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Today, I am going to talk about something really difficult. I am a very guarded person, and I do not like to lay my cards on the table for everybody to see. However, I am also a ‘helper’, and I have seen a lot of people either feeling let down by CBT, or terrified because they are about to start. So I am going to say some things that are going to make me feel very vulnerable, and I hope people are kind.
I have been in therapy, on and off, since I was 16. I won’t go into details about the ‘why’, just the ‘what’. My first dalliance with mental health ‘professionals’ came in the form of art therapy. My GP thought it would be useful for me, after I refused psychotropic medication to handle this depression and nothingness that I couldn’t remember not feeling, and couldn’t verbalise the visible anxiety that the thought of medication had induced. You guys, I went to one session. It was 11 years ago now, but all I remember was a middle class lady who I would never identify with, getting nothing out of me for an hour and telling me to ‘scribble my feelings’. I was 16, not ready to talk about the stuff in my brain and I felt like I was being mocked.
Next came ‘family mediation’, which was doomed from the start. I was in a room with two women, one of whom I knew in my personal life. I grew up on a tiny island in remote Scotland, so of course this was going to happen. I was asked if I was comfortable seeing her, ‘given our situation’, but try asking an anxiety ridden people-pleaser to speak up about what she really feels. I said yes, refused to talk, literally had to colour in smiley faces to communicate my mood – then my dad died, I clammed up even more, in my last session they told me they had decided I was silent because I was in danger and they had involved the police. As an adult I now understand why they did it, but as a grieving 17 year old who was drowning her feelings in booze and couldn’t get her mind straight, I felt pretty blindsided and incredibly betrayed. I developed a deep distrust of counsellors and I vowed never to see one again.
And then I had a baby. Not immediately – it was five years later, actually. The birth was terrible. We both nearly died, but I won’t go in to all of that. After his first birthday had come and gone and I was still crying over not having the birth I wanted and having nightmares about the whole experience, I approached my GP and was finally put on medication. You will remember I had previously been very against it; the idea of medication altering my mind made me feel incredibly uneasy. In fact, during my a-bit-more-than-booze days, I had convinced myself that there were people living inside my laptop and phone who were trying to control my brain (lol seriously. Fear not, I do now have a diagnosis and am on some good meds!) and the idea of taking mind-altering medication was causing me flashbacks. After a year of increasing meds and a diagnosis of Low Mood changing to Depression changing to Mixed Anxiety and Depression, I began CBT.
My first counsellor, C, was lovely. Such a sweet lady. We got on super well, and she was the first professional (including my GP) who I felt was taking me seriously. I received the diagnoses of PTSD and PND and we also covered some of the basics of my social anxiety. Ironically, now that I am on my third round of CBT I am able to identify that I was having panic attacks that I wasn’t telling her about because I didn’t realise they were an issue. We did a lot of those worksheets that CBT gets a bad rap for, but generally I was quite closed off with her and felt like I was handing her issues to deal with so that I could stall long enough to avoid getting in to anything serious. Round One of CBT failed for me, but it wasn’t C’s fault: I just wasn’t ready to let it help me.
Round Two was Couples Behavioural Therapy, so CBT of a different kind. It instilled the principles of CBT but was an experimental treatment that was being trialled under the supervision of a university in America, in which couples where one or both of you have issues with depression learn to better support each other. It was there that I met R. I felt at ease with him immediately, and he was wonderful with my husband and I. I shared things that I had never shared with a counsellor before – perhaps because I had my husband there for moral support – and it was like he heard what I was saying but also knew what I was too afraid to say and helped me say it. It had been better than the first time. We had homework as a couple, and were able to work on some individual issues but the majority of the work was on interpersonal skills, understanding eachothers triggers and communication. Though CBT had helped me this time, I still felt I needed more. Two months after our couples CBT finished, I had applied for another round. This time, when I had my telephone consultation, it was decided that I needed to attend the highest intensity CBT. It took around 5-6 months for my name to reach the top of the list, but once it did I was over the moon – I had been assigned to R for the second time.
I don’t know if it was chance or if it was because he knew my history and what I needed help with. But I can’t express how glad I am that I have finally opened up and been honest about my thoughts and feelings because it is so refreshing to have somebody understand what I am saying and why I am saying it on a much deeper level. My most recent diagnosis has been panic disorder with agoraphobia and secondary depression, but that might change again – who knows? High intensity CBT so far has involved plenty of homework (I have to go outside EIGHT SEPERATE TIMES this week alone!!) and I have even had a session where we artificially induced panic just to explore the physical sensations and acknowledge that panic can do literally nothing to harm me. I am treated like a valid person, not just the name at the top of the list, and I am so glad I went for round three.
If you are struggling with your CBT, please give it time. Identify what your issue is. I have seen complaints that the worksheets are too reductive, or that your therapist isn’t suitable. These are things that can be discussed and ultimately changed if necessary! For those about to start, take your time and be as honest as you can. It hurts at times, but you won’t change unless you are ready.
If anybody would like to talk more about CBT, please comment and I will do my best to share specific elements of my experience. Please be respectful of the fact that this was very difficult to write and I do not want to discuss personal triggers or reasons for visiting a counsellor. I am not a therapist and cannot offer any mental health advice in lieu of attending CBT.