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CBT not working...Should I try something else?


So to keep long story short iv been in CBT for 3 years 3 different psychologists and tbh I don't think it's done much (I saw a psychiatrist and I found him the best even though we did no therapy).  


Background: I have severe health anxiety and Generalised anxiety and a bit of agoraphobia, iv have done CBT, talking therapy and DBT and they aren't bad I just don't feel like iv improved much if at all and the improvement I have seen is honestly, in my opinion, my medication. I do the homework and go to sessions and pay attention etc. I like my therapists I just haven't really found it useful. Im specifically anxious about health and dying and my own mortality. CBT hasn't helped because it's about identifying irrational thought patterns but I KNOW I'm being irrational. 

Example; I get a headache and think oh I'm dying I'm having a stroke and I'm a med student I know I'm not having a stroke but despite the fact that I am able to be rational about it and know I'm probably fine doesn't help me, I'm still anxious and worried. 


The fact that I can't control most things in life and that death is inevitable and that any of us could suddenly just drop dead without warning makes me panic. I KNOW that all of these things are possible and that there is no point worrying about it because I can't know or control it but this doesn't mean I'm not anxious or that it doesn't affect my life negatively. 


I can't get rid of this fear and I can't control if I die so how can I just accept that this is how life is I can't do anything about it and just deal with the fact that death is inevitable and that life is almost entirely random and unpredictable? 


Also what kinds of therapies are based on science/studies (I don't like wishy-washy therapy styles) that are good for anxiety, OCD and health anxiety that might help me based on the above explanation?


Thanks Smiley Happy 

Re: CBT not working...Should I try something else?

Hello @Charlie-29-1999, thanks for sharing this with all of us here. Finding the most beneficial treatment can be so complex and time consuming. It sounds like you are really aware of exactly what is going on for you.. which can be the hardest part sometimes! I know a lot of users here have had experience with this as it is quite common - so you are not alone in this. Just so you know, unfortunately we cannot provide medical advice here at ReachOut. Everyone is welcome to share their experiences but keep in mind that the only person who can determine appropriate or recommended treatments is your health professional. Is this a conversation you have had with your health professionals? It can be a difficult conversation to have although each person responds differently to treatment. There is no issue with letting your professional know that you aren't finding the support helpful. This way, they can work with you to find a therapy/treatment that suits you best Heart 

Re: CBT not working...Should I try something else?

@Charlie-29-1999 I've had the same issue, CBT just doesn't do much for me, and DBT's had limited success for me so far, though that may just be my current psychologist.


I know what you mean about wishy-washy therapies, I find them so annoying.


Hmm... my first instinct reading that was Acceptance Commitment Therapy.

I think that it involves accepting negative feelings and finding ways to keep those feelings in perspective, among other things.

There are some studies which show positive evidence, though not a huge amount yet.

Since it shares similarities to mindfulness, my main concern would be finding a therapist who's not too deep into the mystical side of it; there'll probably be some scientific ones and some.. less scientific ones.


That's all I can think of right now, but I'll come back here if I remember anything else.

Re: CBT not working...Should I try something else?

Hi @Charlie-29-1999! I'm sorry that you've been through so much without seeing much improvement. Smiley Sad

There are tons of psychological approaches, even some that seem to be at odds with each other, but most of them have been well-researched and have good evidence showing that they can be effective. Just because CBT is the most well known and used does not mean that it is the answer for everything and it won't be of help to every person. Sometimes, it just takes trial and error to find the right approach and treatment for you.

I don't have a lot of advice that is specific to your situation, but I also tried CBT and found that while it was beneficial for my anxiety, it did not diminish my other symptoms. My psychologist sent me for a second opinion from a psychiatrist, who recommended a trauma-based approach. This involved things like rewriting nightmares, exposure and showing how to deal with flashbacks. That suited me better and helped me more. I still do some CBT on my own, as well as other techniques like mindfulness, which my psychologist also did. There are a lot of mindfulness exercises which helped with my anxiety, such as imagining that my bad thoughts were being carried away by clouds. Have you tried mindfulness before?

Re: CBT not working...Should I try something else?

@Taylor-RO I have sort of spoken to psychologist about it and we are trying to use more exposure therapies and mindfullness approaches, however I am uncomfortable telling her I don't think its working. My GP has said maybe try 3 more sessions and then reasses. 

Re: CBT not working...Should I try something else?

@WheresMySquishy If I went and saw a psychiatrist would they be able to help me find or recommend a different type of therapy? I was under assumption they usually do medication more so.


Yes I have done and do mindfulness with my current psych. 

Re: CBT not working...Should I try something else?

@Charlie-29-1999  I don't know about all psychiatrists, but my psychiatrist recommended a particular type of therapy that she wanted me to do with my psychologist. She said that she just thought that I needed a lot of therapy. She was reluctant to put me on medications unless my symptoms were impacting on school.

Are the exposure and mindfulness exercises not helping either? I've heard that graded exposure may be beneficial for agoraphobia, but I don't have a lot of experience in it myself.

If you have been receiving treatment for three years and you feel that nothing is working, it could be time for a review. Maybe you can ask your GP about this. What do you think?

Re: CBT not working...Should I try something else?

I would second ACT because it's about accepting and acknowledging thoughts rather than trying to change them. "I'm noticing that I'm feeling anxious about going into work today"..."I'm noticing that my tummy is feeling unsettled". Rather than challenging these thoughts and feelings you just acknowledge them and let them float away. Also it's important to note that any therapies that are being practised by psychologists should be evidence-based (based on science and research) but this doesn't mean they will seem logical or regimented. CBT is very widely practised because it is taught in universities but it is not the only option out there. You seem like you know what you want in therapy, so maybe using a website like Find A Psychologist might help?

My therapist uses a combination of CBT, ACT and Schema therapy (which involves reframing stories we tell ourselves over and over among other things). I think the MOST important thing is finding a therapist who you connect with, who respects you and is caring and kind. This element consistently comes up in research as one of the keys to successful therapy.

“Your now is not your forever."
― John Green, Turtles All the Way Down

Re: CBT not working...Should I try something else?

@Charlie-29-1999 sometimes it takes a few tries to find something that works. Talking to your psychiatrist sounds like a good starting point. I've seen various mental health professionals and not all of their methods suited me. It might not only be about using one type of therapy but various in combination. Hope it all goes well.