Bad experience of CBT

My girlfriend suffers from agoraphobia and is heavily dependent on her mum. She's unable to go into busy/open/enclosed places, nor travel a long way from home. She hasn't tried therapy for many years after some bad experiences the first time round. When she first became ill, she tried counselling, CBT and group therapy, but did not find them very useful. The counsellors were not very understanding, they seemed to think that there must be something real and physical that she is afraid of, as with other phobias. When she tried to explain that that is not the case, that it is the fear of having a panic attack that is so debilitating, they did not seem to get it.

The CBT was not very effective either, she had to go to the hospital for the sessions, which in itself she found very difficult. She described one session which was particularly bad, when she had a panic attack in a hospital hallway. The therapist was on hand but tried to let her deal with it herself, telling her to breathe through it. Her mum was nearby but was told not to come and help her - just thinking of that day brings back the awful sensations of the experience. As a result she remains sceptical about the effectiveness of CBT.

The group therapy was in a closed-off room that was not conducive to learning how to overcome the agoraphobia.

The only other therapy she has tried, and which worked best than any of the others, was a short course of EFT - tapping etc. This seemed to resonate with her better than anything else.

It seems to me she has been unfortunate in the therapy she received. The good news is that she is willing to give it another go, and will be contacting a therapist recommended to her.

What types of therapy would you recommend for someone like my girlfriend who suffers from agoraphobia?

I've had lots of therapy which made me worse. I have often found therapists strangely abusive, perhaps even wanting to do harm. There are, however, different forms of CBT, and I am beginning to feel some optimism about a form known as Acceptance and Commitment Therapy (ACT). It's gentle, in the sense that it's about not fighting anxiety but just letting it be. Ironically, that seems to defuse the anxiety to varying degrees. Edna Foa's approach to treating OCD, many years earlier, appears to be similar. So, yes, this is classified as CBT, but it sounds like it's not the same as what your girlfriend has been receiving. (You're in a relationship. I'm so jealous! lol)

I was in a CBT group for 6 months and it did not help me at all. I find CBT way too shallow and not at all useful for me. I know some people find it useful. We are all different and we don't benefit from the same types of therapies.
I have been going to different kinds of therapists, psychologists and psychiatrists, over the past 13 years. I have found different types of psychotherapy helpful.
I am currently seeing a very good therapist who's work is mainly based on psychoanalysis. We talk about litterally everything. She is very good at helping me understand myself, my childhood, feelings, needs, boundaries. It's important to understand how anxiety started, and why we are having other difficulties in life. I want to understand and analyze all of that. Understanding myself helps me a lot with everything. Focusing on "removing" the anxiety, doesn't do it for me. I have issues that don't have anything to do with anxiety, so if I worked on only the anxiety, there would still be other issues that I need to address. Psychoanalysis helps me with this.

@EarthCircle that's helpful, thanks. It's good to know there are different approaches to therapy, as I'm sure a single technique won't work for everyone. I haven't heard of ACT but will certainly look into that. She's definitely looking for a gentle approach. She wants to go at her own pace and not be forced to do such-and-such by such-and-such date. The pressure of having those sorts of goals makes her feel more prone to a panic attack. She prefers to make progress without the pressure.

Personally I'm not sure how much to force it. On the one hand I don't want to see the therapy making her upset, but on the other hand I'm told you have to get more anxious before you get less - 'no pain, no gain' if you like.

Nanita said:

I was in a CBT group for 6 months and it did not help me at all. I find CBT way too shallow and not at all useful for me. I know some people find it useful. We are all different and we don't benefit from the same types of therapies.

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I'm sure my girlfriend would agree. I'm glad you've found a therapist who is good for you. A more holistic approach you might call it?! I think it's important to get to the root cause in my gf's case as well, as it all seems to stem back to an upsetting experience she had at high school, when a group of 'friends' turned on her in a nasty and brutal way. That was 10 years ago now.

Sounds like an important point to bear in mind is there is no silver bullet and she might not find an effective therapist straight away, but given time and patience there will be some form of talking therapy that will help her.

I had years of psychoanalytic psychotherapy, and didn't find it useful at all. However, at this point in my life, I think I might find it useful as a means of reflecting on my life and creating a narrative that would give it meaning. I'm not sure that would reduce my anxiety though. For that, I'm more inclined toward ACT.

green_man said:

I'm sure my girlfriend would agree. I'm glad you've found a therapist who is good for you. A more holistic approach you might call it?! I think it's important to get to the root cause in my gf's case as well, as it all seems to stem back to an upsetting experience she had at high school, when a group of 'friends' turned on her in a nasty and brutal way. That was 10 years ago now.

Sounds like an important point to bear in mind is there is no silver bullet and she might not find an effective therapist straight away, but given time and patience there will be some form of talking therapy that will help her.

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Wow, that experience must have been horrible and traumatic for her, I'm so sorry. I think she would benefit more from other kinds of therapies, not CBT.

EFT or Emotional Tapping Technique is very effective in my experience, but it might not be able to stand alone?
I had good experiences with Gestalt Therapy and Integrative Therapy too.

It has a lot to say what person the therapist is; a method can be helpful if it's the right therapist, or useless if the therapist just isn't right for the client/patient.

Like I said, for me, going to therapy isn't about just working with the anxiety, it's about dealing with everything that makes it difficult for me to be me... and about understanding myself and learning about feeling safe, having self confidence, sensing my own needs and boundaries, and so on.

I agree with a lot of what Nanita has said. You should keep going to different therapists and try and find someone that really works for you. I saw two different ones before finding my current therapist, who works great for me.

Like Nanita has said, a big part of it is, I think, talking about everything with a good therapist and trying to discover and understand everything about yourself. Writing/journaling is also good and sometimes you think of things or make discoveries on your own and can bring them up with your therapist.

But I don't think you should focus on any one thing and hope that it will be the magic treatment or cure. I think the more things you use, and the more often you use them, the better chance you have at getting better/coping with things better. And different things work better for different people.

For instance, having a routine of stretching, massaging, meditating, and writing for 1-3 hours before bed has helped me a lot with general anxiety and depression. And having a good therapist for 2 years, along with writing regularly has really helped me as well.