Therapy (session 3)

(continued from Distorted Thinking)

I talked as we sat in the parked car outside the bookstore for a little while before we finally went inside. After some searching around, we were able to find the Self-Esteem book, and it was in the self-help section as I was warned. I made my wife carry it as I looked around at the sci-fi and fantasy book sections. Not finding anything that I wanted to buy, we made our way to the checkout line. I guess it shows how much I avoid the possibility of others judging me by the fact that I had my wife carry and purchase for the book. I just feel so lame holding a self-help book; at least she could say it wasn't for her. I quickly began reading it as we drove home. I said I might do a small book review here in this post, but I’ve decided against that. You can go read the table of contents and the first chapter online here.

I read as much as I could in the book over the weekend and ran into a couple of sticking points that I decided I’d try to bring up in my third session. I ended up more than half way through the book by the end of the weekend. I didn’t want to move on much further in the book until I had a chance to talk about some of the sticking points I uncovered. That week was very busy at work and didn’t have very much time or energy in the evenings to read anymore. I watched my thoughts carefully that week to complete my “homework” assignment from therapy. The problem was I had been living the methods of CBT for so long (most of my life on some thoughts) that they were gone before I had time to notice change in my feelings. Even the new thoughts that I had added to my internal shutdown list were getting shutdown so fast now that I wasn’t noticing changes in my feelings on those either.

The only thing I was going to be able to add to my homework 5 column list would be my concerns that I really should have something to show for my progress that week. After thinking about it some more, I figured I wasn’t going to stress over it. If I found my feelings changing, I could take that opportunity then to complete my homework assignment. If my feelings were fine all week, well that would be a good sign I figured.

Soon the week was nearly over and it was time for my therapy session. I started the session by saying that I didn’t actually complete the homework assignment. My therapist told me that it was alright, they have many clients that don’t actually get it done the first time either. I responded by saying that it wasn’t for lack of effort. I really did try to do the homework assignment, but that the thoughts were gone before I had a chance to write anything down. I don’t think I explained myself very well because the therapist then said that it was like that for most people at first; and that I’d have to keep trying.

I explained a little more carefully this time. I recognized the CBT process; it is something that I have been doing for a very long time already. I just didn’t have words to explain it. There were some items on the distorted thinking list that I had already been aware of as “dishonest thoughts,” and that my brain was already trained to shut those down without much effort on my part. There were some items on the distorted thinking list that I had thought were not healthy but I hadn’t completely shut them down before. Last week, after realizing that they weren’t indeed healthy in the end, I had added them to my internal shut down list. Now, they weren’t affecting my overall feelings anymore, and were getting shutdown nearly as quickly as the older ones. Finally, a couple of distorted thoughts on the list that don’t bother me, but I’d stay aware of them. I explained very carefully the process going on inside my head and how if my brain caught it in time no change in feelings would occur. It would go from neutral feelings -> trigger / antecedent event / randomness -> distorted thought -> shutdown thought -> opposite or healthy thoughts -> same neutral feelings. I had been doing this long enough that it would skip affecting my feelings for the worse. The reason I was having problems earlier in the month, was that I hadn’t completely recognized that some of the distorted thoughts I had kept around, were indeed distorted. Now, that I was more aware of the downsides of them I would shut them down faster and shouldn’t be affected as much by them.

This time the therapist understood my explanation, and asked a few follow up questions. They were satisfied and happy for me. I said that I had always thought the thinking process that I had been following was abnormal. I was reassured that it was very good and healthy, and it sounded like I was doing it correctly. So, now my concern wasn’t any longer that I didn’t have the tools to deal with distorted thinking, but that it happened so frequently. I’m pretty good at shutting the thoughts down before they affect my feelings, but it happens so much that it wastes so much of my time, “bandwidth” and energy. Because of my past and other factors, I’m spending 60-80% of my resources just shutting down and countering distorted thinking. Here is where the therapist said was where medication would be able to help. Ah-Ha! This was excellent news. I had an appointment to see that psychiatrist the following day, so now I was even more excited to see them.

I then brought out the Self-Esteem book and said I had made good progress in reading it and I had a couple of sticking points that I wanted to discuss. I flipped open the book to the Compassion chapter. I explained that I totally understand the concept and the complete nature of how they are defining compassion. I agree with it completely on normal everyday or even minor events. I have compassion and I practice a very compassionate existence. My sticking point was the example they had used where a son decided to get back with his father after many years of them fighting over some money. For that example it makes sense, we shouldn’t let a minor thing like an argument over money come between people. There are people in my life, specifically family members, where the hurt and harm they have done me is not minor. It was malicious and intentional. I’m not making it up or distorting my thinking on this point, they truly intend to hurt, harm, tear down and destroy. I really don’t see how I’m supposed to find compassion, empathy or forgiveness for them, when they haven’t owned up or even sought it. I don’t see any reason ever to have contact with them again. I have tried multiple times in the past, each time they have taken advantage, lied and tried to destroy my life. What am I supposed to do?

They asked if I felt a “should” about being in contact with them. I said not after what they have done and by the fact, they haven’t attempted any restitution of any kind for their actions. They are so “sick” they don’t even think they have done anything wrong. I feel I have a duty to protect myself from them. The therapist agreed and told me that I don’t owe anything to them. I don’t have to have contact with them. I’m an adult and they are adults, it is my right to choose not to get involved and protect myself if I feel that is healthiest for me. Then they asked if the LDS religion had a compassion or forgiveness concept. I said yes, of course, but it is totally a mind control mechanism and is really messed up. I re-affirmed that I agree 100% with what the Self-Esteem book has laid out as compassion, and that is how I’ve lived my life, even when I was LDS. My concerns lay with to what degree do we have to take that compassion. There must be some point where you have done your part and nothing more can be expected of you. I’m going to have to bring this up again because I need more discussion around it.

The next topic I brought up was from the Responding to Criticism. There is a concept discussed in the chapter that you should do when criticism is not constructive, nor is it accurate. They call it clouding, and it drives me “crazy.” My mom used to do it all the time, act as if she agreed, or would agree with only part of the conversation and then ignore the rest. I think it is completely dishonest and should never be used on those around you have to live or work with. Or on those that you have to see on a fairly regular basis. The book was not exactly clear on the constraints of when is appropriate. The example they use is a server having to deal with a customer that is just being a jerk, and she uses the clouding technique not to take the criticism to heart. Ok, I can see for that example it makes sense, but the book is not explicit in my feelings that it should only be used when you are dealing with a stranger or someone that doesn’t matter. For work, or a marriage, I can’t see that technique ever being valid. I feel you should always probe to understand the “real” complaint, and come to some agreement. The relationship is always worth the time and effort it takes to come to a common ground.

Also, if you ever do cloud a criticism by someone that you care about, what are they going to think if you aren’t following through with their criticism? It is going to make them think you don’t care about them or respect their opinion. It’s always just best to get to a common ground. The therapist asked a couple more questions about how the book explained it, and then agreed with my assessment. Clouding is only for one-time experiences.

That was the end of my third session, and it ended again at nice logical conclusion.
If anyone else has read the Self-Esteem book, I’d love to hear your thoughts and perhaps more detailed discussions about it.

(next up - psychiatrist visit and medication)