Thursday, 23 May 2019

The CBT Diaries Week Four

Guess who's back - fourth instalment too. The real fourth instalment was another week off of  therapy as my counsellor was still ill. The lovely folk at Mind gave me a call this time so I knew in advance. I just figured a post wouldn't be worth another week of no therapy. 

Coming back to normal weekly sessions gave me something to look forward to throughout what was a pretty up and down week. I've been open with everyone from family to my doctor about how although my anxiety and depression have been occurring less but when it does occur it feels amplified. A session was needed for sure.

My scores this week

Anxiety = 12
Depression = 13

Scoring a lot less than previous weeks, and in proper me fashion, no real distinction between whether it is anxiety or depression being the one focus. 

We then set our agenda which was as follows: 

1. Homework review
2. Reflect on the last session 
3. Anxiety coping strategies
4. Diet and anxiety
5. Homework 

I contributed agenda three and four (I deliberated a lot prior to this appointment - thinking of things for the agenda is hard!) 

We started with the homework review where we looked over the flow chart exercise sheets. They were from two weeks back, which actually was a useful thing. We focused on two particular incidents. One was my panic attack on route to the library two weeks prior: I had been walking down to the library for the morning, and whilst on my walk, I had a panic attack - for no reason. When I reached the library, I filled out one of my flow chart sheets, and in trying to understand it, I had no idea why I felt the way I did. One of my thoughts was 'why are you panicking when you aren't actively worrying about something?' I carried on walking, reached the library, read some books and the feeling passed a long while after. 

Danielle discussed panic attacks with me and drew a diagram illustrating how a panic attack works. Something will trigger a panic attack - this could be something like a thought, or it could be something a little more abstract such as a colour, song, smell, image. We tried pinpointing what triggered the panic attack, but being two weeks prior, I just couldn't remember. I reasoned that I usually listen to music, however couldn't be sure. All I knew is that I hadn't had a panic attack just from walking before. We problem solved the thoughts in a panic attack and what the worse possible outcome of a panic attack can be. We also looked at avoidance techniques and behaviours. Whatever the thought of a panic attack, you shouldn't avoid it. You need to fully embrace the thought and understand the thought cannot hurt you, to be able to move past a panic attack. The word embrace seems to have featured a lot today. It seems the last thing I'd want to do is actually entertain the thoughts but it made sense. 

The second flow chart was a situation where I had been unnecessarily thinking the worst. We looked at the thoughts and behaviours. When picking apart the situation we decided when thoughts spiral, look for the evidence in those thoughts instead of distraction techniques. 

We moved onto a reflection of the last session and what has helped me so far - I said Larry the Lizard obviously!

Next, to be able to consider different anxiety coping strategies, Danielle had to figure out some factors that were making me anxious. This part of the session moved into a bit of a 'what's been happening recently' ... I discussed how very recently I had felt quite tearful which is not a reaction I regularly have. Danielle asked me why I felt tearful, which helped me describe and identify what had made me upset. I had described a situation where I was receiving advice from my family and others over an issue I am currently experiencing. In discussion, we all had different views. For myself, I want to be able to make the right choices. I'd listened to opinions. Amongst all the opinions I was conflicted in what I felt was the right choice. Even to the point, my original standing and beliefs I was deeply questioning. 

Danielle then told me she wanted me to jump out of the window. The conversation went like this: 

Danielle: I'd like you to jump out of the window. 
Me: Erm no? 
Danielle: No really, I think you should jump out of the window. 
Me: I don't think that's a good idea. 
Danielle: Why not? I'm telling you, you should jump out of the window. 
Me: It's dangerous, I'll get hurt. 
Danielle: No seriously jump out of the window. 
Me: No, it's not a good idea. 
Danielle: I am your therapist... I know what is good for you. Jump out of the window. 
Me: No I can't jump out of the window. 

The point of this? Danielle's opinion may be to jump out of the window, but I knew I couldn't and shouldn't do it. In any situation where I'm taking advice, you can listen to all the advice out there, at the end of the day you have to make a choice as you are the person with the full picture. Danielle explained especially when it is people you know giving advice that they will have a smaller picture of the situation and a personal feeling as to what is best based on their life experiences. Only I have the full picture, and ultimately as much as a decision I would like to be handled by someone else, I'll never feel fully satisfied if it isn't my decision. I explained how I felt unable to control or handle the situation. Danielle replied it doesn't have to be solved instantly or 'when the time is right' ... I had said 'maybe when I have more confidence I'll feel the time is right' - this idea was soon de-mythed as Danielle put it that no matter what I will not feel confident dealing with it all the while I'm anticipating it. I have to take control. I discussed a few more particulars with Danielle, and she  suggested some reasonable ways forward.

By the time we finished discussing all of this, we ran out of time for item four on the agenda, so we planned to stick it on the agenda for next week. 

Homework this week is a chart with each day of the week divided into four sections. In each section, or when it occurs I need to write down something I did that felt good for me. This is a contrast to my first week's homework which focused solely on the negative. I'm looking forward to reflecting on the self care side of things. That's it for another week. 

Any questions or comments, give us a shout! 

Further resources: 
Making Sense of CBT by Mind (I wish I'd read this pre-writing this post!) 

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