Posted by dirkgently1066
24th Jul 2016

Following my second session of CBT, a chance to take stock what what I have learned and what I hope to achieve.

Firstly though, letís address a couple of important issues.

*What Is CBT?*
Cognitive Behavioural Therapy is a treatment designed to address the thoughts and feelings that drive our behaviours. It works on the basis that if we can change how we think and feel about a situation or an event, then we can change our behaviour accordingly, which each being intertwined.

For depression and anxiety, this means addressing deeply held belief systems and tackling negative automatic thoughts to see things with a more balanced perspective.

*The Difference Between Counselling and CBT*
Both can be useful treatments and indeed I have benefitted from the services of each.

In short, counselling is a talking therapy that offers a chance to find support and share problems with a skilled listener who can offer some direction in resolving problems.

CBT on the other hand is a targeted form of therapy used to tackle more deep rooted issues where simply unburdening oneself of the problem is insufficient. By seeking to understand, address and change thoughts, feelings and behaviours, the patient is challenged to take control of their recovery, effectively becoming their own therapist as they develop the coping skills needed.

*Whatís The Problem?*
As I have detailed extensively, my mental health issues relate to depression and anxiety. As my sense of being unable to cope winds up, so my mood winds down, a tag team of torment.

Whilst I had a broad understanding of where the underlying causes of my symptoms lay, the reasons are myriad and require some untangling. Primarily my issues relate to confidence and self esteem, or rather the absence thereof. A deeply held sense of inadequacy permeates my thoughts, in turn fueling my feelings and as a consequence directing my actions.

Week one focused primarily on work and my relationships within. Three years on, there remains a a looming shadow of my redundancy, a monkey that I have been unable to shake from my back. The loss of status, responsibility and familiarity continues to weigh heavily upon me. Despite making new friends and acquaintances, I retain a sense of being on the outside looking in. My world feels inherently smaller than it was. I lack the confidence to act in a way I consider true to myself, instead reigning myself in. I want more but when presented with an opportunity to do so, was so overwhelmed that I was forced to retreat, further reinforcing the sense that I am not capable. I wonder why I am less than I was before and how I could ever hope to get back there.

Week two turned towards family. Having children (not to mention being married to the most beautiful woman in the world) is undoubtedly a blessing and yet I must also acknowledge that my children are the single biggest source of my anxiety. I feel tired and quick to lose my temper, constantly questioning my conduct and abilities as a father and husband. I look to my brother, so full of energy and fun and wonder why I am not able to embrace parenthood in the same way.

*Thought Record*
As CBT focuses on thoughts, part of my Ďhomeworkí has been completing a Thought Record. These are designed to help you recognise negative automatic thoughts, those skewed, unbalanced thoughts that pop into your head uninvited, and learn to challenge them.

It is worth remembering that thoughts are very much like clouds that drift into our minds and can drift back out again just as quickly. A thought or feeling, however intense within the moment, can be gone the next. This is not to undermine their importance, rather to draw attention to the fact that all things pass.

With that said, letís take a look at an example in more detail, which expands on the work related anxieties I touched on above. Each thought is graded from 1(lowest) to 10 (highest) based on how much you believe the thought to be true. Within the moment, I began to feel isolated from the team, which served to reinforce the underlying belief, borne out of a lack of self esteem, that I was not truly valued and that it would not matter if I wasnít there. At a score of 10, within the moment I believed this thought intensely, which made me feel incredibly sad, a recurring theme that I will come back to.

But letís look at this though a different lense, challenge the thought. When I choose to engage, my involvement is valued. I have made friends and built relationships within the team. Do I feel isolated because I have been left out or because I am excluding myself? Sure, my desk position is physically on the periphery of the team but if I am honest with myself, more often than not I choose to remain apart for a variety of complex reasons, not least of which is a sense that I cannot truly be myself. I stand on the periphery, waiting outside the metaphorical open door to be called in, becoming disillusioned at not receiving the call, failing to understand that those already inside are simply waiting for me to enter. An alternative therefore is to engage more, to involve myself more and see what happens. Take some risks perhaps and see how I feel. It isnít enough for me to fully believe it yet, hence a sadness rating of 8, but it is something to work with.

This past week, I was taken aback when my therapist suggested that I was happy in my current job. My immediate reaction was, ĎMe? Happy? How very dare you.í But perhaps it is fair to say that, whilst Iím not yet where I want to be, I am where I need to be, at least for now.

*I Got A Feeling*
Over the last few weeks, my primary emotion has been one of sadness. It sits there, sometimes flaring up but at other times just lurking in the background. There is a certain level of resentment that those around me do not know and do not understand. But then how can they? They cannot mind read and so unless I share, no one will know.

Additionally, I feel vulnerable. Partly that is of my own making. Posts such as this, openly sharing my thoughts and experiences, expose me in a way that most people would not contemplate. But that apart, I feel more emotionally fragile, I do not always know how to process or express the thoughts and feelings I experience.

In the first session, my therapist helped me to understand this is a consequence of my journey of recovery. I recognise now that I spent years suppressing or ignoring certain emotions. I played the fool, acted remote, pretended I didnít care. I was embarrassed to show emotions and laughed at those who did.
Now, I find I am a softer, kinder person. I feel empathy and compassion. I feel warmth and affection. I no longer feel a need to hide who I am and how I feel. I am coming to understand and embrace my emotions and I am ready to share them openly and honestly.

The principle point of these therapy sessions is to learn to be happy with the life I have chosen for myself. As was highlighted to me, it is folly to compare myself to others. To look at someone else and judge your own actions and worth by their standard is to cherry pick the parts of their life you envy whilst ignoring their very different circumstances.

*Yes, ButÖ*
Week 2 revealed overthinking to be one of my character traits, the Ďyes, butí reaction to any positive that sees me search out the negative.

I recognise that having three young children, including twins, is hard work and that as they get older, things will become easier. But then again, I worry that I am wishing the years away and that I will look back with regret at a period of their lives that I didnít take the time to properly enjoy.

My current work situation is undoubtedly improved from the previous one. I have limited stress, I leave the office on time, I donít work extra hours at home. But I am no longer a manager, I no longer have any serious responsibilities and as such, feel as though I have lost a part of my identity.

These are thinking errors. It is an immediate, automatic response that seeks to invalidate the good and focus on the bad. It is a voice that I am trying to learn how to block out. I am guilty of overthinking and over analysing. I must learn to calm my mind and that is best achieved withÖ

I used to write a lot about mindfulness. It was one of the central concepts I took away from the Priory and a bedrock of good mental health.

For those unfamiliar, mindfulness is the act of being in the present. Our minds often have a tendency to wander and whilst generally harmless, this can become an issue where your thoughts begin to dwell too much on the past (rumination, leading to depression) or the future (procrastination, leading to anxiety). Mindfulness therefore teaches us to recognise when the mind is drifting and to bring it back to the present moment, without judgement.

In a practical sense, it means that when I am with the children, just to concentrate on that. When all three of them want to play with me or sing songs or muck about, there is no value in worrying about the washing that needs folding, the grass that needs cutting or the tweet I havenít read. This thinking simply leads to resentment at precious time being lost whilst not focusing on the most important thing that is right in front of me. So instead I look to be mindful, to embrace what is happening within the moment, let the past stay where it belongs and let the future reveal itself as it will.

This week I will be trying an app with some built in techniques to help focus the mind but it is a skill that can be practised at any time.

*Still To Come*
In future sessions, I hope to address my inherent inferiority complex, my need to judge, rank and compare myself to others and my obsessive thinking. Plus, er, some other thing that Iíll keep to myself for now, ta.

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