I have had a few clients recently who have been able to engage in the cognitive therapy with good effect in shifting their dysfunctional cognitions and managing to incorporate more adaptive thought processes and engaging in increased activities (so the c and the b are covered) but still they report that even though they can challenge and restructure and do more they still do not 'feel' better. e.g., i realised the other evening that I was beginning to worry again about going to the bowls and having a panic attack. I used the cognitive restructuring to challenge that distortion and went to the bowls using the other skills, but can't say that i enjoyed it or feel and better for having gone. Now while I reinforce that affect may not change initially over time and with repeated exposure to coping in those situations that have previously given you concern, affect will follow, but what do I do if it doesn't follow. I have investigated with the client what else might be happening for them to explain this, have we focussed on the wrong thought, feeling, activity but nothing elucidating has been identified. All suggestions gratefully received.
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