Wednesday 11 June 2014

And breathe...

I have about three blog posts worth of things I want to talk about, and I'm not going to be writing them in any particular order. I was tempted to write them all this week, but I think that may be a *teensy* bit ambitious :)

I think I may have talked about my first session of High Intensity CBT and since then, I've had another two sessions. If I remember correctly, the therapist said that I will have 10 sessions altogether? This is a little better than the 6 guided CBT (level 2) sessions, and I'm hoping that I can make some progress now.

Although there's bound to be some digression, I do like how these sessions appear to have a bit more structure to them. I now have a Therapy Contract and Care Plan; something I didn't have before. In it, my long term goals are:

1) To go out e.g. to town and visit friends.
2) To seek support from others when I experience thoughts of self-harm/suicide.

I would like to make "getting back into employment" a long term goal, but that's dependent upon my physical health as well. Although I'm sure the DWP would disagree, it's also a bit too ambitious right now. Generally, I'd like to be better at seeking support instead of shutting myself away, and I'd also like to be able to get out of the house (for something other than an appointment) more often. To me, those seem like realistic and fairly focused goals. There are other little bulletpoints in this plan, which are more general. These include working with the therapist to ensure the treatment is tailored to my needs (well, as much as CBT can be I guess), being given choice in my treatment, making sure the therapist takes into consideration things such as disability and religion (when suggesting treatments), keeping each other informed of things such as cancellations etc and attending every session if I'm able to.

So far, the main focus seems to be upon the Depression. I have far too many complications when it comes to the Anxiety, so I'm not sure if we'll even have time to begin to try anything for it. At each session, we have to talk about my suicidal ideations. I still find it very hard to open up or even properly understand what goes through my head when I have these thoughts. I may be fairly open, speaking about them on this blog and social media, but I don't like talking about them with someone directly. My therapist is keeping in contact with the crisis team, but I've not been referred again. At our last session, I said that I feel I'd be wasting their time, as I've not got any solid plans and I haven't attempted suicide. I have to just say whether I believe I'm at risk or not. I think she is reassured enough for now.

It was nice to get away from that subject for the majority of the last session. She said that she wanted us to try Mindfulness this time.

The therapist asked me to close my eyes, try and relax and concentrate on my breathing. Then, I was to focus on the things I could hear around me, what I could feel physically (the back of the chair against me, any aches, pains or stiffness etc). I also had to place my hand on my thigh and, as I concentrate on my thoughts, point to the left of my thigh to indicate a past thought, the middle for a present thought and the right for a future thought. I could open my eyes at points when I needed to (I did get very dizzy and thought I was going to fall off the chair quite a few times!). Once I'd finished this, she asked me to look round the room slowly, to bring my focus back, and then talk through my thoughts, feelings and anything I noticed.

I told her that I found it very hard to relax and I my thoughts did tend to change from one to the other, to the other, very quickly. I also got distracted very easily (there was a baby crying and some people having a loud conversation in the waiting room). When asking to concentrate on my thoughts, I often found that I wasn't completely sure of what I 'was' thinking. I'm sure it's impossible to be thinking absolutely nothing, but maybe most of the time (unless a very vivid idea occurs) our thoughts are mainly subconscious? Don't quote me on that, this is just me trying to understand it all! I didn't say this to her exactly, but I get a lot of muscle twitches with the Fibromyalgia, so I don't think I can ever sit completely still. The pain makes me tense up as well; which can't help the twitches much. Because of this, I feel very self conscious about closing my eyes and trying to sit still, while someone is watching me. What I did tell her was that I felt a bit silly about it.

She wants me to try and practise Mindfulness every day (even if just for 5 minutes). According to some research she found (I can't remember the title of the study, otherwise I'd search it out myself), it is supposed to be helpful for Depression, fatigue and chronic pain. I am definitely going to try and do this; although I think it might prove difficult at first. I'll of course blog about how I go, whether it helps any of the symptoms etc. It was nice to do something a bit different this time though.

In my next blog posts, I hope to keep you updated as to what I've been up to recently (appointments and otherwise) as well as more thoughts on the Work Programme, ESA assessments etc.

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