Cognitive Behavioural Terror

Of course when I first got referred to Cognitive Behavioural Therapy I was delighted.

For too long it had been that whenever I mentioned problems with anxiety, panic and terror to my GP I was prescribed drugs - not a bad thing in itself but generally lacking. The SSRIs for depression tended to make me put on weight and the beta-blockers for panic were more of a short-term solution. I wanted to get to the root of the problem and it seemed that the Holy Grail was some kind of therapy, getting to talk to someone. It was of course difficult to get my GP to refer me and even when she did she warned that there would likely be a long waiting list.

By the time I eventually got to see someone my life had changed somewhat and I had made plans to leave my day job which was one of the major causes of the anxiety I suffered. I had no illusions that this would be a cure all, some kind of magical fix, but I did feel that I was taking control of my own life and that made a big difference.

I figured it was still worth attending these sessions though, given how long I had waited for them. The first sessions I attended weren't Cognitive Behavioural Therapy - they were just a short series of four which gave me some kind of assessment. I found them very useful - if only for the fact that I was able to talk to someone about how I felt without the danger of them thinking it was something to do with them and taking it personally - or rather the danger of me thinking that they might think it was something to do with them and taking  it personally. Someone whose job it was to listen. Someone impartial. As someone who has been described as a good listener it was good to finally experience this from the other side.

Of course it didn't last. There were only four sessions and I had no reason to expect that I would get any more. However I was pleasantly surprised when the person I had been dealing with said that she thought I would benefit from further help and referred me "up" to a Cognitive Behavioural Therapist. I'd have to wait a bit before they started but I figured it was worthwhile. Better to have to wait a couple of months than not have it all together.

I was quite enthusiastic when sessions started. A lot of what the therapist talked about made sense - and the instructions to question my own anxiety as I experienced actually seemed to work. This was clearly the start of a major change in my life. I was very excited.

Email comes in with a message that sends the familiar dread spiralling up into my brain and down into my guts? Stop and think about it. Ask what I think is the worst that could actually happen and then ask whether that is actually likely to happen. Then ask what IS likely to happen. And so on and so forth.

It worked!

I started keeping notes of whenever this happened, comparing and contrasting. During the sessions I got to the root of a lot of my anxiety - worrying about what people think of me; specifically worrying that people might think me boring. It wasn't too difficult to trace back these feelings of anxiety either - when I was a child in the days before anxiety I did used to endlessly go on about my enthusiasms (such as the London Underground or ants) in a monomaniacal manner which resulted in people telling me I was boring.

So now that I had uncovered this it was simply a case of overcoming it using the techniques I had been taught right? I was ready for a brave new world in which I would be able to go to social gatherings and talk to people and finally after all this time Have A Life.

Or so I thought.

The problem was that the techniques didn't work with everything and didn't work all the time. Sometimes I would get an email or other electronic communication to which I would have The Reaction but on which The Technique simply wouldn't work. It was like trying to paint an ice cube. No matter how much I kept telling myself that the imagined consequences wouldn't actually be that bad even if they did happen which they probably wouldn't, the dread remained. The dread hung around for several days.

I thought that this was probably something to do with brain chemistry. It made sense - after all I had in the past noticed a definite positive change when taking anti-depressants (even if the physical side-effects meant that this wasn't a permanent solution) which showed that some of what I was feeling was based in the chemical world. When discussing these intractable anxieties at the next session I happened to mentioned my brain chemistry theory to the therapist at which point - while not actually saying anything - they got an expression of extreme disapproval on their face and then carried on talking without referring to my suggestion. I could tell that in their worldview there was no such thing as brain chemistry and that as far as they were concerned the root of all problems lay in cognitive behavioural therapy.

Still if this had been the only disagreement I could have coped and might even have finished the course of sessions.

But there was something else. I was going through a period of simultaneously being very busy but not socializing very much. Readers may have noticed that when talking about the anxiety triggers in this blog entry I keep mentioning emails or other messages (and I do believe that such things are just as valid as other forms of social interaction). I simply wasn't getting out so keeping the diary or putting the techniques into practice in the real world was difficult. Plus on the rare occasions when I was out and about making notes wasn't that easy.  It's not as if I could pause a conversation that I was finding difficult anyway by asking the other participant if they didn't mind if I made notes on my phone.

Eventually I found myself frantically scrabbling around on the morning of the session trying to remember (or even making up) occasions to put in the diary I had to keep. Without me being aware of the point at which it had done so, the therapy sessions had themselves become the main thing in my life giving me anxiety.

I had to think about it for a bit - I don't like leaving things undone or bailing out - but in the end I had to stand up for what I wanted, just as I had done the previous year when deciding to leave my day job. I cancelled the remaining sessions.

I still wonder whether I did the right thing. Was the anxiety that the sessions were inducing me part of the cure; should I have let it take me outside my comfort zone in order to cure me?

I guess I will never know.

Icon created by Julian Claus from The Noun Project


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