Self-help CBT

[flobob]

I wrote on another thread a while back that I had bought 2 books: Overcoming Depression and Healing without Freud or Prozac.

I said I'd write a thread about what I thought of the books in case it was of help to anyone else.

I've now read Overcoming Depression. It says in the book itself to not read Part 1 if you are feeling depressed as it is quite technical and may be confusing to a depressed mind. So I skipped that bit and read the rest.

It has been very helpful already. Lots of examples of how a depressed person might feel and why that would happen. It's good to see that other people have similar feelings and that my feelings aren't so strange. Then lots of case studies explaining how "this person" dealt with the situation through CBT with the psych who wrote the book.

I cannot remember lots of it, but a major part seems to be about challenging your own negative thoughts instead of allowing the negative thoughts to dominate and overwhelm you. It is hard but I have managed it and the negativity isn't as frequent now.

For example, just before I moved house earlier this month, my friend said she didn't like going out in the town where I was moving to. That immediately made me think "she won't come to see me" and that got me upset, but I was able to challenge this thought with "going out in the town and visiting me in my own house is different, she will visit me at home". So sensible. And I did it all on my own. ;D

What I'm going to do next is read through Part 2 of the book again and mark the bits that relate to how I feel and react. Then I will concentrate on what the book says about those areas and see if I can improve on those - probably one at a time because it is difficult to re-think yourself. After all our feelings and thoughts are spontaneous and not planned and this way you have to plan thoughts until it becomes natural to think like that.

Cognitive Behaviour Therapy - such a confusing term but this book explains it very simply and well, I thought.

I'll write some more as I read the book again as I hope it helps someone else to understand what it is about. The not understanding it scared me a lot when it was first suggested to me.

I think it was suggested because I refused to take meds.

[Scarlet]

Thanks for that Flobob, the book sounds very interesting. Have you started the other book yet?

[flobob]

Hello Scarlet

No I haven't started the other book yet. Thought I'd just concentrate on one at a time and as this first book feels good I'll keep trying with it before picking up the other one.

But I haven't really begun re-reading the first book yet and marking the bits that are relevant to me. Finding the time, energy and concentration to do that is difficult. But I am determined to try soon.

I'll let you know how I get on.

Best wishes, FloBob

[flobob]

Hello
I just wanted to update here because I've now worked on the first chapter "Initial Steps" and am feeling better for it.

I read through that chapter and underlined in black anything that sounded like me and then underlined in red anything that I thought I might be able to do. Then when I'd done all that I wrote those bits only into a notebook. From that I found 4 things that I could try as a first step. They were
- do one positive thing per day
- eat healthily
- take exercise
- don't criticise myself

So nothing too demanding and the middle two seem to be recommended for everything in life! Because my OH is away working I don't eat properly - it is all too much effort to cook. But I knew that I should try. So for the past 3 weeks I have been trying harder on that front. It doesn't necessarily happen in the evenings but the daytimes are better and I always have breakfast now.

The positive thing is difficult in a way because it is hard to know what is positive. And it seems really sad to have a positive thing being "unpacked more boxes" from when we moved in early October - but that was my positive thing yesterday. Only 1 box left now ... I think, unless there are some lurking somewhere I haven't noticed.

The not criticising bit is also difficult because it is hard to realise you're doing it. And even though I know I'm doing it in my head I don't know how to not do it apart from just not thinking it which doesn't mean I'm not deep-down thinking it. It's like I have 2 levels of thinking - the one that says it to me and the secretive one that is just whispering to itself. But this morning I had a stomach ache and was criticising myself because I'd eaten too many Pringles last night (yeah, I know not healthy! But yesterday I'd eaten 3 healthy meals: cereal & OJ for breakfast, lamb stew for dinner (my Mum cooked it and gave it to me for LO so I shared his!) and tuna sandwiches for tea (LO wouldn't eat them and had cheese and biscuits instead). So in the evening I pigged out. And then when I had a stomach ache this morning I was criticising myself but realised it and instead thought "yes, I did eat too many Pringles, but I've often done that in the past and it was after eating healthily all day and if I get up and eat something now my stomach ache will go" - so I got up and ate a banana. Hurray for positivity and hurray because my stomach ache has gone.

The book does say that you should "talk" to yourself in this way, which obviously feels ridiculous. However it has made me talk to myself nicely like a friend would rather than being nasty to myself.

I am also keeping a diary where I write down briefly during the day or at night the things I have done for those 4 items. Just so I can record things and see how I'm doing. When I've tried in the past to improve things for myself I'd try for a while and then have a bad day or week and think "that didn't work, I won't bother". So by recording it each day when I had a bad day on Sunday last weekend I didn't just give up completely. Actually Sunday was a day when I didn't have breakfast - that wasn't the cause of the down day because I felt that way immediately on waking but maybe if I'd had breakfast I might have had more energy to deal with stuff and the day might have improved.

At the end of every chapter there is a set of exercises to do. Some of these overlapped with how I was doing it and some were extra things.

Yesterday I started reading the next chapter "Thoughts and Feelings" and this one is much more difficult. I'm half-way through and not sure I can relate to it as well.

I think that CBT might work for me because I'm ready for this process. I think it would be very difficult to do all this if you were still in the depths of depression. I had counselling in May/June/July time and I think that helped me up. There is a lot of work involved - just the time to read with LO and work is difficult. Maybe also feeling more normal on meds might help someone be ready for CBT.

I'll update again when I'm further on with the book. And not long now until I get my assessment appointment for CBT with the NHS. I just hope that they don't decide I don't need help because I'm doing this on my own. I still want help.

Flobob

[Scarlet]

Very interesting Flobob..

Seems a few ladies on here are waiting for or currently having CBT..

When do you expect to hear about your appointment hun? Will it be int he New Year now?

Scarlet
X

[Veritee]

Dear Flobob

Great idea for a topic

I do not know if you are interested but there is a DIY on line CBT course that you can do too that we have spoken of here before an this forum thread: veritee.proboards7.com/index.cgi?board=help&action=display&n=1&thread=2613./

It is NHS funded in recognition that CBT works very well for a lot of people and that it is something that you can do for yourself.

It is called Living Life To The Full

and it can be found at: www.livinglifetothefull.com/index.php

The site has won several awards - one from the British Association of Counseling and Psychotherapy.
Some here have tired it and have found it useful

I would be interested in what you think if you want to give it a go?

Veritee

[Veritee]

PS Did not take meds either - not at all although I advise women to do whatever is best for them and whatever gets them through and to explore the possibility of Medication, in patient stay in hospital, counseling or any other treatment they feel may work for them

- I had some very good counseling and support.

I will write more about the counseling I had and my opinion of CBT later on this thread if thats OK?
Veritee XX

[marion]

I have CBT from my psychologist and I find it very good. I think you have to be ready for it thoguh and over some of the physical symptoms a bit as at first I was too ill to believe that just talking could help. I thought that the only way to get well was to be on loads of drugs but for me it really has been a combination of the two.
Love
Marion.

[flobob]

Hello Marion
I agree with you. The time has to be right for each person to accept this stuff.

Hello Veritee
Yes, please do add to this thread. Thank you. And thanks also for those links I'll check them out.

FloBob xx

[Veritee]

I do not want anyone to think that I am negative about CBT as I do think it is a great tool that is easily available and one that you can even do yourself through web sites and books.

I have had CBT on the NHS for 10 sessions years ago, and then more recently to help get over an accident and recently done the online CBT course myself

and even been trained in and used CBT techniques myself when I was a youth worker working with young people with emotional and mental health difficulties - I was a youth worker for 14 years for Cornwall County Council and many years before this in London

But I also feel it has its limitations, imostly n the area of the therapeutic relationship between you and your counsellor which is so very important in counselling and therapy.

And of course if you do DIY, CBT, you have NO relationship with a counsellor at all.

I believe that CBT can be very useful, but with the proviso that if you can get more in depth, ongoing counselling or therapy or can afford to pay for it privately please use this as well.

If you can not, I feel that while you are doing your NHS provided CBT or you are doing it yourself via a book or a web site you need to ensure you have good backup in the form of support

– from friends, family and or HV etc and this forum can help too.

And that you consider medication along side. As while many may disagree, it is my observation that CBT alone will not always completely help you through PNI .
However it can be very effective if you are someone who responds to it to get you thought the worst of your thoughts, fears and symptoms.
And many of the techniques are useful to anyone .

As I have said I have done CBT when I was ill many year ago and the online course to try it out before I recommended it on here. And used CBT techniques myself although not fully trained in it.

Both were of some use to me personaly but I am one of those that CBT although it has some effect is not the type of counselling that is best for me, especially if it is self help and not done by a good counsellor.

For me the most important part of counselling is always my relationship with the counsellor.

Without that relationship I do not call it counselling but a 'therapeutic technique'

Which I guess Cognitive Behaviour therapy is - it is not counselling - not even by name - or even therapy but a therapeutic tool that you can either do fro yourself of have someone help you to learn

Personally to resolve or learn to cope with any emotional/mental issue or anxiety illness I have to have someone to bounce off and also need to feel that someone cares - at least for that hour in the counselling session - and that they are giving me what is sometimes called in therapy , 'Unconditional Positive Regard'

The term 'Unconditional Positive Regard 'comes from the person centred approach to counselling and therapy which is approach we use on this forum to support and it works well for me .

The problem for me with even CBT done by a face to face counsellor is that this type of counselling really does not fully take into consideration the therapeutic value of a skilled and empathic counsellors input and the relationship you build up with your counsellor

CBT can actually be learned and practiced by almost any medical professional ( and youth worker as I was ) with the right training and as you can see can actually be done online or through a book with no counsellor input at all.

This is both positive and negative.

Because the reason why CBT is the most widely available type of counselling on the NHS and practiced by many types of professionals from CPN, HV, OTs, Mental health Nurses is because with the right training almost all can do it and because the CBT program is quite prescriptive ( set) it can be taught quite quickly so costs the NHS far less than the years of training any other type of counselling would need for someone to practise it effectively and safely.

So the positive here is it is more widely available and give people access to counselling they otherwise would not have due to NHS costs

And of course this is why it can be done by yourself through the internet and books or tapes and again this makes this kind of counselling more accessible to more people.

But the negatives for me is that CBT counsellors are not always as highly trained specifically as counsellors as with other approaches ( this is not always so as very skilled counsellors offer it as a quicker solution for a specific issue alongside other approaches ) and as the relationship between you and the counsellor is not considered as important with as others

Therefore people in a lot of distress who really need a chance to offload, grieve perhaps for the trauma they have suffered and for the sadness they feel, while being supported though this by a counsellor they feel safe with and have confided in -

........can find themselves in a room with a 'counsellor' who is only concerned with getting them through a fairly set program, who does not allow space to offload - which is sometimes essential before you can free yourself up to make any changes, and the counsellor is not even interested always on why you are as your are right now, what your fears and issues actually are -

Some people do prefer this as they do not have to delve into past issues or look at their feelings as they are right now

However others like myself find this approach highly frustrating and without the chance to offload, explore issues at my own pace and build up a relationship of trust with the counsellor, not of much use.

With CBT you usually only get a limited amount of sessions too – about 8 to 10. Yet unfortunately PNI can last many years!!!

with other more person centred approaches counselling can continue until both you and the counsellor agree it is time to stop - and this can be months to years. When you are ready for it to stop.

But of course the NHS does not have the money to provide counselling for years so if you do this you will have to pay for it yourself

So CBT is an easily available therapy - and often effective within its limitations - which can be of use to many people and one that it is possible to be offered by your local surgery , HV , CPN etc.
And also as flobob you have discovered you can do DIY , CBT from a book or a web site .

This can and is very helpful

But I would not recommend it as the ‘only ‘ treatment or help you seek

Doing CBT on your own is a tool you can use to help you but really can not be called counselling as it lacks the essential element of, being ‘counselled’ by an empathic counsellor. Which is the whole basis/definition of counselling after all.

So I would say if it helps you - use DIY CBT and of course NHS offered CBT, but if you can make sure you have other support and treatment too.

PNI is not an illness that it is easy to ‘go it alone’ you need support, reassurance and input from others.

For some the reassurance and understanding of this forum has been very helpful, but I would not recommend this forum alone any more than I would recommend DIY CBT.

Both can help of course, but you need back up and understanding and support form those around you too.

Sorry if I do not make mush sense and I have gone on too much .

But I just wanted to try and explain the limitations CBT may have , especially when doing it for yourself or online .
Use it as a tool but do not rely on it for a cure .

Veritee XX

[flobob]

Hello Veritee
Yes, I agree with you. In fact I had just realised that it wasn't about working through past events and was thinking about finding a counsellor privately to do that alongside this CBT. Because I've had my 6 NHS sessions already and wouldn't get any more I'm sure.

I just wanted to write here about how it worked so others could get some understanding. Because when it was first suggested to me when I was very ill I didn't know what it was about and was too scared of the unknown to really want to try it. And all I could find on the internet about it was in language I didn't understand - "counselling-speak" - so I really didn't have a clue what it was all about.

I'm surprised to hear that CBT is provided by so many people in the NHS - I hadn't realised that it was such a quick learning process. Surprising in that I am still having to wait 4 months to get an assessment appointment with no idea when I'll actually get started on the CBT!!!

And like you say I don't think it is good to have any treatment from people who may not have had the full training. I must admit the impression I got from the doctor and psych was that the CBT person would be fully trained. But then I had always thought a psychiatrist treated you for mental health with therapy, and I'm wrong about that, so what do I know?

It is helping me because I don't like opening up to people, even more so with strangers, and talking on here allows me to say what I really mean and clear things from my head, and get on with the logical part of CBT. Which works for me because I am a logical person - I hate being logical, it is so boring! but I have accepted that is what I am.

I get what you say about support from those around you. I don't have that fully from my partner, and because of that I find it difficult to talk to my friends ("if the man who loves me more than anyone in the world, won't listen, why would anyone else?" and I feel a burden to people just turning up when I am miserable). I am now very scared that I won't get better even with trying so hard.

FloBob

[Veritee]

Hi FloBob

It is late and I have only just seen your reply - so I can only reply briefly- just tired tonight - sorry

but I will say 4 months is actually very quick to get CBT on the NHS as many wait for much longer
Perhaps others will add their experiences of this?

and most other types of counseling is not available on the NHS for most.

I think it is a cost thing?

I was lucky enough to get a limited amount of sessions of psychotherapy based counseling/treatment at the end of my PNI with a really great counselor, but this was about 15 years ago - it is less likely now as far as my information that you will get this now on the NHS.

So if you can afford to get open ( non limited) person centered or psychotherapy based counseling privately - and if this would suit your needs - I would say go for this as well as any NHS treatment if you can.

But only if this is for you as it is not for everyone.

But if this would not suit you please use any method of getting through PIN that will help you

I am not suggesting anyone you got to /referred to will not be fully trained in CBT. And the level of counseling training your counselor will have will depend on who they are and what capacity they are doing CBT with you

I am not saying that DIY CBT will not work for you or others at all

I was telling my story about how counseling and therapy worked for me - I am not an expert and all any of us can do here is tell it how it is for us.

I think I went 'off on one' above and got carried away in explaining about my own experiences of counseling and therapy , I am very sorry if this was not helpful :(but it was only from my own personal and limited perspective.


You are as you say a very logical person so it very well could work well for you
I am not I am afraid logical at all - I tend to operate on emotions only so CBT without a counselor who I 'took' to or on my own - was of limited use in my case as I explained .

but if it is good for you please use it - use anything that helps
CBT, DIY self help, Medication, anything that works for you is good
I was not trying to say that you should not use it - I was just sharing my experiences which are only mine
Got to go to bed now - but will reply further when I can

However this is a great thread you have opened up and I am sure others will add their experiences of CBT and other counseling here.

Have you tried the on-line CBT site : www.livinglifetothefull.com/index.php
as it is good to do he course especially if you are logical and like this sort of approach

..........talk to you later when I am less tired - but please continue to contribute your thoughts on this as they are very useful, and anything I say is only from my own perspective and I know that we are all different.

Veritee XX