- Hey everybody, happy Thursday, now today,
we're gonna talk about what to do if therapy isn't working.
Today's question came from a Patreon livestream
where we were talking about all sorts of different things,
and this question got a lot of chatter.
So I thought I would turn it into a full video.
That question is, "Katie, what if therapy
"just doesn't work for me?
"I am still crippled by OCD and am just now
"at the end of a year of a really intensive CBT and ERP,
"and nothing has changed.
"I totally gave 100% in this, worked really hard,
"did all the homework, showed up,
"sat through the anxiety, attempted all the exposures.
"And my therapist is great, but now,
"I feel like I wasted a year, I am no further forward.
"Is it time to just accept that this is my life
"and stop trying to change or improve it?
"Everyone says CBT and ERP are the gold standards
"for OCD and that it works, except it hasn't."
Now, I loved this question because I think a lot
of us can get caught up in situations where we think
that this one type of therapy is the best one.
And then, we work really hard and it doesn't work.
And then we can feel really shitty about our situation
and our progress, and think that, maybe,
this is just how we always have to feel.
But don't worry, that is not true at all.
Now, the first thing that I want to talk about is
that there are hundreds of types of therapy out there.
And for good reason, there are tons of different ailments
and ways that each mental illness can affect us.
Some of us can have different mental illnesses
and comorbid with this, we can have depression
and we can have an eating disorder.
But there are so many combinations,
that's why there's so many types of therapy.
Also, rolling into my next thought about this,
is that everyone is different.
I say that all the time, but it's very true.
Right down to our cells, right, so our brains are different.
There are gonna be certain things
that we can do and can't do.
There are gonna be certain types of therapy
that are really, really hard and almost impossible
for us to do, and then there are others
that are gonna be great and easy,
and we feel like we can really work
through it with our therapist.
So we all have ways that we learn best
and ways we prefer to be talked or listened to.
We all grew up in different homes with different dynamics,
and there are gonna be different ways
that we're used to just talking with people.
And so, therapy and therapists have to work
with all that different stuff,
all the things that make us unique and wonderful.
Overall, I just want you to know that just because one type
of therapy didn't work, remember, there are hundreds.
Just because one didn't work doesn't mean it's over
or that you're broken or weird.
I know our brains go right to that nasty self-talk
when something like this happens, but trust me.
Just like it can take a few therapists
before we can find the one that we truly like
and want to work with, we should think about the type
of therapy that we're gonna engage with in the same way.
It might take a few tries of different types
before we find the one that's a good fit.
I know that a lot of people are gonna have questions
about, like, well, how do I know
if therapy's a good fit for me?
Overall, it should be pushing you,
maybe a little past your comfort level.
We're always supposed to be challenged.
Not retraumatized, not disassociating all the time, right?
So we should be challenged,
and we should see some improvement.
It's not overnight, but if you've given it like three months
of real work and we're not feeling
at least a little bit better,
bring it up with your therapist.
Talk to them about it,
it's okay to ask them to try a different one.
Also, just keep in mind that it's really important
that we like our therapist first,
then find the right type of therapy, okay?
When it comes to this specific question,
yes, CBT, or cognitive behavioral therapy,
and exposure therapy, that's really what ERP is.
It stands for exposure response prevention therapy.
That's always hard for me to say, I don't know why.
But those are the quote unquote best for OCD.
But they aren't the only treatment for OCD.
There are lots others, here's, just gonna name some.
There's aversion therapy,
rational emotive behavioral therapy,
systematic desensitization, and many, many others.
Not to mention that medication can be an option
for a lot of us, I've found medication
to be really beneficial for a lot
of my patients who struggle with OCD.
So know that there are a lot of options out there.
Just because this gold standard version didn't work
for you doesn't mean that it's helpless or hopeless.
All it means is we just need to look
into some other options, find one that works better
with us and our personal struggles.
Overall, just try to remember that just
because one therapy, like I said,
out of hundreds of options, doesn't work for you,
that doesn't mean you can't get better.
A lot of it depends on your relationship with your therapist
and how well the therapy itself works with your strengths.
Think of those things that you're just good at.
Like, I am not artsy-craftsy person.
So if I was working with an art therapist,
that would really slow my progress,
because I have a really hard time getting
into that realm and working within it.
I am good at doing some homework, talk therapy,
and having some structured things
like CBT/DBT-type behavioral techniques that I can try out.
Those are things that work for me.
So just take a minute and consider what things
within therapy have helped you in the past?
Are there certain tools and techniques
that you really liked?
Maybe they were difficult, yeah, it's hard to come up
with all the things and fill out the impulse logs,
or whatever it is you're working on.
But at the end, it was really beneficial
and you were still able to do it.
Just think about that, because we want therapy
to work with, not against, our strengths.
And know that if you ever feel like a type
of therapy isn't helpful or working,
or you and your therapist maybe just seem to be
at a standstill, it's completely okay to ask them
if you can try a different style or structure.
As a therapist, it's always my goal to help you best.
If I don't know that something's not working,
I might think I am helping you,
and so, don't be afraid to speak up.
Because remember, it's your treatment and your life.
So speak up, try your best,
and I promise you, it will get better.
Thanks for watching, I will see you next time, bye.
(gentle jazz music)