![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by NikkiT2 on November 9, 2003, at 12:16:27
OK, tomorrow I give my first talk to students!! I'm spending the afternoon with some Community Mental Health students, to give them the Service User (SU) perspective - what we feel is good care, what is bad care etc!
Anyway.. I'm terrified. Totally and utterly! So I need to CBT myself, and I'm not good enough to just do it quietly in my head!
So..
Statement - If I wear my old but comfy trainers they're going to think less of me for not having decent ones.
Reality - They probably won't notice whats on your feet. Your trousers almost cover them anyway. And people don't judge others on their trainers anyway.. Not once they're over puberty anyway!Statement - They won't take me seriously because I'm so fat
Reality - Your opinions don't change because your waistline does. People will be interested in your comments and what you have to tell them. They're not going to dismiss everything you say just because you're not a perfect size 10.Statement - I'm going to sweat really heavily travelling there so wil look a mess
Reality - Yes, you probably will. So leave 30 mins earlier than you planned to, and find a cafe to sit in and have a cold drink before you go to their building. Its a busy part of London, there will be cafe's everywhere.Statement - I won't have anything interesting to say.
Reality - You're preparing, you have notes. You have lots of comments from others, handouts for 40 people, and it will mostly be question and answer. You can leave early if needs be, and that would be quite good as you would then miss rush hour home.Above all, remember they have invited you. They want to listen to you. They wouldn't be doing this course if they weren't interested in it. Anything you say will be helpful to them in the long term, and might improve things for your friends and others who suffer.
Phew..
Nikki
Posted by Dinah on November 9, 2003, at 13:29:27
In reply to CBT'ing myself!, posted by NikkiT2 on November 9, 2003, at 12:16:27
You have the huge advantage of really caring about your subject matter.
Posted by mattdds on November 9, 2003, at 18:41:55
In reply to CBT'ing myself!, posted by NikkiT2 on November 9, 2003, at 12:16:27
Nikki,
This is great! I have wanted to see someone else who goes through the same process for so long on this board. You're doing some terrific work here!
I do this nearly every time I get upset. Sometimes my dialogues get pretty lengthy. I should post one sometime.
By the way, I don't think anybody is "good enough" to do it inside their head. It seems like it has to be articuled in very clear language until the pattern is totally engrained in your being. At least that was my experience with CBT. I think this is why many people don't get better when they "try" CBT - they don't actually do the homework. It just doesn't work any other way.
I'm sure you'll do fantastic on your speech. A few suggestions that have helped me.
1. Remember not to shoot for a perfect speech - this will only create more anxiety.
2. Nervousness is normal and sometimes helpful for public speaking.
3. Avoid catastrophizing. It will not be all over the newspapers tomorrow even if your worst nightmares about the speech come true. Actually, people will likely have forgotten about your nervousness (if they notice it in the first place) within 10 minutes of leaving!I'm glad to know someone else is helped by these techniques.
Best of luck!
Matt
Posted by fallsfall on November 9, 2003, at 20:26:50
In reply to Re: CBT'ing myself!, posted by mattdds on November 9, 2003, at 18:41:55
I would love to come to your lecture! But I don't think that I could get a plane from the States in time. Maybe you can pretend that each of them is really one of us - and that will help you feel that you aren't there to be judged, you are there to help them (and us!)
Posted by ace on November 9, 2003, at 21:21:36
In reply to CBT'ing myself!, posted by NikkiT2 on November 9, 2003, at 12:16:27
> OK, tomorrow I give my first talk to students!! I'm spending the afternoon with some Community Mental Health students, to give them the Service User (SU) perspective - what we feel is good care, what is bad care etc!
>
> Anyway.. I'm terrified. Totally and utterly! So I need to CBT myself, and I'm not good enough to just do it quietly in my head!
>
> So..
>
> Statement - If I wear my old but comfy trainers they're going to think less of me for not having decent ones.
> Reality - They probably won't notice whats on your feet. Your trousers almost cover them anyway. And people don't judge others on their trainers anyway.. Not once they're over puberty anyway!
>
> Statement - They won't take me seriously because I'm so fat
> Reality - Your opinions don't change because your waistline does. People will be interested in your comments and what you have to tell them. They're not going to dismiss everything you say just because you're not a perfect size 10.
>
> Statement - I'm going to sweat really heavily travelling there so wil look a mess
> Reality - Yes, you probably will. So leave 30 mins earlier than you planned to, and find a cafe to sit in and have a cold drink before you go to their building. Its a busy part of London, there will be cafe's everywhere.
>
> Statement - I won't have anything interesting to say.
> Reality - You're preparing, you have notes. You have lots of comments from others, handouts for 40 people, and it will mostly be question and answer. You can leave early if needs be, and that would be quite good as you would then miss rush hour home.
>
> Above all, remember they have invited you. They want to listen to you. They wouldn't be doing this course if they weren't interested in it. Anything you say will be helpful to them in the long term, and might improve things for your friends and others who suffer.
>
> Phew..
>
> NikkiHi Nikki,
I'm glad you find CBT helpful...I hope I didn't offend you before...
Ace.
Posted by ace on November 9, 2003, at 22:58:03
In reply to Re: CBT'ing myself!, posted by mattdds on November 9, 2003, at 18:41:55
Matt- you didn't want to continue our discussion on CBT?
I want to make 3 things clear so as to make my feelings clear.
1. I believed you have suffered severe depression and I never doubted that. I never ever underestimate the suffering of another being- despite how they look, sound, smell etc etc.
2. I believe that the CBT has helped you.
Point 3.
1. I personally find it hard to see how CBT works as I do not agree with it's main tenets.
Also, I do not think anybody who looks into this method is being foolish or silly- they are just trying another way to survive in this world- like all of us.
I hope this clears the air, and I hope you have not taken offense to my comments. We might just have to agree to disagree, as they say!
Good luck,
Ace.
Posted by mattdds on November 10, 2003, at 21:02:49
In reply to Re: CBT'ing myself! » mattdds, posted by ace on November 9, 2003, at 22:58:03
Hey Ace,
>>Matt- you didn't want to continue our discussion on CBT?
I hope I didn't imply that, I love to discuss the topic. I just thought the thread had run its course.
I did learn a long time ago that trying to convince someone to your way of thinking is fruitless and winds up actually polarizing the other person to their way. So if the discussion you had in mind entails trying to convince you that it works (or vice versa), I'd rather not discuss it.
I really appreciate you having "faith" that CBT actually did work for me (and many others, as shown by a mountain of scientific evidence), even though you don't believe it works. It's nice to have someone believe you when you say you're suffering (and when you get better with a treatment). Thanks.
>>1. I personally find it hard to see how CBT works as I do not agree with it's main tenets.
I don't *know* how it works either. I'm quite sure it *does work* though. And again, you'd have to have a pretty elaborate argument to say that it doesn't. This is not a disputed therapy, the vast majority of credible scientists say it does indeed work, even for severe depression.
On that same vein, scientists have no clue (okay, they have *some* clues, albeit very few) about how antidepressants work. But the fact is, clinically, they work for many people. Do you *know*, or for that fact need to know how Nardil works?
I would have a hard time believing that your only problem was serotonin, dopamine, and norepinephrine deficiency (all in a vacuum), and the treatment worked simply by restoring these levels. Sound like a Zoloft commercial?
But the fact is, all we know about Nardil is that it raises levels of cerain neurotransmitters. To me, this is not a very intricate understanding. My feeling is that anyone who is still buying into the monoamine hypothesis of depression needs to do a bit more review of the recent literature.
But who cares why? Nardil quite obviously works for you! That is what clinical research shows - efficacy, that's it!
I could make some *hypotheses* as to how CBT works. To me it makes perfect sense that an animal's (human's) feelings / behaviors would correspond to the way they interpret the world. It all begins with our sensory organs, filters through to the cortex (where we make "conscious" decisions, and where beliefs and thoughts occur). From there, after the "threat" has been perceived is when the emotional and fear neurocircuitry is activated.
It is downstream from the cortex that all the "biological" treatments lie. But I believe that the emotional neurocircuitry does not get out of sync in a vacuum. Wouldn't it make sense that someone with continuous threat-related thoughts would feel continuously anxious? To me, CBT is trying to convince our cortex and the archaic "downstream" neurocircuitry that we are not being chased by a wild animal (to use anxiety as an example).
Don't get me wrong, I have no doubt that neurolochemical changes occur after this onslaught of threat-related thinking and beliefs, and involves actual biological changes. But I'm not convinced this all happens randomly or in a vacuum. I feel with *only* "biological" treatments, we are treating it too far downstream.
This is not to say that meds aren't helpful, they certainly are, and in many cases, restore an individual to complete function. So I don't care how we get there...whatever works!
I'm no neuroscientist, but this makes sense to me. I remember reading a theory in my neuroscience book that emotion and behavior arise directly from "lower-level" processing areas in the brain, but *only* after a threat has been assessed in the neocortex. So what doesn't make sense about this? This seems to work very well with CBT theory.
I don't believe feelings are random and unconnected to thoughts, beliefs and perceptions...this would not make sense biologically, and such animals would not likely have survived millions of years of evolution. What purpose random feelings and behaviors serve in early periods of evolution? The cortex perceives threat, and *then* the fear and emotional circuitry is activated. I believe depression and anxiety are products of tangled webs of cortical processing that is amenable to restructuring with CBT. People suffer because they are constantly (and inadverdantly) eliciting the fight or flight response, and this causes actual physical changes to the brain.
This is just my crazy, juvenile understanding, and obviously only a hypothesis, but to me it makes sense.
>>I hope this clears the air, and I hope you have not taken offense to my comments.
No offense taken, dude. The air smells fine here to me (besides the New York pollution).
>>We might just have to agree to disagree, as they say!
I'm completely fine with that. But why magnify this one disagreement? In general, I think we agree much more than we disagree, right? Even to me, an avid supporter, there is much more to life than CBT.
Take care,
Matt
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.