My experience of CBT (so far…)

I have recently started attending Cognitive Behavioural Therapy (CBT) to address my anxiety. I have not yet completed the full course of sessions, but thought I would write about my experience of CBT so far. CBT is different to counselling (which I have also tried) in the sense that it can help you manage your problems by changing the way you think and behave. Counselling can also be useful as a means of expressing your feelings, however CBT is more practical and gives you a way of coping with those feelings.

I wasn’t sure what to expect from my first CBT session. It was less daunting than I had thought, I was given a questionnaire to fill in which is for the therapist to get a better understanding of your levels of anxiety and low mood. I fill in one of the questionnaires every week so there is a record of how those things change or improve on a week by week basis. The first session was mostly talking about what I feel are the most important issues to me right now, and what I would like to get out of the CBT sessions.

Each week, the therapist draws up an agenda of what we will talk about in that session, this is usually something we plan together so I know what to expect. The sessions are just as much about what I want to get out of them as they are about what the therapist thinks might be helpful for me, I find this makes it easier to feel relaxed because I feel more in control of the situation.

As a part of the therapy I am expected to complete ‘homework’ each week – which varies from week to week. I won’t go into detail of every piece of homework I’ve completed because it would make for a very long blog post, however the tasks have included keeping a diary of my activities for the week and rating these out of 10 for productivity and enjoyment, making notes each day of things I am grateful for and things I have done well. I was also advised to set aside just one hour a week to do something relaxing or enjoyable just for me (this is of course not limited to one hour, however if you find it difficult to relax sometimes, starting with just one hour makes it seem much more manageable.)

The ‘homework’ of setting aside one hour each week got me thinking about how sometimes we’re so focussed on the bigger picture that we forget how important little things are. It’s so easy to take things or people for granted without even realising it. Work can get on top of you, or there might be big stressful things going on in your life. Of course these things require our attention – work takes up such a big part of your life but it isn’t your whole life. Stressful situations can seem overwhelming, but it’s important to take a break from those things too and to give your mind a rest from nagging thoughts.

Another thing we have covered in the sessions is something called ‘tolerance of uncertainty.’ As an anxious person I find that I often need to feel ‘in control’ of certain situations to be able to feel calm, or I need to have all the details about something. Sometimes I want to know the outcome of something or know exactly what to expect from a situation. Sometimes if something doesn’t go to plan, or something unexpected happens, or maybe I say or do something that upsets someone it can send my anxiety into overdrive. The sessions I have attended so far have taught me that rather than increasing certainty of a situation I must start trying to increase my tolerance of uncertainty. This is of course easier said than done but by attending more sessions I hope that this is something I can improve on.

I hope that this very brief overview of my experience so far may help you to know what sort of things to expect from CBT if it is something you are considering for yourself. This is of course only my personal experience and therapy will look very different for anyone who attends. What is important is that you reach out and ask for help if you feel you are struggling. It can seem daunting to do so, but it is so important to acknowledge when you need a little extra help to deal with things.

My experience of disordered eating

Before I get into this post, I just want to put out a warning that I will be addressing my experience with EDNOS / disordered eating and it goes without saying that some people may find what I’m saying triggering so please do not read this if you are struggling and there is a chance that you will find this difficult/upsetting/triggering. The last thing I want to do is make anyone feel worse.

Beat the UK’s Eating Disorder Charity offers telephone helplines, recovery information, advice on how to talk to your GP and also runs daily chat rooms alongside so many other really useful resources: https://www.beateatingdisorders.org.uk/

Sufferers of EDNOS (also known as OSFED) may display some of the characteristics of other eating disorders such as Anorexia, Bulimia or Binge Eating Disorder but they do not fit the exact diagnostic criteria for those conditions. It is believed that 1.25 million people in the UK suffer from an eating disorder and although it is difficult to gauge exact prevalence rates of eating disorders it is estimated that EDNOS/OSFED accounts for around 47% of cases.

I’m not entirely sure where this blog post will go as it’s not something I have planned, but as I’m typing this now I will try my best to be open and honest and frank about my own experience of disordered eating and my attempts to seek help. I think everybody with an eating disorder, or who engages in the behaviours associated with eating disorders will have a different experience and every single one of those cases is valid. It’s incredibly easy to feel invalidated when you’re suffering with an ED, it’s very easy to convince yourself you’re not unwell ‘enough’, or that you’re a fake, you’re not really suffering, everyone else is worse. It’s so important to know that however your eating disorder presents itself you are absolutely worthy of treatment, help and support.

I personally have never binged as a part of my disordered eating. I have restricted calories and also purged. I have struggled with my body image and self-esteem since I was at school which over time has developed into what I can only describe as a fear of putting on weight. I also suffer with Depression and Anxiety and I feel that all of these things tie in together. To me, there is nothing worse than the feeling of being full it triggers in me an overwhelming desire to purge. I often obsess over food, sometimes my whole day can be spent preoccupied with thoughts of food and eating and how many calories I have consumed. I exercise sometimes compulsively to compensate for the food I have eaten. This can be difficult to manage especially when I am at work. I work a 9-5 office job, purging when possible but trying to keep it a secret from colleagues. I sometimes feel intense hunger and feel like a failure if I give into that. When I purge it’s not because I have eaten too much, often I have eaten what would be considered a ‘normal’ amount, sometimes I feel the need to purge after having eaten barely anything at all. I dislike the feeling of being hungry yet at the same time the emptiness is always preferable over feeling full. I hate the thought of putting on weight. I feel a very strong need to control what and how much I eat, and to control my weight and body shape.

I would like to note here that I am not recovered, but am committed to recovery. I originally contacted a charity to access CBT or counselling because I was unable to deal with the emotional and physical impact the disordered eating was having on me. I decided it was time to get help when people would say they were worried about the amount of weight I was losing. my eyelashes came out, my hair was thinning, I was exhausted. I was scared of getting help but I did know that something had to change and I couldn’t continue struggling indefinitely. The initial telephone assessment lead to the charity referring me to an Eating Disorders Service, for which I also had to attend an initial assessment. I found the assessments draining emotionally, you find yourself baring the parts of you that you hate the most, the parts you’ve tried to hide for so long. You also are facing the idea of getting better, which in itself is absolutely terrifying.

I don’t like to admit that at the time, I didn’t know that I wanted to get better. The only way I can describe it is it felt like, and still now feels like my mind is made up of two parts: the rational side and the irrational side. The rational part of my mind knows that my behaviours are unhealthy and I need support and help to get better. The irrational side of my brain tells me I’m not sick enough to need help, what I need is to lose weight, I’m too fat, I need to engage in those behaviours. It’s like the two sides are constantly battling each other, sometimes one side is stronger and sometimes the other takes over.

Once I had attended the assessment with the Eating Disorders team I was discharged. I was told to attend counselling at my place of work (I’m lucky that this service is offered free of charge to staff). My BMI wasn’t showing that I was underweight. I felt like a failure, like I wasn’t doing an eating disorder ‘right’. I felt embarrassed. I felt ashamed that I even considered going to the assessment. I compared my disordered eating to those that were ‘worse.’ Going to the assessment just to be discharged made me feel worse than I did before. I do not want to belittle the work that the service provides, and I don’t want my story to put other people off seeking help but I do think that it is important to note that people can suffer from eating disorders at any weight.

I sought help from the counselling team, only to feel disappointed again. The first thing the counsellor I was assigned said to me was “I don’t specialise in Eating Disorders so I don’t know how much I can help you with that” – I tried to talk to her for a couple of sessions about the things I was struggling with only to receive advice I’ve heard before – ‘just try eating more, try to be comfortable with feeling full’ – I was asked if I was happy with any part of my body, I said that I don’t mind my legs and was told ‘your legs make up over half of your body so you like at least 50% of yourself.’ I felt again like my concerns weren’t being taken seriously. Maybe this came from a lack of understanding of eating disorders and body image, and again I am absolutely not belittling the work of a counsellor I just think you have to find the right one for you. However, as I wasn’t feeling any better by attending the sessions, I withdrew from that service. I am currently accessing Cognitive Behavioural Therapy which I am finding more useful. CBT addresses my anxiety more than anything else. I’m now trying to recover just by sheer willpower alongside the CBT. I have good days and bad.

One thing I have noticed is that even on my better days is that my mind is never quiet about my disordered eating, the thoughts are always there. I don’t always give into that ‘irrational side’ of my mind, but it is always present. I hope one day to feel a little more free from that and I am hopeful that moving forward I will find things a little easier.

I sincerely hope that this blog post has, if nothing else, helped even one person understand some of the aspects of disordered eating or helped you, if you can relate to anything I’ve said, feel a little less alone. I encourage anyone suffering to reach out for help in any capacity.

Working on me

Things have got to change. Over the last few days I have really let negativity take over and whilst I do believe that sometimes it is very helpful to just let yourself feel whatever it is you’re feeling and let those emotions just be, I also know when it is becoming detrimental to my overall happiness.

There are a number of things that I have been working on over the last few months and I thought I would share them, some of these things might work for you, but this is just as much a reminder to myself not to lose sight of the things I want to work on.

  1. Meditation – I will set aside some time each day to meditate. Even if it is only 5 minutes. Meditation takes practice and I would like to incorporate this into my daily routine. I have used the free trial of headspace and found their Basics course really useful to get to grips with ‘beginners’ meditation. There are also a huge amount of guided meditations on Spotify or YouTube if you’re unsure of how it all works.
  2. Gratitude – I will write down at least three things at the end of each day that I am grateful for. Even on my bad days there are things I can show appreciation for, even if they sound silly. They can be big things or tiny, it doesn’t matter – what matters is that I am noticing them.
  3. Reflecting on what went right and what I can learn – I will notice when something has gone well or “right” and notice how that makes me feel. I will celebrate my achievements. If something hasn’t gone to plan, instead of feeling upset or angry, I will try to find a lesson or something that I could do differently next time. Setbacks are not failures, they are opportunities to learn and grow.
  4. Decrease negative comments – I will actively try and cut down the amount of negative comments I make. I will allow myself time to think before I react and before I speak. If I want to say something negative, I will try to think of a positive in its place. If I have something negative to say about another person I will remind myself that it is not helpful.
  5. Tell people what they mean to me – I will let people know that I appreciate them. I will spread as much kindness, joy, and love as I can to those that mean the most to me.
  6. Be kind – I will do what I can to help others, I will be supportive, I will offer a listening ear, I will try to understand other people’s needs. I will be kind without expecting anything in return. Kindness is about what you give not what you get.
  7. Be present – I will be present in the moment and appreciate what is happening at that time, I will not fret about the past or worry about the future. I will try not to take things in the wrong way by really listening to what people are saying. I will respect other people’s space and acknowledge my needs too. I will notice the things I can see, smell and hear and appreciate those things. I will not procrastinate. I will make to do lists and focus on my goals. If I notice that I have let my mind wander to unhelpful places I will get myself back on track.
  8. Appreciate people for who they are – I will really notice all of the positive things about people. It is so easy to take people for granted and not even realise you’re doing it. I will make sure I appreciate all the little things about people that make them unique, interesting and wonderful. I will not just pick up on negatives, I will appreciate and love people exactly as they are and not expect them to change. I will allow people to be exactly who they are around me with no expectations.
  9. Be happy – my ultimate goal is to be happy, and live the most grateful, fulfilling and authentic life that I can.

some thoughts

It is lovely to do things to help other people, to support them, to listen, to give love and to be there for people in every way that you can be. It’s also equally important to be there for yourself.Don’t change who you are – your kindness, your ability to give, your strength are all things that should be celebrated but it is absolutely not selfish to do what’s best for you.

Self care can look different for everyone. For some people it might be a spa day, a treat or an indulgence. For others it might look a little more ‘boring’ like taking the time to tidy a room in the house. It might be making a list of all the things you like about yourself, or making a list of goals. It might be celebrating the fact that you even got out of bed today. It could be taking a step back from the responsibilities of life and just taking even 10 minutes to yourself. Perhaps it’s meditation, or having a hot bath. It might be calling a friend, or baking the best kind of cake, or listening to your favourite song (can we just take a minute to appreciate that Lizzo exists…). I’m no expert, but whatever your version of self care looks like it’s so important not to let that slide in favour of everything and everyone else. 

You are gold, you are important, you deserve love. You deserve happiness. Remind yourself of that especially on the days when loving yourself feels hard.

Most importantly, realise that those qualities of yours: kindness, your ability to keep going; whatever it might be, they are not weaknesses. Don’t stop doing those things. Just be there for yourself too.

(As a side note, it is so very important to understand that other people might just be engaging in self care too – everybody needs it so it is vital not to pressure others to give more than they are able to and not to demand too much from people. At the end of the day, we are all just human beings trying our best to get through the day.)

Finding the Positives

Yesterday was my wedding anniversary, the first since I split from my husband earlier this year. I wasn’t sure how I was supposed to feel. Perhaps I was supposed to mourn what I had or contemplate what could have been. Maybe I was supposed to feel numb or spend my day Bridget Jones-style howling along to All By Myself. I knew it was coming and spent more time than I care to admit wondering how am I expected to act? to feel? After a very ‘typical of me’ overthinking session I realised that I shouldn’t be concerned about how I’m supposed to feel, I should just feel. Whatever emotions come, whatever feelings arise I should just allow myself to experience them and to feel them without expectations.

Now –  as much as I am a chronic overthinker, often riddled with anxiety – I have recently been practising the art of Positive Thinking. I surprised myself when I decided that the date didn’t have to be one associated with loss, sadness or negativity and instead realised that in losing a marriage I have gained so much more. 

The biggest thing, I think, is my sense of self. I spent an incredibly long time in a relationship where I felt that I wasn’t my true self, always trying to be somehow different. I admit, it took me a few months to really feel like I found myself again but now I truly feel that I am a more authentic version of myself than I have been in years. To anyone going through a divorce or a break up, through all the ups and downs and emotions and feelings and self-doubt – you have this opportunity to rediscover yourself. You can focus your energy on rediscovering and realising your loves, your passions, your quirks and all the things that make you you – something that should be embraced wholeheartedly.

My girl friendships have blossomed, a wonderful friend of mind once said “all friendships are fab but girl friendships are the bees knees” and I feel so incredibly grateful to have the time to give more of my energy to those friendships that I cherish the most. I am lucky to have such strong, joyful and kind women in my life. Advice, support and a listening ear should never be taken for granted.

I have been able to throw myself into things I would never have considered before – positive thinking, meditation, mindfulness and spirituality. I embrace these things with my whole being and they have been such a great help to me, not just in hardships but every day. I had spent a lot of time around negative people and honestly I didn’t realise how much it was bringing me down until I removed myself from that situation. I feel more gratitude for small things than I ever have before – staying in and watching a movie, listening to a thunderstorm, a moment of silence – I feel lucky every day for even the smallest of things.

I am lucky to know many excellent people, and one of the most beautiful souls in my life said to me “things aren’t falling apart, they’re falling together” – I believe these words to be very true.