petak, 25. prosinca 2020.

Why ABC Model in Cognitive Behavioral Therapy is not working in reality

Albert Ellis (1957) called the ABC Technique of Irrational Beliefs:
It's a framework that assumes your beliefs about a specific event affect how you react to that event. A therapist may use the ABC model to help you challenge irrational thoughts and cognitive distortions.
https://www.healthline.com/health/abc-model


In reality this model is not working. This is my experience.
I have read about this model in 1996, so I had a chance of 24 years to give it a try. Unfortunately this logical step approach works nothing. In fact, it is even dangerous. It creates intrusive thoughts as by-product. Let me explain.

I've come up to this topic thanks to Twitter community once again. Which proves my point in my Agreeableness theory about interdependence, communication and community. There was a quote from Facts:
The only thing making you unhappy are your own thoughts. Change them.

And I explained my point of view, to which one comment was:
Your reaction to a trauma depends on your thoughts

I have said:
This is very misleading and unhelpful text. There are people with trauma, they get imprint of stress that copies itself to certain people, words and situations, kinda like PTSD. Therefore it has nothing to do with thoughts, it is chemical.
 Some people have broken stress response in brain, it doesn't shut down the door and cortisol keeps on running. Also people regulate it by listening to your advice and then develop Pure OCD,intrusive thoughts.
Try not to think of pink elephants
Ironic process theory

ABC theory proposes that your intervene every time and what out for your own thoughts and derail them if they go onto wrong truck. This is psychologically speaking using crutch. I guess they think if you start with crutch, you will eventually throw it away and do it automatically. Nope. Because of so many levels:
1) Fears are subconscious - you cannot correct them by logic. You must dip into your mind by associations, suggestions and imagination. The same way the fear crept inside. Therefore, picking up on your thoughts, stopping them, analyzing them will not help. Analysis leads to paralysis. This is the exactly reason why I put quotes in my blog and pictures below my text.
2) During childhood kids experience trauma. Some have mild, while some are perhaps more sensitive and experience mild trauma more deeply. Child cannot know, child is not build up to respond to bullying, abuse, attack in the right way, kids cannot explain it as adult, their skills are too young and unfinished. As Skinner said, society attacks early on. Therefore, a child as grown up has a pattern of thoughts with virus code inserted in regular thought patterns. You cannot change your thoughts. There are parts of thoughts that are infected. You cannot cut the healthy parts - it is not necessary and why would you harm yourself, thoughts are not branches of tree to be cut of and replaced in spring.
3) Trauma creates imprints. They are flash bulb images that come up when the wound is triggered. It is unconscious. This has nothing to do with thoughts. It is being programmed by narcissists, gaslighted that you are by default wrong. Therefore if you change your thoughts - you will gain nothing since the trigger is still there. If you are surrounded by toxic people. If you live in psychological safety environment, your thoughts would automatically be better and healthier, if you have good role models around you.
4) OCD - if you start to meddle with your thoughts in order to feel happy - this is definition of OCD. Pure OCD is desire to react to negative thoughts, negative feelings and do some ritual in your head - replace some thought and thus influence your thought pattern. This desire to feel good and to remove bad thoughts is vicious cycle, it is OCD, it is hamster wheel. You think you are doing a good thing, while in fact you are keeping your anxiety alive by reacting to your thoughts. Brain is built to keep you safe. So if you come up with ABC model idea to search and replace thoughts - you are enforcing OCD. OCD is desire to change your thoughts so you don't feel toxic shame. Instead of being in the flow, reacting to surroundings in healthy way, instead of being focused on your goals - you are focused on analysis of your thought patterns. If you try to stop thinking about pink elephants - you will think only of them. This is how brain works, if you tell yourself not to observe you are observing this non observance. And you think about it in the end even more and harder. OCD advice is to have goals and strive towards them, by accepting negative thoughts as chemical mismatch in your brain.
5) Positive psychology tells us interdependence is important. Community is important. People you are surrounded with are important, our behavior is pliable, it is molded without us being aware. Toxic people have too much strong influence - in so much that we are not aware of it. If you have close relationship with narcissist, you are gaslighted, mocked, made fun of, attacked and yelled at - of course your thought pattern will be negative.
6) Microcosm repeats itself on Macrocosm. Feng shui - this means if you change something in your environment, it will reflect in your inner world. If you clean your room, desk, clothes, with time you will have clearer mind, you will not be preoccupied by external opinion. Then your thoughts will have more space and more time to focus on things you like and the things you do, without interruption by unnecessary fears.

I would not claim that CBT is totally wrong. Education is also the key. You will benefit by knowing ABC model, and it will benefit you to know about the existence of irrational beliefs. But in reality, working thought pattern is the flow, where you are not preoccupied by your fears. You naturally do what you like, you know where you going and you are focused on your healthy idea where you feel is the best for you.

Reaction to trauma is not healed by mere changing thoughts. It is psychological wound. You cannot change your thoughts. Changing thoughts would be adhesive bandage aid for not asking where were you cut, who done it and was the cutting being repeated again? You can change your point of view, it is not change of belief (for example removing perfectionism as belief by allowing yourself to be imperfect). It is about knowing the irrational belief and finding a specific virus command implanted by trauma (abusers) from your childhood - and then replacing it. To example about imperfection it is about realizing you are unconsciously not allowing perfect people in your life - if they do not match to your perfect ideal of human being, for example the way they look or dress. Perhaps something on their face you automatically dismiss them as invalid and block them out of your life immediately without being aware you are doing it - you become aware you are doing this prejudice and you stop it. Before you may have read about the irrational belief of perfectionism - but you were not aware in what way it affected your social life. You might thought it was about having a perfect conditions that are outside your control - and you may have even dismiss the irrational belief itself as informative yet not helpful or applicable to your specific view on life. This will also reflect on your own image, you will not demand perfection from yourself and feel ashamed if you are not looking great. The trauma is you've learned when you were growing up that you must look your best in order to be validated and if abuse is ongoing your close relationships might giving you still the wrong messages you unconsciously take for granted.

ABC model is the product of Aristotelian logic. You label something and you think your job is over & done. Unfortunately, reality is not straightforward. Reality is dualistic. People will not tell you the truth, out of shame or ignorance, they may not be aware what to tell that is crucial and people who are trying to help them by advice may not know where to look. So instead of old, non functional Aristotelian logic - there is fuzzy logic. You are aware your point of view is egocentric and you have Copernicus moment by realizing Einstein's theory of relativity- other entities around you are not fixed and movable from your point of view. There are other dimensions that you cannot find out and you cannot comprehend. So you take every belief with a grain of salt, a skeptical attitude. It is healthy to have mental attitude of accepting other realities as valid and into account. In practice this would mean try things out and experiment with them. See what works for you.

Another example: shy people are afraid to make fool of themselves. Dr Aziz came up with brilliant idea; shyness overflood - you think that certain action, something you wear, something you want to do - will cause someone's negative criticism and negative opinion - do it anyway. Do the thing you are scared to do. You have thought pattern of being afraid of negative response, afraid what someone will think of you - you do not change this thoughts, you don't meddle with thought themselves, they are still there - you simply do the opposite from what they tell you. You check out your fears if they will come true.

Toxic positivity can cause damage if you ignore signs from dangerous source, if you make pretend there is no danger, for example being in company with psychopath. Labeling is regarded as something negative, since it collapses reality and creates limited reality you believe in. However, the process of recognizing something is toxic is important. It is about enlightenment. It is as body starts to recognize virus and starts to defend itself. When we do not recognize something and we don't label it, we cannot make changes and steps to improve the situation. Through education we can learn how to recognize something as toxic. Therefore, ABC model is detrimental in this process of discovery, if we make pretend everything is perfect and thus ignore the symptoms.

ABC Model also cannot work because you don't know what the problem is, even when you think you know. You don't have insight, expertise, knowledge so you can't really know what is really going on. You might think that something in your thoughts is wrong and defective, while the real problem might be somewhere else. Social anxiety works also like a domino piece, it has two sides - and if you cover the lower part with your thumb, you cannot see the information below. Emotions are like tip of iceberg, there is so much going on underneath. And if you explore one area it can quickly roll over and you get it upside down. And it may seem to you like you are dealing with the same issues such as depression because it appears similar to previous experience, while in fact there might be some other issue in reality.











YOU TUBE comments - example:
Poster: And to reach self love, you need acceptance.
Me: It is not that simple.
What happens if you are raised by toxic people and live in toxic country, where ashaming others is national pass-time? What happens when you are hypnotized into self abuse and you are not aware of it? What helps to know healing is self love if you are not educated to learn you are being perfectionist and demand perfectionism, as learned by toxic environment. Self love would be detrimental in that case, since it would enforce addictions to give yourself love.
Poster: I have the same hurt and toxic people, we all do. Monks are the ones with the answer. --> pay no mind
Me: "I have the same hurt and toxic people, we all do"
This is egocentric and Aristotelian approach.
You think you have toxic people around you so you come to conclusion:
1) there is only one kind of toxic people and all toxic people are the exactly the same as yours
2) the degree of hurt that you experienced is the same for all humanity
3) the reaction that you experience must be the same for all humanity. There are no highly sensitive people out there, all people react and are affected in the same way as you are.
Instead of this labeling approach, author of this book, as so many official advisors out there need to use Fuzzy Logic.
"pay no mind" does not work in reality.
Poster: You set the bar. That will bring peace.
Me:  "when you realize that only your opinion of you matters"
Ok, that is easy advice for someone who had no trauma growing up. But if you were traumatized, and if you were brought up and live close by narcissists, your boundaries are non existent, you are raised without opinion and you have no cognition that there are suppose to be walls.
Unfortunately, this book and people like you being devil's advocate. You have good intentions but the result is that you further traumatize people who are manipulated, hypnotized and invalidated suggesting that they simply need to change their thoughts and magically they will not care what someone thinks critically about them or their actions.
This book is not mentioning toxic people. Toxic people do not have label on their forehead - you cannot recognize parasites, so you trust them and invite them in your life and listen to their toxic advice without being aware what impact they have upon you.
"People can develop specific fears as a result of learning."
LITTLE ALBERT EXPERIMENT
"To the researchers' amazement, the environment quickly became so threatening to participants that the study had to be ended after only 6 days. Every guard became abusive and authoritarian. As boredom increased, they used prisoners as playthings.
Stanford Prison Experiment"
"What happens when you put good people in an evil place?
Those in the position of power will naturally use (and abuse) their authority.
It is the power of social situations, rather than the dispositions of people,that leads to evil behaviour.
PHILIP ZIMBARDO"
"Mental illness was a "myth", a diagnosis primarily imposed upon individuals whom society considered eccentric or unmanageable.
Anti-psychiatry
David Cooper, 1967"
Poster: I see you're setting yourself up for failure because, 'toxic ppl were worse to you!'
Me: Nope, you got it all wrong. It is about acknowledging and realizing there is a wound and there are parasites feeding on that wound. Without this enlightenment, you will never make right decisions - focus as stated in this book. And you will obsess over opinion of other people, due to wound. You advice is unrealistic, it doesn't function in real life because you have cognitive distortions, wounds from your wound and toxic people. Life is not black and white, and you cannot generalize life and people. And you can allow to be imperfect and have bad days - but overall self esteem should be having positive attitude and belief you can handle the life's struggle - the belief that you are able to face challenges - no matter what toxic people are saying.
Jean Piaget said that the purpose of growing up is building children to cope with stumbling blocks. The universe is intelligence test - it means you must put some effort and muddle through - this is explained in the book. You say that there is only one way for self esteem - pay no mind. Sometimes you do have to pay your mind, it depends on the situation and the people you are surrounded with. Sometimes the best option is to leave them - or in many times - to alert them if they cross your boundaries, not being afraid of conflict. Your advice is: pay no mind, don't be assertive because who cares. There are situations where you should care and pay your mind.
I like this Joel Osteen quote:
"Nobody wants to be around sour, critical, condescending person. People want to do business with whom they like: Positive, friendly, kind, considerate.
Many times how dirty our neighbor clothes are depends on how clean our window is. Too often we holding on to hurt, disappointment, it steals our passion, you got to let it go. This is new day."
Also this from Hour of Power:
"Expectations especially when we put on people is unkind and unfair. Expecting things from people is unkind and unfair."
"Put unfair expectations on people you will push people away,not closer. Hold desire but hold it loosely,craft it with wet clay. There is no better way to ruin everyone's Christmas than by coming into Christmas with gigantic unchangeable expectations how Christmas is suppose to be"
"Stay true to you" is not functional in reality because no man is an island.
If you are really enlightened you would know that focusing on yourself is egocentric. Tell me, what will you do at the end of your life with all the money, fame, success? You think it will go along with you to the next life? Being enlightened is being aware of Einstein's Theory of relativity - everything and everyone around us move, we are not the center of universe, and we need to develop empathy to see matters from other people perspective. It is realizing we are perceiving our reality through what we have experienced so far - if we were surrounded by people who take advantage of others, bully others and abuse others, we will always be in defense mode - even towards people who are good to us. Your advice that I am focusing on toxic people attracts more toxic people is therefore something you do - since this is your perspective projected on me. I never abuse people, I would never think someone is abusive, I trust people and enter into communication with good spirit and good intentions - therefore I am not focused on toxic people. This is problem if I ignore the facts that there are bad people out there  - that are best to be avoided - if alerting them of their misbehaviour didn't help.
The highest form of human development is interdependence and cooperation. Community and psychological security in community.
Your good intention advice to stay true to yourself is invalid, since people who are surrounded by crab mentality (which for some reason is never mentioned by official advice-givers) will influence you no matter what you try to do. Human behaviour is pliable, it is plastic. It reacts to its surroundings.

Fact, TWITTER: What you wear has an effect on how you behave.

Fact, TWITTER: Having negative friends is linked to depression, lowered self esteem, insomnia and anxiety. Positive friends promote good overall health.

Fact, TWITTER: Over thinking ruins happiness.

My YT Comment on /Deflating vs Ritualizing/:
I've discovered this is a "glue problem", double binding. Whatever you do, it turns out bad. I noticed this when I first find out about intrusive thoughts - I questioned how do I know whether it is GAD or OCD, and what about people who have both? For GAD, it is recommended to actively stop thoughts. For OCD, it is recommended to accept thoughts and focus on something else, on your goals. This is conflict in approach, and you lose whatever you do.
Also, for people with low self esteem, steps in ignoring OCD make a person develop inferiority complex over time and lose self confidence, because if you do not correct negative thoughts patterns and leave them be, as suggested by experts, will do more damage in the long run.
As I understand the goal for OCD treatment is that we do not waste any energy on our triggers and that our actions are natural and genuine, not robotic and product systematic loop thinking.
This also goes for cognitive distortions such as emotional reasoning, believing I feel bad therefore I am bad. If you leave it as it is, a person takes certain auto-pilot mode and become pushover, people pleaser in order to avoid feeling bad - and PureOCD techniques of letting thoughts on their own do damage in this case in the long run. This makes OCD complex.
It is also problem with CBT's ABC model - where they suggest actively to modulate and change your thoughts in order to feel better. Yet, if you meddle with PureOCD relentless intrusive thoughts, as we know, you make yourself feeling worse, avoidant, fearful in the long run since it acts like skin allergy - the more you scratch it, the more it itches.
No matter what, I found ERP method as suggested on OCD sites to be beneficial.

Cognitive tools are irreplaceable in healing cognitive issues, but they do not address
all the levels of our wounding. They are especially limited in addressing emotional issues,

Complex PTSD: From Surviving to Thriving by Pete Walker

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