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I was referred to CBT whilst pregnant as I was on Citalopram at the time. It's strange really, my doctor has never wanted to refer me to anywhere to talk about my issues, they just prescribed me this or that and hurried me out of their office. But as it turns out, these sessions have been more helpful than pills ever were.
In the same way, I always struggled with counselling in that sense. Yeah, it felt great to get all of these feelings off my chest but then once my counsellor determined I was "better" - then that was it. Goodbye Emily, have a nice life, next patient please.
I absolutely dreaded my counselling sessions because although it was good to talk, I always left feeling emotionally drained and so down. I figured that it was a laboured process, and you had to re-visit all of these bottled up feelings before you could be "better".
One day I went to my usual counselling session, in an upbeat mood. I didn't really have much to talk about. I felt good. Happy. So my therapist decided that her job was done. I was fixed and no longer needed weekly sessions. I had opened up to her about things I would never have dreamed to tell my closest friends and family, but was that really it? What if I suffered with SAD that year? Or I randomly had a panic attack? Or I (god forbid) had to deal with death again? Would I just magically be able to cope?
Cognitive Behavioural Therapy is different. One of the first things my therapist Abby said was - 'Your anxiety is never going to go away. But you can learn to accept it and just be with it". Abby teaches me to manage my anxiety by changing the way I think about my behaviour and consequently; the way that I behave.
Firstly, Abby is no typical counsellor. She is upbeat, quirky and actually used the term "just fuck off" in my second session. You can't help but feel positive when she's around. And I think that is so important - positive energy begets positive energy. Who's going to feel upbeat and positive around someone sat in a chair just staring at you with pity in their eyes, waiting for you to cry? (Yes, that happened).
During my first session, Abby spoke to me about my life. Just asking me very general questions as if she was a new friend over coffee getting to know me. Obviously, talk turned to Evie because lets face it, who wouldn't brag about that cheeky lil face at every opportunity?! We got talking about how her sleep was going and before I knew it, we were talking about my anxiety.
And it was as easy as that. No awkward staring, no probing. She managed to pick up on the anxiety I had when Evie went to sleep. I would lie in bed and wonder whether she'd somehow managed to smother herself, or randomly stopped breathing. Now, forgetting for a moment that I'm sure all mothers think this and that Evie literally doesn't move an inch in her sleep; this was really playing on my anxiety. I would lie there and chew it over and over, my breathing would become heavy and laboured and I would toss and turn. Eventually, I would have to get up and go check her. Once I was happy she was ok, I would get into bed and think 'ok what's next to get anxious about?'
Just from this one conversation, Abby taught me a technique to manage my breathing, body language recognition, a delay tactic and a way to understand how anxiety disorders work.
- The 'square breathing technique' regulates your breathing - a tool used during panic and anxiety attacks. It's basically breathe in for 4 seconds, hold for 4, out for 4 and hold for 4. I've had so many people tell me to focus on my breathing during an attack but come on, who actually does it when it comes down to it? Certainly not me. But counting whilst tapping in time to the counting, distracts me as my mind is focused on the tapping and the counting.
- Body language is just that. Body language. Whilst I was stressing trying to get Evie back to sleep for more than an hour at a time, I would unknowingly be tense, with my shoulders high and my jaw clenched. Just taking the time to stop and notice these things made me feel instantly a little calmer and subsequently, calmed Evie down.
- The delay tactic was to help with my OCD tendencies when it came to going in to check on Evie. As well as Evie, my anxiety causes me to get horrible, random thoughts about people I care about and I have to call them or text them to make sure they're ok. But by delaying the action on these thoughts, I'm training myself to resettle, much like I had to do while sleep training Evie. So now if one of these thoughts pops into my head, I wait 5 minutes and if I feel ok, I'll wait 10 minutes etc etc.
- Understanding anxiety disorders was a big one for me. Abby actually turned around and said that she often has crazy, irrational thoughts as well. And, shock horror, everyone does. She used the example of; 'I could just drop my baby down the stairs right now'. Someone without an anxiety disorder can have this thought - but they will then think, 'wow that was weird, what a random and horrible thought'. However someone with anxiety will think, 'why did I think that, it must mean something, I'm now going to drop my baby down the stairs, I must be insane'. It's about learning to think like person A and not like person Anxiety.
What I will say is, if you're struggling with anxiety, I really urge you to push your doctor to refer you for CBT. As far as I'm aware the waiting list for NHS funded CBT is quite long (I was prioritised as I was pregnant), but it is so worth it. I wasted so much time on Citalopram when I think I could have managed my symptoms much better with weekly sessions. Don't struggle in silence and feel free to email me if you have an questions!
e,x
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