For this anxiety chats post, I am going to share my experiences and my perceived benefits of embarking on a course of Cognitive Behavioural Therapy (CBT). For those of you who haven’t read my first anxiety chats post, please pause here and go back and read it, I detail the type of anxiety I face which may help you understand why this was so beneficial to me.
So what is CBT and how I did I end up receiving it? Firstly, I want to say it took me a long time to admit that I was struggling with anxiety and depression. I am pretty sure I had been struggling for years before I finally went to see a doctor. Many people had suggested it to me and what I have learned from being on the other side of it and a piece of advice I would give you if you know someone who you think might need help, they will only go when they want to engage with the process. That is how it worked for me, It wasn’t until I took a step back and realised how I was (not getting out of bed, cancelling plans, being constantly exhausted… I could go on) that I realised I needed help.
My first step was seeing a doctor who gave me a questionnaire, based on the results he suggested that I call up a helpline which puts you in touch with local therapists in your area. Another thing I will caveat is that lines can be long, and the wait can be weeks if not months. I will admit I was seen very quickly, the results of my survey showed I had a severe case and I had an appointment within a matter of weeks.
So what is CBT? It is a talking and ‘homework’ based therapy which focuses on managing your problems by helping change the way you think and behave. It is not about removing your problems and talking through them, like people assume you do during therapy, it is about helping you deal with them in a more positive way. It is based on the concept that your thoughts, feelings, physical sensations and actions are all interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.
Do you know when you hear yoga people refer to it as their ‘practice’? Well in a very similar way CBT is essentially re-training your mind, and it takes practice and I admit it is not easy!
The 3 key areas that my therapist wanted to focus me on were…
- Getting things back into my life that gave me joy that I had stopped
- Helping rationalise my worry
- Sleep – I was struggling with my sleep which was making everything feel worse
#1 Getting Things Back…
One of the big things that happened for me is I stopped doing anything in my life that I used to great pleasure in, I stopped everything and just went to bed, quite literally. First I had to identify some areas which I missed. For me it was cooking dinner, exercising, catching up with friends and going out with John.
Then she gave me an activity calendar – I found the one she used on this website – HERE.
I had to plan some events in to focus me and also fill in the blanks hour by hour. The idea was that you completed a brief description of the activity, one word that describes your Mood, and rate the intensity of your mood on a scale of 0 – 100%, your sense of Achievement for the activity on a scale of 0-10 (A0 – 10) your sense of Closeness to others (C0 – 10), and sense of Enjoyment (E 0-10). An activity may be sitting down, or lying in bed, not only washing dishes, walking etc.
This was to start to reintroduce things which I had stopped doing as well as showing the activities which gave me the greatest enjoyment, which I may have stopped doing before. I love being organised so this method really worked for me by helping focus me. I completed one of these planners every week for 6 weeks, and what I saw was my enjoyment of lying down in bed go down, and my enjoyment in activities increase.
#2 Rationalising Worry
This was the area I really thought would be the biggest struggle, and it was. My therapist started me off trying to explain about how the brain has been trained since caveman time to be fight or flight, to help protect you from threats, of being eaten by animals or worse. Since we have developed our brains haven’t stopped using fight or flight and in fact they are much worse than ever before, so they are always looking for threat and for lack of a better word – freaking out 24/7. That’s sort of what my brain does all the time, irrationally fighting fears that aren’t there!
What I was made to do every time I worried was to note down the following…
- What I was worrying about
- Scare of worry from 1 – 10
- What the worst case scenario was
- If the worst case scenario happened what would I do about it
- Why I believed it would happen – what is the evidence it may or may not happen
- How do I feel now from 1 – 10
By completing these questions what you it helped to see on paper was how your worry was usually irrational, in the aspect that there was no hard evidence for you to base the worry on. It also allow you to be practical about what you would really do if it did happen. At first I completed this religiously on paper, I think I have a full notepad of it, and what I learned to do gradually is do it mentally without having to note it down unless it is really severe. This is still a technique I use to this day whenever I struggle – it has stuck with me.
So one thing I did learn about sleep is that your struggle with sleep is different for depression and anxiety. When you are depressed it traditionally takes you longer to get to sleep and anxiety kicks in usually by waking you up in the middle of the night and then your brain starts and wont quiet down when you want it to. I think at my worst I was on about 4 decent hours sleep a night, and for any of you who struggle without sleep as I do will understand, it makes EVERYTHING feel a thousand times more difficult.
One method that helped was called The Worry Tree – which you can view HERE
The worry tree is about helping identify what type of worry it is and therefore how you can deal with it, for example is it hypothetical (e.g. what if?) or is it a current problem. If it is hypothetical then it is about deciding if you can influence it or change it and if not, let it go or postpone to another time and with a current problem it is about making action plans about resolving/fixing the issue.
What was great about the hypothetical part which was what I suffered with most, it was allowing me when I was up in the night to either allow myself to ‘let it go’ or even better ‘postpone’ it. I was allowed to give myself 30 mins of worrying a day – so I would wake up in the night and tell myself to postpone it to my allocated time and then I was free to let it go. What happened after time… by the time the 30 minute allocated time came around I had forgotten what I had been worrying about, because it had either happened (if I was ‘what if’ing about an event that was coming up) or I had managed to move on.
I had 6 weeks of hour long sessions, and it genuinely changed my life. I have kept a file of all the tools I was given and at time when I take a dip I get them out and refocus myself. I can’t speak highly enough of CBT, I love how practical it is and at the time it is hard work – but if you are thinking of doing it or you are currently – keep going! YOU CAN DO IT!
Until next time
Little Lemon x