Hello!

I just wanted to share this amazing training that provides clinical skills in all three of these modalities (CBT, DBT and ACT). You also get 18.5 CEU credits!

[https://mentalwealthinc.substack.com/p/the-ultimate-dbt-cbt-and-act-training?r=8m448p&utm\\_campaign=post&utm\\_medium=web&showWelcomeOnShare=true\](https://mentalwealthinc.substack.com/p/the-ultimate-dbt-cbt-and-act-training?r=8m448p&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true)

My Substack will feature many CEU opportunities going forward (we've partnered with great providers) as well as discounted therapy materials like workbooks, worksheets, etc. Feel free to subscribe! There's also a paid option for monthly materials sent to you on top of other perks :)

[Mental Wealth Inc | Daniel Badillo, LMHC | Substack](https://mentalwealthinc.substack.com/)

I've been in therapy since early July. I'm starting to feel safe with my therapist to begin opening up. I feel like every session we talk about different things without truly addressing the previous. At a previous session I revealed some work trauma. I ended up having a nervous system shutdown and couldn't proceed. Last session said trauma was brought up again but I was so persistent that I couldn't possibly see it any other way. I didn't completely shut down this time but was heavily activated. The session proceeded to me sharing something else about me that I struggle with so then we tried to talk about that. I was very persistent again that I couldn't see it any other way.

Is therapy usually all over the place. Or do you address one thing at a time?

I feel like I will never see it any other way, does change ever occur through continuous discussions about previous things?

I don't feel I am getting what I need in my binge eating disorder treatment. I would like to lose weight and also heal my binge eating, is it REALLY not possible at all?

This question in general gives me anxiety.

I have a hard time being vulnerable with anyone. Last session I tried hard to address some work trauma and ended up being thrown into a nervous system shut down. I felt completely ready to share and have no idea why my body reacted in such a crazy way. I was frozen, my muscles tightened and I was almost curled in a fetal position. It eventually led to me dissociating. I have a session tomorrow and I'm honestly scared to talk about anything now.

I’m super frustrated with how things turned out today. Everything was going well until the end. And then I ruined everything by turning into the Hulk to protect me from my fears. That’s super scary to me.

Then I spend the next moments filled with guilt and shame.

I’m not looking for a solution, but community and understanding 💚 hopefully you guys can relate

Edit: headed to bed. Tomorrow is another try

Since childhood, effort has never been about the process for me — it's always been, “finish fast, get the top result, then relax.” Even as a kid, I used to see most tasks as a burden — something I just needed to finish and get done — which was accompanied by anxiety and physical tension. This pattern never really got interrupted despite years of academic and professional success.

The anxiety shows up something like this, for example, when results or evaluations are announced. In school, my hands and legs would get literally wet with sweat when teachers were about to hand out marksheets, and I'd avoid looking at the results board. This continued through competitive exams and university — I would avoid checking practice test scores and sometimes even delay looking at my semester results for several days. More recently, I've delayed checking important exam results or answer keys by a full week.

Even day-to-day studying carries this same burden — “I need to finish this topic today so I can relax in the evening.” I believe this attitude has contributed to me underperforming in important exams multiple times: I'm focused on finishing rather than absorbing and learning. On top of that, old, unrelated memories intrude while I study — being scolded or hit as a kid, a bad confrontation, past failures — and derail my focus. Even after I let a memory go, I feel drained afterward, and the same physical symptoms (sweaty hands, armpits) show up during these episodes too.

I'm 28 now and preparing for one final major attempt at an important personal goal. These patterns go back to childhood, so I need a therapist who can actually work at the root level rather than only helping me manage the symptoms temporarily. At the same time, I need help coping with the immediate, day-to-day pressure and performance anxiety associated with this final attempt.

I've already tried online counselling services and a national mental-health helpline, but the guidance was largely generic — meditate, exercise, socialize — and it didn't move the needle on any of this. I'm not looking for quick-fix advice or temporary motivational boosts; I want to understand and work on the underlying patterns and develop genuine, lasting change.

What I know is the thought journal/record, which seems more like things I will do on my own. What are the actual therapy sessions like?

Was just curious how others handled it. Also does your therapist always notice when you dissociate?

I refuse SSRI'S and my psychiatrist wants me on Lexapro. All I want is something to help me with anxiety but she refuses to touch the propranolol that my primary put me on. Now she is wanting me to do IOP or voluntarily hospitalize. I said no to both and that I want to just try therapy. Like why isn't that enough? Why can't that just be the option to see if it works first?

Super irritated and annoyed. I am just starting to trust my therapist and I don't want to change anything right now! But my therapist and psych work at the same facility so now I'm scared she is going to put notes in or talk with her and I'm going to lose the one person that I'm starting to trust.

I struggle getting things done. I have spend years researching how to be disciplined. I always thought that something was wrong with me for not completing my task. . After self reflecting, I realize it is not that I was born different or not motivated, it is because I am hugely afraid of pain/discomfort. If I sense a micro dose of discomfort, my natural urge is to run away and hide. I tried to power through my discomfort but on the third day, I felt a wall of resistance.

Can someone please recommend a good app for CBT for past trauma and anxiety around it that's affecting my current relationship. Thank you

I haven’t been sleeping as I wish since 2023, after moving and after chemotherapy and immunotherapy which had put me in chemopause for 2 years, and I might be in perimenopause .

I moved into,a town from a house in a lake community, I traded a larger space of a house with logs expanding and contracting and 2 other people, to a multi family unit apart with less space, one family member and upstairs neighbors whom I can hear doing various things like opening their doors, flushing, moving furniture, child frolicking at sometimes 9 pm. On top of my own household sounds which startle me. I can sleep through some sounds, but I can be woken up by the sound of a shower curtain pulled . I’m so jumpy at sounds

I’m anxious, depressed, scoliosis, asthma , have neurofibromatosis and never been tested for ASD and have tinnitus and for two years some thing when I lay down to sleep where my inner ear feels plunked every 4 minutes. On top of feeling startled between 5 to 25 minutes. I’m more nervous since I cut myself off a practice close to soulbonding 3 years ago. I don’t exersize and other forms of sleep hygine are gling to be hard, because I live in the apartment.

With all these factors , how easy would it be to get the CBT for sleep when I’m reacting to household sounds like a cat on Independence Day , depressed from tinnitus and feel traumatized ? I can’t live off Ollie sleep gummies , Zquil is rarely used out of desperation . I feel like I’m trapped in a box that is sinking and possibly have sleep anxiety. Ear plugs make me hear my tinnitus and body sound more noticeable

Anyone either similar situation can use CBT for sleep ? I think I mostly get consecutive 5 hours a day, and wake up at 4 with my mother

Is this something that will develop over time?

I had my 7th session today and I have been prepping my brain for this session with a subject that hits so deep with me as it is constantly torturing me in my thoughts. In my career I am exposed to trauma every shift. I never have time to process this trauma and I bottle everything up because I cannot be vulnerable with anyone.

So I started unpacking. But it was like every time I tried to tell more of it the harder I struggled to get my words out. I'm trying to hold back tears, I'm trying to control my emotions as I normally do but it started getting harder and harder. My body started to be physically tense and I felt like I couldn't breathe, I felt like I was curling into a fetal position, I felt frozen like I couldn't move, then I dissociated.

My therapist went and grabbed ice and asked if I was still in the room, I told her no. She helped ground me to bring me back.

I'm over here so confused, embarrassed, and ashamed. Like why couldn't I control my body?!? I'm trying to process it. Was that a panic attack? Was that just a reaction to trauma? I've experienced panic attacks a lot but this was so different and scary.

I suffer from task paralysis and ADD/ADHD , Executive dysfunction and procrastination
Time blindness and difficulty starting tasks
Emotional dysregulation and rejection sensitivity or lack of self righteousness

ADHD and anxiety/depression or lack of motivation to do what I can explain in 10000 words

and the whole shebang if I am missing something
which I am not able to list down for the same cause

Today my psychologist was bland and straight forward since I was very brutal with him and his techniques

He said your dopamine is soo depleted and at critical levels that you don’t have method of reward that can sustain your person on anything physical and you aren’t trainable or therapy dosent work on you and since you aren’t willing to take synthetic drugs to put it back I am not able to help you

Did someone else face this problem and any possible solution you would suggest??

For context I am 32 year old male adult child who could get away with the chaos until now but I need to step into role or a lead at work and step into role of a dad at the same time and I am seeing the world sinking around me

Thanks in advance

I understand that some level of anxiety is part natural human emotions but do people really live life truly in control without constant fear and deep sadness that is not on medications? Is that ever truly achievable without medication?

I'm just so overwhelmed and feeling so hopeless.

My psychiatrist wants me to take Lexapro to control my anxiety, panic attacks, and major depression. I have no desire to take any form of antidepressant. I feel like she pressured me into agreeing to it because I have SI. I did pick them up from the pharmacy 2 weeks ago but my bottle still sits completely full.

Short map of the protocol, because the jargon is the first barrier and nobody explains it in order.

Sleep diary, week 0. Before anything changes, you track. Rough morning estimates — when you went to bed, roughly when you fell asleep, how long you were up, when you got up. Two weeks of this gives you your actual sleep time, which is almost always different from what you assumed.

Sleep window, week 1. You set time in bed to match the sleep you're actually getting, not the sleep you want. If you're sleeping 5 hours across 8 in bed, the window becomes about 5.5. Wake time gets fixed first, bedtime moves later to fit.

Stimulus control, ongoing. Bed is for sleep. Awake and frustrated, you get up. This is what rebuilds the association your insomnia broke.

Titration, weeks 2 onward. Weekly sleep efficiency goes up, the window expands 15 minutes at a time. Efficiency drops, you hold or trim.

Cognitive work, throughout. The catastrophizing at 2am, the arithmetic about how many hours are left, the belief that tomorrow is ruined. This part gets skipped constantly and it's half the treatment.

That's the whole shape. It usually takes 4 to 8 weeks, and it gets worse before better.

Not medical advice — sleep restriction isn't safe for everyone to self-administer, more on that in a separate post.

Last session I brought up that I felt really embarrassed about what I shared in the previous session. I understand they can't remember everything you talk about and highlight possibly only the important things mentioned. But it was the first biggish thing I have been able to share. Because I have been pretty superficial and vague about everything previously since it's so hard for me to be vulnerable.

So when I brought up my regret and embarrassment she said "remind me again what it was?" And quickly looked at her notes to refresh. It really made me feel terrible. Like I'm just a paycheck. Is this the norm?

The professional I am doing my CBT with is insistent that deep breathing exercises will start the process of calming and focusing, so I am better able to recognise the physical 'tells' of stress, such as clenching muscles, saying certain things, heart racing etc

But I don't feel any physical 'tells' that I am stressed...

And trying the distraction techniques, like focusing around the room don't click for me, it's like 'yes, I have done that, nothing felt different'

The marginal benefit I am getting is that doing the breathing exercises takes a bit of time, and in that time I calm down a bit and feel better...

Is that the experience others have? From the way it is talked about their appears to be some sort of expectation that it is obvious you will feel some difference, and I just don't.

Any advice for this?

I have been having a hard time being vulnerable and just shared more superficial things until the last couple sessions. My therapist has helped me with intrusive thoughts and SI but I feel like otherwise it's talk therapy and nothing really behind it? Monday will be my 7th session. Is it still too early because it took a handful of sessions to start digging deeper? Maybe I'm just searching for a fix overnight and I obviously know there isn't one. I'm just new to therapy and I'm tired of feeling so anxious and depressed all the time.

Hi, does anyone know of any good workbooks that can be used without/outside of therapy? Specifically, something like a workbook focused on Exposure Response Prevention with CBT for OCD, and/or one for AVPD as CBT is supposedly one of the best treatments for both. I'm looking for myself as well as someone else as I think it'd be cool if we could both get a workbook or something and go through them together, as a sort of support system kind of thing where we're doing it together and stuff. I'm not really in a position to afford or get a therapist soon, so I'm looking into alternatives that can still be beneficial.

So, does anyone have any good suggestions of maybe ones you've read or used or heard of that were good? I'm open to other sorts of suggestions if you have them, as well! Like Youtube channels or something like that.

I'm trying to find a therapist in Egypt that's good and not that expensive

I want someone to help me with BPD (borderline personality disorder) and have any kind of experience with DBT (cause as far as i heard that's the most effective therapy for BPD)

I don't mind if it's online or in person

Does anyone know about that ?