I’m Considering Asking My CBT Therapist to Read One of Your Articles…

I’ve started in-person CBT sessions with a therapist and I took your advice by leading with what I was able to recall from my traumatic experiences. I told him how powerless and lowly I felt in those moments and that, as a result, I feel defenseless in dealing with other people, shy away from developing close relationships outside of my family, avoid sex like the plague, and that I’m just not good enough in general to even do well in God’s human game. Basically, I hide out from people most of the time – similar to how the individual who wrote the question for the “I’m Afraid of Humans & Ashamed that I Can’t Trust God” article does. I told him that my goal was to change my behaviors by first changing the traumatic beliefs that are fueling them. While he didn’t really respond to the God issue, he corrected me by saying that it’s the other way around; the way that I change beliefs is by first gradually changing my behavior. He called it the “fake it till you make it” method. He says that if we don’t make significant progress with CBT alone, he recommends I get chemical assistance via Zoloft/Sertraline. I’m wondering if this would work well in my case and how far could this method potentially take me in correcting my trauma and feel I could really use your advice here.
Also, I’m still attempting to go through the exercises in your article about correcting traumatic beliefs and I was wondering if it would be wise to share the article with my therapist in hopes that it would maybe help speed things along.

I would strongly caution you not to share any of my articles with your therapist. That is likely to go over very badly and make your relationship with him feel awkward, which will then cause you to not gain any benefits from working with him. To understand why this is such a bad idea, here are some things to understand about therapists…

The Therapist Perspective

There are many different ways to try to resolve mental health problems. Every approach is built on theories about underlying causes as well as an individual’s capacity for change.

Psychological theories are very similar to religions in that they all promote specific beliefs and some are more open minded than others. In some religions, for example, you are strongly pressured to not associate with folks from other religions. In some areas of therapy, you’ll find the same close-minded attitude among therapists who are using different approaches to treating their clients. Generally speaking, therapists have a very difficult time working together to treat the same client. This is not just due to differences in their beliefs; it’s also due to their treatment methods being incompatible.

Suppose you were trying to teach someone how to read. You have spent a lot of time carefully working out your lessons plans, and you are very excited about helping your student progress. Now reading is a very complex subject, and there are many rules that you’ll need to teach your student if he’s going to learn to pronounce words correctly. If you drop too many rules on him at once, he’ll be frustrated and confused, so you’ve come up with a strategic plan for which rules to introduce first, and which ones to save until later.

At first, things are going along very well, and you and your student are both feeling encouraged by the progress he’s making. You’ve just started teaching him some of the first rules of how to pronounce words correctly, and he’s picking up the material very well. But then one day he arrives at his session looking confused and frustrated. He explains that he’s gotten himself a second reading tutor to help in addition to you, because he figures he’ll learn faster that way. But this second tutor is using a very different approach, and he’s teaching your student some of the rules that you’ve been intentionally saving for later. Now your student is feeling confused because you told him that when he sees the letter combination ough, it is pronounced oo as in through. But this other tutor has said that ough is pronounced uff as in rough. You’re both right, of course, but to your student, it sounds like you’ve been lying to him. You’ve been oversimplifying things on purpose, because that’s what good teachers do, and so has this second tutor that your student has decided to work with. The problem is that you and the other tutor are introducing concepts in a different order, and that is causing your student to become aware of complications faster than either of you wanted him to. Both of you intended to ease your student in by giving him a few straightforward rules to focus on, then slowly introducing him to their many exceptions over time. It was a sound plan until you each started with a different set of rules. Now your student is feeling confused and overwhelmed by realising things aren’t as simple as he thought it was and this is exactly what you didn’t want to happen.

This reading example illustrates how therapists often feel when they have a client who starts working with another therapist at the same time as them. That other therapist will inevitably be using a different approach which will seem contradictory to what the first therapist is trying to do. The result is a frustrated client who is being pulled in two different directions. The client either tries to start getting his therapists to align with each other by arguing with them (never a winning strategy), or he feels pressured to choose one side over the other (rather like the child who feels he must choose between Mom or Dad).

Trying to get your therapists to talk the same language is an epic waste of time, so you really don’t want to go there. The way therapists communicate to their clients stems from complex and often deep rooted belief systems which are not going to be changed through verbal debate.

In my material, I emphasize the importance of dealing with root causes, which is of course very important in mental health recovery. CBT is a method which isn’t designed to deal with root causes. Instead, it’s designed to help you identify better ways of dealing with your immediate problems. CBT focuses on right now, whereas the article you’re referring to is focused on understanding how the past has shaped your current beliefs. CBT rightfully acknowledges that there is a strong relationship between our behaviours and our beliefs, and it attempts to shift current negative beliefs (“my life is pointless”) by making changes to your current behaviours (such as setting small, doable goals of productive activities that you can do in a day). CBT can be very useful for someone in your position, who feels very stalled in life and whose lack of activity is reinforcing a sense of inability.

Beliefs and behaviours strongly influence each other, so your therapist is correct in saying that your behaviours can reshape your beliefs. It’s useful to remember that traumatic beliefs form when we try to understand our experiences. To fully change those beliefs later on, we need to collect new experiences that our minds will see as evidence that their initial conclusions were wrong. For example, if you believe you are powerless to defend yourself, you will feel very afraid in the world. You cannot fully change this belief by only using positive self talk. At some point, you must start behaving in a way that feels powerful to you personally, such as saying “no” when you don’t want to do something instead of telling yourself that you have no choice. When you’re having trouble identifying the specific behaviours you need to start shifting your internal beliefs, CBT can be well worth trying. CBT won’t help you understand how your negative beliefs initially formed, but when you’ve already made a lot of those connections yourself–which it sounds like you have–you don’t need CBT to help you in that way. Instead, you need it to help you identify ways that you can change your current behaviours to shift the negative beliefs that are currently holding you back in life. Coming up with a specific action plan for helping you positively adjust your current behaviours is where CBT excels, so it’s definitely worth giving this method a chance without trying to turn it into something that it’s not meant to be.

Now for the sake of all my readers, let me clarify a bit more about the value of CBT. This method is worth trying when you are at a point where:

  • You feel you’ve got a decent grasp on the root causes of your current negative beliefs, meaning you see connections between your past negative life experiences and your current negative beliefs.
  • You are tired of feeling hampered by your negative beliefs, but you feel you could really use some fresh ideas about specific, practical ways that you can improve your daily quality of life.
  • You’re feeling motivated enough to put effort into trying the steps your CBT therapist recommends (as long as you feel comfortable, of course–never agree to do a therapeutic exercise that feels wrong to you internally!).

Now because CBT isn’t designed to identify or deal with root causes, it can’t help you understand why you got to the point you’re at today. It also can’t resolve the spiritual stress that is caused by your subconscious latching onto trauma coping methods that your soul finds immoral, such as fantasizing about inappropriate sexual interactions or drinking too much alcohol or self-harming. Because validation is a critical part of resolving psychological trauma, CBT is not sufficient in helping your subconscious feel like its fears are being respected and understood. CBT doesn’t attempt to deal with the soul at all, so it’s going to be useless for addressing soul concerns.

The bottom line is that CBT is a useful tool for trying to identify practical steps that you can take to help your quality of life today. But it is not, I repeat: NOT an effective solution for things like alcoholism, drug, or porn addictions. CBT is also incapable of resolving things like pedophilia or any other revision to the natural sex drive. If you’re trying to reduce how often your mind pushes you to get drunk or focus on perverse sexual fantasies, you need to focus on identifying root causes first. Self-compassion and understanding are critical tools for lowering your internal stress levels enough to make adjusting your behaviours even possible, let alone helpful.

If you aren’t doing anything to identify and deal with root causes, CBT will give you nothing more than a temporary patch that might ease certain trauma symptoms (like anxiety attacks) for a brief period if you really apply yourself. But the moment you stop doing the steps, you will swiftly revert back to where you were before because you’re not addressing any of the core issues. Dealing with the core issues is vital to making a true recovery. But when you are working on root causes (instead of trying to avoid dealing with them), CBT can be a very helpful addition to your self-help efforts.

Imagine that you’re far out at sea when you realise that your small boat has sprung a leak. In this situation, dealing with the root causes of your trauma would be like rapidly reducing the rate at which the water is pouring into your boat, while CBT methods would be like the physical patches that you apply to the holes. If the water pressure is too high, any patch you try to apply will be torn off. But once you reduce the water from a gush to a trickle, those patches can be a fantastic help.

In your case, you are working on your root causes, but you’re having trouble shifting any of your core beliefs. It sounds like your daily behaviours keep reinforcing those beliefs, which is working against you. Give your CBT therapist a chance to share his techniques with you and be open to those techniques having some value. If they are helpful to you, you’ll start feeling a positive difference fairly soon. And he’s right that there is always a certain degree of feeling like we’re “faking it till we make it” in the process of recovery, because it always feels “fake” when we’re trying to embrace a new, positive belief that we inwardly think is false. Both your mind and soul need time to ponder new ideas before they decide to commit to them. While they are still on the fence, it can feel uncomfortable and difficult to keep trying to practice a new, healthier way of behaving or thinking. But perseverance usually pays off in these situations, so give the CBT a chance. Unless your therapist starts leading you in a direction that you feel strongly against (and you should always respect your gut instinct), you should give his ideas a chance while bearing in mind that his approach is only intended to help to a limited degree.

Prescribed Antidepressants

As for the drugs, I’m not a fan of using prescribed antidepressants unless it is really needed. I’d explore herbal alternatives first (meaning the kinds of herbs you’d make a tea out of, not something you’d get high on), just because herbal combinations tend to have a more positive, balanced effect on the body’s already strained systems. The potential negative side effects of herbal treatments also tend to be a lot less problematic than the potential side effects of prescribed medications. Remember that when we use antidepressants to reduce symptoms of psychological or spiritual stress, we’re really just trying to limit how your mind and soul can express their stress through your body. We’re not fixing root causes, because unless the depression has a physical origin (such as a hormone imbalance), you can’t fix it using physical means. At best, well chosen chemicals (natural or lab-made) can reduce the stress the body is going through by the way your mind and soul are behaving. But the real solution is to get your mind and soul to stop being so aggressive towards your body so that your body can get a break.

Now if you do decide to take prescribed antidepressants, you need to respect these drugs as the powerful things that they are. Do not suddenly stop or drastically reduce dosage of these kinds of drugs or you can end up rapidly plummeting into a very dark mental place. Drugs that try to make significant changes to your body’s brain chemicals (such as raising your serotonin levels) will often have some very nasty backlash effects if you change your intake too suddenly (this includes accidently skipping or doubling a dose). Your body adapts to these drugs over time, which results in them feeling less effective, yet you can’t just get off them or you’d feel even worse.

Understand what you’re getting into: antidepressants do not make you go from feeling depressed to feeling super happy all the time. Often you can feel significantly better at first (if the dose is sufficient), but over time you’ll slide back towards feeling meh as your body adjusts. Because these drugs are easy to start and hard to stop, and because they can have some very undesirable side effects, you might want to try a much gentler option first by exploring herbal adaptogens. This is a class of herbs that help your body cope with stress better, yet they have a far more gentle effect on your body’s systems, which enables you to get off them or accidentally forget a dose without experiencing a severe crash. Herbal remedies like this work best when taken consistently over long periods. If you search for adaptogens in Amazon’s store, you’ll see a lot of options come up. There are many herbal formulas which combine several well-known adaptogen herbs into capsules for convenience. You can look into the various herbs mentioned to understand their value, or you can just get a bottle to try and see if you notice any positive effect (you typically need to allow several weeks to notice a significant difference when using mild herbal formulas). The good thing about herbal adaptogens is that you can try them without getting instantly trapped, and you don’t have to worry about a bunch of scary side effects because they aren’t harsh on your system. Bear in mind that not all herbs are safe to just experiment with; some are very strong and even toxic when overdone. But the kinds of adaptogen formulas you’re going to find on Amazon will be pretty safe to try plus you can read about other people’s experiences in the product reviews. You can also find books that specifically teach you about herbal adaptogens if you want to delve more into that subject.

Stress is very hard on the body and always leads to imbalances over time. Trying to correct those imbalances through natural foods is often a lot more helpful in the long run than using strong chemicals that have been designed to only target a very specific issue (such as your serotonin level). But bear in mind that I am very biased against trying to override your body’s natural processes in forceful ways. I am a strong proponent of trying to listen to the body, and letting it have a say in what kinds of methods you use to support it. I believe that listening is a vital part of dealing with all three of your elements, and once we start taking strong chemicals with dangerous side effects, it’s a lot harder to make quick adjustments to or immediately drop treatment methods that the body doesn’t like. I believe the body is extremely intelligent and that it has an amazing ability to lead you to the help it needs if you are willing to listen and follow its cues. But that’s me. Many people reject the idea that the body is inherently wise, and they instead view the body rather like a dumb, stubborn animal that can only be driven back on course through force. Other people view the body like a car that is incapable of speaking or helping a human mechanic diagnose its problems, therefore the mechanic’s opinion is the only one worth listening. As always, a person’s core beliefs about the human design impacts how they will attempt to resolve health issues. Everyone is biased, and I try to be clear about what my own biases are so that people can understand why I give certain kinds of advice.

This post was written in response to OneRoughDiamond.