View Full Version : Which type of therapy to address confidence issues?
Hi to anyone reading this,
I've just returned from a short break which has helped to clear my head about my anxiety issues. I think I now know what I need to work on, but I need external help with this -- probably some type of therapy -- and I'm not sure which type might be suitable. I'd be grateful for any pointers.
I'm fairly sure now that the root cause of my difficulties is my perception that my own self-confidence is very fragile, which leads me to try to protect it by avoiding situations that would put it under strain. That in turn causes me intense anxiety as I dwell on potential future setbacks, many of which are difficult or impossible to avoid.
Ironically, I've spent the last week doing something that I've never done before and, as such, required quite a lot of confidence -- I went away on a backpacking holiday with a group of complete strangers. In the process, I re-discovered the person that I'd like to be more regularly: relaxed, sociable, funny, kind, helpful, caring and *confident*.
This discovery was significant to me because I had been starting to doubt whether I could ever be that person any more. Too often, while anxiety has me in its grip, I am tense, grumpy, self-absorbed, grimly serious. selfish and extremely doubtful about my ability to cope. I wondered whether I had permanently lost a part of myself and become stuck in this mode. Apparently not!
Now that I've proved that I still have the capability within me to be the person that I'd like to be (at least, on special occasions), I need to figure out how to bring that back into my normal life. Presumably it must be a choice, even if it's one that needs to be underpinned subconsciously.
I know that I *like* my relaxed self, and I *hate* my stressed self, but that doesn't seem to be enough to convince me to embrace the former. It feels as if something is blocking me, but I'm not sure what that is or how to overcome it.
Any ideas on how I should proceed? I feel that I need external help and I'm assuming that some form of therapy would be useful. I'm concerned, though, that I've had several rounds of counselling before and it didn't seem to help with this issue (although I'm prepared to accept that this may have been down to me rather than the skill of the counsellors).
Many thanks for any practical suggestions.
All the best.
-- aquarian
Well done during the holiday! :)
You don't say if you are on medication or seeing a doctor for your anxiety. Who referred you for counselling before? Your doctor is the best person to speak to as he will have to refer you for any therapy.
Thanks for your reply and encouragement. :)
I'm not currently on any medication. I finished on citalopram (10mg/day) over a year ago, after taking it for about eight months.
My GP has already referred me twice for counselling (six sessions each time) -- once last summer and also the year before. In between, I took myself privately to another counsellor for several months when I went through a particularly bad patch and couldn't stomach the idea of going back to my GP and waiting for a referral.
In each case, the counselling was useful in the short term, but it didn't yield any magical insights and I don't seem to have been able to hold on to the gains in the longer run. I'm wary of going back to my GP because it feels as if I'm at fault for not taking on the outcome of the counselling and not applying the CBT tools properly. I've looked back at my notes from back then and I find it difficult to relate to the things that I wrote down which seemed good and logical at that time.
The other thought that I was having regularly while I was away last week is that I'm actually a different type of person to the one that I thought I was. I've always been encouraged to take solitary technical jobs (probably because it's what my father did and I've been good at them too), but lately I've been feeling burnt-out. Last week, I felt literally euphoric when I had the chance to be part of a group. It was as if the "real me" had been released from its cage for a while.
I feel sad at the thought that I might be missing my true vocation. Ironically, one of the roles that I think would suit me quite well is being a counsellor, because I'm a strongly empathic/feeling sort of person. Clearly, though, it would take a major slug of self-confidence for me to consider leaving my current role and trying something new.
So, I'm not quite sure what sort of help I need. Sometimes I just want to tackle my anxiety head-on, at other times I feel that I need to re-build my self-confidence, and occasionally (as now) I wonder if I need a "life coach".
I hope this helps to explain better my situation. Many thanks for any further input.
-- aquarian
Hi Aquarian,
That sounds so incredibly like me! I too do not like the anxious self-absorbed depressive that I so often am, much preferring the more sociable, fun, bright and positive creature that I glimpse only on occasion. Such self-loathing to any extent is bound to be unhelpful however. It's difficult to say what kind of therapy would help. What I'm finding helpful is psychotherapy which I have privately with a Psychologist. Unfortunately it can be a long (and therefore expensive) process. CBT tends to be offered as it's seen as a relatively (and apparently, effective - for some people) quick and therefore inexpensive fix. Psychotherapy however may uncover the reasons underpinning your perceived lack of confidence and help you move on. CBT may have a place, still, in combating any negative self-beliefs from which any unhelpful thoughts or behaviours may stem (the downward spiral technique may help to uncover the 'core' belief which is damaging and limiting, for example). Sometimes it's a mix of therapeutic approaches that help. Psychotherapy I would say is particularly helpful if there have been early 'traumas' or difficulties which have had a lasting impact. The anxiety of stepping out of your comfort zone is difficult and something I struggle with enormously. Having the support of a sympathetic and understanding Psychotherapist or counsellor may help. It is important to find someone that you can relate to and whom you find understanding, however. Best of luck. I hope you find something that helps.
eight days a week
10-10-11, 16:55
Really glad to hear that the trip was so full of insight as well as fun, aquarian :)
For self-confidence (which I struggle with myself, as no doubt many others/almost all do here) I guess I'd recommend psychotherapy from my limited experience, rather than counselling. I haven't been through it enough to know if dealing with the underlying cause(s) then cures the symptoms.
For anxiety relief / coping strategies I'd recommend CBT.
Bouts of six session counselling sound extremely limited to me, I don't know how that could even scratch the surface for most people, let alone for the counsellor to get to grips with the client, or for a meaningful professional relationship to be established!
I've had two sets of counselling of 12 sessions each. Both were very experienced and 'talked a good game' but both really didn't get anywhere with me - like you I don't necessarily blame them. Both said they saw me as a bit of a mystery by the end. I think looking back I had barriers that I've had my whole life which stopped me opening up as I needed to - and also had the expectation that they would be able to break those down.
However I've just finished six sessions of psychotherapy. The therapist identified one of these significant barriers straight away and (in a way that wasn't uncomfortable) challenged me on it. Partly as a result he later helped me make connections that the counsellors just hadn't been able to.
Before this I had 16 sessions of CBT which helped me with my anxiety a great deal but wasn't enough to break the back of it - I think both because it wasn't taken far enough and I wasn't given enough sessions. (Not addressing the underlying cause may have been a factor too).
I guess it depends on your area on how you can access CBT and/or psychotherapy. Counselling was offered through my GP, who knew nothing about CBT. My psychiatrist (NHS) offered me various pills only, it was when I saw an occupational therapist working with her that CBT was suggested. When that was about to end the therapist 'passed me on' to the psychotherapist. Now I've been offered a psychotherapy group (which I'm very confused about joining, but I'll make a thread about that perhaps).
I'm sure counselling does help some people a lot, so it's probably the first port of call for most people. If it's something other than counselling you want I would recommend asking (pushing) for it at every point - GP, psychiatrist, etc. I'd thoroughly recommend CBT for symptoms of anxiety and to learn some ways to deal with it. With a better therapist/more sessions I think this can cure many people. I would also from my limited experience recommend psychotherapy. I'd go for the CBT first though as that is shorter-term than psychotherapy, and I've been told they shouldn't be mixed.
I found high-intensity CBT with the NHS helpful. I had 11 sessions, and I'm sorry I didn't have more, it took that long to 'scratch the surface'. But I had to stop because I graduated university (yay on that count!) and left the town, not because I'd 'used up' my sessions. She would have been happy for me to continue.
Confidence wise, I found doing work on Core Beliefs, and rethinking my Rules for Living useful. With my high intensity therapist, she made sure her advice and suggestions were flexible to fit my situation. Better than the low intensity worker who I saw initially, who only re-iterated standard stuff to me, and ironically made me feel worse and lowered my confidence more as I thought it was my fault and incompetence that I couldn't apply his suggestions - when in fact it was simply his one-size-fits-all approach was never going to have much to do with me!
I'm not sure what a counsellor's approach would be. I imagine the more important thing is that they will take in your situation and issues and help you as a person, rather than trying to fit you into the text book.
Many thanks for all of those replies. It's very useful input for me as it confirms that a range of approaches other than medication are available and can be effective.
Things came to a head for me over the weekend and so I'm seeing a GP on Thursday (actually a different GP from before as my normal one is away). I'll ask him whether it's possible to refer me for any of these treatments and, if so, which in his view might be the most appropriate one.
Cheers!
-- aquarian
I saw the GP today and explained my symptoms -- here's a transcript of the notes that I made earlier and took with me:
- Feelings of anxiety and dread -- they can occur at any time but particularly at the start of the day
- It's often difficult for me to get going in the mornings, although I've still been able to drag myself to work (just about!)
- I'm still able to think logically about problems but with heavy feelings of dread, and I have little confidence in my ability to solve them
- I'm feeling low and drained from experiencing this anxiety for several months now
- I've stopped (or have tried to stop) doing things which I fear might trigger my anxiety -- this is gradually becoming more and more restrictive
- There's no obvious cause -- this seems like a deep-rooted and recurring condition which hasn't come to light during previous counselling and CBT sessions
However, I had a major revelation just before the GP appointment thanks to an insightful comment from my wife. She wondered whether the root cause of my anxiety might be that I'm comparing myself adversely to my father, who is much less emotional than me, and deals with setbacks calmly and confidently as they occur rather than worrying about adverse possibilities in advance. As my wife's words sank in, not only did they fit the pattern for me, but they seemed to hit a nerve at a subconscious level, giving me a bit of an emotional "wobble". I'm now convinced that she's on to something!
So, when I saw the GP, I explained my belief that there's some buried emotional stuff in this area that I need to work on, and that conventional counselling as before might be too superficial for this. From the responses earlier in this thread, I think that I might need some psychotherapy to drill more deeply into this aspect and work it through to a more positive conclusion.
Unfortunately, my GP was only able to recommend broad counselling on the NHS for which there's a waiting list of 6+ weeks (actually better than I expected). However, I'm now feeling sufficiently clear in my own mind about the nature of my issues to consider pursuing this privately and in quick time -- at least for a trial session to assess whether I've found the root cause. If that doesn't seem promising, then I can revert to conventional counselling/CBT.
By way of further background, I'm a professional engineer, following in my father's footsteps, but although I'm capable in this role, I've never felt entirely at home with it. As I hinted earlier, I'm more interested in ideas and people than things. For anyone familiar with the Myers-Briggs Type Indicator (a psychological instrument which divides people into one of 16 personality types). I consistently show up as an INFP, which is very unusual for an engineer, and more akin to a counsellor! The clue is the letter "F" which indicates that my internal world is one of feelings and emotions rather than cold logic (and I'm very strongly polarised in the "F" direction).
Many thanks for your helpful responses in this thread. Any further input is most welcome!
All the best.
-- aquarian
Hi Aquarian,
It sounds good that between you and your wife you have managed to identify some of the causes of your lack of confidence. I hope it is a bit of a relief to you to be able to see it clearly, even if there isn't an immediate solution.
Perhaps if you do end up on the normal counselling/CBT waiting list, if you bring notes like you've written here to your sessions, you'll be able to 'hit the ground running' and not have to waste sessions going through all their standard stuff first.
Good luck!
Hi Aquarian
At lot of your notes feel very familiar to me, I'm currently having cbt, but im sure i need to dig deeper to tackle my problems.
I have done the myers briggs at work some years ago - i cant remember what my type was back then but i know for certain it has changed somewhat. Have you ever thought of retraining? I'm currently training to be an occupational therapist - its not a career change as such as i work as a support worker in ot now but in physical medicine - but after several placements and my own experience with anxiety and depression and an intense interest in psychology - i most definatly want to specialise in mental health xx
Thanks for your replies. I've just left a message with a psychotherapist who appears to have a good track record of dealing with anxiety disorders, and who is also skilled in hypnotherapy and life coaching. I'm hoping that might be a wide enough range of tools to help me. My biggest fear of all is that I'm stuck this way regardless of what I try. :weep:
I definitely needed to take some action today. This morning, I had a minor setback and, even after I had solved it, I crumbled into a tearful state. I think I'm stuck in a vicious circle of low self-confidence and anxiety, in which I feel "fragile" and so I try desperately to keep everything as simple as possible for myself. Of course, I know that it's only a matter of time before I hit some sort of snag (more anxiety!) and, when I do, I tense up in expectation of flying apart. Even when I don't, it's a tiring cycle to endure. It's also difficult to explain to others that apparently mundane events are running me down. I'm otherwise rational and balanced, but I'm feeling very lost inside. :wacko:
Thanks again to everyone who has contributed to this thread. I appreciate it a lot.
I received a 'phone call back from the psychotherapist whom I called on Wednesday and we had a brief discussion on the telephone. I've booked a session with her in a couple of weeks time. In the mean time, I was particularly struck by one of the comments that she made.
I had explained to the psychotherapist that, although counselling and CBT had helped me somewhat to cope with the symptoms of anxiety in the short run, I had found them ineffective in getting to the root causes. I said that my anxiety seems to stem from a bunch of feelings that I'm unable to put into words. She suggested that my anxiety might be rooted in experiences from early childhood when I didn't possess the language or understanding to express my thoughts or feelings about them.
The significance of this remark only struck me later on, when a lady passer-by chided her child who was messing about on the pavement for "getting in the way of that man". Now, that's always sounded odd to me. I know that I must be classified as a man -- I'm in my mid-forties with a wife and children -- but it still jars me when I'm described that way because I don't feel like that inside. Deep down, I feel like a child trapped inside a man suit, pretending to be an adult.
I've been pondering this thought ever since. It may explain a great deal, including why my anxiety and panic attacks resemble the tantrums of a small child, but I find it troubling to consider that I might not have grown up properly and have only become good at pretending to be a grown-up.
To cap it all, last night I had a dream last night in which I met a small boy. The boy was sociable, caring and inquisitive -- seemingly a great lad -- but he was also very frightened. He was an idealistic soul, but he had just become aware of the cruelty, sadness and death in the world, and didn't know how to cope with it. He wanted to find a safe place where he could hide away from it all. When I tried to explain that this would never be possible in real life, he started to scream and throw a tantrum.
It doesn't take much imagination to conclude that the small boy in my dream is me. I assume that this must be fertile ground for a psychotherapist to explore. I don't want to get rid of the little boy, though. It isn't his fault that he feels that way, and I like many of the qualities that he brings. Indeed, I feel at my best as a person when my child-like aspect is able to blend comfortably with my learned adult behaviour. That's the real me! The problem at the moment is that this ideal combination doesn't show up very often, as it's much too easily disrupted by external stresses.
I'd be very interested (and relieved!) to hear from anyone else who recognises this scenario. :)
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