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>> No. 27760 Anonymous
20th November 2018
Tuesday 6:37 pm
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I had my first assessment with a therapist today, but I couldn't take anything she said seriously. It was like talking to a salesman, nodding at the right times, carefully framed responses.

I don't know why I bother, it's all so pointless. Long, lonely, miserable march to death.
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>> No. 27761 Anonymous
20th November 2018
Tuesday 7:07 pm
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Stick with it lad. it's one of those things your first session won't really indicate much for.

After a few more sessions it might improve, or it might just turn out she's a bit shit at her job. But the important thing is you're doing something.
>> No. 27762 Anonymous
20th November 2018
Tuesday 9:09 pm
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>>27761
This. You're doing something good, this is just the start.
>> No. 27763 Anonymous
20th November 2018
Tuesday 9:27 pm
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Therapists are like shoes: some of them are useless and just do not fit. Try to get assigned to another one if she is useless.
>> No. 27764 Anonymous
20th November 2018
Tuesday 9:36 pm
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I know this feels rather default but you tend to get out what you put in (I suppose in extreme cases that's utter BS but I'm assuming you've an average, run-of-the-mill therapist and not a lunatic religious therapist). But I agree with >>27763 too, she might just not fit you.

It's similar to how people often tout 'going to the gym' as a good solution to many problems. Going to the gym does fuck all, you have to go to the gym and put effort in.

I found it a bit painful simply because there was so much cliche present- both in what I was saying and in how she was responding. After I'd worked through that is where real progress happened.
>> No. 27787 Anonymous
26th November 2018
Monday 11:40 pm
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Some therapist most of all like to hear themselves talk.

See how this goes the next few times, OP, and don't be afraid to stop going if you feel it's a dead end for you.
>> No. 27790 Anonymous
28th November 2018
Wednesday 6:59 pm
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They're sending me to a CBT workshop

Apparently that is sitting in a powerpoint presentation group for two hours a week for three weeks

I can think of little more to make me feel any more lonely.
>> No. 27791 Anonymous
28th November 2018
Wednesday 7:00 pm
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Also I don't fucking see the point in any of this, nothing becomes better, it's just 'how do you accept you're in the shit', none of it is improvement

running and hiding
>> No. 27792 Anonymous
28th November 2018
Wednesday 7:28 pm
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>>27791

A big part of depression is learned helplessness - at some point, life taught you that there's no point in trying. You can't just snap out of that, but you can gradually retrain that part of your brain. Tidying the house or going for a walk might seem pointless in the face of depression, but those little day-to-day things train your subconscious to believe that you do have some control over your circumstances. The more you do, the better you feel; the better you feel, the more you feel able to do.

NHS provision for mental health is frustratingly crap, but there is some good news - the evidence shows that doing CBT yourself based on a book is almost as effective as face-to-face therapy. The vast majority of local libraries have a "reading well" section filled with self-help books that have been vetted by experts. I'd highly recommend giving it a go.

https://reading-well.org.uk/
>> No. 27905 Anonymous
18th January 2019
Friday 7:26 am
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Attempted suicide, in hospital.
>> No. 27906 Anonymous
18th January 2019
Friday 1:37 pm
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>>27905
Are you getting help?
>> No. 27907 Anonymous
18th January 2019
Friday 4:13 pm
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>>27906
Assisted suicide isn't legal in Britain.
>> No. 27910 Anonymous
18th January 2019
Friday 8:41 pm
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CBT is shit. Read up on its history in Britain and you'll learn that it was basically just a product packaged and sold to the NHS who, years and years ago, were looking for cheaper alternatives to traditional psychotherapy, which cost a lot of money and usually took place over months or even years with questionable efficacy. CBT promised concrete results backed up by studies—and, most importantly, it promised them in a handful of sessions at a fraction of the cost. This is why the NHS are so aggressive about promoting it. However, although CBT is indeed an effective short-term solution for a lot of people, there is precious little research indicating that CBT has any overall long-term effect. CBT is probably less useful these days than it used to be when it arose in the late 70s/early 80s because a lot of its content has entered the mainstream and become common knowledge. The idea that thoughts, feelings, and behaviour were linked was borderline revolutionary for the average person back then, although we consider it obvious now.

CBT is actually just a heavily diluted plagiarism of a much more robust ancient Greek philosophy called Stoicism.
>> No. 27911 Anonymous
18th January 2019
Friday 8:53 pm
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>>27910
>CBT is actually just a heavily diluted plagiarism of a much more robust ancient Greek philosophy called Stoicism.

And why is this a problem?
>> No. 27913 Anonymous
18th January 2019
Friday 9:46 pm
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>>27911
It's not. That was meant to be encouraging towards checking out Stoicism.
>> No. 27914 Anonymous
18th January 2019
Friday 10:39 pm
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>>27910

>CBT is actually just a heavily diluted plagiarism of a much more robust ancient Greek philosophy called Stoicism.

To be slightly pedantic, it's really a systematised plagiarism of REBT. There are clear Stoic influences on REBT and CBT, but the Buddha was saying more or less the same things 200 years earlier.

CBT has the strongest evidence base of any psychotherapy and we know it offers substantial improvements to a large proportion of patients in the short-term. You're right to say that the long-term evidence is quite weak, but a treatment that works in the short-term is still very much worth having. The bigger issue IMO is that although there's reasonably strong evidence for CBT, we've never actually run clinical trials on the specific form of CBT delivered by IAPT services. The fact that CBT works when delivered by a clinical psychologist over 12 to 20 one-hour sessions doesn't tell us much about the benefits of six half-hour sessions with a Psychological Wellbeing Practitioner.

I've said this several times on .gs, but it bears repeating - the key to beating depression is to just keep trying. We have lots of effective treatments, but none of them work for everyone and we have no way of predicting which patient will respond to which treatment.

If you took SSRIs and they did nothing for you, try an SNRI or a tricyclic or mirtazapine. If you had psychotherapy and it didn't work out, consider whether the problem was just a mismatch between your needs and that particular therapist or that particular school of therapy. Getting some exercise or starting a new hobby aren't going to cure your depression, but they might offer a slight improvement in your mood that you can continue to build on. The principle of marginal gains comes into play - reducing your symptoms by 5% might seem insignificant if you're in the throes of a deep depression, but it becomes highly significant if you can find five or ten things that each give you a 5% improvement.
>> No. 27915 Anonymous
19th January 2019
Saturday 1:03 am
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>>27914
I'm not sure you could call modern CBT a plagiarism of REBT so much as a revision or reworking of it, but perhaps that's what you were getting at with "systematised". I'd say Buddhism and Stoicism are really quite different. There's some overlap, but they're distinct enough outlooks that it would be doing a disservice to anyone who might want to learn about them to equate them with one another. The Buddha specifically stated that awareness was his teaching. This is the key idea of Buddhism—not to attempt to reframe reality as something other than what it is, not to get lost in a process of monitoring and engaging thoughts, but simply to experience true objective reality for the sake of experiencing it. In contrast, REBT, CBT, and Stoicism are all frameworks through which your goal is to alter your subjective perception of reality.

I do agree that a short-term treatment is better to have than not to have. I think maybe the best use for it is to smash through the learned helplessness barrier, to open those people up to the possibility of change who were previously so browbeaten by their mental health problem that they thought change impossible. But timing is critical. I think it should jumpstart an ongoing treatment that doesn't just end immediately after the workshops or whatever. Unfortunately, this is hardly ever how it works in practice. What tends to happen with the NHS is that they'll refer you to CBT and then leave you to your own devices. You'll have a good month and then you're back to how you were. But you're even worse off, because the novelty effect of the CBT has been spent and your mental health problem has immunized itself and you'll never get the same result or opportunity from it again.

The trouble is that nobody cares. It's a box-ticking exercise. If you go mad and kill yourself (or anyone else), the NHS will just shrug and say "we gave them the treatment". And that's the whole point of it—not really to help people, but to give themselves justification to redirect blame for other people's health predicaments back to them, all the while saving precious money but not actually doing what they exist to do in the first place.

I agree with your last couple paragraphs, too. You should exhaust all avenues that are open to you—particularly if you're at the point where you're attempting suicide. What have you got to lose? Might as well go nuts. Try all the legit options as well as the batshit crazy ones. You can read some oddly specific stories about curing depression online. Stuff you'd never even think of, like tiny dietary changes that make no sense intuitively.

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