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MKM's avatar

This. Is. Brilliant. So well written!!!! It should be required reading for anyone anywhere who teaches people how to do therapy, who administers a therapy practice and/or people already providing therapy. Like the old person I am, I have copied and pasted this post into a Word document and saved it to my computer. I plan to show it to any and all therapists I hire for myself going forward. Thank you so much, Christine, for taking the time to write this, really thinking all this through.

Everything you've written here is consistent with the research I have read about the nature of the **relationship** (e.g. characterized by non-judgmental witnessing of the client's pain?) between client and therapist being the primary determinant of the efficacy of therapy provided (as opposed to what exact therapeutic modality is used, e.g. CBT versus IFS, EMDR, SE, etc.)

However, that said, my experience has been that when it comes to healing trauma, nothing beats the somatically-focussed methods, such as IFS, EMDR, and of course SE. And the deeper the better. But how can a client be expected to "go deep" if they can't/don't trust the therapist? Of course they can't unless the rapport is there. Trust must be earned. And nothing in the way of "concrete, measurable progress" can occur if the client does not feel safe enough with the therapist (or that the therapist is competent enough to "get" the client).

One of the traits I have noticed of my fellow RTSers (folks with Religious Trauma Syndrome) is a tendency at sometimes to retreat into intellectualizing as a way of avoiding confronting, or, even more threatening, accepting, and communing with, certain sensations and/or emotions that fundamentalist religionistas would deem "sinful" or "dangerous" or "disgusting." This type of dissociation and/or living "in one's head" is consistent with living in a body whose mind has become a torture chamber after one has been threatened she must, upon pain of eternal conscious torment for failing to think the "correct" thoughts and thus feel the "correct" feelings--also known as ***believe*** the right way, "take every thought captive" by any means necessary, so, likely by force, as in efforting in the style of self-shaming, living the adrenalized lifestyle style that we the dopamine-starved who've exiled our hypothalamus for its "sinfulness" are destined to lead, **striving** to love what we hate--by sheer force of will. Retreating out of the body and up into one's mind, abandoning the body, trying to extinguish or at least displace the supposedly corrupt self that is supposedly corrupt due to one's own sinfulness, to replace that self with Some Punitive Adoration-seeking Mind-reading Spirit (SPAMS) is consistent with the brain damage many traumatized children's bodies show, which is an unusually large prefrontal cortex.

So, yeah. I share your hatred of CBT. (Although I did save my own life with it in the early '90s, when I was instructed in it from the almost totally emotionally tone-deaf therapist at the student health center assigned to take my case--poor him--at the university I was attending when I had my apostasy and became viciously suicidal. Ironically, the only reason I did not kill myself was my fear of being sent to hell by evangelical Christianity's "all-loving" and "all-powerful" deity, whom I had finally realized I was just not able to love).

Dashing to get this posted. Triaging a crisis with our little foster dog, here. But wanted to say well done. And thank you so, so very much. 30 billion other units of insight to articulate, but can't right now. All the love and all the power to you, my dear friend.

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Christine Greenwald's avatar

Dang, MK, 10/10 stars for your comment; let's all study it and go home educated! Seriously, I am so appreciative of your thoughtful (as always) comment! SPASMS is such a good acronym and it deserves to be caught on to in places outside here. I did not know the thing about the unusually large prefrontal cortex! Whew, that makes the experiences / intelligence of some of my quite traumatized child and teen clients kinda make sense, wow!

100% about the needing to feel safe in a trusting relationship, and how hard it is to feel safe if you're just a note to be written, a piece of funding, a unit of measurable progress (things which are, IMHO, more likely to correspond with CBT treatment and managed care).

Whew. I'm sure there's quite the back story of your 90s college self, but I will say how very glad I am that you are here today. I I love the way your mind works (being as that's mostly the context in which I know you; not trying to ... uh-oh, intellectualize or anything!! The intellectualizing/religious trauma part was also such a good point!).

Much love and power to you too, friend!

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Catherine Quiring's avatar

I appreciate the acronym SPASMS. That is a great description. I love watching Queer Eye, and the final episode of the most recent (7th) season is about a young former nun who reminds me so much of myself in my early adulthood. So over controlled, even with more progressive views, and it was a bit eerie to see an older version of myself moving towards freedom, but still in SPASMS, as you put it.

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Carolyn's avatar

Thank you. I’ve said for years that I can’t go to CBT or consciously use it because of how it was overtly (in our church of the time) linked to taking thoughts captive and being transformed by the renewing of your mind. The whole thing makes me squirm, feel sick, and guilty. It is so good to hear someone talking about this link and confirming my experience.

I’ve seen therapists who have used a person centred approach, my current one very much so - which is hard work because I have to decide what to talk about, and then talk my way through it, to find my own realisations and answers … which is hard, but which also suits me rather than have ‘answers’ presented.

And the not believing in a wrathful God who will send me to eternal conscious torment in hell…but being scared of ending up suffering ect in hell… oh spot on!

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Christine Greenwald's avatar

I'm glad that you feel validated with what you already knew!

I also like person-centered! The play therapy I've been trained in uses a Rogerian (Carl Rogers) approach, so basically ... person-centered for children! I'm glad you're having a good experience.

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Shaina Fisher Galvas's avatar

It’s been a shock to me how hard it is to find pediatric mental health support that really takes seriously my child’s inner world. Even when descriptions of the modality seem to indicate the approach I’m looking for, it all feels so behavioral. Why is it so hard for the field of pediatric mental health to understand that I don’t want to manipulate my child into overcoming her fear; I want to be with her in her fear and help her body find it’s way back to safety?

And yeah, CBT feels very gaslight-y to me. Like, an accurate perception of the world is traumatizing, because the world is traumatizing. Lying to myself about the world, and telling myself the lies are more “accurate” doesn’t help. But somatic practices to help my body find its way to safety, even in a fucked-up world, make a huge difference.

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Christine Greenwald's avatar

I agree with Catherine -- I would have LOVED to work with a parent like you, working with their child in therapy! And "lying to myself about the world, and telling myself the lies are more 'accurate'" - oof, yes yes yes, and YES to helping your body find a sense of safety in the mist of a fucked up world!!

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Catherine Quiring's avatar

It makes me so happy to hear how you’re supporting your child. If you can find someone who does IFS you’ll probably have more luck with this. 💛

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Shaina Fisher Galvas's avatar

Thank you so much for that input! My daughter is 4. Do they do IFS with young children? (My own therapy is a combination of IFS/somatic/psychoanalysis and it is so helpful).

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Catherine Quiring's avatar

I’m not sure if they do IFS with kids that young, but they for sure do Theraplay, which is amazing. I used it when I worked with kids and it has a similar in the moment, in your body, in relationship, and also in play experience for kids.

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Catherine Quiring's avatar

Thanks for this, Christine. I feel similarly. It feels to me like CBT is helpful in limited ways, and it can only help you be more successful in our culture without recognizing or challenging the cultural pressures that maintain a level of stress on you. Change your thoughts and behaviors so you can be acceptable to God, or change your thoughts so you can be more productive, and thus feel more worthy and be more acceptable. Whatever the normative cultural values are that are creating pressure on you, be it religious or capitalist meritocracy values, it's still pressure that amounts to chronic stress, which affects us the same way as trauma. I mean PTSD does stand for Post-traumatic STRESS disorder. I'm going to try not to go on a rant here, but even having the word disorder on that, and pretty much everything in the DSM, is another related problem to the skills-based treatment expectations of managed care. This is a normal response to stress and trauma! Not a disorder. Okay, I'm going to stop myself here and not go on a further rant about this. Thank you for the light touch in your article. I can get intense about it so fast! One additional thing - I love Jennifer Mullan's new book Decolonizing Therapy, which is an amazing critique and hopeful path forward out of CBT-based, managed care-based, disorder-based treatment, to collaborative individual and systemic care.

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Christine Greenwald's avatar

👏👏👏 YES to all that!! I'm here for the rant! CBT is trying to make us adjust to capitalistic productivity standards; PTSD as an actual normal response to stress / trauma (not gonna lie; I ignore the part of diagnostic criteria where things need to be an outsized reaction -- like wtf, someone who's been through something highly stressful with an "appropriate" size reaction STILL deserves treatment!). I've never been about as you say, the "skills-based treatment expectations of managed care" -- no way!

I just placed a hold on Decolonizing Therapy and am excited to read it. :D

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Catherine Quiring's avatar

Let me know what you think of Decolonizing Therapy!

I thought it was interesting that I read some of the DSM diagnoses more in depth recently for an article I was writing about neurodivergence, and I had a similar reaction to when I read the Bible - how could this be in here? Every other word is deficit or disorder! And the Bible, I mean there’s so much to be shocked by!

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Christine Greenwald's avatar

It's such a deficit-based model, that DSM!! Did you publish that article? I'd love to read it!

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Catherine Quiring's avatar

Thanks, Christine! I just sent it off to D.L. Mayfield for her substack. I haven't heard yet when she'll be publishing it.

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Ivy Zeller's avatar

Back when I was a nervous evangelical first entering therapy, I ended up in CBT. I did that for a few years, and it was helpful for a while. But the seismic shifts for me really started after I switched to EMDR. Thank you for shedding a light on the fact that one-size-fits-all solutions aren't the answer to finding individual or collective healing!

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Christine Greenwald's avatar

I'm just picturing you as the "nervous evangelical" and that just sounds so very classic for us (ex) evangelicals. 😅 I'm glad it was a starter for you and I'm also glad you found EMDR!

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Lindsey Melden's avatar

Yes, so relatable 😂 I have really had to sit with my nervous part a lot recently. She is very concerned we are fucking it up 😅 (life, parenting, etc etc)

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Chuck Petch's avatar

Christine, RIGHT ON!! EXACTLY!!! I spent my life using CBT-like affirmations, especially in a Christian context trying to change my thinking. It NEVER worked. It's like putting frosting on a cowpie. It might look like cake, but it's still a disgusting sham! I only found healing after going deep to find and heal the places where the trauma and painful thoughts and emotions started. No amount of "bringing every thought captive" ever worked for me! Great realization, btw, of the equivalence of CBT with evangelical belief. I don't know if I saw it before, but I sure do now!

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Christine Greenwald's avatar

"frosting on a cowpie" 🤣 And it feels so *actually* good to find the places where the trauma and painful emotions started, and unearth and heal those wounds!

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Lindsey Melden's avatar

Cheers to all this!!

The connection between CBT & “taking thoughts captive” blew my mind.

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Steve Florman's avatar

You've just made me think that, as I choose a therapist after a couple years of serious trauma, that I might be better off with a shiny new one rather than an "experienced" one who might not be up to speed - internally - on modern neuroscience.

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Christine Greenwald's avatar

Maybe! But maybe not! I think you can get a good sense of where someone's coming from by reading their bio, looking for key words related to what you're either wanting to treat or the approach you want to use (if you know!). Incorporating somatic methods (which includes EMDR; things that give attention to the body and nervous system) is a pretty good indicator someone is familiar with modern neuroscience!

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Mica Montana's avatar

This is such a great insight, thank you for sharing. I’m wondering what an equivalent religious somatic response for working on those religious fears and traumas would be - do you think there is one?

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Christine Greenwald's avatar

Ooh, so I am not sure I fully understand your question (so feel free to clarify!) but if you're meaning a healthy way of healing from religious trauma using somatic methods, I think that just being in touch with whatever the body is telling you is a -- really, THE -- starting place! Moving from not trusting one's body or experience at all to learning to trust and respect the wisdom of the body? Yes please!

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MaryAnn McKibben Dana's avatar

As a progressive Christian pastor who cares a lot about mental health, I’m super grateful for this window into CBT and how it can be problematic for people recovering from high-control religion. I’d never even heard the phrase “taking thoughts captive”… [shudder]

My question is, thoughts on DBT? It’s been the best thing to help my teen kids learn to process and self-regulate… and also to help us as parents help them. I like that so much of it is somatically oriented (eg the TIPP technique) but is more accessible to me as their parental support than, say, EMDR. But DBT does include some skills that address one’s thoughts/cognitive distortions, so perhaps it’s similarly triggering?

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Christine Greenwald's avatar

I'm so glad you haven't heard the phrase "taking thoughts captive" -- my husband is also a progressive Christian pastor, and the amount of toxic theology that he *hasn't* been exposed to just boggles my mind.

Anyway, I think DBT (from my understanding - no formal training) is really helpful! It's more mindful and accepting of emotional states, letting them pass through instead of becoming attached to them and believing them to be permanent (again, correct if I've misunderstood, but that's how I describe it!). Somatically oriented is super helpful, and a corrective to evangelicalism's belief in not trusting the self or the body. Nothing wrong with addressing cognitive distortions, because sometimes we really need that -- it's more the fundamental framework of CBT I take issue with, and to me DBT has a different fundamental framework! Also, I love that it's been helpful for your kids and you as you support them! Thinking of your comment from the marathon post, I'm sure that's very, very needed for you guys 💛

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MaryAnn McKibben Dana's avatar

Thanks for the additional context and conversation!

And we mainline Christians are just as screwed up about the body as evangelicals, you'll be 'glad' to know (haha, sigh). We just get to our screwed-up-ness by different routes. Appreciate you!

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Chuck Petch's avatar

Copied from my comment on Medium:

OMG, Christine! Your article gave me a major deconstructive realization. Judeo-Christianity is foundationally flawed: When Moses went up the mountain, he had a transformative direct encounter with God (assuming the Bible account is true) that made his hair white and his face glow, but he came down the mountain with the equivalent of CBT, a list of behavioral commands. Right from the start Judaism substituted rote belief and behavior for genuine deep transformative spiritual experience. It's no wonder our culture always loves the quick and shallow fix, including psychological ones. Psychology just follows an age-old fundamentally flawed cultural pattern. But anybody who has experienced true deep psychological healing knows how it differs from shallow behavioral therapy just as surface belief is no substitute for genuine life-changing profound spiritual encounters.

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Christine Greenwald's avatar

I think generally speaking people, especially if they're not very emotionally developed, will substitute a list of behavioral rules for true inner change! (lol and I know I would have said this AS an evangelical, not realizing exactly how much I had to abide by a list of behavioral rules). Similar to Christianity and all religions, Judaism has more orthodox/conservative and more liberal versions. I've heard some Jews talk about the rules and rituals not in a legalistic sense but in a relational way, or a way of demonstrating identity and devotion as a people group (I'm not doing it justice but even when I was evangelical, I was moved by their descriptions). But our base human impulse usually seems to be to flatten these profound encounters (often had by someone else) into something concrete and measurable (and punitive!).

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Andrew Ginder's avatar

Hey Christine! It’s been a while since I’ve blogged about the religious trauma found in 12 steps. I would like to tell my story now, just don’t know how. If you could email me I’d sure appreciate it. I need to get my story out so it never happens to anyone needing to find recovery…

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Katharine Strange's avatar

I so relate to this! I received CBT through a govt program for postpartum depression (thank you Canadian healthcare) and while it did give me a few tools, it often ended up being so frustrating. Mindfulness and looking for "thinking traps" = no match for C-PTSD. I was so grateful to eventually find a therapist who specialized in family dysfunction who directed me to EMDR.

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Christine Greenwald's avatar

Yes, CBT is no match for C-PTSD!! Yay for Canadian healthcare, but also glad you eventually found your way to a therapist who did EMDR!

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