CBT: Eleventh Session

// TRIGGER WARNING – SELF HARM //

I went into this session the best I’ve felt in a long time. I only self-harmed once in 7 days. I am so proud of myself for being clean for 7 days. I told my therapist this obviously, and she was so made up and she knew I was going to be so much happier when I start going out more. I went for a meal last Friday, a party on Saturday and wales on Sunday. That is such a big step for me with my social anxiety!

My therapist did say that once I start fighting my anxiety and panic attacks and start going out more, my depression will get slightly better over time and my self-harm should do.. and it is!

We basically just talked about what I did the last week, and what I wanted to. There was no CBT involved really, it was just talking and I love it when the session is like that, it’s ace to get things off my chest! I told her about my blog and volunteering with time to change. I also told her that I’m starting to really have an interest in mental health, however, I’ve not done any a-levels and spent my time in college training to be a chef so my life can only go down one route, but as my therapist said.. there’s always time to change! I can always do a-levels whenever I want to! Or even a counselling course!

She asked me to write a list of things I wanted to do. At first, I listed about 3 things as I was struggling, but we got talked about what I want to do and the list was massive!

The list is:

  • Go out more – challenge my anxiety
  • Start working again
  • Read more – it’s a good distraction for me
  • Going out alone – don’t be afraid to go out by myself
  • Go to London – meet some of my really close friends from twitter!
  • Meetup in July – try and go to a meetup in July.
  • Blog more, and do media for time to change.
  • Host talks – Something I’d love to do, express my passion in mental health and host talks in youth centres, schools etc.

I never realised this until yesterday. It’s good to have a list of goals what you want to do, it keeps me motivated, and whenever I feel low, all I have to do is look at the list to get motivated to feel better.

I’d recommend making a list of things you want to do, I am always adding things to it, it’s not a list of what you need to do as soon as possible, it’s just for motivation purposes and it’s helping me already!

As always, thanks for reading!

Liam

CBT: Tenth Session

// TRIGGER WARNING – SELF HARM //

This session was my tenth ever CBT session! Wow!! We went through my depression going worse and my self-harm, and the self-harm cycle. It was a really good session, really eye opening and I learnt so much.

I told her about the last two weeks, how depression and self-harm have gotten worse and about how I hardly went out. She explained that not going out is just feeding the depression and making self-harm worse. It’s time that I really push myself to start going out more. She mentioned propanolol to me and how she thinks it’ll help me a lot going out etc, so I’m going to ask my doctor about it next time I see her!

We had a look at this cycle, called the “self-injury cycle” It includes six steps in the cycle. This just carries on and the self-harm carries on. I need to try and break this cycle by starting to do things, so the depression doesn;t get worse, if I start doing things it should help break the cycle!

  • Mental anguish, the first step. I know, what a weird word?! It just basically means what goes through your head at the time. For example, self-critical thoughts, images etc.  For example, for me, it’s self-critical thoughts mainly.
  • The second step, emotional engulfment another word I didn’t know what it meant. It just means what emotions are you feeling, especially distressing emotions. I feel anger, sadness and upset and I feel disappointed in myself too.
  • Panic stations, the third step in the cycle. What are you feeling, what happened next? feeling out of control, numb etc. Then, the next step in the cycle is action station. In what way you self-injured, how, when where?
  • The next one is action stations. What way did you do it? Why? What reason?
  • Feel better/different, the fifth step. Relief, euphoria etc.  I feel calmer and a sense of relief and release of all my emotions.
  • The last step, grief reaction. When did you feel bad about yourself? self-disgust, self-hate. shame etc.

We went on to discuss this even further, and we both filled it out with the thoughts I think and other things. She said it’s important if I feel the urge, to be around people, as she noticed that I told her I only self-harm when I’m by myself. Funnily enough, I didn’t realise that, eh that’s why I’m in therapy right? To understand my messed up brain, and to learn how to control my mental health!

I came out of this session feeling so confident, happy and just all the good feelings you can feel. She told me to go to the party on Saturday, to enjoy myself and just feel how good it is to not go home because you’ve had a panic attack. Something I have to stop, if I stop that, there will be little to feed the depression, so my self-harm should get better.

As always, thanks for reading!

Liam

CBT: Ninth Session

This session, again, was the best session I’ve ever had. It’s making me feel so good how each session is just getting better and better! I’m thinking back to my first few sessions with my previous therapist, I liked the sessions and learned a lot about myself and my mental health, but I just think they didn’t help much as it takes me a while to open up in a session, and I’m so happy I’m having longer sessions now!

I had a mini panic attack out of the blue today just before this session, didn’t really know why up until I had the session, funnily enough, the session was solely about panic attacks and how they work, how they get triggered, and what I can do to stop them/control them!

As usual, it started out with doing a questionnaire. I then told her how bad I felt last weekend, solely because I got invited out for a few drinks but I kept overthinking it and said no, and it made me feel so down and depressed. She then went on to explain how it’s a vicious cycle. Being invited to go out, end up saying no and then feeling low and then the self-inflicting behaviours start, but she reassured me that we can break that vicious cycle.

We talked about the symptoms I get from panic attacks, she wrote them down (legs shake, uncontrollable breathing, churning stomach and light-headedness) She then explained how thinking about those symptoms or panic, can actually cause you to panic, I thought that was pretty unbelievable, so she told me to say those symptoms out loud until I felt those symptoms, it actually happened. Me thinking and saying the symptoms out loud, actually brought on the symptoms, something I’ve never heard of/thought of before. She wants me to try and socialise more, and if I feel a panic attack coming on, don’t leave situations like I normally would, and try to ride the panic attack out and see how good I’d feel then – as I feel awful going home from somewhere early as I had a panic attack.

My therapist also explained about the trigger of panic attacks – fast breathing. If you are able to control your breathing, you can stop the panic happening. She then told me to start breathing really heavy, as I would if I was panicking. I did it, and it caused a panic attack, and she was able to calm me down out of it within minutes. That was just to teach me the trigger of panic attacks and also teach me that they are not dangerous or bad. We went through Diaphragmatic breathing, and she showed me how to do it, I have to practice it every single day now. I have tried doing it before, but when I went bad in terms of mental health, I just stopped as I had no motivation what so ever.

This was my last session for two weeks. I am motivated to do well in between those two weeks. It scares me as whenever I have no CBT for a week, I tend to go downhill a bit, but I am determined to not go down and just keep going up!

As always, thanks for reading!

Liam

 

CBT: Eighth Session

I was going into this session with a bag load of nerves, anxiety and panic. I was panicking for this session as I had to tell my therapist something pretty serious which happened within the week of having no CBT. Luckily enough I could actually tell her, sometimes when I want to say things, they just don’t come out, but they did today!

As usual, I filled out a PHQ-9 GAD-7 questionnaire but didn’t get told if my scores were higher, the same or lower. It was hard for me to truly say everything, but I did and it made me feel so much better getting it off my chest. We then spoke about how I went out to Liverpool, and that I panicked when out, and how it stops me from going out again.

We started on this formulation sheet, that spoke about my experience of bullying in high school, which makes me think that everyone is thinking horrible things about me, so anxiety is basically being the bully now. We figured out that my core belief is that people will think I’m “weird” “not normal” and “strange” which I worry about people thinking on a day to day basis, and it makes me panic when I see people staring at me, as I immediately think that they are thinking that.

I also found out my unhelpful thinking habits, I got told to have a read over them within the week without CBT, and I related to “emotional reasoning” “judgments” “mind-reading” “prediction” and “critical self” These are important to find out, as once you’ve found out you can then focus on beating the thinking habits! She also wants me to start exposure therapy again after a few more CBT sessions, but she wants it to be more intense, like in my previous exposure therapy, I just left after doing it for like 5 minutes at a time, she wants me to do it until I have a panic attack, and that panic attack ends. Which is scary!

I got shown a “thought record” which she wants me to fill out, especially when I go out. It has columns of “emotions/moods” “physical sensations” “unhelpful thoughts/images” This will give her a wider view of what I feel like when I go out. Pretty similar to a panic diary, same layout just different columns!

I spoke with her about how I rarely go out because of the chance of anxiety taking over and then making me panic, and therefore going home early. We both know my mental health is ruling my life, but the session was so good and informative, I came out of it with such a big smile on my face, knowing that I have learnt so much about my mental health in one hour session means a lot as it’s stuff I 100% know and I 100% know I can beat!

After that session, I felt the best I have felt in months. It felt so good, to come out of a session not drained, and feeling happy! On to the next one next week!

As always, thanks for reading!

Liam

CBT: Seventh Session

I could not help but dread this session, new place to go, new therapist to meet. So much to worry and overthink about. I was worrying that my therapist wouldn’t be as nice as my previous one, or as understanding. Turns out she was just as good!

This session was basically a duplicate of my first ever CBT session really, so this post will probably be very short! We first started off with the usual GAD-7 PHQ-9 forms and asked my about my medication, told her that I had side effects but they are slowly easing off, she asked me the questions and I answered, and she asked why and such, just so she could get more details, as she was writing notes on me.

I told her absolutely everything, even things that I didn’t tell my other therapist. I was shocked I was able to! Things like past experiences of bullying in high school, such as comments about my appearance and my speech, which she thinks is a trigger for my MH as I always think back to that, and feel that everyone will say stuff like people did in the past. I also explained to her how I feel on the way I look, and she said she thinks I  have BDD (body dysmorphic disorder) which could be a big part of my anxiety. Finding that out was very overwhelming. I could have cried, I was really close to doing so. She gave me some information on what it was, and a website called www.bddfoundation.org to have a look at.

She then mentioned that it will be a hard road to recovery for me, but it will work! She did mention that it’ll get worse before it gets better and because of my SH, she is going to take things carefully, which I totally appreciate. I was so scared, and I even told her. It was so hard for me to go into a new place and go to a new therapist, and she totally understood! She gave me a sheet of unhelpful thinking habits and wants me to look through them and tell her which ones I feel like I do, such as “mind reading” as I assume people are going to think I look weird because I feel like I’m too thin and look too thin, which links into BDD and such. Also “catastrophizing” as I imagine/believe the worst will happen in every situation,  which I actually went through with my previous therapist!

I haven’t got CBT next week, which might be a bit offputting for me as I’m in a routine now of going to CBT every Wednesday. Coming out of the session I had yesterday, I felt overwhelmed, but after a few hours of trying to get my head around the session and BDD, I can’t feel demotivated. I will beat this mental health, I will learn to manage it.

 

As always, thanks for reading!

Liam

CBT: Sixth Session

Prior to this session, I had a GP appointment and got prescribed fluoxetine/Prozac. The doctor said it should help my depression and anxiety, and also make CBT work better, or at least help. It’ll take four to six weeks to actually start to work which sucks, but every anti-depressant is the same I think.

This was the dreaded sixth session, the reason I was dreading it was all because three weeks ago my therapist mentioned that I’d only have 6 sessions, 8 at a push. So I knew this session would be a big one, but I didn’t know what would actually happen.

So, we just got talking about my GP appointment and my feelings of being put on medication and finding a perfect time of the day to take it, which is 3 pm! My therapist then told me to fill out the usual GAD-7 PHQ-9 sheet. My scores were the same, can’t remember exactly but they were 1 or 2 off the highest on both parts.

She then mentions that she has been thinking about this session throughout the week, and that she thinks I need extra support, and that she thinks I should have more CBT, but hourly sessions, I was truly happy, but then I found out it wasn’t with her. I told her how hard it would be for me to just all of a sudden move to a new therapist in a new clinic at the same time of starting medication. She totally understood that it was bad timing, she then found out that the waiting list has literally four people on it, including me. Meaning that I will not have a week or more, without CBT. I literally have the appointment next week, all because my therapist works absolute wonders.

I don’t know what I feel about changing therapists and changing clinics too. I would have felt better if I was in the same clinic, as it’s like a routine for me to go every Wednesday, and she totally understood, she knew it’d be hard, but if she did give me the two extra sessions just to get me ready to move, the waiting list could be longer, so it might be a sudden change, but it’s the best time as I don’t have to wait on another waiting list.

She also told me to not worry and gave me a number to ring if anything goes wrong in terms of if my therapist isn’t doing a good job, it’s going to be so hard for me to open up to some complete stranger, I know my therapist was a stranger to me, but it took me weeks to actually trust her, and now I’ve just been moved on? I was really annoyed, but then I realised it’s for my own good, hour-long sessions would be really good for me as I find it hard to go through everything in thirty minutes.

Here’s me hoping and praying that my new therapist is just as kind and good as my previous one.

CBT: Fifth Session

// TRIGGER WARNING: SH //

As you may have seen on my twitter, I’ve had a bad few days, the worst I’ve ever been. I decided, yesterday to text my therapist just so she asks me and then I can’t avoid telling her what I’ve done. So the past few days, I’ve started self-harming again, it sucks and I’m so happy I actually told my therapist today.

This wasn’t a usual CBT session, solely down to what I have done, this was literally just a conversation about what I’ve done, and what needs to be done. She decided that I should be on medication, or at least try it. She immediately told me she will phone my doctor as soon as my appointment finishes, and get me an appointment, she was brilliant. As I was on the bus, I got a confirmation text for the appointment, how fast!

She was so understanding, I found it awfully hard to tell her what I did, and why I did it. But she just let me talk, she knew I had more to say, but I said as much as I could in this session, and she totally understood. I am feeling a bit better after actually telling her, it sucks that I have to go through this but I will get through this, it’s just a mere blip and it’ll get better. She gave me booklets on SH and distractions to stop SH and a booklet all about anti-depressants. She also mentioned an SH group talking thing which is every Friday, I’m still a bit unsure about that, but she gave me the contact details just in case.

So, hopefully, next week will be a better week, GP appointment and CBT next week on the same day! Hoping that will be a good day, and I hope I get something out of it, to help this annoying thing.

Sorry for such a short post, but we didn’t go over anything to do with CBT, no exposure, no panic, it was merely just me talking about the last few days, which honestly, I needed to do.

As always, thanks for reading!

Liam

CBT: Fourth session

This post should have been posted this Wednesday, but I’m a bit behind… but I have no CBT next week so it should all even itself out!

This session was my first session after attempting to do exposure therapy, I didn’t do it very well, I was told to do 4 days of it, I only managed to do one. It was such a hard, big jump.I didn’t learn anything new this session, which felt weird, but it was good not to. We just went over how exposure therapy went, and what we could do to change that, and went over why it didn’t go to plan. As usual, I did fill out a PHQ-9 and GAD-7 form, like every single session. Depression went up, Anxiety went up. Not good.

Exposure therapy, and how the first week went.

This was the main topic of the session today. I was open about what I did, and I wasn’t going to hide from it. I didn’t do well in terms of what I should have done, but my therapist was still happy that I even did one day, to be honest, it is a step in the right direction, even though it’s a tiny step. As I explained in my blog post I did about my third session, which you can find here. I was planning on going the shops as a start of my exposure therapy. I told my therapist about how little exposure I did, and we discussed and came to a conclusion, that it was too big of a step, and it gave me more anxiety than I thought it would.

So, this week I am going to not go the shop, but walk to the shop, every other day for two weeks. Since my therapist is in training next week, I will not see her until the 15th, so this gives me time to get up the courage to do it. I’ll try my best.

We also talked about what happens after my 6th session, which has made me worry a lot, you’d probably know how much I’ve been worrying if you see my tweets from the past few days. I don’t think they will let me leave if I’m still struggling with my mental health, so I’ll cross that bridge when I get to it.

 

As always, thanks for reading!

Liam

 

 

CBT: Third session.

This was a big, deep session, I was very anxious over it. We went through mainly exposure therapy, and how I am going to do it when I’m at home, planning what days to do it on, and what time.

I learned a lot this session, mostly about how exposure therapy works ( I thought I got thrown in the deep end) but it’s actually worked as doing something that gives you 40% or such anxiety and doing that multiple times a week, for example, going the shop. We went over a lot this session, the avoidance hierarchy was the thing we went into a lot of detail, as you plan the exposure therapy around that.

Avoidance hierarchy:

This was something very new to me, even with my research of CBT, I didn’t know what this was at all. Avoidance hierarchy is a ladder, where you put on each step a situation and then a percentage of anxiety, on mine, the first step is to go to my local shop at midday when it’s not as busy. The highest is talking to a total stranger at any time, which is 100% This links into exposure therapy because this is virtually the backbone of it, you plan from the ladder of avoidance.

My first week of exposure therapy will consist of me going to the shop, four times. This will help as I am putting myself in a situation which makes me panic, but doing it multiple times in one week, my anxiety should go lower in that situation at the end of the week, well I hope so.

Conditions:

I also had to go over these, it’s important to follow conditions as exposure therapy might not be as effective. The first condition is for it to be Graded, basically doing it from the avoidance hierarchy ladder, starting at the bottom working your way up at a steady pace. The second condition is prolonged, you’re meant to stay in the situation that causes anxiety until it drops by 50%. The third condition is that it has to be repeated, me and my therapist has said minimum 3 times a week, ideally every other day. The repeated part is very important as your anxiety in that situation goes down after each day of doing it. The last condition is doing it without distraction. Naturally, you can do things to distract you from your anxiety, for example, I use my phone when I’m anxious and I don’t give eye contact.

 

Sorry for the lack of posts recently, I’ve been recovering from eye surgery, slowly but surely getting better!

As always, thanks for reading!

Liam

CBT: Second session.

I had my second session of CBT therapy today, it went better than last session. We didn’t really cover much more other than going into more detail about panic attacks and then going on about exposure therapy (which scares the heck out of me!)

Vicious cycle of panic:

This was the first thing we went through today, it’s basically a cycle of what happens when you panic, it goes trigger – thoughts/images – feelings – thoughts/images – behavior then repeats as the panic attack goes on. I related to this a lot as this is basically what happens to me. She also spoke about like me worrying about being in a panic attack, like I always think I’m going to throw up and I hate throwing up, but she went over how I’ve had a lot of panic attacks but only threw up once.

Positive self-statements

My therapist noticed my struggle with filling out some parts of my panic diary, especially the “answer to negative thought” column, but she said that was totally normal as I never really know what to say about my anxiety and panic attacks, so she gave me a list of stuff to say to myself, there’s preparation statements like “I might enjoy it if I go” “It’s not going to be as bad as I think”

Exposure therapy

We didn’t go through this in much detail, just because my therapist didn’t want me to worry about it. (too late!) She basically only said that it was happening next week, so stupid me researched it and made myself worry even more

 

Only a short blog post this one, sorry! I think the next session will make a long blog post… hopefully!

As always, thanks for reading!

Liam