
Best,
Matt
Posted by KrissyP on March 4, 2003, at 23:51:31
In reply to Re: cognitive therapy, posted by mattdds on March 4, 2003, at 23:31:44
ha ha ha:-) I think it's great that there are the psychobabble "veterans-I wish I would have known about this site a long time ago:-)
It's just great!
Take Care,
Kristen
-------------------------------------------------YMMV. Sorry, should have just spelled it out. I don't think many people know about this except the old psycho-babble veterans! What a strange little world this is here, haha.
Best,Matt
Posted by Dr. Bob on March 5, 2003, at 0:00:33
In reply to Re: cognitive therapy » dave1, posted by KrissyP on March 4, 2003, at 18:59:09
> I remember when I did CBT...
This is a fine discussion, but since it has to do with psychological treatment, I'd like it to be redirected to Psychological Babble, thanks.
Bob
PS: And follow-ups regarding posting policies to be redirected to Psycho-Babble Administration.
This is the end of the thread.
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