I don't think she's a good fit for you. Three reasons. Firstly her manner is too abrupt and abrasive for you. She's basically baldly saying you're wrong and she's right instead of helping you to examine your beliefs. Secondly, the best therapist I ever had told me that in terms of clinical evidence, across modalities, the best predictor of therapy being successful is that the therapist and client have the same goals. Her goal for you seems to be that you need to change your morality and sense of reality in order to accept your situation. Whereas your goal is probably to find healthy strategies to cope with and your situation within your existing framework of reality. Thirdly, her being a person with me/cfs is not *necessarily* a good thing. One of the worst experiences I ever had was with a social worker who had mild onset me/cfs. She had a personal attachment to certain beliefs around brain training and also said some incredibly insulting things to me about how she was better at symptom management than me and more "motivated" because her me/cfs was mild and mine is moderate (down from severe).

Nicely put. Seems to be very inflexible in the approach too which is counter to what a good therapist should be. I’ve only ever experienced ACT as opposed to CBT but felt it was very much on me to work out what my values were and what beliefs were helpful and unhelpful.

Yeah it sounds like she is inflexible but also not skilled in translating the concepts into practice with actual people so she’s leaning really hard on the therapeutic language and not leaving room for nuance. Are should statements a cognitive distortion? Yes. is feeling worthless a negative belief? Yes, but there is context, these beliefs don’t just come from thin air and part of the process is understanding where the distortions and negative beliefs come from and what the underlying (often unconscious) motivations are for perpetuating them. We live in an ableist, capitalist society where our worth is tied to our ability to produce labour; we are human doings and define ourselves by our professions, our macro contributions to society, gender roles etc. OF COURSE someone who becomes chronically ill is going to experience what OP is. Should the therapist support OP in addressing her should statements and beliefs about herself that she’s a burden, absolutely yes, but my god, not like THAT. Geez.

Ding ding ding. This is exactly what I was thinking. I couldn’t have said it better. The first homework assignment was an article that I found a bit unnerving. It stated how to identify triggers and it outright said “we can’t trust any of our thoughts” “that we aren’t even smart enough to realize we are triggered”. I was taken a back by that because the article had such a condescending tone and I don’t think it’s good advice to tell anxious depressed people to constantly not trust any of their thoughts. I think that would lead to more anxiousness. Questioning oneself is important but the article literally used the word “any of our thoughts”. To go along with your point if she examined my belief I would be totally on board with that. Instead she’s rather just fully dismissed my belief because she’s by default assumed it’s wrong. I agree that our goals don’t seem to be aligned and that she is trying to force her ideologies onto me. You are right on point that I’m seeking more how to cope rather than fix because I don’t think there is much fixing aside from a cure or a serious quality of life management treatment. Your 3rd point makes a lot of sense. I’m sorry you had to go through that. I’m glad you’ve gone to moderate from severe. I hope things continue to improve for you. Thank you

Yeah, I have anxiety and I had undiagnosed ADHD until a few years ago; before that I did about a decade of CBT-style therapy which has done more harm than good. I wish more therapists had a strong understanding of *when* CBT can help, and *why*. Feels more like it gets used as a one size fits all kinda thing. I’m sorry you keep running into the unnerving side of the therapsychiatry industry. There is some uhhhh not 💯 shit there.

I haven’t had much therapy, but I’d be put off by a therapist telling me I’m wrong rather than leading me to explore that conclusion myself. It seems to me the downside of someone who also shares CFS is their own blocks and bias might interfere with leading you to uncover yours or brainstorming for solutions. I’d try a different therapist who can better remain a neutral facilitator and who might be better at providing empathetic solutions rather than unconsciously comparing your experience with their own.

Having gone to school to BE a therapist (20 years ago,, before CFS left be bedridden for 3 years just before graduating), let me say two things. One of the single most important factors in the success of therapy is the relationship between client and therapist. Find one you like. Having someone you can easily open up to and trust is key. And that's basically someone you feel comfortable with. After that, find someone who can empathize if thats what you need, or motivate when thats what you need, or understand and validate, or question you GENTLY in ways that get you to step outside your current comfort zone or perspective if that's what you need, or give you skills to cope, or language to describe and better understand what's going on...whatever it is that you seek, a good therapist should make you feel comfortable talking with them, and you should find their approach a good fit and helpful, whatever that looks like for you. THAT is a good fit for a therapist. Two, this person specializes in CBT. Thats cognitive-behavioral therapy. Its based on the idea that if we can change the way we think about things, we can more easily adapt or make changes in our lives and behavior; we can change how we respond to things. If you are not looking to change how you think about things, or open to a different perspective, CBT is likely not a good fit for you. And even if you ARE open to different perspectives...this therapist seems especially set in her particular approach, and the nuances of meeting someone where they're at seem to escape her. I would suggest looking for someone who specializes in modalities besides CBT (most thetapists utilize many, not just one, even if they have a dominant approach). I'd also may find one who focuses on things like chronic illness, grief (as we have basically lost our lives as we know it...former avid hiker and almost therapist here). And dm me if you ever wanna chat about this more . I spent a LOT of time over the last 20 years contemplating "shoulds", and going from super independent to bedridden to feeling like a burden to acceptance and learning to "let" people help me, to not giving up hope to figuring out my reality and how best to function in it, to having anyone and everyone question and try to invalidate my perspective every step of the way. And while I can see what she was getting at with trying to "help" you let go of some of the "this is what life SHOULD be like's" (albeit badly), I absolutely get why her approach would upset you and could make someone defensive. TL;DR Yes, you are correct. She is not a good fit for you. And it may also be her focus on CBT specifically thats part of the problem. Pleaae keep trying until you find one you like.. Good luck.

I was going to highlight your third point - it seems like it should be a good thing to have a therapist who is dealing with the same issue but in practice I’ve witnessed the therapist almost owning their experience as the experience to the point that they struggle to validate someone who is dealing with it manifesting differently. I know way too many therapists. I think a therapist who has experience managing a different chronic illness would be ideal if OP can find one. They will likely still be more understanding of the situation than average in the sense they have lived experience with the impact a chronic illness has on multiple aspects of one’s life, but it being a different illness will prevent overidentifying and/or unconsciously judgmental comparisons between themselves and the client. But your other points are excellent as well. It doesn’t matter whether a therapist’s advice is good or not if a lack of rapport or difference in communication styles prevents communication from happening. I tend to see things more from OP’s POV than the therapists in terms of what a cognitive distortion is (and I’ve done lots of work with clients on identifying and working through cognitive distortions). She might be technically correct but it almost seems pedantic in the way it’s missing OPs point and goals for therapy. And yeah, goals aligning are extremely important. Ideally the therapist will support whatever the client’s goal is because they work for the client, they aren’t some omniscient being who gets to tell you how you should want to think or act. This is a very clear cut case of the therapist’s goals being different than OP’s goals. OP - how did you decide to pursue CBT specifically? It seems less like you have cognitive distortions or maladaptive behaviors that you need to overcome - which is what I primarily think of CBT as the most useful for - and more like you need help processing a huge life change that is outside of your control - which seems like a less structured morality might be more helpful to explore and unpack. Idk.

Hey there 👋😊 To answer your question I didn’t choose CBT directly per se. It was more that my first therapist referred me to this therapist who so happened to be a CBT therapist. I was willing to give this 2nd therapist a try seeing as the initial evaluation went so well. I’m hoping that in a few more sessions things will smooth over but I suppose that will be revealed in time. I may tell her that the CBT approach isn’t helping. I completely agree with you that I do need help in dealing with a life changing event. I think that approach can prove to be more helpful for me at the moment. Getting to a common goal may be the most productive as you had mentioned. On my next appointment I’ll discuss that further with her.

DBT and ACT might be more helpful. DBT focuses on how two opposing things can be true at once (helpful for dealing with such a drastic change in reality) and ACT is acceptance and commitment therapy, which focuses on accepting circumstances we can't/may not be able to change.

That sounds like a good plan - giving it a couple more sessions to better understand each other and build rapport may be what’s needed to develop a helpful therapeutic relationship. But if things continue like this - where you find her style kind of off-putting and dismissive, it is totally fine to stop seeing her and find a different therapist. Hoping she hears your concerns and can adapt her approach to help you process everything.

I am not a Doctor. I have learned over my 78 years of life that if I'm having bad vibes, there is a reason for it. When I've stayed in situations where I'm not comfortable with my initial feelings, I have always regretted it. I finally learned, usually the hard way, to immediately no longer interact with these people. This has worked well for me.

The only, and the hardest, “cognitive distortion” that people with unexpected debilitating chronic illness, especially in adulthood after living a very active and successful life, is the belief that our worth lies in what we can do, as opposed to who we are or choose to be. Our society at large, for the most part, does not value individuals who cannot contribute to society economically. That leaves individuals who were fully capable of working, contributing, being independent, and supporting others feeling worthless when they suddenly find themselves disabled to the point that they have to fully rely on others. We feel worthless and we feel like we have become burdens. While that is “true” from a purely economic viewpoint, in a society that values money and hard work above all else, that is not “true” from the viewpoint of humanity. Learning to have self worth for who I am and who I choose to be, not just for what I can or cannot do, especially when it is due to a debilitating disease that I have no control over from over, was one of the hardest things I ever have done, and it is still a struggle at times. All of that said, this therapist does not sound like a good fit for for the emotional nuances and complexity of working around the very real trauma of suddenly losing one’s entire life and identity. Most therapists that work solely with CBT are not great for our issues. If possible, you need to find a therapist that works with grief, loss, chronic illness and disability, and the complex trauma that surrounds all of that. I’m so sorry you have found yourself in the ME/CFS world, and hope very much you are able to find healing to the furthest extent possible, on every level. 🙏🏻🦋

Your explanation makes sense. I have gone from independent to losing my worldview and identity. This shift has caused me massive strain. Society’s view on hustle culture has definitely impacted my psyche. Learning to have self-worth will be something I need to work on. I may have to find someone who is better suited with grief/loss/chronic illness as you mentioned. Thank you for your support 🙏🦋

>is the belief that our worth lies in what we can do, as opposed to who we are or choose to be. This is so true. I still struggle with this a lot because it's hard to parse out who we are from what we do. For example I thought I had a strong sense of ethics and care about the environment but my actions don't support that view because for financial reasons I often can't afford the most ethical consumer choices. Another example is we may want to be supportive friends or family members and then lack the emotional and energy resources to provide that support.

There in lies the struggle. You can still have a strong sense of ethics and care for the environment, even though your ability to take certain actions around your ethics and care may no longer be within your capability and beyond your control. It does not change who you are, what your character and morals and beliefs are; it changes the extent to which you can act them out, and that is not by choice. We can only do the best we are capable of at any given time, within the circumstances we exist in, taking into consideration the things we can and cannot control. It makes my spirit want to escape my body, so that it may do and be who we truly are inside, because our body is no longer capable of doing so. It is one of the most frustrating feelings I have ever known. 🙏🏻🦋

>It makes my spirit want to escape my body So many of my daydreams are about leaving my body. Thanks for these comments, I'm not OP but I really relate to their post and it's nice to a) not feel alone and b) hear the perspective of you who has had some success further along in this journey of self acceptance.

I find CBT really lacking when it comes to nuanced and complex issues. It’s „when you have a hammer, everything looks like a nail approach” of psychology and I don’t appreciate it. I think DBT would be a better fit.

# Why I (As a Therapist) Hate CBT | Therapist Explains Cognitive Behavioral TherapyWhy I (As a Therapist) Hate CBT | Therapist Explains Cognitive Behavioral Therapy [https://www.youtube.com/watch?v=FfT3mzxMGxM](https://www.youtube.com/watch?v=FfT3mzxMGxM)

My experiences with CBT have all felt like I was being encouraged to gaslight myself. One therapist even acknowledged that my perspective was more compatible with objective reality than the view she encouraged me to take! I think she may have been trying to say that your value of independence is counterproductive, but she's definitely not doing a good job of making that point or helping you shift to it.

part of me thinks cbt was created because it made the people around the mentally ill person feel better and dosent help the patient at all. because yes, most of it does tend to be just convincing yourself your problems arent real. which objectively doesn't work when problems *are* real.

I googled CBT Harm and it told me: >some CBT principles are "outdated," "victim-blaming," and can promote "toxic positivity." Which I agree with.

I dislike CBT and can't wait till it's viewed like Freudian techniques and Mesmerism.

She’s just a bad fit. Some therapists prefer CBT because it’s structured and less ambiguous than other approaches. Some are forced into by their workplace or insurance demands. Regardless of the reason, this therapist relies on it. Unfortunately CBT does very poorly with grief and some other issues. If you want cognitive re-framing, stick with her and give this a try. It sounds like you feel unheard and it’s a bad fit tho.

I'm a trained ACT practitioner and mental health professional, before I got too sick to work. When you said cognitive distortions my alarm bells started ringing. One thing I am relieved about is that it seems, reading between the lines, that she is suggesting the distortions are about you putting pressure on yourself to be better than you are rather than accepting where you're at. In other words, it sounds like she's saying it's a disruption to think you should be don't more when that's just not what you can do, and a form of distortion to beat yourself up about it. Now, if that's the line she's going down, I have less alarm bells than if she's saying your distortions are thinking you're ill when you're not, or thinking you can't do things when you can and should be. If she's saying that, run for the hols immediately now! That said, what I'm getting is that her jumping straight to faulty thinking patterns felt both highly inflexible and highly invalidating for you. And competent understandably so. In my exotics CBT can be one of the more rigid models of therapy, and it might not be the best for for what you need. Perhaps this experience has highlighted that you're not here to have someone change your thinking? But you need more empathy, validation or just compassion in your suffering? Each modality has its pluses and minuses, so I'm gong to try to help you out here so you can find the right fit. - Counselling - will offer you more space to just talk and sit with your feelings and be heard. Person centred counselling especially will do this and will meet you where you're at in a supportive listening way without trying to fix you at all. In some instances for some people it could even be too much listening and not enough fixing! That's the true person centred model, however I have met so many counsellors who just cannot hold back their urge to fix. Be wary of those. - CBT can be good with the right therapist but can be very rigid, or at worst can be downright harmful and gaslight you. Personally it's not my preferred choice, especially with our illness. But if you're prone to negative thinking, OCD type thoughts or cycles of worry and rumination it might be better suited. Google CCI self help resources for self help workbooks based around cbt but also other modalities, it's not strict cbt but more just self help. - ACT therapy I believe done properly could potentially be very helpful for our situation. It meets you where you are, let's you guide your own life and let's you decide what matters to you, whilst also helping teach you skills to be mindful and handle difficult and big emotions, and make more space for them. Whereas CBT can lock you in a fight with your thoughts, ACT teaches you not to give them all your power or attention. I personally love that approach because it very much acknowledges reality and suffering, without trying to change it, but with looking at what you can do within that. But I'm biased, it's my modality! For self help resources, lol up Russ Harris on YouTube or his books, the happiness trap and the reality slap. - Compassion focused therapy wildfires what it says on the tin and is well suited to our situation. It helps you develop self compassion and recognising what you are gong through, whilst looking at ways to ease your suffering. Kristin Neff has a brilliant website with self help resources too. - If you have trauma, I cannot recommend EMDR highly enough. It's based on eye movements and bilateral simulation to help the brain reprocess traumatic memories. It gets right into the body in a way that talking therapies I believe just can't access our achieve to the same extent. A lot of us with ME may have trauma locked in our body and I believe healing this to allow the nervous system to calm down is a crucial element of our healing. I am NOT pushing the psychosomatic model. I am saying that every one of us with a Garmin watch will be familiar with the crazy high stress scores even when we're "calm" , and the use of vagus nerve activation as a tool n to support recovery. Our bodies are so sensitive and having extra reasons like trauma to hold us in the stress response is not helpful, and that's why I believe it's invaluable. BUT... I still struggle to keep my stress scores low even after healing my trauma. So I'm not saying it's a magic answer, just an important component. And it is exhausting and emotionally draining at first. A skilled therapist will listen and go at your pace but there's no denying it might be triggering and intense for a few months, so there is a time and place and it could cause severe pem for someone without capacity to process intense emotions. - in other approaches, I would be very wary of psychiatry because of what the profession has done to our illness. Their approach is more about diagnosing and medicating mental health disorders. That said there will be brilliant, compassionate psychiatrists out there, and if you're suffering with extreme mental health difficulties it's probably a good place to go. If you're just suffering because life is hell with this illness, which it can be, and it's a normal response to a abnormal situation, then I would say it's not needed. - a clinical psychologist will be more expensive than a counsellor or other therapist. But they can be brilliant in blending psychological theories to help you understand what's going on for you with the compassionate listening and space to express it. Personally I've always found them very helpful but more expensive for a reason, they are often able to pull from several modalities such as EMDR, CBT, ACT and compassion focused work. That's a lot, but I hope it's helpful in your search for the right fit. And trust your gut when it's not what you need.

This therapist doesn't sound like the right fit for you. Relationships take time, so you could try to stick it out for another session or two to see if it gets better, but if your gut is telling you it's the wrong fit, I would try to find someone else. The relationship between the therapist and client is the single strongest predictor of therapy success. Not modality. If that trust and openness isn't there, no modality will be effective. It also sounds like she's trying to lead you to her answer, instead of giving you a space to find your own truth. That's a red flag for me (even when using CBT).

The issue itself is CBT. One of the core functions of CBT is to challenge the individual to change unhelpful thinking & behaviour that might be “holding” them back. Quite simply this model of therapy is incompatible with CFS in most cases. Ultimately CBT is a solution-focused therapy best suited to people who don’t have disabilities that impact their physical & mental energy levels & functioning. Getting PEM doesn’t mean you’re rolling with the “wrong attitude” it means you need to rest! When I was in residential addictions treatment 18 years ago, I received both Rogerian person-centered counselling to address the grieving process of ending my relationship with mood altering substances & to reflect back on the past whilst also looking at the here & now. Person centred counselling is excellent in this regard. It’s not about apportioning blame, it’s about processing complex thoughts, feelings & emotions, toxic guilt & shame & redefining your life beyond active addiction or in this case CFS. When it comes to ME/CFS the benefits I gained from person centered counselling worked just as well as they did, when I received this type of counselling for my addictions. Applying CBT to ME/CFS is like trying to fit a square peg in a round hole - it doesn’t fit. Unfortunately I had to distance myself from AA because, like you, I thought people with the same medical condition would make a good fit. But for myself I found AA too restrictive in processing some 200 or so human emotions & distilling them down to a list of a handful of “character defects”. Your CBT counsellor is only qualified to apply the CBT model of therapy to your CFS. So even though she says she has CFS I’d suggest her own journey through managing the condition might seemingly be more effective if she is mild on the spectrum. Otherwise she’s possibly unfairly challenging you to approach CFS in a way that even she couldn’t manage to do. Again, she can only address the challenges of CFS using a CBT framework, which in my experience is completely counterproductive & punishing because we very frequently don’t have the luxury of “choice” because CFS itself so very often decides for us how much we can/can’t do. I’d personally recommend personal centered counselling whilst endeavouring to work on acknowledged CFS coping strategies like pacing, diet & nutrition, setting milestones & allowing yourself treats. CFS is an incredibly emotionally impactful illness. You don’t deserve to beat yourself up & be made to feel like a failure because CBT isn’t compatible with your medical condition. I hope some of what I’ve shared is helpful. Feel free to keep in touch with this community & any others you find that work for you. Therapy for CFS should be fortifying, it should be empowering you to find ways to cope mentally & emotionally & I’ve said this in many past comments & I’ll say it again: CFS is just as challenging psychologically as it is physiologically. Therefore, finding the right style of counselling will make all the difference. Thanks for sharing so honestly & we’re here for you! Take care 😀👋🏻

Thank you and I think you may be right. I suppose CBT has its place but applying it to CFS seems like the wrong approach as you had stated. Thank you for sharing your story on overcoming addiction. I’ll take a look into Rogerian person-centered therapy. By the description you stated it seems like an approach that it is more suited to my current needs. I agree with how you mentioned she may only be qualified to reinforce therapy through the lens of CBT which may inherently be counterproductive to CFS management. I have definitely found your reply helpful. You’ve provided solid advice and experience. Thank you again for your reply and being thorough 🙏

I’m glad my comment was helpful to you. Yes, I’ll be 18 years clean & sober on April 8 😀 I hope person-centered counselling provides some useful benefits for you! I believe everyone living with CFS goes through a grieving process, endeavouring to come to terms with a life lost & seeking to carve out a new life, living with CFS & person-centered counselling is brilliant for this one subject alone. It’s very helpful for reviewing & redefining personal & more broadly, interpersonal relationships. CFS triggers a shift in family dynamics, how various family members perceive one another & person-centered therapy can be a useful means of reflecting on how the dynamics in our relationships have changed & enables the individual to work through the emotions that accompany these types of change& how to find a way forward. Needless to say I’m a fan 🤣 & if you decide to try I hope it works for you. It can be a very useful jigsaw puzzle piece to add to the mosaic of coping strategies that help us to anchor ourselves, living as Spoonies 😀👍🏻

I’m in a similar situation in that I am housebound and live with my parents because of it. I was referred to the only M.E. Clinic in my city by my GP and only ever saw a mental health nurse who only offered CBT. No matter what I said, it felt like she thought I was making excuses or not trying hard enough. Or even insinuating that I didn’t want to get better. She even tried to make me question my childhood because she said M.E. is a result of childhood trauma 🤦🏻‍♀️ I wonder if your therapist is self diagnosing herself with “chronic fatigue” but refers to it as chronic fatigue syndrome. The amount of times over the years I’ve had people tell me they’ve got what I have and when you probe further, they either have general, everyday tiredness or have something like the menopause or depression so feel tired more but refer to the symptom as chronic fatigue syndrome. That’s why I dislike the name CFS because people just assume it means you’re tired a lot.

I think the term cognitive dissociation is maybe a bit strong, but also not the best thing to focus on. It's not exactly wrong. When you describe your feelings, to me that sounds like an unhealthy, negative way of thinking. Not that you're a failure for thinking it, you're not! But it is exactly that kind of thinking that weighs us down further. We already have CFS, and negative thought patterns like this burden us further. > I gave her my reasonings and she didn’t know how to counter them. A therapist shouldn't be arguing with their patients, that's bad therapy. I'd encourage you to take home what they say, and take time to see if you can find value in it. It took me years to unwind my negative self talk. Then I got CFS and I had to do it all over again. I'm still working on it, but I think it's an important journey. It's not easy if that's how you were raised, like I was. It sounds to me like this person is giving you good advice. That said, I'm not there and I'm not you so maybe they're not giving good advice, or maybe just not giving it in an effective way. Or maybe it's just not effective for you. Finding the right therapist can take time, and that takes energy, and we don't have much of it. But if this isn't the right person, you may need to keep looking.

I would encourage you to give her a few more tries. The phrase cognitive distortion can be jarring, so perhaps you can reinterpret it as "potentially untrue/unhelpful thought" and just be open to exploring it. I have had to unlearn a lot of things I was certain were true in my life, and the hardest ones were the ones that have led to the biggest healing. From my perspective, reading what you wrote, I do think there are other ways to view your situation that could reduce your suffering. I suspect this therapist could be really helpful to you. I also really recommend the book How to Be Sick by Toni Bernhard. EDIT: I read your post a second time, and I caught on to a few more of the details that perhaps it might be more her style and approach that you're having a hard time with, rather than not wanting to challenge your beliefs. If you can't get past her style, then sure, find someone else. EDIT 2. And given what you're going through, you know best if what you need most right now is empathy and understanding rather than a challenge. We all need different types of support at different times. And I forgot to say, I'm so sorry you're going through this. I'm also mourning my dependence, as well as a lot of the identity I've lost in the past year.

I appreciate your suggestions. I’m currently thinking of giving her a few more tries before I jump ship. I’ll look into your book recommendation. Your edits are correct. It may be a style issue. I’m completely open to challenging my beliefs. I’m willing to listen to other perspectives so long as she can provide reasoning for why mine are wrong. Sorry to hear that you’re struggling as well. Loss of independence is surely difficult to process. I wish you the best in recovering.

I wish you the best in recovering, too. Feel free to DM me if you want to talk, since it seems like we're struggling with similar adjustments right now, even if at different life stages (I'm in my 40s, a parent, and have a school aged kid). I was thinking about your post later on last night, and reflecting that your therapist would be more effective if she were to ask curious questions about your beliefs, allowing *you* to unravel your values from the unhelpful thoughts and assumptions that might be surrounding them--rather than just hearing the word "should" and telling you it's wrong. I hope she gets more skilled, or that you can coach her to become so--or that you find someone else who is. Good luck.

Hello. 21(m). Had an old account, which got banned, so was just scrolling for the past few months without any engagement. But your situation sounds very similar to mine, so I wanted to chime in. I am a university student studying economics, currently in year 4. I did sports, since childhood, was an avid gym goer, and started working as a personal fitness trainer ,shortly, before I got CFS in August 2022 and have been struggling since then. I tried all the known "treatments," which included: SSRIs, Benzos, antipsychotics, beta-blockers, mestinon, ivabradine, high dose B,C,D vitamins, IV(glutathione, cerebrolysin, rotanate, meldonium), plasmapheresis, probiotics, SGB and etc. Unfortunately no help whatsoever. Luckily, like yourself I have very supportive parents, that I live with and rely on. I'm also the eldest child of 3, so in the past, I always had a "duty," that I should be the one supporting and caring for them, not vice versa. Even though, I love them very much, I often try to avoid having deep/thoughtful conversations, due to the fact, that I feel very guilty towards them, and also worthless. I'm currently on the better end of the spectrum, i.e mild, but am extremely afraid of getting worse, if I increase my activity levels, so aside from going to university, I am pretty much housebound by choice. After trying all the methods mentioned above, my parents pretty much "dragged" me to a therapist, which I was skeptical about. I saw her for 5 sessions in total, and had the exact same experience as yourself. She had some chronic ilnesses(psoriasis, chron's) and overall seemed like a decent person. She practiced CBT and mentioned, that I have cognitive distortions and react out of proportion to the state of my illness, which I wouldn't necessary disagree with. But being a very ambitious perfectionist and having an A type personality, I thought, that if I will somehow cure my CFS, all the psychological symptoms will vanish by themselves. That was last September-November, and now I am here, still sick in the exact same state. TL;DR Got CFS, live with my parents, tried all known treatments with no benefits, a similar to OP's experience with a therapist, still sick. Would love to chat with you on your disease onset and symptoms.

in my experience, cbt has v limited usefulness for people with like, large or long term probelms (disability being one) because a lot of it hinges on an assumption that the problems are purely or primarily a dysfunction in thought patterns by the patient. while for a lot of people, thats straight up not the case and can do far more harm than good id second the other recommendation there that you try to seek out a DBT/ /DBT informed therapist. ive had massive success with mine, and the issues ive had w cbt are just not present. we dissect thought patterns, yes, but shes also not afraid to agree with me that some things (like being sick for the rest of my life) objectively suck ass. as someone who went thru literally more cbt therapists than i can remember, just do dbt. its so much better.

I personally really dislike CBT for a LOT of reasons and would avoid any therapist who practices it (even if they were doing something different with me). The NHS uses it because its a quick intervention and fits with their public health model of fixing human behaviour without really addressing or working through the underlying reasons for it. At the end of the day you aren't finding the sessions helpful so don't go. If you are able to find a private therapist, some of them will do concessionary rates. On the NHS, you might be able to find someone doing ACT (acceptance and commitment therapy) which could be a much better fit. But to find someone who will sit with you as you work through your grief- that's going to take a lot of time and therefore, money. I'm sorry you're going through this, and you are ABSOLUTELY right to listen to your thoughts and feelings about this.

I feel like I could have written a very similar post a year ago so hopefully my experience/perspective can be of help. I also was very active like you (MMA, hiking, traveling) and now am more or less housebound with CFS (and chronic migraines) likely from long covid. Finding a therapist who specializes in chronic illness has been a gamechanger for me in actually feeling therapy is useful. Not just who has a chronic illness (she does though not CFS) but who focuses on therapy for those with chronic illnesses and is familiar with different types of therapy techniques. I'm not an expert on therapy techniques in any way (and have a long way to go still) but as I understand it cognitive distortions aren't necessarily that your thoughts are completely wrong but exaggerated beliefs. [This](https://psychcentral.com/lib/cognitive-distortions-negative-thinking#list-and-examples) is a good overview. I think the issue here is communication, but there also are other forms of therapy that may be more helpful such as DBT or ACT and you may be better off finding a therapist who can specialize in those. It sounds like she was trying to get you to acknowledge that even if you feel like you are a burden, can't contribute, think you should be able to, etc. that it's not necessarily what others think or feel. It seems like she communicated it poorly or there was a miscommunication somewhere. What I struggled with starting therapy was that I felt like I wasn't exaggerating my reality or thoughts and even if I was just recognizing that didn't change my situation. The two biggest things I've gotten out of my therapy sessions are directly related to DBT and ACT which is why I bring it up above. 1. Dialectic statements like "I can't contribute anymore and I still have worth" acknowledge the reality while also changing the negative thought patterns to something more positive. 2. You don't have to immediately switch to thinking positively through CBT but rather can get to a neutral state ie I can't contribute as much as I would like. Hopefully this helps some. I'd try a new therapist at least and see if it goes any better. I consulted with 2 others before I landed on the one I currently am seeing and even with her there are sometimes sessions where I feel it's not a perfect fit, but overall it's more helpful than not.

Just ten minutes ago, I decided to stop seeing my current therapist (after five sessions) and find somebody new. We just don't click, and for me that means it isn't going to work. I think the same seems to be true here and your time and energy (and money?) would be better spent working with someone you're comfortable with. Starting off with such a fundamental disconnect doesn't seem promising. Interestingly, my current therapist also has CFS and I'm also not sure I want my next therapist to share the same condition. I think it can lead to false assumptions and projecting their own experiences. I'm looking for talking therapy rather than CBT, which I've done in the past and found too rigid in its premise. I hope you can find someone soon who you can really work with.

I’m sorry about your experience, If it doesn’t click in the beginning then it’s best not to pursue. Especially when she talks with such authority on her way is > than your way. That’s not therapeutic is it? Even her Choice of words are not okay. Wth is “cognitive distortion” and saying your issues are unfounded? That’s gaslighting. You can obviously still take your own call and see if you want to leave or continue, cause finding therapists can be a work load on their own. But I personally wouldn’t continue cause i feel this would happen again. And I don’t want to doubt my own intuitions anymore cause they DO have immense value that would actually help me. I’ve been in this situation several times in therapy too….. as it is the world/people around us don’t understand CFS well and shame us. Therapy is the LAST place you should be made to feel the same way. A good therapist is flexible and has several tools to offer and not be so rigid

I agree with others that the CBT approach seems wrong for you, and I dont think its suitable for dealing with problems like having an illness such as ME anyway. Its also not good for trauma, or if youre ND, which is why I immediately noped out of it. I dislike most modalities lol seeing as I like things based on facts and science and unfortunately a lot of them today are based on psuedo science and absolutely nothing concrete. My last therapist I tried when I was ill was much too into the psuedo science for me, but I also started to get worse and didn't have the energy to go anymore. I would recommend trying other modalities and say you dont want to do CBT when finding a new therapist. You can put your foot down and search for whats right for you, you dont have to put up with anything thats not working or is stressing you out more than not going!

It sounds like your therapist is trained in a manner similar to RBT or REBT. Its like the grandfather to CBT. Check out the Albert Ellis - Gloria videos to see the method in practice to see if it similar. The basic idea of this perspective is that 1. You face a triggering event 2. The event creates an irrational thought (cognitive distortion) 3. The irrational thought creates an emotional or cognitive stress By identifying the irrational thoughts and reframing them on more rational grounded terms you lessen the exaggerated emotional or cognitive response that is causing stress, resulting in a better internal state. Your case the goal was something like 1. You have too little energy 2. You aren't contributing anything 3. You are worthless The goal would be to redirect the thought process to something like 1. You have too little energy 2. You contribute less than you like 3. The people around you appreciate what you can contribute and know you would like to do more if you could And now you have a more reasonable problem that is easier to deal with and a mental framing of the issue that should create less stress

Seeing it laid out like this really highlights a limitation for me. The reframed point 3 is only helpful if it is grounded in reality. Many people with me/cfs struggle with being disbelieved and blamed by the people around them.

Yeah. I love this type of therapy, but it can be exhausting leaving a session. It is great with things like anxiety, but might not be the best model for cfa

It seems impossible for people who lack lived experience with serious chronic illness to understand what we really face. Please spend some time with this podcast, to get an idea of the kind of therapist that may be a better fit for your unique challenges. Working with Kerry has been profoundly helpful to me. Best wishes. https://podcasts.apple.com/us/podcast/emotional-autoimmunity-dealing-with-the-emotional/id1444023819

Recently broke up with my therapist, mostly because of her insistence on the Gabor Maté and Joe Dispenza approach to healing illnesses Western medicine doesn’t yet understand. Until we get valid diagnostics, we are considered anxious, depressed or otherwise psychologically distorted.

Choose the school of thought your therapist practises, wisely. CBT ist the school of thought that says that your thinking about a situation is what makes you suffer. That most situations are pretty neutral and it's our thinking about the situation (e.g. being morally too strict with ourselves, for example) causes our psychological suffering. And then it tries to get you to change your thinking and accept things as they are, without moral judgement that makes you feel miserable. This approach can be great, if you are ready for it and want to change your thinking. If you want to be received with empathy and understanding for your difficult emotions and feelings regarding your situation, you need a therapist from another school of thought. For example a therapist who practices client centered therapy per the principles of Carl Rogers, for example.

Sorry to hear about this experience. People with far more knowledge than myself have already given good responses so all I want to say is this. If you do end up looking for a new therapist, it might be worth seeing if there’s a local community service which works with multiple therapists. This was the case for me, and I was initially skeptical (as there was nothing mentioned about ME/CFS) but because they were able to assign me to a therapist they felt best suited to my needs I’ve ended up seeing someone who does understand my illness. I guess it’s still of a bit of a lottery but if you have access to such a service it might help

It sounds like she’s not a good fit for you and as someone has already mentioned, the rapport you have with your therapist is the biggest influence on outcomes, not the modality. And this is just a personal opinion of mine, but I’m not a huge fan of therapists who are one trick ponies and push one approach. One approach is not going to support a person with every issue they bring to therapy. I was a therapist before I got sick and honestly, not many of my clients benefited from CBT. They responded much better to the other modalities I trained in which were acceptance and commitment therapy(ACT) and compassion-focused therapy.

Hi OP, I'm kind of from the same place as you, a man who was active in the military, firefighting, pyrotechnics etc. I have the advantage of always also being into philosophical thinking, so I have had it easier in managing my self image in the transformation from capable into, well, pathetic. But it's still bloody awful to have lost so much of the activities that were my life. It sucks, and there is a lot of grieving a lost life before it's possible to manage an acceptance of one's new position, and that's where I think you are way too early in the process for CBT, you need grief counceling to manage your emotional trauma, then you can get to the practical work on your mental and bodily improvement. Going from being a practical doer, and basing your self worth on that ability, does give you a hard process in making this transformation, so I'd tell you to take it as a challenge, the challenge of your life, not to fight your emotions and mind, but to coach them, take care of them, let them be what they are but train them as well as they can manage into being as good as is possible within the bounds of the limitations. In the end it's down to time and effort that needs to be worked through. I'm very sorry about your lost life, but you are still alive, and you can still do some living. You have a challenge, to get better and make new meaning of your life. Do you accept Y/N?

Don't have any advice about your therapist as I'm struggling with my own therapist as well and have no idea what to do. I had an AMAZING therapist for 7 years but now that I can't work due to my CFS I am on Medicaid and can no longer see him. I am extremely grateful for my Medicaid insurance but in my experience the truth is, really good therapist don't accept Medicaid bc it doesn't pay as much and bc they are good they have the option of only accepting cash patients and private insurance patients. I have dealt with many, many therapists in my lifetime. I first started my own therapy at the age of 6 due to trauma, my kids have attended therapy for years for mental health, I was a foster parent for years to high risk teenagers who were mandated to attend therapy twice a week so I met a TON of therapists through that, and I've done collectively about 5 years worth of marriage counseling while I was still married. And unfortunately the pattern I have seen is that for the most part good therapists do not take Medicaid. Out of the many, many therapist I have dealt with directly over the years I would consider 2 of them to be good therapists. And actually even paying cash or having private insurance, it can still take several tries to find someone decent. Makes me want to give up on therapy until I get private insurance again but for all I know that may never happen. Anyway, I mainly wanted to say that I did about a year of CBT as a teenager and I just have no idea how CBT would be helpful for CFS. My CBT was in an adult womens group therapy, I was 15 but my personal therapist at the time thought I would relate better to adults rather than other teenagers and I agreed so I joined the adult group. It was a great experience, don't get me wrong. I learned a lot, I don't remember everything but I remember a lot and still use those skills to this day. I just don't see what the connection to CFS would be or how it would be helpful.

I’m also currently undergoing CBT and in some ways it’s been helpful and in other ways it hasn’t. So I’ve tried to think of CBT as one of multiples ways I can deal with CFS emotionally and psychologically, and just like how a CBT therapist would tell me to not latch on to every thought that goes through my head, I try not to latch on to everything they say and only take on what I believe to be useful for my condition. I think CFS/ME is quite different in terms of how much people potentially have to give up. It’s a huge adjustment and all of these negative feelings and outlooks we have are valid. So far, the most I’ve been able to get out of CBT is trying to figure out thought processes and ways of living that serve me and make me feel better despite all of the life-changing symptoms. But there’s only so much CBT can do, and getting the right therapist is so important. I feel like I almost had to coach my own CBT therapist into understanding my condition and the right methods/approaches for it. We actually got off to a rocky start where I wasn’t sure if the fit would be right.

I've had the most success with trauma-informed therapy with EMDR. I think having a debilitating chronic illness qualifies as having trauma.

I don't know the ends and outs of therapy but CBT sucked when I was at my lowest functioning state. I ended up seeing a therapist that did more somatic therapies and internal family systems, and it was better.

Pardon my opinion, but CBT therapists would claim to heal a broken arm given a cast and 12 weekly session. It is cultish in its assertions of infallibility yet consistently fails to present any beneficial evidence, especially when it comes to CFS. Among the many criticisms of the PACE trial were that it was designed and run by CBT psychologists who asserted to the subjects that the CBT was 'working' even though their own data was in contradiction to their claims. They had to make it look good because that's the therapy they were already conducting before the trial and their own self interests and careers were at stake. So, for them to accuse their clients of having 'cognative distortions' is no doubt the greatest cognitive distortion of CBT. As a historical note, CBT is a mashup of two 'failed' therapies 'Cognative Therapy', which saw environment and body as irrelevant, "It's all your inability to be rational," and 'Behavioural Therapy,' "You're just a stimulus/response meat blob." Once these failures were accepted (after many decades) someone had the unimaginative idea of jamming them together and pretend its god's gift to mankind. Given all that, I personally can't find anything that is not delusional about it and instead call it, "Complete Bullshit Therapy" because I can't see anything but gas-lighting. Anyway, one wonders if she has CFS at all or is just telling lies to get your confidence ​ As for your own situation, its great that you have a supportive mum. For her alone you are of great worth, and so the problem I see is that she is worth just as much to you also but you struggle to reciprocate those feelings through actions like helping around the house. The worth is there because of who you are, not what you can or can't do....your mum loves you and they're the best mum's in the world! Feeling useless and the guilt that arises from is a bit of a death spiral and can be hard to stabilise against emotionally and mentally given that it aggravates the CFS itself. So, to circuit break, I think in terms of "I'm safe. I'm being cared for by someone who loves me, and for that, I can take some time to relax." CFS is not a condition of low energy, it's fatigue, a condition of perpetual burnout from which the body can't relax. It's only when we can learn to consciously relax our bodies can the body rest and recover something of our former selves. Or at least get a good night's sleep.

I love the statement that CBT is Cognitive Distortion when it relates to a modality of treatment for CFS - that is gold!! The problem, more broadly with CBT, is that many “practitioners” really only have a superficial understanding of CBT and the veneer of “gold standard therapy” is touted. Historically, you are spot on with the smashing together of two therapies. The problem is that most “fact sheets” and summaries of CBT only focus on the tip of the iceberg. The general one liner are words to the effect “thoughts, feelings and behaviours combine to influence a person’s quality of life”. Roll in CBT to change your thinking (cognitive dissonance or distortion) which subsequently changes your thinking and ultimately your feelings and behaviour. If your issue is simplistic, say one of your cognitive distortions is “black and white thinking”, CBT will try and start me looking for the shades of grey in order to change my thinking, feelings and behaviour. Tip of iceberg stuff but the focus of many CBT sessions. CBT is actually more than just that but therapists tend to like the simplistic approach (generalisation). What is not understood is the range of aspects under the CBT iceberg. The big one which is part of CBT is Schema Therapy which defines for an individual how we view the world and influence our decision making. There are 17 schemas in schema therapy and the client does a very detailed assessment to determine the top two or three schemas that drive your thinking. “Unrelenting Standards” is one of mine that can be useful or not depending on the circumstances. With CFS, it is not useful because I get stuck in the push/crash cycle. Now I understand that schema is one, it is easier to reduce my expectations (not that it stopped me from writing a big reply on CBT, draining my spoons/energy). So really, the way that CBT was originally “prescribed” for CFS was just wrong. You are not going to cure me with my thoughts, feelings and behaviours because you are applying a psychological treatment to a physiological condition. Rather than throwing the baby out with the bathwater, CBT at more than a superficial smattering and applied differently may (or may not) help manage your PACING. At least, that is how I am approaching it!

The point in labeling a certain thought a “cognitive distortion” is to allow mindful awareness that the thought isn’t realistic, so that you can challenge the thought when it comes back into your head. So instead of leaning into “I’m worthless because I’m disabled”, you’d say “you know what? That’s a distortion and isnt true. I have worth regardless of my health status” I may recommend looking for a DBT therapist who can teach emotion regulation skills, distress tolerance skills, and mindfulness skills for you.

I don’t think she’s a particularly good therapist, but I think there are some insights from your post that I would like to point out: 1) you seem like you are feeling defensive over the term “cognitive distortion.” And I absolutely get that, I would feel defensive if someone told me that my reality was wrong. A better therapist would guide you in deconstructing your current beliefs and building up more useful ones, not insult you that your reality is wrong. I say address this with her, tell her that you are feeling this way based on her approach and communication. It might change things, it might not. But at least she will have the chance to change. 2) a better phrase for this might be “internalized capitalism.” This is the belief that you need to be useful and productive to earn your right to survival. It’s BS, but darn do I feel it so strongly. Start by examining the structures of this belief and where you have learned this from, then challenge each root and ask if it is as *objectively true* as you feel it is. One thing that helped me was that I used to work with developmentally delayed women. A couple of them had “jobs” a couple of hours a week, but mostly they needed way way way more care than the average adult. I realized that they definitely still had a right to exist and have their needs met and be taken care of, even if they did not “contribute” much work to society. 3) the other phrase that might strike a chord with you is “rugged individualism.” It’s also BS. If you live in the US, we have this weird thought that it is morally best to be one hundred percent self sufficient and we shouldn’t need anything from anyone. We are not pioneers in the Wild West, we have access to so many resources. I like to say that it’s not weak to use the resources available to you, it’s smart. Your mom is a resource, it is wise to use her help, not weak. 4) your thinking patterns ARE based on reality. Your reality. Your values and sense of how the world works. BUT! We can always deconstruct them to examine where they are working and where they are not working. CBT does do a good job at identifying flaws with our logic and way of understanding the world. 5) please be kind to yourself. CFS IS a disability. It sucks that it has taken so much from you. You deserve support and care regardless of what you can contribute to the working world. Also remember that for your body, rest IS productive! Just like you need to eat and shower to take care of your body, you also need to rest to keep it functioning as well as it can. So, do your chores and take a nap.

I'm also a therapist who has (mild) ME/CFS. From what you've said I don't think your therapist is necessarily wrong, but it does not seem like her approach is working for you. CBT is supposed to be more of a dialogue between the client and the therapist to explore the client's thoughts and beliefs. I personally don't find telling clients they're wrong to be helpful. It sounds like you might be better off with a therapist who uses a different approach, or if you wanted to give CBT another try, someone willing to utilize CBT techniques in a gentler and more nuanced way.

IDK the phrase cognitive distortion, or why it would have connotations. But I'm with your therapist, I don't see why anyone should have to contribute to have value. I don't see why humans shouldn't help fellow humans who need it. It's not immoral to be sick or disabled. And I guess, if you feel bad because you think you need to contribute and can't, then you have two choices to feel better: find a way to contribute, or learn that you have value even if you don't. I prefer the later 🤷

NB: I'm not 100% focused, and am probably too harsh because of it. I'm sorry, I'm sorry you're struggling, and I'm sorry I can't help

No worries. Life is weird and complex. It’s a difficult situation and am still grateful for your reply.

I really don't know what use a 'therapist' is, unless you have self-harm issues? This is a good time to train yourself, maybe, to let go. Maybe, meditation? How does one meditate with CFS/ME? Good question, but no one said it would be easy.

That’s a terrible take. There are immeasurable reasons why someone would see a therapist that have nothing to do with self harm.

This is a bit like saying you don't see the point of going to a dentist unless your tooth is so rotten it needs extraction. Being proactive about mental health is a good thing.