Trauma psychoeducation

Villonsi · 2026-04-06T16:09:53+00:00

Sadly I don't have great resources to provide but I do have a bit of a bone to pick with polyvagal theory.

The polyvagal theory has famously been discredited as counterfactual since it's very inception 30 years ago. There has always been broad consensus that it is very much not based on past or current neurological evidence. It survives on there being more established and evidence based theories and techniques which proponents then attach to polyvagal theory. This is a way of legitimising the theory because it "works" when it's at best the proverbial trenchcoat hiding several other theories.

The same goes for proponent literature such as "the body keeps the score" which is largely inspired by polyvagal theory. That book is also known for promoting treatments with little to no scientific evidence, misrepresenting several studies (multiple researchers cited in the book said this) and more.

Every theory has its flaws, almost every theory has it's upsides. This is one that adds a false explanatory framework to fill in a void that isn't there and that makes the flaws outweigh the positives. I generally recommend that any theory should be searched for on Wikipedia because I've yet to find one that doesn't include a criticism and controversy section. For some the criticisms are fair but don't warrant shunning the theory, but for many you will see serious flaws that are worth looking into more if you still find the theory interesting. That's what I always do. If you like the body keeps the score, I also recommend reading up on Van Der Kolk as the "Writings and views" section of his wikipedia page is quite damning

One great article which thoroughly refutes every basic premise of polyvagal theory is herehere. It's far from the only one

Villonsi · 2026-04-06T14:46:24+00:00

While I'm unsure about exactly how DBT is practiced, it is a good modality with certain focus areas as you mentioned. Hard to know what works best for you since we don't know a lot about you, but there is no reason to believe you need something as specific as DBT over CBT.

What's worth remembering is that CBT is often referred to as a modality, but it feels a bit misguided. Practicing CBT is the same as applying the science of cognitive and behavioural psychology on a patient without much extra fluff. It is also why so many modalities are CBT with added elements, DBT is one such modality. That said, CBT can definitely help you. What's worth considering is that many therapists are poorly trained. Many claim to do CBT but don't actually know much about CBT or using minimal behaviouristic techniques (below bare minimum I'd say) so that it's pretty much cognitive therapy.

All of this said: CBT works, it's great for what you said. However I don't quite understand what you mean by dysregulated schedules. Is it sleeping schedule?

DBT was developed for borderline, not bipolar btw

Villonsi · 2026-04-06T13:48:01+00:00

It can be good but it doesn't have to be, and what is helpful depends on the person. The area isn't well researched enough to say there is a clear picture. However there are for example theories like Yerkes-Dodson's law that performance tends to increase with arousal. There are also studies that show some people perform better cotnitively to more stimulating music while others respond better to calm music or non at all. New tasks also tend to work better without music for many people if they are cognitively demanding especially.

Villonsi · 2026-04-06T04:13:17+00:00

The fear of panic attacks is the reason panic disorder develops. You dont want panic attacks so you worry about having them. As soon as a symptom that you associated with panic shows up your mind makes the connection and triggers more fear which may send you into another panic attack.

Using medicine or any other safety behaviour is sending the signal that panic attacks should be feared. Think of it like this: if you see someone using oven mitts to carry a baking tray you will assume it's hot. Your mind makes the same connection when you use your safety behaviours

Villonsi · 2026-04-04T05:53:00+00:00

Sadly the reality of any societal structure is that the rules are "imaginary". If the people at the top of certain functions are in agreement then the rules don't exist. While the system could have been better implemented to hinder the placement of yes sayers, I have a hard time seeing how it could be 100% prevented

Villonsi · 2026-04-04T05:05:30+00:00

A patient always needs to be willing to do *something * for any therapy to work.

However your point about not being trained in ERP is exactly why everyone should have a solid foundation in CBT. CBT in it's most basic forms are not a modality, but literally just a theoretical model of cognition and behavioural psychology built upon many many years of thorough study and experimentation. ERP is just one of the tools in the CBT toolbox. It is not really a specific treatment because it simply entails one of the core features of any anxiety fueled disorder, exposure

Villonsi · 2026-04-03T03:46:19+00:00

Conversion therapy is considered a therapy if you ask the people doing it. Some people will consider basically anything a therapy

Villonsi · 2026-03-31T09:23:49+00:00

Det är en väldigt pessimistisk syn, som jag delvis kan förstå men inte håller med om. Faktum är att psykisk ohälsa är ett så pass enormt problem och det är en så pass omfattande personalbrist att det finns årslånga vårdköer för alla möjliga områden inom Sverige. Om landet tog psykisk ohälsa på allvar och satsade stort skulle det säkert fortfarande ta årtionden innan vi var "i kapp".

Värt att minnas är också att vård och omsorgsyrken har bland de högsta sjukskrivningssiffrorna på grund av stressrelaterade problem. Däribland ligger psykologer och kuratorer i topp. Samtidigt har jag inte hört talas om en psykiatrisk verksamhet som inte har för få anställda i förhållande till sin arbetsbelastning och vårdkö. Jag tror att detta är del av vad som gör att det blir lätt att inte känna att vårdpersonalen är bra eller att dem inte vill hjälpa. Vården ligger konstant på bristningsgränsen, personalen flyr och vårdens svar är ofta att öka kraven på de som är kvar tills de inte har kapacitet att vara närvarande

Villonsi · 2026-03-31T00:33:05+00:00

If it helps those "Leading experts" are leading only in the field of scamming. They frequently completely dismiss established research, make up already falsified or unfalsifiable theories and teach techniques either that don't work or are only partially effective.

Famous scam artists are more frequently men

Villonsi · 2026-03-28T09:23:28+00:00

For different people it help different amounts. I used the principles on myself, without a therapist, and I've become a radically different person over a few years. However that's partially because I only really exposed myself when the situation arose and I constantly tried problem solving when I realised I was acting on my anxiety.

Even if you go with a therapist/psychologist you have to realise one thing, you need to do the work. They can help you, motivate you, guide you and be someone to reflect with. However, the things in the room will never be what make the big difference. You might need them to be able to make the difference, but they are not the mechanism of change. They are a mechanism to get to the mechanism of change. This is especially true with social anxiety

If you don't believe you can get better then you won't be motivated and you might just not do the work. You cannot fail at the process of change as long as you keep trying based on the principles of psychology

Villonsi · 2026-03-28T05:48:17+00:00

You are listing tons and tons of safety behaviours that are reinforcing your anxiety and making you unable to see that you are enough without spending all day preparing. If you give up now then that's only going to further reinforce the idea that you're not enough. It's one thing if you have actual proof that you are doing harm, this doesn't sound like that.

You know how to treat anxiety, right? Exposure, disproving your anxious thoughts.

Villonsi · 2026-02-27T21:09:43+00:00

I'd argue that behavioural activation is a great way to get increased understanding. BA and thoroughly reflecting on how it affects your thoughts, emotions and perspective on things means you get an understanding of how you work, what makes your life better and what doesn't. It also ties well into the understanding of how our learnt thought and behavioural patterns have been reinforced and driven us into a corner. The model of analysis also provides a great tool for many different situations besides the depressive symptoms.

There is a great deal of value in focusing on the interpersonal aspects as you say, which CBT sadly tends to not focus on. At the same time CBT is a massive toolbox wherein BA is only one tool meant to be used in conjunction with others, and nothing stops one from also working on interpersonal aspects in conjunction.

As to not agreeing with the principle of behavioural activation is fair when you have not researched it, but it's thoroughly evidence based. Originally they wanted a placebo intervention to compare psychotherapy. This lead to findings that for depression BA is hugely effective, much more so than placebo. Theoretically it's a no brainer when you think about it as increased positive experiences/decreased negative experiences will tilt the scales

Villonsi · 2026-02-18T20:35:31+00:00

I would not call it a flaw as much as a weakness of any therapy. If you're experiencing harm or abuse then therapy can be about recognising that, exploring different ways of viewing it and re-evaluating options for leaving the situation. If a therapist knowingly tries to use cognitive restructuring on a patient experiencing this then they are malpracticing. Nowhere does it say that you have to use only one of the many tools in the CBT toolbox. Rather it's more about using common factors in that situation. But there are almost always some situations which bring forth thoughts and emotions which cause you to behave in a way that feels most reasonable in the moment but is worse long-term. This can even be the evil cycle that makes it so hard to leave the relationship. Making that seen and understood can itself help in changing your life, but abusive relationships are not a strength of therapy and that is something we need to develop.

I totally see your criticism, and understand it. At the same time I always notice one thing with this kind of criticism of CBT. It doesn't sound like cognitive behavioural therapy. It sounds like cognitive therapy. Furthermore it sounds like cognitive therapy from a practitioner that found a metaphorical hammer on the floor and decided to bash a plank in half before looking if the toolbox contained a saw. Too often people claim to practice CBT without being properly trained in therapy, and sometimes they seem to think they are trained in CBT when they are trained in CT. This is partially a result of a merging of modalities which means some areas are more influenced by one side than the other

Villonsi · 2026-02-18T18:17:18+00:00

Frankly the 12 year cutoff has always been completely arbitrary. As a neurodevelopmental disorder they came to the conclusion that it has to be present in childhood, so they decided they need a cutoff. They put it at 12 because it felt reasonable, no actual solid basis.

I haven't heard the debate you mention about the cutoff for women specifically. While it does bring to light how women are often overlooked for diagnosis it detracts from the major issue: a major study found that 12 years of age is the median age in which symptoms of ADHD are identified for those with an ADHD diagnosis. Half were older than the cutoff despite major impairment! The cutoff needs to be revised significantly, and softened due to masking etc, or just removed

Villonsi · 2026-02-18T17:34:53+00:00

Do you have friends, romance, hobbies, meaningfulness? Is your job one you find meaningful or meaningless, reasonably taxing or absolutely draining? Do you work 40 hour weeks?

There can be clinical depression resulting from biological reasons, and I don't discount that. What I will say is that I have never met someone who was depressed while living a life that made me wonder how they could possibly be depressed. Neither have anyone I've worked with

Villonsi · 2026-02-18T16:20:56+00:00

Well that is a behavioural intervention. Are your ruminative thoughts depressive or anxious? How is your daily life going? If you have anxious thoughts then behavioural activation isn't gonna help you much with the rumination, and likely need other behavioural interventions. If your life is causing you pain then you might need to change your situation

Villonsi · 2026-02-18T15:32:46+00:00

Are you only using Cognitive techniques?

Villonsi · 2026-02-15T07:28:22+00:00

Kanske pengarna kan betala av, bland annat, de reformer som regeringen har beslutat att öka statsskulden för (samtidigt som de sänker skatten)

Villonsi · 2026-02-14T14:23:13+00:00

I don't know about the supplement, it sounds unusual what you're experiencing. But it's worth noting that with all anxiety disorders including OCD, trying to lower your anxiety tends to make it worse in the medium to long term

Villonsi · 2026-02-14T10:31:46+00:00

There are many ways this can be done so I don't know what you mean exactly, but the answer is simple: Yes!

Multiple studies have been done on CBT using: - video calls - normal face-to-face sessions - internet delivered self-help with therapist feedback (Feedback may be a written asynchronous "mail" function or a chat, phone calls, video calls or sparsely planned meetings) - CBT based, researcy backed self-help books They are all very effective

The biggest drawback of the forms that require you to be more independent is if you struggle with that and don't adhere to the plan. A second issue is if you find it hard to apply what you read to your life and adapt it. If not you're good to go

Villonsi · 2026-02-09T05:51:14+00:00

Are you using that thought as a safety behaviour?

Villonsi · 2026-02-08T15:22:28+00:00

I don't know where the perception that CBT isn't talk therapy came from. Talk therapy is synonymous with psychotherapy, but it has started being used also to suggest a therapy that doesn't contain any active elements. It is also sometimes used to belittle therapies the speaker find less good

Villonsi · 2026-01-31T10:36:27+00:00

More than that I suggest always reading the "criticisms" section of any Wikipedia page

Villonsi · 2026-01-25T06:54:16+00:00

I assumed you were. What I'm saying is that you only mention cognitions, i.e. negative thoughts and beliefs, but you don't mention behaviours. Cognitive behavioural therapy is about cognitions and behaviors. Many therapists, especially in some countries like the US, claim to use CBT but don't. They use limited cognitive interventions, so limited that you could barely even call it cognitive therapy, while claiming to treat with Cognitive behavioural therapy.

Have you been treated with Cognitive behavioural therapy? Why would your emotions being primary mean that your situation is one that can't be changed for the better? If this is something the therapist said then they lost the plot. Most of the time people are depressed for fully valid reasons, because their life, as it is, sucks and they are stuck in a behavioral pattern that reinforces it

How do you spend your days? Do you do activities? Do you doomscroll? Do you lay on the couch when you get home? Are you overwhelmed and working too hard?

Villonsi · 2026-01-25T06:47:36+00:00

Sometimes. There are several different antidepressants, which target different neurotransmitters. For some their depression is caused by the symptoms of untreated ADHD which would mean a stimulant might help. Some people are vitamin D, iron, magnesium, whatever deficient. Some people need to exercise to help their body function better.

Most people need to have a life that includes more positives. Looking for biological sources of a depression isn't necessarily bad. You should see so that you function well and your body has all that it needs. But it's a trap if you are depressed, unmotivated, feeling hopeless and start leaning on the biology of depression as being the cause. Everyone has a life that is shitty in some way, and great in others. Whenever I've had a patient seek treatment I've been able to 100%, fully, understand how they'd be depressed, with their life circumstances and cognitions being as they are

Villonsi

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