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Old 09-27-2019, 02:54 AM   #1 (permalink)
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Therapy - what were your experiences? Psychotherapy v CBT?


Hi there.

I was going to post this in the alcoholism forum but felt it might be a bit off topic so am posting here. I am making progress on getting sober but relapsed again this week after 37 days. I am regularly getting over the month mark this year but seem to get stuck. The precursor to my relapses is not any sort of romanticism of drinking or temptation when out socially but actually the onset of a really dark mood which fills me with anger, unhappiness and anxiety. I kind of "[email protected] all of this sh!t" mood where all I want to do is take the intensity of it away with the dulling agent that is alcohol - even though I know that it's a very blunt instrument by which to achieve this goal - given all of the negatives that come with it.

So, I think it's time for me to look into therapy. But I'm not sure what to expect and I have heard that really deep levels of introspection in a longer term course of psychotherapy can actually make people feel worse and not better? And then there is CBT which I have done some reading on, but have no experience of. Can these two different forms of therapy be done in a way that's complimentary to the other? Although that's getting in to expensive territory.

Would welcome any and all thoughts on the subject from your personal experience.

Cheers,
Brian.
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Old 09-27-2019, 04:13 AM   #2 (permalink)
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I have experience going through psychotherapy and find it to be very helpful for me personally. I am able to talk about things that I otherwise wouldn't be able to talk about and get things off my chest. As well as get unbiased feedback. I have three separate Dx and along with my medication the therapy helps keep me stable. As far as CBT, I don't have any experience. But, have heard it helps some people. So, I am considering giving it a try along with my regular therapy. Never know how well it works unless I give it a chance. Everyone has an approach that works for them. Keep trying until you find what works best for you and helps keep you in a good place.
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Old 09-27-2019, 05:28 AM   #3 (permalink)
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Sorry you relapsed again. Glad you are back.

Succinctly, I don't think any type of mental health care is an either/or proposition. CBT is such a great tool - changing our thinking (I found the workbook exercises I did especially helpful as they are so specific) is something everyone can stand to assess, not just us alcoholics.

I've had non-med therapists (ie not psychiatrists), psychs who also talk and pastoral counseling over the years. Right now, the first and third w med checks for the second.

GOOD experts, especially with substance abuse training, have been the most important for me in sobriety.

To the "worse not better" thing...I have found that any help that's useful prompts discomfort since we don't like change - so whether that's "worse" is up to us, depending on if we are prompted to grow because of introspection, discussion, and revelation, or we reject it. Clearly, I find "better" the result of the good resources - I use that qualifier again because I've seen much less and much more skilled and productive folks over the years. Meds are another part of the discussion, and one I feel is important to examine.

Good luck - truly, good decision making and change wished for you, rather than luck.
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Old 09-27-2019, 06:37 AM   #4 (permalink)
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Thanks Wes and August. Sounds like I may have to fork out a bit of cash on this - but I have been putting it off thinking I had it nailed. But there is still that sticking point which is clearly an inability to deal with certain feelings. Therapy is a no-brainer. I've identified someone who works near me. And your point, August, on the variable quality of these practitioners is absolutely noted. I guess you can just tell straight off the bat? Or do you reach these conclusions as the result of lots of trial and error and weighing up the good against the bad?
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Old 09-27-2019, 07:12 AM   #5 (permalink)
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It would be nice to have insurance to cover some of the costs
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Old 09-27-2019, 07:36 AM   #6 (permalink)
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Originally Posted by Briansy View Post
Hi there.

I was going to post this in the alcoholism forum but felt it might be a bit off topic so am posting here. I am making progress on getting sober but relapsed again this week after 37 days. I am regularly getting over the month mark this year but seem to get stuck. The precursor to my relapses is not any sort of romanticism of drinking or temptation when out socially but actually the onset of a really dark mood which fills me with anger, unhappiness and anxiety. I kind of "[email protected] all of this sh!t" mood where all I want to do is take the intensity of it away with the dulling agent that is alcohol - even though I know that it's a very blunt instrument by which to achieve this goal - given all of the negatives that come with it.

So, I think it's time for me to look into therapy. But I'm not sure what to expect and I have heard that really deep levels of introspection in a longer term course of psychotherapy can actually make people feel worse and not better? And then there is CBT which I have done some reading on, but have no experience of. Can these two different forms of therapy be done in a way that's complimentary to the other? Although that's getting in to expensive territory.

Would welcome any and all thoughts on the subject from your personal experience.

Cheers,
Brian.
CBT addresses catastrophic thinking. Psychotherapy is better in your case. There is a reason you relapsed. Addictive behavior is never random, there is always a reason and a reward.

Psychotherapy can get to the cause of your abusive drinking and offer high value alternatives that can empower you to regain control over your emotions.

If money is an issue, get the book by Lance Dodes, "The Heart of Addiction."
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Old 09-27-2019, 07:54 AM   #7 (permalink)
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Thanks Wes and August. Sounds like I may have to fork out a bit of cash on this - but I have been putting it off thinking I had it nailed. But there is still that sticking point which is clearly an inability to deal with certain feelings. Therapy is a no-brainer. I've identified someone who works near me. And your point, August, on the variable quality of these practitioners is absolutely noted. I guess you can just tell straight off the bat? Or do you reach these conclusions as the result of lots of trial and error and weighing up the good against the bad?
A few thoughts-
Yes, I have spent a lot on therapy over the years. Most of it has not been covered by insurance. To wit, my therapist is $120 a session (an hour), and I see her a couple times a month; my psych is $215 for 35 min (incl med discussion) and I go every 3 mo (that was every 2 wks when I quit) and our pastoral counselor is $130 (for an hour, and we go every couple of months; it's awesome couple time).

As far as "knowing off the bat" - yes and no. I have gotten a "click" feeling with some therapists and not others (I am just going to use that therapist word generally from now on as I think it does apply to the collective). That has sometimes meant not going back after a couple of sessions, one notable time in particular when I got an appt time wrong and he yelled at me; others took a little longer and in one scenario I ended up complicated-ly over-medicated.

I am very fortunate with the team I have now, and my entire network of drs and caregivers, from GP to recent back surgeon, are largely referral based from people I trust, and each other. For me, this area is essential and a priority. Trust me, I know perspectives vary- my husband had zero "need" for drs til getting sober and honestly, marrying me and beginning to see why the path of "getting help" can be monumentally important to well being and good relationships.

I'd also caution you against your analytical, "weighing the good v bad" thoughts here. Some things are specifically identifiable - many are nebulous. We can easily get in our own way, especially the more intelligent we are. And IQ and EQ are totally different things.

You've probably guessed (ha) that I believe in a multi-pronged approach. I do not believe in doing it yourself or EVER having things nailed, as you said. I know we have butted heads when you haven't liked what I've told you, so I will just close by saying thanks for asking my input and I wish you the best. Permanent sobriety and a life in recovery truly is the simplest way I can imagine living, and while life can be complicated my program and resources and internal tools can get me back to simple most of the time.
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Old 09-27-2019, 07:58 AM   #8 (permalink)
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I am not an addict, but I have went to different therapists over the years. I think CBT was the most successful for me in that I feel it really helped me to change the pathways in my brain leading to different ways of reacting and different ways of thinking. That's just me though.

There will be parts of therapy that will be hard no matter which way you choose, but coming out on the other side with different thinking is what was key for me. This type of therapy was also very successful for my young adult daughter.

It was expensive, however, it was also worth every single penny. You have to invest in your own wellbeing, and this changes you for life.

Just my two cents.
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Old 09-27-2019, 08:02 AM   #9 (permalink)
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It would be nice to have insurance to cover some of the costs
In my experience, it may - but you of course have limited choices. One thing I have researched is those orgs who providing sliding fee scale, etc services.

I've been and am fortunate to be able to pay for care that is top notch. It's still valuable when "covered" or merely "accessible," IMO.
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Old 09-27-2019, 08:10 AM   #10 (permalink)
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I would add that the person who most helped me in my life was a volunteer I met at a crisis center. No money was charged.

There are many ways to healing, and many people who are willing to help.

Lots of books to read, as well.

I'm not sure how much therapy would work while still drinking. I mean, a lot of the cognitive distortions are being caused by alcohol, drugs and other addictions. Continuous Abstinence is the 1st Step. If I were going to search for "therapy" and I was still drinking, I'd make sure to pick someone who is well-versed in addiction/alcoholism and then I'd be 100% honest about my past and current use because that is the elephant in the room.
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Old 09-27-2019, 08:14 AM   #11 (permalink)
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I've done psychotherapy, somatic therapy, and group cognitive behavior therapy. They all had some benefit, but like others have said, it depends on you and what you need.

I liked talk therapy for just being able to spill my guts. It's important to get a good fit, though. I benefited from therapy most when I was sober, I have to say. I had some people who were sympathetic, but didn't know much about addiction and how it can cause mental problems. I also had one therapist look straight at me and say, "I don't believe in addiction." I didn't go back to her.

Once I was sober, I had a pretty good somatic therapist who I talked with a lot, but she also helped me focus on my body. She helped me see some patterns that I had never considered and provide good outside perspective. I would not have benefited if I had been drinking.

I went to the group CBT as part of a research project, so it was free. I was sober when I did this. It was for anxiety and to be honest, I think that helped me the most. I liked the logic behind it and I saw results. For me, analyzing why I felt the way I did never seemed to help. (I've been anxious and prone to depression my whole life.) But challenging the thoughts and looking at how I could react differently really set me on a different path.

My best friend, similar in temperament to me, found CBT useless. (But he's also still drinking, so that might play a part in it.)

So I'd recommend trying whatever you can. I HATED the CBT at first and I think it was because it made me uncomfortable. That's usually a sign that it's something I need.

I got most of my therapy at a discounted rate by seeing students who were under supervision and just getting their hours. They were fantastic and really helpful and eager. There are also probably clinics that provide discounted rates if you look around, especially if you're near a major city.

I'd really recommend therapy. I always did it short term, but still got a lot out of it.

Best wishes to you.
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Old 09-27-2019, 10:16 AM   #12 (permalink)
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I'm not sure how much therapy would work while still drinking. I mean, a lot of the cognitive distortions are being caused by alcohol, drugs and other addictions. Continuous Abstinence is the 1st Step. If I were going to search for "therapy" and I was still drinking, I'd make sure to pick someone who is well-versed in addiction/alcoholism and then I'd be 100% honest about my past and current use because that is the elephant in the room.
I spent a lot of money going to therapy and drinking - and taking meds and drinking. On the whole, a waste - sure, I learned some things and got some stuff "out and addressed" but my drunk mind got worse as I kept drinking, so diminishing returns and all.

Lying to professionals like I did (and, um, I know I didn't really fool my excellent pysch whom I've gone to since before I quit) only did me disservices in many ways.
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Old 09-27-2019, 10:31 AM   #13 (permalink)
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Just wanted to add that my experience was similar to those above.

Going to therapy while drinking was pretty much a waste of time. Addiction is characterized by lying, deceit, avoidance, and creates other mental health issues. (And I would have said I was an honest person while drinking. I couldn't see where I was lying to myself and others to protect my addiction.)

An addiction specialist might be a better fit if you're trying to get sober. And only if you're honest.

Just my two cents.
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Old 09-27-2019, 11:28 AM   #14 (permalink)
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Just wanted to add that my experience was similar to those above.

Going to therapy while drinking was pretty much a waste of time. Addiction is characterized by lying, deceit, avoidance, and creates other mental health issues. (And I would have said I was an honest person while drinking. I couldn't see where I was lying to myself and others to protect my addiction.)

An addiction specialist might be a better fit if you're trying to get sober. And only if you're honest.

Just my two cents.
I relapses after 37 days of not drinking. My whole point of doing this is to help me stay stopped. You're kinda describing a catch 22 situation
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Old 09-27-2019, 11:58 AM   #15 (permalink)
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Apologies to sound obtuse just now. But I am hoping to go beyond what an addiction counsellor can offer and am not drinking every day, nor do I have any problem being fully honest. The game is up for me, that's something I've accepted for a while now so see no point in hiding anything.
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Old 09-27-2019, 03:22 PM   #16 (permalink)
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I almost asked above- are you sober now? So, your plan is to be sober and start seeing someone? That's the best route IMO and in this scenario I would liken therapy to AA - a desire to stop drinking is what you need. So, we don't want you to relapse again, but if you start seeing a therapist now (sober) and are working with someone, as part of your recovery plan, and you relapse, that's different than what I was doing by drinking all along.

That person would be there to help you stop relapsing. It's all up to you of course, every choice to drink or not drink, but I think you know that you're past the idea of using books alone, or the stuff you did when you first joined here.
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Old 09-27-2019, 07:30 PM   #17 (permalink)
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Hi August. Yes, that's right. I drank for one day, it was horrible and now I'm on day 3, the idea of drinking again repulses me. The point being to use this person (or these people) and their methods to fortify me so that things don't get on top of me so intensely. There's always that feeling of intense anger and frustration that leads to the drinking. This notion of drinking being enticing in and of itself has genuinely long gone. But I'm sure you see it here all the time. The penny slowly drops. But what this last failure has shown is that I'm going to need specific tools to defuse those feelings of anger and frustration before they are allowed to really become impossible to control. Perhaps I should try both the longer term therapy and CBT concurrently. I'll investigate this and will book something for this coming Wednesday - that way I'll have a week under my belt and I'll be out from the worst of a detox that will cloud my brain.

Sound like a good plan?!
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Old 09-28-2019, 01:09 AM   #18 (permalink)
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Sounds good - my thought is simplify: make a therapist appt and go. Be honest and lay things out and ask your questions about CBT. My psych is the one who brought it up with me. Whatever research you can do into someone you can see- ie are the categorized as someone with specialization in addiction, or CBT/DBT, or childhood trauma, or whatever might apply (we used this type of selection info when finding an in-network therapist for my step son, for example).

Like with anything- one step at a time. I know you want to figure it all out but you have proven like I did in my attempts that I can't tackle all of it at once; starting with an appt, or a sober day, or a next right choice, and going from there is the path I have found to staying sober so far.
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Old 09-28-2019, 01:30 AM   #19 (permalink)
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Sounds good - my thought is simplify: make a therapist appt and go. Be honest and lay things out and ask your questions about CBT. My psych is the one who brought it up with me. Whatever research you can do into someone you can see- ie are the categorized as someone with specialization in addiction, or CBT/DBT, or childhood trauma, or whatever might apply (we used this type of selection info when finding an in-network therapist for my step son, for example).

Like with anything- one step at a time. I know you want to figure it all out but you have proven like I did in my attempts that I can't tackle all of it at once; starting with an appt, or a sober day, or a next right choice, and going from there is the path I have found to staying sober so far.
Thanks August - I've made an appointment with a guy that I work really close to on Wednesday. He does "Jungian" psychotherapy - no indication of a specialism in addiction or any background in CBT. But I can see how it goes and hear his views on the CBT side of things. It may be that he advises to focus on one course of action for now and go from there.
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Old 09-28-2019, 01:32 AM   #20 (permalink)
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Cool! Look forward to hearing how it goes.
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