If we could evaluate CBT based on our journey, it would include two completely opposite experiences. Keeping in mind that our daughter’s medications were being followed closely by her psychiatrist in both cases, she was referred twice for CBT. Looking back, both doctors had very different approaches to her therapy. I’d guess that her age played a part in that regard, but still, noticeably a huge difference to how they developed a relationship with her and built on the trust necessary for her to confide in them.
The first time she entered into treatment, she was about ten or eleven years old and went to a child psychologist that specialized in beating OCD symptoms. She was seen once a week, or every other week (it’s been a while!) for the better part of a year.
The doctor wanted to meet with the family first (although, I can’t remember if her brother was expected to come to this appt. or not), to get an overview of how her treatment would proceed, and probably to see how much family support she had. He would have me come in at the end of each appointment to go over what she’d be working on and explain the plan for how she was supposed to “approach” the specific symptom they’d chosen to work on, as well as how she was supposed to practice her “homework”. At the time, it seemed as though she was responding pretty well to his method of treatment. But it didn’t take too long till I started paying attention to which “symptoms” she was “offering up” to him to work on with her. At first, I decided they were just symptoms she had been privately struggling with. But, as more and more “new” ones surfaced as symptoms that deserved treating, I began to take note to see if she might “expose” any of those that we’d all struggled with as a family and that had actually laid so heavy on her mind. Over the course of her treatment, I can recall two that fit that description. Both of which, in the end, remained just as intrusive and painfully present. Although, at the time, throughout her visits, she appeared to “fight the good fight”, and follow through with all the steps of his treatment, wanting him to think he was completely successful in “beating those OCD symptoms”. I remember being a happy participant in some of this “treatment” and fanfare of celebration, just being so happy to support her through it and not wanting to doubt her sincerity, no matter what she was working on. I was just happy she seemed to be actively engaged in acknowledging her OCD.
In truth, looking back, I believe this particular doctor’s methods (not to be overly critical) were not well-suited to her at all. His treatment included role-playing as a super hero, zapping the intrusive thoughts in her mind whenever they began to take control. I believe that she really did want to cooperate and follow through with his treatment, even though it seemed sort of silly to her. We even chuckled about it as we went along. Not to make light of his methodology, as I’m sure he’d had lots of success with many patients in order to gain the trust of our psychiatrist. The big problem was that these symptoms were kind of like old friends. Yes, they were “intrusive”. Yes, they made her life painfully difficult most of the time. BUT, it was all she’d ever known. From the time she’d had cognitive thoughts, these were what filled her mind. It was a lot more comfortable for her to allow her worries to just stay put. She was just not ready to surrender all those things to this doctor at this time. Again, I’m just a mom thinking back.
Her second round of CBT was prescribed by the same psychiatrist about five or six years later. Again, he was following her meds and seeing her on her usual schedule as well. This new psychologist was more of an auntie figure to her, it seemed, which was excuse me…just what the doctor ordered (sorry). She had OCD as well, so she really “got it”. She saw her every week for several years. The two of them connected almost instantly, which as I mentioned in a previous post, was a smidge tough for me, since all of a sudden things were being shared between them that had been reserved for just the two of us. Up until then, her OCD for the most part had been left up to me to defend and protect. Finally, she’d found someone, a professional, that knew HOW to walk this road with her. Her psychiatrist had always been very good with her and she knew she could trust him, having been with him for so long, but his function was clearly different than this would be. This wonderful woman was going to listen, and listen, and give ideas and tools that no one had ever thought of (or at least taken the time to share with her). They developed a wonderful relationship, and so did she and I. I believe that even if she didn’t work on specific symptoms, she learned a lot about acceptance and permission to love herself from someone other than her mom.
Eventually, this doctor left our area. This was very sad for our family. I know she helped our daughter immensely and helped her build confidence. This treatment took us up to a time when trying to get set up with a new doctor would have been more of a stressor than a help, as her high school schedule was filling up dramatically. It just had to take a back seat to getting through her obligations. More on that in posts to come…
Also, this lady was a tough act to follow, I tell ya!