Wednesday 14 March 2018

CBT for Anxiety Session 3 - Facing my Fears

I had my latest CBT session on Monday, last week. On that day, as well as the stress and worry about my Nan, I'd had a shock after finding out a close friend of mine was transphobic. This seemed very out of character for him, but the post he had supported was so obviously abusive that I had no option but to block him.

Losing friends in any way is very distressing for me. I may dissociate or panic, my mood will plummet and the whole thing will play on my mind for at least a few days afterwards. Needless to say, I was on the verge of a panic attack whilst on my way to therapy. I was looking forward to therapy, however, as I really needed to vent how I was feeling.

Therapy itself went very well. Surprisingly, I didn't cry (although I was pretty close!). We talked about losing friends, as well as my Nan and her declining health. I found my therapist quite validating. She understood why I felt the way I did, and was reassuring as well

After all that, we moved onto the main reason I wanted CBT; to get out of the house more. We talked through the topic of Panic, and discussed the booklet she had asked me to print off. I'd filled in the activities I was asked to complete. I'd mentioned my symptoms of OCD as well. She wanted to know more, and whether it was still a problem for me.

I'm sure I've written about my OCD before, but cannot find the post right now. I may edit and add the link if/when I find it, but for now I will describe the obsessions and compulsions I have.

The first time I started having symptoms of OCD, I was about 13. I was being verbally/psychologically bullied badly and was looking for something/someone to help. I didn't talk to friends about it, as one had spoken to the bullies (in a well meaning but misguided way) and this had made it worse. Teachers didn't help either; arranging a meeting where I'd have to speak out in front of the bullies which of course meant I didn't have the courage to say much.

At the time, I and a few friends had started to dabble in Paganism. It was on a very superficial level, so I couldn't explain what it is to you in detail. We learnt blessings and prayers though, and I thought that saying these blessings/prayers may help to protect me from the bullies. It eventually got to a point where I "had" to start them at exactly midnight, and had to repeat them three times every night. If I had a bad day the next day, rather than blaming the bullies, I blamed myself for not saying the prayers/blessings in the "correct" way. I also carried things (which I saw as lucky charms) in certain pockets of my blazers. I would panic if I could not find these things straight away and I would hold them throughout the day for reassurance.

Once I left school and the bullying stopped, these compulsions stopped. Later on, I started to get an overactive bladder and this really heightened my anxiety and need for control. I would "go" at least 4 times and each time, I had to wipe 10 times. I would count to 10 each time. This would lessen my anxiety slightly but for the rest of the day, needing the toilet would be at the forefront of my mind.

My compulsions are much less, since I've been on Sertraline and since I've taken Vesicare for my overactive bladder. I don't spend as much time in the toilet, so I don't see these symptoms as a real problem now. Other than this, I do some things in three's but I don't think they are done strictly enough to be called compulsions.

I explained all of this to the therapist and she was reassured that I don't really fit the criteria for OCD any more. I can't tell you how relieved I am that these obsessions and compulsions don't have so much control over me anymore!

Anyway, onto my other anxiety problems, e.g. getting out of the house. At the moment, my limit is to occasionally walk from my house to the local shop, and do a small shop by myself. I have gone from being on the verge of/having a panic attack to just feeling moderately anxious. I'd say this is progress! I do want to be able to travel further by myself though. My therapist gave me a worksheet with a table to fill with distressing situations. For my homework, I had to list the distressing situations I wanted to work on. I'd have to rank them from most to least distressing, as well as rating them from 0-10 (0 being "no distress" and 10 being "extremely distressing"). I have listed as many situations as I can for now, and I will write them below:

  1. Do some volunteer work (10/10)
  2. Go to a Slimming World group with mum (9/10)
  3. Take a train somewhere, alone (9/10)
  4. Take a bus into town, alone (9/10)
  5. Take a taxi into town, alone (8/10)
  6. Take a bus, with mum (8/10)
  7. Take a taxi to therapy, alone (7/10)
  8. Take a taxi with mum (4/10)
  9. Walk to the shop, alone (3/10)
There are various reasons why each of these is very distressing or not so distressing. It depends on factors such as, how familiar the destination is, how busy the destination is, how busy the mode of transport is, how long the journey is likely to be, how easy it is to get out of the situation etc. For example, walking to the shop alone doesn't cause too much anxiety now as I know the journey and the destination well, I tend to know how busy the shop is at certain times, I know how busy the journey there is likely to be, and I know I can escape the situation whenever I like, without anyone noticing. On the other hand, going to a Slimming World group means going to a destination I don't know well, with a big group of people I don't know, I may be required to speak up, I'm expected to last the duration of the session, and getting out of the situation early wouldn't go unnoticed. 

I am so fed up of being controlled by my mental health however. I want to be able to face my fears and get to a point where I realise nothing terrible is likely to happen. With the help and encouragement from my therapist, I hope to at least tackle some of these distressing tasks.

Wish me luck!

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