It’s been a good few weeks since I started CBT, and thought now would be the right time to share my experiences with you so far.
Since my mental health conditions are ongoing, I’ve had multiple assessments and this isn’t the first time I’ve had ‘talking therapy’ in order to help alleviate the symptoms of my anxiety and depression. When I initially presented with mental health problems, we decided counselling would be the best thing. Counselling is more about talking through the issues that are bothering you; CBT is working out how to change your behaviours and learning how to better rationalise your thoughts by searching for ‘evidence’, rather than clinging onto assumptions. Though I actually really benefited from counselling, it was the right thing for the time. I hadn’t explained my deepest, darkest fears before; I hadn’t confided in someone and told them all about my secrets and how I felt about myself and so on. And for that time, counselling was great. It gave me a voice, and provided that undivided attention I needed to address these issues and tackle my mental health head-on. Now I’m at a different stage in my life, and I didn’t feel talking about everything again would be beneficial right now.
This is where CBT comes in. The NHS defines CBT – or cognitive behavioural therapy – as ‘a talking therapy that can help you manage your problems by changing the way you think and behave’, and is particularly useful for ‘anxiety and depression, but can be useful for other mental and physical health problems,’ (NHS, 2014). Rather than just discussing your thoughts, emotions and resulting behaviours, you are actively developing coping strategies and methods to manage your behaviours, which are often unhelpful and perhaps increase feelings of anxiety/depression.
It’s quite a long-winded explanation, so I’ll try and illustrate with an example from my sessions:
Situation : Seeing deadline date in diary
Thoughts and Images: of a bad mark, disappointing others, feeling unworthy and useless
These thoughts and images then produce
Emotions and Physical Sensations: ‘nervous tummy’, palpitations, impending sense of doom and anxiety.
as a result of these emotional and physical sensations, my behaviour changes:
Behaviours/What I did: withdraw, ruminate, ask for reassurance, plan rather than do, hide away from impending situation.
These behaviours then reinforce my Thoughts and images, and so the cycle perpetuates and continues. The idea here is to address the behaviour; it is very difficult to stop the thoughts, but I can stop behaving in an unnecessary and unhelpful way. So, rather than withdraw, perhaps I should focus on what I have done. Changing this focus involves taking into account my good marks, keeping an activity diary to show myself what I have achieved despite how I’m feeling. I know this sounds so simple, but I often get too blinded by my anxiety and depression that I forget what I have done. It helps me immensely to keep track of this.
If you’ve had dealings with anxiety, depression or similar conditions, you’ll know how troublesome assumptions can be. And when I’m at my worst, when the irrational thoughts pop into my mind, it’s so hard to get rid of them. My therapist is keen on getting me to realise that my assumptions – eg ‘people think I’m stupid – are just that; assumed, with no real evidence. Assumptions are largely negative, and don’t help anything, so I’m working on undoing that negative thought process and replacing it with something useful, instead.
Another thing we’ve identified during my sessions is the fact I have OCD -obsessive, compulsive disorder – and have been engaging in classic ‘OCD’ behaviours, including repeatedly checking. This was a bit of a revelation for me. Admittedly, I did wonder whether the checking I’ve been doing was normal, but I didn’t realise it was OCD. I tend to become fixated with checking various things, including checking locks on doors, both in my own place and when using bathrooms on campus, and sometimes this checking can go on for minutes. On a particularly bad day, I’ll go to check multiple times an hour, or wake up and check because I’m so anxious about whatever it is I’m checking. I also like to have certain items arranged in a certain way; the hangers on my clothes rails are often rearranged every night for fear of ‘ruined’ clothes. I am always worried about things breaking because I didn’t put them away properly, so jewellery is often checked and put back, and my alarms set, reset, checked, set, reset, checked…you get the idea. It’s strange. Thing is, I know these things aren’t actually useful, but at the time, checking things is the only way to rid myself of the anxiety. It’s complex, because the more you check, the more you find it difficult to not check. My therapist described these behaviours as coping strategies, as they help me to feel like I’ve regained control, even if it’s just momentarily. And even though I know my door locks as soon as you close it, it just isn’t enough. It’s like my irrational thoughts, and my unhelpful assumptions; I know it isn’t really helpful, but in that moment, and at that time, that’s all I can do to alleviate my worry.
Undoing these things will take time, and will have to be done step-by-step, but for now I’m feeling positive, and I’m hoping to get the most out of my sessions. I have another on Tuesday, and hopefully my progress will continue.
It feels good to be sharing my progress with you. This is a good way for me to see how far I’ve come, and hopefully I’ll be able to look back at these posts and feel proud. I haven’t always been upfront about things, particularly the OCD, and it’s time to just accept it and learn how to deal with it. Mostly I’m sorry that I hadn’t told Drew, or at least not enough. Hopefully I’ve rectified that.
It’s fairly stressful over this way, but as always, I’ll find a way.
Hope you’re doing well and look after yourself.
ps: here is the link to the NHS page regarding CBT if it’s of any use:nhs.uk/Conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx