Monday, 10 October 2016

World Mental Health Day - What is CBT?

What is CBT?

As is World Mental Health Day, I thought I'd write about Cognitive Behavioural Therapy - CBT. When I was first diagnosed with Anxiety and my GP recommended CBT, I didn't really have an idea what it was. Through talking with friends, I had an inkling that it had something to do with retraining your thoughts, but I didn't know how, nor did I know why. So, on the off chance there are others who will soon be starting CBT or know someone who will be, but don't know what it actually is, I thought I'd share some of what I've learnt.

I was on a 4-6 week Guided Self-Help CBT for anxiety and panic that ended up lasting four weeks. This is important to note, because CBT isn't just for anxiety; people with depression, for example, can also be put forward for CBT, but I don't quite know how it would work for other mental illnesses. Guided Self-Help means my therapist would explain things to me each week and guide me, ask specific questions to get me thinking about my anxiety and the situations I'm in when I'm panicking, and set me tasks and homework, but I did the work. It's important to realise that work is involved; your therapist can't wave a magic wand and fix things for you, and though talking therapy may be helpful to people in general, my form of CBT required me to do the work - I had to read, I had to fill in worksheets, I had to think about my anxiety and do certain tasks that felt uncomfortable at times, but in the long run were so helpful. You have to put in the work to start to get better.

CBT looks at how your thoughts can lead to certain actions. The example my therapist gave in my first session was someone hearing a noise in the middle of the night that work them up. A person with anxiety might think there is an intruder, and their reaction to this thought is to stay where they are, but be alert, listening out for any more noises, slowly working themselves up. A person without anxiety, however, might think the cat knocked something over, or it was just dishes clanking against each other in the dishwasher, and will then get up to check that everything is fine before going back to bed. It's your thoughts and the actions your thoughts leads to that leads that CBT aims to make a difference to, which will make anxiety easier to manage.

Through CBT, I learnt about what is actually happening in the body during a panic attack. I cannot begin to tell you how helpful it was to understand what the physical symptoms I experienced actually meant, each and every single one of them, and why they were happening. Understanding that my body was reacting in a way to best protect itself from a perceived threat made panic attacks less frightening. When I have a panic attack, my body is trying to look after itself, not trying to hurt me. Panic attacks are still scary and awful to experience, but understanding why my body was reacting the way it was made it easier to to bear.

CBT also looks at and explains panic cycles; how a trigger can lead to a physical sensation that causes you to feel anxious and panicky, which then leads to more physical sensations followed by "catastrophic thoughts", which increases the feelings of anxiety and panic, and on it goes. It also explained safety behaviours, actions you take in the moment that will alleviate your anxiety in the short term, end a panic attack quickly, but in general makes anxiety harder to manage. This is because it leads to the thought of, "If I don't do X, my anxiety will get worse, which will lead to Y." But by doing X you're not challenging the idea that Y will happen. It might, it might not. My therapist asked me questions, helping me work out my safety behaviours, and how they're actually unhelpful. My therapist explained to me that as I remove safety behaviours, and allow my panic attacks to continue, I will slowly learn that my Y doesn't happen, or if it does, it's not nearly as bad as I think it will be. Each time, you learn that your safety behaviours aren't as required, and your anxiety doesn't peak quite as high, slowly making the anxiety easier to manage.

I also learnt certain relaxation and breathing techniques to practise each day. These techniques should lower stress levels generally, and make feeling anxious and experiencing anxiety attacks less likely to happen. I didn't find these quite as helpful as everything else, but everyone is different.

This post is not going to help you manage your anxiety. I am not a therapist, I am not able to help you/your friend through a blog post. This is just an overview of my experience and what I learnt. Your/your friend's experience of CBT might be different, you/they might find that what helped me may not be what helps them. The work must be done between you/your friend and the therapist, who will go into much more depth on the things I've only just touched the surface on here. But now, hopefully, you have a better understanding of what CBT is, and more of an idea of what to expect. I hope you found this helpful.

CBT made such a difference to my life. I find it much easier to manage my anxiety now, and haven't had a panic attack in weeks. CBT has made me feel like my old self, and I feel free again.

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