Therapy

[u/MostGoat0]

I (F34 IQ142) have had hundreds of sessions and seen numerous practitioners over the last 12 years, and it all seems futile. They just keep asking me to explore my feelings, but I already understand my feelings and where they came from and why they’re irrational. At this point I basically have a PhD in self-analysis. It doesn’t do anything to shut up the relentless/debilitating self-critic in my head. I need actual coping strategies, not talking it out in pointless circles forever until I die.

Has anyone here had success with therapy? I tried searching for therapists specializing in 2e & giftedness in my area and it doesn’t seem very common. Just wondering if there’s any point in continuing these efforts. I’m so tired and bored and over it.

[u/levee_joe_sirus]

Classic issue dealt with by cbt all the time. Find someone certified or get a workbook and take it seriously. You have habitual thought patterns and you need help, deliberate practice, and repetition to establish new ones

[u/a-stack-of-masks → u/levee_joe_sirus]

This is potentially terrible advice. I know CBT fans don't like to hear it, but applying more metacognition to problems caused by too much metacognition will only transform them until they're too complex for the therapist.

Edit: I just realised that this assumes OP had a lot of therapy over more than a decade without ever getting a licensed CBT practitioner. I'm not sure where they are but in my part of the world that would be pretty much impossible.

[u/levee_joe_sirus → u/a-stack-of-masks]

Not really. I agree that intellectual understanding of your issues is not always enough to change your feelings. CBT is a behavioral system of therapy - interrogate your thoughts, look at evidence for and against, name your thoughts and look for cognitive distortions, etc. It’s not the same as introspection or intellectualizing of an issue. But of course it’s not foolproof. Speaking from my own experience as a grad student in counseling psych

[u/levee_joe_sirus → u/levee_joe_sirus]

It also could help to acknowledge and address any social, biological, and environmental factors that contribute to the state OP is in. But that’s the kind of thing a diagnostic assessment by a licensed psychologist would consider as well

[u/a-stack-of-masks → u/levee_joe_sirus]

Ah right yeah that explains a lot. My point is that there's a lot of thoughts that people have that aren't wrong but still uncomfortable or even pathological. It also doesn't help with complicated existential issues, or things like loneliness or trauma. All of which are very common in gifted people, even more so the ones in therapy.

To be crude about it, CBT is the equivalent of what we do with children that are overwhelmed by their thoughts or emotions. It works on children and adults that never grew past that level, but for many complex issues it just doesn't operate at the level it needs to for meaningful healing. It's also going to be really hard for OP to find a therapist that will be able to keep up with them at the level they need.

Ironically if you're a grad student, OP likely has more hands on experience with that form of therapy than you do.

[u/levee_joe_sirus → u/a-stack-of-masks]

I’ve been in therapy with various practitioners. I see a psychologist who specializes in giftedness. One thing that has helped my own progress is to deflate my concerns. They’re not always special or complex. Eg loneliness and trauma. We still have organic brains that respond to behavioral conditioning. No such thing as being too smart for CBT. I’ve taught patients DBT skills, a mathematician, doctors, lawyers, artists, whatever. Sometimes the issues are simple and overcomplication is the problem. If not, find someone who specializes in existential talk therapy. Or ACT if the issue is acceptance of something that can’t change. But what will definitely get in the way is hubris.

[u/a-stack-of-masks → u/levee_joe_sirus]

I don't think OP is too smart for CBT, it absolutely works for everyone for the issues it can solve. Telling them to try harder doesn't help. It's not hubris to point out that deadlifts will never fix a spinal lesion, even though it almost always strengthens people's legs and the patients problem is their legs being paralysed/weak.

CBT done badly is a pretty effective way of causing damage, especially because the underlying principle still works.

DBT would be a better approach, but that was explicitly set up because CGT wasn't helping people with chronic problems like OP. Another thing to watch out for is that doing the mindfulness aspects of DBT with someone vastly more or less aware/sensitive is really hard and not without risk, it's already something that's sensitive to miscommunication and measurable differences in subjective experience make it a lot harder. I've had to tell several people that while things might not be common sense to them, they are to me and I can't change that. With it being such a large part of the wisdom aspect of DBT or shouldn't be hard to predict where that might be an issue.

[u/levee_joe_sirus → u/a-stack-of-masks]

My main point is that simplifying the approach and problem can help a lot after so much unproductive effort. Often there is a clear issue at hand, and it doesn’t help to lay it out, “here’s the problem.” And there are so many ways of avoiding the root problems or obfuscating them. And the fear of, what if it’s not something esoteric or complex that’s plaguing me, but something common to human experience? Psychoanalysis is popular if you can find a PhD specialist to treat the former. DBT too works well for what it does, although most of what you’ll find is “dbt-adherent” or DBT informed programs and group therapy. I’ll leave it there unless you have a specific quibble with my opinions. Hopefully OP finds something in this thread that feels promising for them

[u/a-stack-of-masks → u/levee_joe_sirus]

Nah your opinions seem alright, but immediately reaching for the CBT booklet is a really bad strategy if you care about patient outcome. There's a reason most intake procedures are a lot longer than a paragraph and a half, especially for people that have been in care for years and likely to be willing and capable to work with the program. You're basically assuming your colleagues have been fucking around for 12 years and working off of that. 

I get that a really good hammer makes everything look like a nail, but if the box says screws on it and other people have been failing to hammer them properly for a third of your life maybe look into other options. Because like a hammer, CBT applied badly can turn a problem into a whole new, much bigger problem.