Cognitive Processing Therapy 5.0

Photo by Anthony Ievlev on Unsplash 

“Shame is basically the fear of being unlovable – it’s the total opposite of owning our story and feeling worthy. In fact, the definition of shame that I developed from my research is:

“Shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.“”   

~Brene Brown 

According to Brene Brown, shame is being afraid of who we are (not owning our story) and feeling unlovable to others. Shame is believing that we are a mistake or that we are not good. Shame is not just our own beliefs about ourselves but our perception about what others believe about us. Shame is paralyzing, ugly, and violent.

In session 5 of Cognitive Processing Therapy, I found myself in what seemed like two different worlds from start to finish. I think the beginning of the session was probably out of what would be considered typical protocol. Usually we review the work I have been doing throughout the week, but we spent a significant amount of time on that through the extra sessions I needed.

Instead, we discussed some of my maladaptive coping methods. Most of my maladaptive coping methods come from feelings of shame about who I am and what I have done throughout my life. To keep record of maladaptive coping methods and emotions that go with them, I process my week through something called a diary card. It is a method of reflecting on emotions felt, urges to use maladaptive coping methods as well as the intensity of that urge, whether I used maladaptive coping, and what appropriate skills I used to regulate myself. The diary card is used in Dialectical Behavior Therapy. Turning this diary card in prior to each of my therapy sessions makes it pretty difficult to hide where I am each day. The diary card I turned in Tuesday morning before my session was not exactly ideal, nor did it look like the diary card of someone who was doing well working through recovery.

Prior to my session, I had communicated pretty intense feelings of shame, anger, and sadness. I was not processing those emotions appropriately. In fact, I was using almost every maladaptive strategy I have in my rusty, overused, toolbox. I was (am?) on a collision course. My diary card made all of that abundantly clear.

CPT focuses a lot on fighting the urge to use avoidance. My therapist keeps telling me that using these maladaptive strategies is a clear indication that I am avoiding something. So, session 5 was a little like a brainstorming session. We discussed the context of the emotions I was feeling as well as some of the thoughts that occurred before those emotions. I tried to articulate and process why the thoughts I was having were so shame inducing. I want to know why I feel so much anger and sadness. I want to know why I feel so much shame and guilt. I want to know that, despite my thoughts and feelings, I am accepted by others and myself. I want to be brave and own my story, but I do not know how to own my story when I cannot identify the stuck points that prevent me from seeing the truth about the world, others, and myself.

Because stuck points prevent me from seeing truth or accepting reality, we spent a considerable amount of time discussing one specific topic and trying to identify the stuck points involved (the brainstorming session). There are several that I can come up with, but it seems that the main one, the one controlling me, is either not yet identified or impossible for me to fight. I was challenged to complete a chain analysis to help identify thoughts and emotions during a particularly triggering experience, but even those thoughts and emotions seemed to be secondary to whatever was truly triggering me. And, honestly, just completing the chain analysis (later, as homework) made me feel more shame.

As I mentioned before, shame is the perception of what we think others believe about or feel about us. I have always believed that I am not good enough or that something is inherently wrong with me. Loving myself and accepting myself and my story seems impossible. It seems even more impossible that someone else could be gracious and accepting of me. It might be possible, though, that knowing others are gracious and accepting of me, will help me accept myself. I tend, instead, to be like a fly trying to escape a web of shame that others seemingly or realistically hold for me (shame webs are another Brene Brown reference).

Moving through CPT effectively means I must escape my shame web and continue to identify my stuck points. I have an incredibly difficult time identifying stuck points to begin with because they are such ingrained patterns of thinking, but working through where I am right now is painful, especially buzzing around in my shame web. I am physically, emotionally, and mentally exhausted from this work. I have had victories, and I am not giving up. In fact, I am moving on.

Because staying on this one point (trying to identify an incredibly sticky stuck point) forever would not necessarily help me move through trauma, we proceeded to the next step. This was the opposite side of the world for me. It was like moving out of discomfort briefly to discuss the next telephone pole in the process. This week, I will be working on “Patterns of Problematic Thinking.” My therapist said, “this one will be easier.” I know what she meant when she said that, but I felt pretty overwhelmed by the idea of completing one of these worksheets every day while trying to continue to complete “Challenging Questions” worksheets and remembering to identify stuck points daily. Changing my thinking, refuting my beliefs, and identifying maladaptive patterns of thinking is taxing.

At one time people believed the sun and stars revolved around Earth. That idea was so difficult to discharge from people’s minds that they labeled Galileo’s heliocentric belief heretical. Changing my own thinking seems to be just as difficult.  Sometimes it even seems heretical.

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