Is there any point in going to therapy if you don't believe it will work?

In My Humble Opinion
61

Actually, I’d consider the three that you had to be more than enough, if you had been the one to end the therapy. If you’d said, “You know, I see where this is going, and I’m just not into it,” then I would agree that CBT is not useful for you.

I mean, ideally, maybe you’d have given it a couple more sessions, because in my opinion, therapy is more along the lines of taking piano lessons, as opposed to, say, hearing a new song, in terms of the time it takes to know whether you’re going to like it and/or get anything out of it. What I mean is, if you hear a song three times - or even just once - and hate it, then I think you can confidently say that song just doesn’t do anything for you. But if you take three piano lessons, and feel like they’re not helping, I might encourage you to try a few more times to see if you make any progress. And I might suggest you go to a different teacher to see if that helps. But ultimately, if you really felt like they weren’t working for you, I’d figure you knew best.

But the way you described it, it sounded like the therapist was the one who told you “This isn’t going to help you”. That’s like taking three piano lessons and having the teacher say, “Yeah, sorry. Piano lessons are not for you. Perhaps you should try the bongos.” If that happened, and you then said, “Piano lessons are not useful for me,” I’d respond, “Maybe, or maybe your piano teacher was just an incompetent asshole.”

That’s all I’m saying.

CBT certainly does not work for everyone, but each person must be the primary judge of whether or not it’s helpful to them. Sure, the therapist can weigh in on your progress or lack thereof, but unless you spent every session glowering silently with your arms folded, I don’t think he could judge after just three sessions that he wouldn’t be able to help you. You could, but he couldn’t.

62

Obviously, you’ve had enough. That’s fine.

CBT is an active process. It’s something that a therapist can help you do, but it’s not something they do to you or can force you to do. I really doubt any therapist is going to say “you’re so fucked up I can’t help you.” but they might say “You are not willing/able to engage in these activities, and so this isn’t really worth our time.”

If you walk in with the attitude of “No stupid therapy can change me!” or “I’m so smart, I can outsmart their dumb exercises” or “Let’s just BS our way through” then you will no doubt get your wish and come out unchanged. You need to go in with the attitude of “I’m done with this depression, I want to change, and I’m willing to put in some difficult work to make that happen.” I think the same is true for any intervention, though. Even the best drugs in the world can’t force you to be happy, and can be outsmarted by someone really dedicated to their depression.

CBT takes effort and commitment. You need to actually put thought into the activities- we all know how to BS and tell people what they want to hear, let stuff go in one ear and out the other, and tell people what they want to hear- but if you do that through your therapy its basically like not doing it at all. It’s fine if you think it’s all a bit silly, as long as you still put some thought and emotion into it anyway. It’s okay if you aren’t really “feeling it,” but it won’t work if you just blow through it without engaging.

Likewise, CBT takes a great deal of discipline. I realized that with melancholy thoughts, I was like an alcoholic- I couldn’t have even a little bit, because I didn’t have control of them and they would inevitable spiral to rock bottom. So every. single. time. I got moody, I had to discipline myself not to go there. It’s work, and it’s work that you need to do 24/7, even when the therapist isn’t looking over your shoulder. Again, sometimes you will slip up, but you have to at least try.

There is a bit of a chicken-and-egg problem here. Depression can make you not want to get better. It can make you want solutions to fail. And it can take away what you need to engage in these activities effectively. If that’s your case, then CBT probably isn’t a solution. I’m not a fan of drugs, but I think one place they can be really useful is getting you to the point where you can engage in therapy.

63

I’ll add another CBT success story, lest someone think I’m talking about CBT without experience.

About a year and a half ago (May 2010), my wife had a miscarriage. This was pretty devastating, considering that we both wanted to have kids, and were very excited about it.

On top of that, my supervisor (who I adored) was fired, my workload increased dramatically, and the type of work I was doing changed as well (for the worse). To top that off, the stress level was higher than it had been because of unrealistic deadlines, managers unwilling to say no, and a host of other mismanagement factors.

Needless to say, I ended up pretty depressed; everything seemed to have gone to shit in the blink of an eye- we lost the baby, my job went from one that I really enjoyed to one that I hated (and still do), my stress level went way up, and I couldn’t see any way out of it in the short term, and no clear path in the long term. I didn’t think of myself as depressed, but I did know something wasn’t right.

My wife was having a hard time dealing with the miscarriage, so I was pushing her to get therapy. We ended up making a deal that we’d both go, because she thought I needed it too.

I ended up googling therapists around my area, and called & talked to a few and made an appointment with one who sounded good.

I went weekly at first, then bi-weekly, then eventually monthly, and I think in 2011, I’ve gone bi-monthly at most. The last time I went in a few weeks ago, he told me that he didn’t think he could help me anymore because I’d improved so much since the last time- he’d done something similar to what jjimm describes with the quizzes, and I’d improved a lot as well.

Anyway, it’s made a huge difference. I still get frustrated, irritated and even feel a bit helpless at times, but the tools I learned help me assess what I’m thinking, why I’m thinking it, and how I can change either what I’m thinking or whatever’s bothering me. (usually unrealistic expectations for myself)

64

Another awesome story, thanks!

I think that one thing you’ll find after a while is that you don’t really think about your coping tools anymore. They’re just part of the way you think. I guess it’s like reaching a level of unconscious competence.

65

Something that our support group provides that can be very useful to people struggling with these issues is that we give external feedback on progress that you really can’t see for yourself. We have people who come to the group who really make huge efforts to do all the work they need to do (and we never try to pretend that it isn’t hard work - it really is), and they make dramatic progress. All they tend to see is the things they still aren’t succeeding at - we hold up a mirror to them and say, “Look! See how far you’ve come! Look at all your successes!” When this happens in my group, the people we’re talking about just glow. It’s a wonderful thing.

Ideally they would be seeing a CBT therapist as well, but those are hard to come by and very expensive. We do the best we can with a bunch of untrained, non-professional volunteers who just want to help other people dealing with these issues.