Tuesday 18 October 2016

My Not-CBT Therapy Session

(Please see my blog posts entitled Let's Try This Again , and Let's Try This Again: Part Two to catch up, before reading this latest post).

So, the wait for therapy turned out to be much less than the 10 weeks I was told to expect! I was very surprised, but glad that I could be seen soon. I've been teetering on the edge of crisis, so have really needed help as soon as possible. The place, where I was to have therapy, was a little further away than I expected, but all slots had been filled in clinics nearer my home. Fortunately my dad could take me pretty much any time though; so getting there wasn't a problem.

I was dreading it on the day. I was under the impression (from the therapist on the phone) that I would be going through CBT yet again. This would be the 4th time, after 3 times with little or no improvement! Thankfully it turned out to be more of an assessment with a mental health nurse (who was also trained in various non-CBT based therapies). This session was very very different to what I expected, and the nurse seemed to pick up on a lot of things about me, when I spoke about various problems I have, things that've happened etc. He decided that CBT wasn't really the appropriate type of therapy for me, and that Interpersonal Therapy would suit me more. He's given me some information about this type of therapy, and I get to decide at the next session (31st October) whether I want to go ahead with it & continue with him as my therapist.

I wanted to talk about this appointment, and how I was feeling, as soon as I possibly could once I'd got back home. If you've read my Quick Announcement post, then you will know that I have now started vlogging about my chronic mental and physical illnesses. I decided to talk about this session in more detail by vlogging about it. The vlog is entitled First Therapy Session That Wasn't CBT!!! If you enjoy my vlogs, please share and subscribe!

I may write a short blog about my next therapy session, but want to vlog again to give more detail. I'd like this blog and my vlogs to complement each other, & I am hoping this works out well.

Thanks for reading, and please comment below if you have any suggestions!

Thursday 13 October 2016

Quick Announcement

This is just a short post, to let you know that I've now started vlogging! A friend suggested it to me recently and, after umming and ahhing for a while, I finally decided to give it a go. I might use it for little updates or to focus on one topic at a time, I haven't decided yet. I do want to try and post vlogs regularly though. Apart from lots of furbaby videos (and a few random ones) there's an Introduction Vlog on there for now. Go check it out, and subscribe to my Amzie Bear channel if you like it!

I will of course keep blogging here, so stay tuned!

Saturday 1 October 2016

Let's try this again: Part two

(TW: Mentions of suicide, self-harm, and abortion)

On Wednesday, I had my phone assessment with the Primary Care Mental Health team. I was really nervous on the day, and was watching the clock. The more I waited, the more nervous I got, and the more shaky I was when the call finally came. In order to prepare for my assessment, I'd gathered together all my paperwork from previous assessments and appointments. I wanted to be as prepared as possible so that I wouldn't miss anything out during the assessment. I completely overwhelmed myself, however.

Although I was extremely anxious when answering the phone, I was very glad to have the opportunity to be assessed again and talk through the things I'd been struggling with. The therapist began the assessment by asking me what sort of problems had brought me to contact mental health services this time. I found it hard to know where to start. I had so much going on in my head that I don't think I made much sense at first. I tried to prioritise the main things that I needed help with; which included how easily overwhelmed I was getting, things from the past that needed addressing, how my anxiety seemed to be worse, and the recent breakdown I had. I told him that I'd been through CBT a few times in the past and found that it didn't help much. I said that it didn't seem to fit my problems, as I wasn't able to talk about certain things in the past that affected how I am now. The therapist said that there were different types of CBT, and some did consider the past when attempting to help with the problems that the person has right now. He told me not to completely shut myself off from the idea of CBT. I reluctantly said that I would keep an open mind, but that other therapies that have been suggested to me by my last therapist and my psychiatrist were EMDR and Psychodynamic therapy. This therapist said to me that there were other therapies we could consider if I found that CBT still wasn't working for me. One therapy he mentioned was a person-centred one. He gave a brief description of what that therapy entailed, and said that this would include going through things in the past and discussing how they affected how I see the world now. I said that this sounded like the type of therapy that may suit me a little more.

He wanted to know how long I'd had symptoms of Anxiety, Depression, and OCD. He also wanted to know the obsessions and compulsions I had now and in the past. Although I was diagnosed as an adult, I'd realised that I'd had symptoms pretty much since the start of primary school. He asked (sensitively of course) what I thought had led to this. Although I struggled a lot, and was in tears for most of it, I just about managed to tell him about the bullying, and the termination I had during my first year of university. He was very patient, understanding, and non-judgmental. He gave me time to talk about what I needed to, and was kind when my mind would go blank & it took me a while to remember what I wanted to say. After this, he gave me a brief analysis of what he thought were my main things that I needed help with.

Next came the necessary, but frustrating part of the assessment; the questionnaires. He admitted that he hated them too. I guess they have to quantify some things, to see how severely a client is affected by their mental health problems. It's just such a restrictive set of questionnaires/ I may meet the criteria for Anxiety and Depression, but if there are any other mental health problems, that could be identified by asking other questions, I don't have that access to those questions.

I may have described these questionnaires before, but the first one I had was the PHQ-9 . This is to test for Depression, and the severity of it. For each question, there is a score between 0 and 3. 0 means "not at all" and 3 means "nearly every day". When responding, you focus on how often you've been experiencing (the things stated in the question) in the last two weeks.

For this questionnaire, you have a score out of 27. My score was 24; which places me in the severe category. The therapist also had to assess my risk of attempting suicide. I told him that although I frequently had thoughts, and sometimes strong urges, I'm unlikely to actively plan or carry them out because of my cat and my parents. I forgot to mention about my regular self-harming, but I guess this is something I can talk about during therapy sessions.

The second questionnaire was the GAD-7 . This tests for Generalised Anxiety Disorder and the severity of it. Similarly to the PHQ-9, there is a score between 0 and 3 for each question. Again, 0 means "not at all" and 3 means "nearly every day", and you are asked to consider how you've felt in the last two weeks.

For this questionnaire, you have a score out of 21. My score was 18; which places me in the severe category.

The third questionnaire focused on phobias. For each types of phobias described, you give a score between 0 and 8 to state to what extent you would avoid various situations because of it. A lot of my fears involve loss of control; for example, losing control of my bladder in a public place, having a panic attack etc. 0 means you wouldn't avoid the situation, 8 means you would always avoid that situation based on the phobias mentioned.

Once these had been completed, the therapist discussed with me what the next steps would be. He said that he believed I should give CBT another go, at least to tackle my symptoms of OCD. He did say that I could have person-centred therapy instead, if I still find the CBT unhelpful. I reluctantly agreed to this. At least I can have access to other therapies, instead of it being CBT or nothing. He said the wait is likely to be around 10 weeks, as the waiting list is long. I knew to expect this anyway. Before we ended the call, he made sure that I knew who to contact if I do become actively suicidal. These were the Out of Hours team, and Samaritans.

 I do feel a little more hopeful about this mental health team, but we'll have to see how therapy goes.