Wednesday

Therapy Diaries // CBT Session 2

In my first therapy diary post, I explained how I felt really miserable after coming out of my first session. Luckily, the second session was much more positive!

The Forms
The first thing we did was fill in another one of those forms. I think I pretty much have to accept that I'm going to complete one every week. At least it seems like a good way to track my progress. The frustrating thing is that it's split into two sections- one for depression and one for generalised anxiety disorder- and many of the symptoms apply to both. So, for example, I lose my appetite and have trouble sleeping when my anxiety's bad but, because this is on the depression part of the form, I end up scoring moderately high for depression. I can 100% say I am not depressed although on paper it looks as if I am. Although it's frustrating, my score for anxiety is so high (as in, the maximum) that my therapist isn't paying much attention to the depression scores. 

After filling in the form, she gave me last week's to compare and was very confused because, although I'd told her I'd had a worse week, the previous form indicated that I was much better. When I looked at it, I realised that she had handed me a form belonging to- and named with- a different patient. Can't say that really set my mind at ease!

The Analysis
In a funny way, things worked out pretty well for this first real session. Earlier in the week, I'd had a horrendous day of panic attacks and had needed to take a couple of days of work to recover. Although this was horrible for me, of course, it meant that we had a very current situation to analyse.

My therapist produced this sheet of the Padesky 5 aspects model and we began filling it in together. The Situation box involved filling out exactly what happened with the facts- where, when, who with etc. That led into my thoughts but it's important to distinguish this from feelings, which comes next. When I was completing these two boxes, she really pushed me to delve deeper with questions such as "and what would that say about you?" In the end, we reached a breakthrough as I reached "that I'm not good enough". As my problems stem from perfectionism, she said that we'll probably find this is the root cause of most panic attacks. Finally we discussed the physical sensations and behaviours- what I actually did (Sit down, cry and go back to bed). 

Once the whole form was complete, we looked at it together and she encouraged me to find links within the boxes. I discovered that the thoughts I have "I'm not good enough. I'm going to let people down. I'm going to fail" lead to my feelings of being flustered and frustrated at myself, which further exacerbate the negative thoughts. This leads into a downwards spiral into the physical symptoms of a panic attack and all three- thoughts, feelings and sensations- contribute to my behaviours. 

This was a complete revelation for me! When I first saw the 5 aspects model, I thought it would be impossible to separate the big ball of panic into these separate elements but, once I had, it became very clear where my problems are.

The Goals
When I'd reached this point of enlightenment, my therapist asked me to look at the sheet and explain what I would change if I had a magic wand. I said I would make the thoughts more balanced to prevent the thoughts/emotions cycle as I figured I can't change situations but I can change the way I view them. Apparently this is spot on and she explained that we will work to change my thoughts so they're more like "This might happen but that's ok because..." rather than "This might happen and it's going to be a complete disaster".

She then told me that the other area we'll work on is behaviours and suggested we start here as it's easier: Even though I have the scary thoughts and the mental/physical symptoms of a panic attack, I need to push through and do the scary things.

At this point, we made a list of everything that scares me and hopefully I'll be able to do some of those things (such as watch Edward Scissorhands without fear) before too long. 

Homework
After a quick review of the session, in which she asked me what I'd learned, she asked me to keep a panic diary over the week. Essentially, every time I get panicky, I fill out another of the 5 aspects models to break it down. 

This week, I'm actually feeling really positive. I think I can see how it will help. My only concern is that I now have 6 weeks left and that doesn't seem like long enough to achieve anything long term. We'll see though! 


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If this post has interested you, you can read my previous post in the series below. Please do share with anybody who it may help as, from my experience, it's very scary to start talking therapies with no knowledge of what to expect.

Previous posts:

11 comments :

  1. I've had a form of CBT/talking therapy, and when I was going through treatment, I was so ill that I didn't want help so kinda pretended to be getting better so I could be discharged (stupid move). However, I must have learned some tools along the way because I never went back to therapy but DID recover on my own. And, I think that's the main idea - it's a short time frame but if you manage to learn how to challenge things yourself, you can continue to recover long after therapy has ended xx
    Sam | Samantha Betteridge

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  2. This is a great post. I had a long course of CBT last year, and have since moved onto Art Therapy. I was considering doing a post about my Art Therapy experience, and I think reading this has given me the push to do it. I found my CBT really useful, and have since gone to rugby matches and to shows with large crowds without panicking TOO much, because of the way I think now. I wish you the very best of luck with your CBT xx

    http://whatlaurendidtoday.blogspot.co.uk/

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  3. Becky this is so incredibly lovely of you to share. It can be a really horrible feeling having no idea what you are going into and I think posts like this would be super helpful for other people considering taking the first step into therapy. Hope you continue to find these times useful lovely. x

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  4. I had a session of CBT towards the end of last year and it seems like we had a similar first experience of our first sessions! Unfortunately for me I was so disheartened by it all I never went to any of my other appointments, but after reading this I kind of wish I had :) Looking forward to reading about your other sessions to see if it's worth me going back :) Good luck!

    Bethan | Thought from Beth x

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  5. Glad to hear your second session went a lot better! I can relate to the first session you had and I didn't find them that helpful in the end. I'm now seeing my university counsellor for talking therapy and after two sessions I feel like progress has already been made as she digs a little deeper than the NHS CBT therapists I had (surprisingly she got me to open up) :) All the best! We can both get through this! x

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  6. I'm really pleased to hear things were a bit better for you. I've done CBT, and I'm amazed at how well the skills kick in if I'm really anxious and starting to panic. Things like the restaurant I chose not being very good -> all my friends will hate me - whereas now I tell myself 'no, they won't hate you. They might be mildly disappointed but they are your friends and they won't hate you', and things like that. It's like I have a little therapist sitting in my head!

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  7. When I had my second set of cbt sessions my counselor also used those sheets and they just didn't work for me at all. I constantly worry, so when she asked for an event I would be like 'errrr everyday?' i had to force events on to the paper but i already knew in my head that they wasn't bad. I don't have panic attacks though, I just worry... I don't really know whats going on to be honest but luckily im seeing someone else about it on Friday. I'm glad to hear it's going well compared to the first session! I think I would've cried if she carried on that way haha. x

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  8. Becky I am so glad you are posting about CBT! I am waiting on my letter coming through the door and I am really nervous about it. Thank you for being so honest in these two posts, they have given me an insight into CBT and what to expect when I go for my first few sessions. I will continue to read your CBT posts as long as you write them! I hope they help you and I hope I can get better too!

    Emma | The Fashion Six

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  9. Really proud of you boo. If you need me to come and watch Edward Scissorhands with you then I am more than happy too! <3 xx

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  10. I find this really interesting. I have ME/CFS and everyone seems to be in panic mode because I'm NOT depressed. Apparently after 12 years of it and a year of barely leaving the house (other than to go to hospital appointments), I should've lost it by now. We're at our wits end on how to get me better (more energy, less pain and up and walking again) and the doctor and specialist have come up with some ideas including a clinical psychologist. Now I thought it was crap, because I don't see how talking will help a physical illness/disability, especially as I've seen them years ago and they got me to fill in lots of silly forms. I hate goals and aims and all that crap, I'm just not a 'list' type of person. I see it as wasting what little energy I may have. However they feel that my coping mechanism of stopping me getting depressed is actually hindering me getting better. I automatically took the hump as them saying it's all in my head. However I feel I have to try it purely to look like I am willing to get help, even if I don't believe it will help. The doctor said he'd tell them what I'm like though and that I always try and guess what they want me to put and why they want me to put it. I just know that if they give me "on a scale of 1-10..." questions I'll be telling everyone "I told you so"!! Though from what you're saying, I'll probably have to prepare myself for that because it sounds very likely!! x

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  11. Glad the second one went well! I know it doesn't seem like many sessions but if it's going to work for you usually six sessions is sufficient, up to eight if the case is severe (that's what my counselling was like anyway) but it can take time after you've completed all the sessions to absorb it all properly and to notice a real difference, it took me a couple of weeks, so don't worry about that bit yet :)

    I had to fill in a form every time, not sure how accurate they always were. Things you've said are things I learnt in my counselling too, and it helped me :) xo

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