Friday 2 February 2018

CBT for Anxiety Session 2 - My Past

(TW: mentions of self harm, suicide, sexual abuse, psychological abuse, and diet)

I'd had a bad couple of weeks between session 1 and session 2 of CBT. I did, however, manage to do the homework my therapist set for me. This was to read and print off a booklet about Panic as well as doing an anxiety based thought record. I filled in quite a few entries for this record, so had a lot to talk about with the therapist. I also wanted to monitor my mood swings in order to help with filling in the questionnaires at the start of session 2 (as well as for my own benefit). One of my best friends suggested this and I found it a very helpful idea.

I used a mood diary template; where I recorded levels (from 1-10) of stress, mood, energy, and how many hours I'd slept. I also commented on my moods and things that had happened that day. I found that I had to add at least 2 or 3 entries for these topics throughout the day (except hours slept of course) as my moods changed. I found my moods changed rapidly and extremely in response to things that happened. I had a couple of days, for instance, where I had read too much into some things and got it into my head that some friends had got fed up of me. This resulted in me feeling very paranoid, angry, upset, and anxious to the point that friends noticed and reassured me. Reassurance helped my mood a bit, but did not completely alleviate those thoughts and feelings.

Moving on to my therapy session, I was a few minutes late but the therapist didn't seem to mind. Once we'd sat down, she gave me the usual questionnaires (see my previous post) as well as a Risk Assessment questionnaire. This yes/no questionnaire asked about suicidal and self harm thoughts, as well as plans and attempts. I did answer yes to some of these, so my therapist wanted to talk about this first. We moved on, once she was sure that I wasn't currently planning to end my life.

We next talked about the thoughts I have about myself, my family, strangers, and going outside. This brought us to various things that had happened in my past, and how they affected my thoughts, feelings, and behaviour nowadays.

Two particular things that were major factors in my mental illnesses were the bullying I experienced at school, and the psychologically and sexually abusive relationship I had when I was at university. These really affected how I saw, and still see myself. I don't see myself as a person of worth, I think of myself as "wrong" no matter what I do or say. I blame myself for everything and punish myself through regular self harm. Long story short,  I don't like myself very much. My therapist commented that I speak about myself very negatively.

The next topic we went onto was lifestyle. What did I do throughout my day? What is stopping me from working? Do I go out much/socially? I mentioned that this past couple of weeks had been difficult and I'd barely been out of the house at all. Partly this was because I felt very demotivated and low, but it was also the Agoraphobia making me avoid situations that make me panicky and anxious. My therapist said that I needed to go out more, and try a short walk at first. I pretty much promised her that I would try to go out more. I also explained why I didn't work, but that I would like to if/when I am ready. I explained that this work would have to be very flexible and accommodating as I have energy "crashes" in the afternoon and need a 2 hour nap when I get too exhausted. Ideally, this job would be a work-from-home one (not easy to find!).

We then went onto general health. Did I exercise much? What is my diet like? Can I cook for myself? I told her that my Fibromyalgia and Hypermobility Syndrome do cause a lot of pain, fatigue etc so cooking is difficult and I need help when cooking from scratch. I spoke about the kinds of things I ate for each meal and that I was doing Slimming World online. Overall, my therapist decided my diet was relatively healthy. She also mentioned how certain inflammatory foods could make my Fibromyalgia flare. I had read up about that when initially diagnosed, but have forgotten now, so will look into it.

The session was coming to a close by this time, as we'd been talking about a lot for a while! My homework for this time is to find 3 things each day that are positive (it could be about my day, myself, something I'm looking forward to or that someone said to me etc). I need to work on being compassionate to myself. She also wants me to carry on with the mood diary and fill in the activities in the Panic booklet.

So far, I'm liking my therapist (apart from her questions about getting back to work soon) and the sessions are at least giving me time and space to vent. I did find this session very emotionally and physically exhausting, however, so had to nap for a while once I'd got home.

My next session is in 3 weeks time, so I hope to write a post on a separate topic before my session 3 post. I hope this post is helpful in the meantime!