View Full Version : Struggling. questions on Cbt..
Hey there been suffering 4 years with going out and socializing, Been doctors at last after being able to get out. Been Prescribed citalopram And been recommended seeing a counselling, I saw one and they've put me on a waiting list for CBT.
The questions i have are: What will the first session be like ?, How much will they push me to go out at first?. also if you have had it before can you tell me how much it helped you please :)
Thanks in advance. Dan
Dan the first session wil be an exploratory session for both of you to assess the suitability of CBT. They will give you homework to do within the course but much of CBT is challenging your thought patterns through self discovery and discussion with your councillor regarding the interpretation.
I have had CBT and yes it is effective but with time it can be ineffective when the sessions stop and that negativity starts to chip away. So my suggestion along with the CBT is to practice mindfulness as that will keep you on the straight and narrow path so negating the chance that negatives will stop your progress.
Dan the first session wil be an exploratory session for both of you to assess the suitability of CBT. They will give you homework to do within the course but much of CBT is challenging your thought patterns through self discovery and discussion with your councillor regarding the interpretation.
I have had CBT and yes it is effective but with time it can be ineffective when the sessions stop and that negativity starts to chip away. So my suggestion along with the CBT is to practice mindfulness as that will keep you on the straight and narrow path so negating the chance that negatives will stop your progress.
How many session did you have?.
Sorry to sound silly but what does practice mindfulness mean ?. Thank u for your advice :)
I have had about 20 sessions but that's because I have ME/CFS which gives me anxiety and health anxieties, you will be probably offered around 12 sessions.
Mindfulness is living in the moment, we tend to live in the past or the future with our thoughts and spend minimal time actual living in the moment and really experiencing life. It is called the present because that's what it is a real present which allows us to uncomplicated our emotions.
It just means that when we recognise our minds starting to wander we gently bring our focus back to the moment, look at colours, shapes, sensations on your skin with the breeze and I am sure you can think of many more things to focus your mind.
This allows the mind to calm. Your brain is a wonderful organ but it has one major flaw, your unconscious mind has no concept of time. If you worry about a past or present event it will still react as though it is happening right now so your body will act appropiately and release those stress hormones that are responsible for keeping your nervous system in a sensitised state. Anxiety is a protective mechanism so look at it this way, your body is been true to you but your mind is acting inappropriately to the circumstances that you are in.
Living in the moment will readdress this balance along with a good hobbie and a positivity that you can go forward and with time you will be well.
cathycrumble
11-11-11, 10:04
I have just started CBT and Ronski is right as that is what my first session was like. I was nervous about starting it as talking and then trying to conquer my fears is scary and I worry about failing but that's my negetivity at the moment. I wasn't always like this.
Ronski you are so good at explaining things and you have helped me. The mindfulness sounds really good to practice. Also the way you explaind accept and not fight the feelings we get when axtious. I have saved that paragraph. I just want to say thank you.
And Danbryn I am sure the CBT will be good. My 2nd session is on Tuesday. As I don't want to take anti depressents I have been off them 3 weeks now so I need help in other forms. And it's people on here like Ronsky and CBT that help us. good luck.
Cathy xx
Cathycrumble if you want any help on any specific need regarding anxiety just PM me.
cathycrumble
12-11-11, 00:46
Thank you for that Ronski, and I will. I have practiced the mindfulness today but I dont know anything about it other than what you said about living in the moment. And I felt so outside of myself it was a little like being my old self. I still got my scary thoughts but i just kept saying its just a thought let it go and also I didn't let my feelings of anxiety overwelm me. Again it is accept. but I will message you if i get a bit iffy lol thanks again.
Cathy
Hi cathy, yes you will get scary thoughts, but gently refocus your mind on the moment, look at colours or shapes, concentrate on some music and just enjoy the moment. The clue is being kind to yourself and allowing your mind to wander and then just bringing it back in line attaching no emotion like frustration or anger at yourself.
Why don't you add some guided meditation to the mix or some relaxing light music say twice a day for half an hour. People have this hard and fast rule regarding meditation that it has to be within certain recognised boundaries. But I don't agree I think music can be just as effective if not more so. I use Katherine Jenkins, Il Divo, Secret Garden. Secret Garden is wonderful because it uses ethereal vocal sounds and relaxes effectively.
Mindfulness and meditation go hand in hand and will improve your general health, no doubt at all. Practice being kind to yourself and you will do well.
Dan,
It sounds like your session that you had was to see if CBT would be suitable for you. Maybe you went through your background of your issues too? If you haven't talked that through with a counsellor yet, that will probably be the first thing you do.
Do you know if it will be guided self-help type work or a face-to-face, high intensity CBT? Depending on the intensity of the sessions, if you are receiving the low intensity, self help type, then your first session may be going through the material that you'll use during the course, and learning about the ideas and methods behind cognitive behavioural therapy. If you receive high intensity from the start, I'd imagine the first session would be similar, of the therapist getting to know you and you learning about the therapy, but without the self-help booklet material.
I received CBT in Gloucestershire, and they have a printed booklet called 'Gaining Control of Your Life'. It is broken into chapters, roughly one per week, each on a different topic to do with controlling/minimising anxiety or another way of approaching potentially stressful situations (eg relaxation breathing techniques, problem solving, making behavioural action plans). I'd imagine other services in the UK would do something similar?
The first chapter/week was introductory information about anxiety, triggers and symptoms. So I went through that with the therapist, identifying what was specific to me. Then it gave thought and anxiety monitoring diaries that I had to fill in during the week/two weeks between sessions. In subsequent sessions I'd first go through what had happened during the previous weeks and how I'd coped (or not) when applying the techniques in the booklet, using the diaries as prompts. Then we'd look at the next chapter of the booklet and during the week I'd fill in the booklet and try to carry out the suggestions in my everyday activities during the week. Then the next session I'd report back on how I got on.
If you're going to receive more intensive therapy, (which I did, after having worked through the GCOYL booklet and finding my anxiety and depression was worse than ever!), then the sessions will be more flexible and your therapist will choose what techniques to teach you to deal with anxiety that are most suited to your situation. Probably more work will be done in the session talking about them to make sure you understand them and that they will be applicable to your situation (avoiding the one-size-fits-all approach). You'll still have to expect homework though!
Good luck with your first proper session of CBT. Do you know when it will be? My main bit of advice is to be honest, especially in the first session, so that your therapist can help tailor their support to you. And to question them if something doesn't make sense, or seems to much like inapplicable theory. (I made the mistake of being too scared to question at first, which just wasted their and my time!)
I have had about 20 sessions but that's because I have ME/CFS which gives me anxiety and health anxieties, you will be probably offered around 12 sessions.
Mindfulness is living in the moment, we tend to live in the past or the future with our thoughts and spend minimal time actual living in the moment and really experiencing life. It is called the present because that's what it is a real present which allows us to uncomplicated our emotions.
It just means that when we recognise our minds starting to wander we gently bring our focus back to the moment, look at colours, shapes, sensations on your skin with the breeze and I am sure you can think of many more things to focus your mind.
This allows the mind to calm. Your brain is a wonderful organ but it has one major flaw, your unconscious mind has no concept of time. If you worry about a past or present event it will still react as though it is happening right now so your body will act appropiately and release those stress hormones that are responsible for keeping your nervous system in a sensitised state. Anxiety is a protective mechanism so look at it this way, your body is been true to you but your mind is acting inappropriately to the circumstances that you are in.
Living in the moment will readdress this balance along with a good hobbie and a positivity that you can go forward and with time you will be well.
okay thank you so much, i think ill take up reading as a hobby for now, Everything you said really has helped me :). Does having anxiety make you feel unhealthy ? just when i go out im out of breath and i feel like i need exercise all the time its like ocd in a way :weep:
---------- Post added at 10:49 ---------- Previous post was at 10:44 ----------
Dan,
It sounds like your session that you had was to see if CBT would be suitable for you. Maybe you went through your background of your issues too? If you haven't talked that through with a counsellor yet, that will probably be the first thing you do.
Do you know if it will be guided self-help type work or a face-to-face, high intensity CBT? Depending on the intensity of the sessions, if you are receiving the low intensity, self help type, then your first session may be going through the material that you'll use during the course, and learning about the ideas and methods behind cognitive behavioural therapy. If you receive high intensity from the start, I'd imagine the first session would be similar, of the therapist getting to know you and you learning about the therapy, but without the self-help booklet material.
I received CBT in Gloucestershire, and they have a printed booklet called 'Gaining Control of Your Life'. It is broken into chapters, roughly one per week, each on a different topic to do with controlling/minimising anxiety or another way of approaching potentially stressful situations (eg relaxation breathing techniques, problem solving, making behavioural action plans). I'd imagine other services in the UK would do something similar?
The first chapter/week was introductory information about anxiety, triggers and symptoms. So I went through that with the therapist, identifying what was specific to me. Then it gave thought and anxiety monitoring diaries that I had to fill in during the week/two weeks between sessions. In subsequent sessions I'd first go through what had happened during the previous weeks and how I'd coped (or not) when applying the techniques in the booklet, using the diaries as prompts. Then we'd look at the next chapter of the booklet and during the week I'd fill in the booklet and try to carry out the suggestions in my everyday activities during the week. Then the next session I'd report back on how I got on.
If you're going to receive more intensive therapy, (which I did, after having worked through the GCOYL booklet and finding my anxiety and depression was worse than ever!), then the sessions will be more flexible and your therapist will choose what techniques to teach you to deal with anxiety that are most suited to your situation. Probably more work will be done in the session talking about them to make sure you understand them and that they will be applicable to your situation (avoiding the one-size-fits-all approach). You'll still have to expect homework though!
Good luck with your first proper session of CBT. Do you know when it will be? My main bit of advice is to be honest, especially in the first session, so that your therapist can help tailor their support to you. And to question them if something doesn't make sense, or seems to much like inapplicable theory. (I made the mistake of being too scared to question at first, which just wasted their and my time!)
mines in 4-6 weeks time, but before i moved house the waiting list was 6 months which is ridiculous.
Im not sure which type of help ill be offered, all the letter i received says is cbt and we will be in touch with a date for you first session.
Ill defo keep the question asking in mind.
Ill tell them everything and make sure theres nothing held back. Im really looking forward too this, but at the sure time very nervous. I expect at times ill feel depressed and a bit of a let down but in the end ill get there with there help hopefully.
Is there any site or an address i can send off for one of them booklets ?
Thank you :)
Dan,
You could try asking your GP or nurse if you could get a couple of Books on Prescription from your library (or buy them outright). Books in the 'Overcoming...' series (eg '...Anxiety' by Kennerly, and '...Depression' by Prof Gilbert) and 'How to stop worrying' by Tallis, are meant to be good, though I found I needed a therapist to help me make use of it.
Suffolk health service have some leaflets that are similar to the Glos ones, but shorter: http://www.smhp.nhs.uk/OurServices/Trustleaflets.aspx. (scroll down to IAPT - self help guides, right click and 'save link as...').
http://www.getselfhelp.co.uk/freedownloads2.htm has a load of free sheets for anxiety monitoring and other things. My therapist downloaded things from there, so they must be decent! And others on NMP have talked about them too.
Good luck!
Dan,
You could try asking your GP or nurse if you could get a couple of Books on Prescription from your library (or buy them outright). Books in the 'Overcoming...' series (eg '...Anxiety' by Kennerly, and '...Depression' by Prof Gilbert) and 'How to stop worrying' by Tallis, are meant to be good, though I found I needed a therapist to help me make use of it.
Suffolk health service have some leaflets that are similar to the Glos ones, but shorter: http://www.smhp.nhs.uk/OurServices/Trustleaflets.aspx. (scroll down to IAPT - self help guides, right click and 'save link as...').
http://www.getselfhelp.co.uk/freedownloads2.htm has a load of free sheets for anxiety monitoring and other things. My therapist downloaded things from there, so they must be decent! And others on NMP have talked about them too.
Good luck!
wow! just looked on the trust leaflets, there are loads that could help me out! Thank you very much. Will look on amazon for them books as i cant get to the library at the moment :)
Dan you sound so much more positive, that's great doing some reading but also look at creative hobbies such as photography or painting. You need a hobby that will fully distract you and allow your conscious mind to be fully occupied.
Yes anxiety can make you feel very unwell and if it dysrupts your autonomic nervous system it can have a major impact on energy levels. Getting out of breath is common and it's probably related to abnormal breathing techniques that has been compounded by your anxiety state. It normally means you are hyperventilating and your tidal volume is less.
The hyperventilation is not the acute type we all recognise but a very subtle form that just ups the rate slightly maybe by only 4 breaths a minute but it's enough to give you the symptoms you describe. Also ensure you breath using your diaphragm and not your upper chest. Also be kind to yourself and do not continually ruminate about exercise as that will increase tension and release of stress hormones and that just keeps the condition going. I hope this helps.
cathycrumble
14-11-11, 19:07
Hi cathy, yes you will get scary thoughts, but gently refocus your mind on the moment, look at colours or shapes, concentrate on some music and just enjoy the moment. The clue is being kind to yourself and allowing your mind to wander and then just bringing it back in line attaching no emotion like frustration or anger at yourself.
Why don't you add some guided meditation to the mix or some relaxing light music say twice a day for half an hour. People have this hard and fast rule regarding meditation that it has to be within certain recognised boundaries. But I don't agree I think music can be just as effective if not more so. I use Katherine Jenkins, Il Divo, Secret Garden. Secret Garden is wonderful because it uses ethereal vocal sounds and relaxes effectively.
Mindfulness and meditation go hand in hand and will improve your general health, no doubt at all. Practice being kind to yourself and you will do well.
Can I down load secret garden? Because I will get my son to do it for me. who is it by? Or am I asking a silly question? lol xx I have been reading your posts and you are so good at explaining things and how to cope with anxiety. thanks again Ronski. xx
Dan you sound so much more positive, that's great doing some reading but also look at creative hobbies such as photography or painting. You need a hobby that will fully distract you and allow your conscious mind to be fully occupied.
Yes anxiety can make you feel very unwell and if it dysrupts your autonomic nervous system it can have a major impact on energy levels. Getting out of breath is common and it's probably related to abnormal breathing techniques that has been compounded by your anxiety state. It normally means you are hyperventilating and your tidal volume is less.
The hyperventilation is not the acute type we all recognise but a very subtle form that just ups the rate slightly maybe by only 4 breaths a minute but it's enough to give you the symptoms you describe. Also ensure you breath using your diaphragm and not your upper chest. Also be kind to yourself and do not continually ruminate about exercise as that will increase tension and release of stress hormones and that just keeps the condition going. I hope this helps.
sorry to keep bothering you, I have one last question. How affective is CBT ?:blush:
Hi Dan,
I know that others have already posted their experiences but thought I'd add mine for good measure. I started CBT about 2 months ago. So far the effect has been generally very positive for me. As others have said the first session is exploring whether you are suitable and will involve talking in detail about how you feel and maybe your past history. (I found that quite distressing - came away with a headache and some stress, but its worth it trust me.) The next few sessions are about challenging your self-defeating thought patterns. (That has really helped me a lot.) Only when you've got a grasp of the ways to challenge your thoughts will you begin exposure, which is where I've been for the last week or two.
Like most things you get out what you put in. The more you work at questioning negative thoughts and emotions the easier it becomes. And at exposure time an element of managable anxiety is inevitable.
For me CBT has helped with my expectations of what I should be like socially and taking the pressure off myself has helped me to be myself and relax more. What has been more difficult and I'm still working on has been my fear of trembling. Hoping that with continued efforts I can conquer that one but I do feel it is gradually getting better.
All the best and fingers crossed that it works for you too.
B
Hi Dan,
I know that others have already posted their experiences but thought I'd add mine for good measure. I started CBT about 2 months ago. So far the effect has been generally very positive for me. As others have said the first session is exploring whether you are suitable and will involve talking in detail about how you feel and maybe your past history. (I found that quite distressing - came away with a headache and some stress, but its worth it trust me.) The next few sessions are about challenging your self-defeating thought patterns. (That has really helped me a lot.) Only when you've got a grasp of the ways to challenge your thoughts will you begin exposure, which is where I've been for the last week or two.
Like most things you get out what you put in. The more you work at questioning negative thoughts and emotions the easier it becomes. And at exposure time an element of managable anxiety is inevitable.
For me CBT has helped with my expectations of what I should be like socially and taking the pressure off myself has helped me to be myself and relax more. What has been more difficult and I'm still working on has been my fear of trembling. Hoping that with continued efforts I can conquer that one but I do feel it is gradually getting better.
All the best and fingers crossed that it works for you too.
B
What did u have cbt for? If you dont mind me asking :ohmy:
CBT will only work if you are honest and open. Research has shown CBT to be effective but after the course has finished it sometimes does not allow on going recovery. The reason is not the CBT itself but ours because without constantly challenging our negativity it tends to return our anxiety sensitivity.
That's where mindfulness comes in as that is a complete lifestyle change so the two go together like a hand in a glove.
What did u have cbt for? If you dont mind me asking :ohmy:
Don't mind at all. For two separate problems which maybe at some level were related.
The first was a fear of trembling in public (handling and pouring drinks being the worst things.) A kind of performance anxiety if you like. Self-help on its own and gradual exposure was very stressful without addressing my incorrect thinking first. So I felt that I needed a therapist to support me through this and point me in the right direction.
Second was that I had a big problem with intimate relationships. Hadn't had a girlfriend for many years, felt inadequate on dates or asking for dates, tried too hard or just dried up when I talked to anyone I fancied, if I thought they fancied me I panicked even more. Had low self esteem in that area.
Maybe its just coincidence but I've been seeing a girl for the last month. Things are going very well and I feel very relaxed with her. Have I just met someone I really like or am I more relaxed and can be myself more in these situations? A bit of both I think, but CBT has undoubtedly helped me accept myself as I am.....
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