A couple of quick things about the two highlighted parts here:
I think it's true that people expect to be given answers in therapy (there are lots of types of course). CBT is the most commonly used these days and it has its limitations. Its mantra, as you will know, is all about THOUGHTS - FEELINGS - BEHAVIOUR, and how to try and make yourself aware of when you are contributing to the cycle between these things and how you react to them as well. For most people depression can be easily understood, it is perhaps mostly due to circumstances, situational, if you will. If this is the case it can be unpicked and you can stop thoughts that are contributing to them, but CBT assumes that the majority of people are situationally depressed and not biologically so. That is where CBT fails as it is no longer about thoughts-feelings-behaviour for some people as there is a new source, one that doesn't fit in the cycle.
Secondly, I'm interested to know which form of therapy it was that taught you to make room for bad thoughts and how does that fit within recovery?
Yes, it's amazing how many people going into counselling/therapy expecting to be provided with the answers and advice. Personally, when I've started with a new client I always ask them on our first meeting what their expectations are? Any misconceptions can be cleared up right there, before we get going.
I've had CBT myself, and I used to be quite interested in it, but I grew tired of the approach eventually. Two reasons really. One being how it was pushed as the gold standard therapeutic approach, when the reality is it's just one approach of many, and no approach has ever been proven to be more effective than any other. CBT was pushed because it was seen as quick and cheap to deliver. That appeals to funders and government.
When I started out we offered open-ended Person-Centred Counselling. Clients worked at their own pace and were not restricted to a set number of sessions. These days, you are lucky if you get six sessions of CBT on a conveyor belt of in the door, out the door. Thing is, it can take a number of sessions for a person to even open up. What if you open up on session five and only have session six to address the emotional tangle that's just been exposed? So many people also need to discuss their feelings, but CBT is more interested in just thoughts.
Also, for me, CBT feels confrontational and sees you fighting against thoughts and feelings. I later learned the futility of that emotionally draining and endless fight, so dropped CBT altogether. I'll come onto what changed my mind when I answer your second question.
I agree on depression. Unfortunately, I've experienced both situational depression and also depression that descends on you for no apparent external reason like a suffocating black fog. The first type is often a quite natural reaction to trauma and difficult life situations. For instance, after a bereavement, losing your job. The ending of a loving relationship etc... These things can be processed and worked through.
The other kind is more difficult. It's difficult to understand what you're dealing with. I'd go to bed one night feeling ok, but awake the next day in the depths of despair. Nothing had happened overnight, yet my inner world had been turned upside down. Add that to a lifelong anxiety disorder and it leaves you in a hell of a mess. Personally, I needed the intervention of meds to bring me a better sense of emotional stability. Only then did I feel I had something of a base to build on with therapy and my own efforts. The meds helped address the nature aspect of my issues and helped free me up a bit so I could address the nurture/environmental aspects. Until I went on meds, it was like trying to build on shifting sands. It felt impossible.
In answer to your second question, it was Acceptance and Commitment Therapy (ACT) that was my lightbulb moment with therapeutic approaches. It's a behavioural approach, but differs from CBT in that rather than confronting thoughts, it makes room for them. So, it takes the draining emotional fight out of it.
The years I'd wasted trying to rationalise, confront, question, dispute and overturn my thoughts got me virtually nowhere. The insane need to replace every negative thought with a positive one suddenly seemed utterly ridiculous and futile.
I'll be honest, crushingly negative thoughts used to blight my life. Even more so because I felt I needed to eradicate them before I could feel better in myself. Thing is though, negative thoughts are normal. The mind is always alert for danger, so it often produces thoughts we perceive as negative and, as such, are uncomfortable.
Problem is, pain in life is normal. Being open to it means we process it more fully and more quickly than if we wrestle with it and try to push it away. Sometimes, we just have to make room for our pain and anxiety rather than enter into combat with it.
This helped me with the bereavement process when I lost my dad and father-in-law within a two week period. I never tried to fight or bury the searing pain. I laid myself open to it and made room for it. I knew it was horrible, yet perfectly normal. I also knew it was a process that does work through if you allow it to. I learned this through ACT, and it helped me process what was a dreadful trauma fully, and in a shorter time period than if I'd fought it.
Of course, you address things you can address. You work on what can be worked on. ACT isn't about being passive. In a nutshell, I'd say it was about identifying your values and living your life according to them whilst making room for the difficult and uncomfortable feelings that might arise whilst doing so. Because you are then doing what you value doing in life, any discomfort becomes worth it.
If we wait until we feel great before we do things, chances are we'll never do them. So, we have to make room for the chatter in our heads and do it anyway. Thoughts aren't gospel truth. They are just words and pictures in our heads. They need not dictate what we do with our lives. The thing with thoughts is, the more you don't want to think something, the more you think about it. The more you don't want something, the more you have it. Being anxious about becoming anxious just guarantees you will get anxious.
For a trivial example. Try not to think of bananas. As soon as you try not to think about them, there they are in your mind. The harder you try not to think about them, the more they are there. Yet if you just make room for the thought of them, and don't try to erase the thought of them if it turns up, chances are you pretty much forget about them anyway.
It's the same with uncomfortable, unhelpful thoughts. If you are willing to have them, they turn up far less. Even if they do turn up, you just accept them, make room for them, but get on with other things. You've then called their bluff.
How does all this fit with recovery?
Well I think that's very subjective. I can only speak for myself. I have suffered with depression and Social Anxiety Disorder since I was a young boy. I've never known life any different, and it crippled me. I left school with nothing. I don't know how I can even read or write. I've struggled with suicidal ideation since I was a teenager and genuinely never thought I'd reach my twenties, nevermind reach my now 59th year. I self harmed for many years and had alcohol issues because I couldn't socialise without being rat arsed first. Education, employment prospects etc, all ruined.
Now? Well whilst I'll always have my demons (which I make room for 😊 ) I can actually function. I got myself through all the training it took to get a diploma in counselling and psychotherapy. That was despite it taking me 12 years to pluck up the courage to walk through the college gates after I first decided I wanted to do the training.
I didn't know about ACT back then. I studied that later on. I was made aware of it by a lovely poster on a mental health forum some years ago. I'll be eternally grateful to her for putting me onto it. Sadly, she committed suicide, but I often think of her. You couldn't even get training in ACT in most of England back then, so I taught myself through books. All I can say is the approach helped change my world, but it's horses for courses. It's about looking at the different approaches and seeing what resonates with us individually.
Sorry, that's a long post to wade through, despite the fact it only scratches the surface really. I hope it answers your questions adequately though.
