This was a highly requested post and I am more than happy to share my CBT journey over the last 12 months but as a disclaimer, please remember that this is my experience, and yours will be different. In total I had 16 'one on one' sessions with a therapist, this was through the NHS starting in May and ending in February. My wait time was probably just under a year. I've seen that they have reduced waiting times and made the IAPT services a little easier to access now, which is excellent because waiting a year so start therapy is just not good enough.
CBT is a talking therapy but for me, my main issue was to tackle my agoraphobia/fear of travelling. There is only so much talking you can do before you start on your exposure portion of the therapy. I could have started my therapy much earlier but after my phone consultation I got an appointment through for a therapist 14 miles away...GUYS if I could travel 14 miles I would not be needing this therapy. I called them back and asked if they actually understood my condition and that I would require a therapist near to where I live at best, and at worst, in Leeds. A space finally came up. Michael was amazing, and filmed the journey there for me so I could see what it was like. It was down a major road in to the city, a road I had avoided at all costs for 6 years. Googlemaps told me it was 1.2 miles away. Easy, I walk that with the dog and I have travelled that the other way (out of Leeds). Welll the day came for my first session and I was bricking it, I got to the first junction and stopped at traffic lights (if you follow my vlogs you will know which aka The Gateway to The City) and dear god panic central. Sweating, heart palpitations and I just thought "I can't do this". I nearly asked Michael to turn around, but the lights changed and we continued on to the next set...until we arrived. I thought to myself whilst waiting "if I am going to have a panic attack, this is the best place to have one".
Each session got easier, and I was no longer dreading Wednesday mornings. It was helpful that the reason for me going was put in to practice each time I had to get there.
CBT is goal based so you will be given homework to do relating to your issues. For me, it was travelling places. My first major goal came up in October and about half way through my programme. I had to go in to the city for my best friends 30th. I say "had to" it was my choice, but I wanted to. Since then I have been back and forth out of the city most weekends. Something I couldn't have even imagined doing this time last year, whilst sat sweaty palmed at that junction.
Perhaps one myth about CBT is that because it is therapy, you sit there analysing your past, your childhood, or why you think you've developed issues. None of this is actually spoken about in any detail. You look at how you think about situations now, in the present and look to change them so you can move forward in the future. Overall it makes it a much more positive experience. CBT is all about YOU changing yourself and YOU have to commit to it. If people say CBT didn't work for them it is because they didn't put in the time, the effort and do the homework.
CBT is often successfully used to treat anxiety, panic disorder, depression, PTSD, phobias, sleep problems, eating disorders and substance abuse. It is now also being used to help treat IBS and CFS, whilst it can't cure the physical aspects of these conditions it helps people asses how they think and manage their thoughts around their problems.
You learn what your Core Beliefs are. These are the beliefs that make you who you are. Some are good, some are bad. You learn how to challenge the negative ones, and work on the good ones. Core beliefs are like magnets and they are always waiting to attract evidence to support them. The more evidence they get over the years, the stronger they become.
Such as: "Travelling in the car will make me panic" - I haven't had a panic attack in the car in 5 years, there are always ways out, cars are safe, etc. " I am good person" - I have friends, people like me, I do good when I can etc etc
Core beliefs are not facts and with persistence (exposure) you can rewrite them. Working through these has been so beneficial, and it's easy to see how it could work for anxiety, depression, PTSD.
You also learn what your safety behaviours are, MY GOD, I have loads, lots of which I didn't even know where safety behaviours (such as clenched fists). I won't go in to all of mine, but slowly you learn to actively drop them (always carrying mints with me) or you become less anxious in situations that you subconsciously drop them (asking how long it takes to get to our destination)
There are 10 types of thinking styles. You can have one, or all, but most people have a few. You focus on which you do most and how to counteract it. For me:
- All or nothing
- Catasrophizing (used to be SO good at this, ha)
- Should/Must/Ought to
Anxiety comes with its own branch of thinking, as we tend to over think and over analyse situations. Which is where avoidance comes in. My avoidance to anxious situations became so bad it ended up turning in to agoraphobia. It is very common for this to happen. If you suffer from anxiety also then CBT would definitely be of help, I wish I had sought it earlier so that it didn't get as bad as it did but I just didn't know how.
What I have learnt:
- Nothing, so far, has been as bad as I thought
- To recognise mental exhaustion (from too much exposure therapy) and slow down
- Traffic lights will always change
- Colouring books help me 'self soothe'.
- Thoughts are not facts
- Harry Potter helps everything
- I clench my fists when anxious, it is totally subconscious but something I realise I have done for as long as I can remember. You will spot it occasionally in the vlogs
- Just because I can do something now, doesn't mean I need to
- Deep breathing is key (going to write a post on this)
- It is *just* anxiety - it cannot harm me
- "What if" is not a helpful phrase, when I what if a situation eg What if I have a panic attack? it is now followed with "well what if I don't?
- My physical side effects are just because of my natural in built fight or flight mode (this is a great leaflet)
- I really am braver than I think
Tips you can use now;
Learn how to deep breath. Properly. Once you have mastered it you can usually breathe yourself out of a panic attack/high anxiety situation.
Try and think about what your core beliefs are, and what evidence there is to support or counter them. If one of your beliefs is "I am worthless" try searching for examples of times you haven't been worthless. This is how you change your beliefs. You then attach or detach emotions to these beliefs.
Perspective - our over active, rationally irrational minds seem to lose sight, try and give yourself some perspective on feelings or situations.
Always look for evidence to support your thoughts, CBT reinforces good old fashioned common sense.
Feel the fear and do it anyway, really, what is the worse that can happen?
I hope this post has been of some help, maybe to those thinking of or waiting for CBT, or if you are just curious as to what it is and how it works. This post doesn't go in to nearly as much detail as I could but take it from me (and you can find the evidence via the vlogs) it works. Combined with my medication and keeping up with exposure I am doing so much better. It is something that I will need to keep at but it will all be worth it. That initial panic filled 1.2 miles (or 6 min journey) is now a comfortable 20 minute journey to places I have never been. I am about to do my biggest challenge yet, and one that was much further down my goal list, but I will be travelling for 2 hours soon back home to Stamford. I will of course let you know how it goes. No matter how much you prepare, plan for, and map out goals, sometimes you need to just dive straight in. Like I said, feel the fear and do it anyway.
Here is a link to the Leeds IAPT you will have one local to you, simply put in your locale and 'IAPT'.
My email firstname.lastname@example.org or message me on instagram @simply.weekend - you can talk to me at any time if you have any other questions.