CBT issues and exposure probs...

[star2sparkle]

We speak a lot about CBT on this forum and exposure therapy and I endorse Robin Hall's books but I have suffered from anxiety, agoraphobia and panic attacks for getting on for 30 years and that is a long time. I am also a qualified teacher of psychology and law and have studied psychology for many years. I am hoping to do a PhD this year.
So I have been trying to do CBT and graded exposure and I have many many hierarchies but this is the problem..because I have mild agoraphobia now, because I have coped all this time and managed my anxiety, I am actually going backwards. I have coped by not focusing so explicitly on my body and my 'negative' thoughts. This has allowed me to have a life, albeit limited. Of course, one could say this is avoidance but also some of the self help strategies are to relax and not think about the negative thoughts. I have even been able to go to the theatre before with my children yet yesterday, I couldn't even make the local shop because of doing CBT. So now I am scared; scared I am going to become housebound again like I was a few years ago...I can see it coming almost, as the feelings of unreality when out are engulfing me! This would make me terribly depressed and distressed. I almost want to forget all that I have learned/been thinking about for the last few weeks! I am a very determined person who goes out to try and make a life because of my restrictions (if that makes sense) but now I am terrified of losing even that ability. Because my anxiety fears are complex, it is really hard to explain. This is why I believe that you should have proper support before starting a programme and real guidance, which I don't have. I have a counsellor but she just says; 'Exposure works...do it' and shuffles me out the door! Now I'm not even sure if I can make it in to see her, ironically! I am going to ask my GP to see someone better...the community mental health team and be assessed but I don't know what to do in the meantime (and I hope I can even have that). I used to go out without always stressing like this, without always thinking. My hierarchies are somewhat ridiculous because my fears are all mixed up and to really do them properly, I'd have to start from the beginning and I wouldn't be able to keep any appointments or drive any distances...in other words, my life would be suspended as I habituated.
Help please!

[Serenitie]

I identify with so many points that you make. From a objective point of view it seems like you are making great progress. The main thing that seems to be holding you back is the ruminating on the 'What If's' and possible negative outcomes.

To overcome agoraphobia and panic attacks that you have experienced for 30 years takes time, patience, determination, guts and hard work. You seem to have all of these qualities in abundance. You are making amazing progress - give yourself credit for this and build on your successes. Try not to over think situations.

No aspect of life is consistent or predictable. Neither is agoraphobia. One day can be filled with a sense of joy & achievement and the very next full of anxiety and foreboding. It is the same for people who do not experience anxiety. Good days and bad. Focus on the good to get through the bad.

Your psychology training may be a mixed blessing too. Too much insight is not always a good thing ( I was a social worker for 13 years). Keep in sight first and foremost the fact that you are human, and as such prone to changes of temperament, fluctuating confidence levels and moods. Be kind to yourself and give yourself permission to have good and bad days.

I wish you every success and look forward to reading about your progress with your recovery.

[star2sparkle]

Thank you Serenitie...what a beautiful name.
Your words have made me feel much more positive. Less rumination and more sunshine I think.
Thank you again for your kindness. I hope you are having a lovely weekend.

[Serenitie]

Good for you! I'm glad that you are feeling more positive :yesyes:

I developed agoraphobia in the last two years and did not leave the house for almost a year last year. I'm on my own journey towards recovery and would like to suggest that we stay in touch and support each other. Sometimes just a few words can change your perspective or make a problem easier to bear, especially when the support that you receive is from someone who really understands what you are going through from personal experience.

Don't be a stranger and enjoy the rest of your weekend :bighug1:

[star2sparkle]

Thank you :) so much. I have been reading about your journey through your posts. We seem very similar. How have you managed to cope with agoraphobia? Did you use CBT and exposure? I can already see what an inspiration you are to others. I am a writer and hope that my messages reassure and guide others. I was in Chicken Soup for the Soul in the hope that someone may feel reassured :hugs:and I write for magazines. I am also very spiritual which I think really helps. Just wanted to share with you a pic from my handfasting last year...magical :) xx

[Serenitie]

You are more than welcome :) Thank you for your kind words. We do seem very similar! I'm am also very spiritual. I design and make jewellery and costume pieces as my creative outlet. I love Chicken Soup for the Soul :) Writing is a wonderful skill to have and a fantastic pastime. I would love to read some of your work!

Your picture is very beautiful. I love it! It is magical indeed!:yesyes:

Re-read your last message and take note of all of the positives you have going for you! :)

I have never had any formal CBT although I am very familiar with the principles through my social work training and study of psychology.

In all honesty, I was at rock bottom last year. I reached the point where enough was enough! I decided that I have so much life to live, things I want to experience, people to meet and much to offer others. I could not achieve these things while I was a prisoner in my own home or in the mindset of an agoraphobic.

I feel the fear and do it anyway! I still experience anticipatory anxiety before I go out, but am fine once the initial anxiety subsides. I refuse to let anxiety define me or restrict my achievements. I may need to build up to certain things, but now I believe that anything is possible, whereas at my worst, I'd convinced myself that most things were not achievable for me. I still have the odd bad or low day, but who doesn't?!:winks:

I also make more time for myself, take better care of myself and value myself, which makes a huge difference as does letting go of what other people think of you. If I panic while I'm out and a bypasser sees, so what? You will probably never see them again and more than likely they have enough of their own stuff on their mind to pay any attention!

I also keep a gratitude journal. I write down 5 things that I am grateful for each day. This helps me to appreciate what I have and focus on what is important to me. I meditate, listen to relaxation audios and laugh a lot! It is hard to be anxious when you are laughing :D

I now have a full and varied social life and a quality of life that I am really happy with :) I still have a lot of work to do, but I'm really proud of the progress I've made and have every faith in my continued progress.

I hope this helps. What are your strategies?

Catch up soon :) xxx

[star2sparkle]

I love your positive attitude and a gratitude journal sounds fantastic. I think I should do the same as it is so easy to get bogged down with negative experiences, sadness and resentment.
I think what has really worked for me is having hope and determination to keep getting up and trying no matter what. I have had some terrible times admittedly but the next day I think of what else I can do to improve my life and those of the people around me. I would love to do more. I am beginning a book this year that I hope will help others with anxiety. It will be partly autobiographical but the aim is to inspire and create hope and happiness (hopefully!) in others.
I am also a cheerful person, love to laugh! Though I think I am quite feisty too. I think life has certainly taught me to stand up for what you believe in and to have courage.
So I think I am very much like you...I get out there and try my very best. I use positive thinking and try to relax. I probably do have safety behaviours but I'd still much rather be out there than sat at home wishing I could be out there and working out how to habituate myself to walking across the field opposite my house! I see the value of therapies but I still think everyone is an individual. My fears are linked up and linked to other things and I think that for me I would need therapy that is much more holistic than CBT allows. Though it could be within the therapy I receive.
In some ways, I sometimes think that when someone promotes a therapy like CBT that can often be self help, it can almost be dangerous. I realise all the positive self talk is good but I think some people need more one to one support than just reading an online ebook, especially if they have suffered from anxiety/agoraphobia/phobias for many years.
I like your ways of being good to yourself. I don't think I do that very well at all. I have meditation cds but always seem to find other things to do! Making time for yourself and appreciating your own self worth...I like that.
Thank you again for helping me to see the positives that I had overlooked :hugs:

[Serenitie]

I agree that hope and determination and the willingness to keep trying are essential to recovering from anxiety.

Writing a book this year will be a huge boost for you! It will be a very therapeutic process in itself that will help you and others. It will be a huge achievement for you to work towards! Good for you! :yesyes:

Like you, I try not to get bogged down too much with the theories or 'rules' of therapy as one size does not fit all! We are all very individual with our own personal experiences of anxiety and different things work for different people. There is value to be gained from therapy, but finding out what other things work for us is a very personal journey of trial and error. I find that if I take the focus away from how to reduce my anxiety to how to increase my happiness and general well being I have much better results which not only help my anxiety but improve my over all quality of life.

I think that the positive thinking which underpins CBT is a good skill but needs to be balanced with the understanding that life is't all sunshine and roses! There are also things that are beyond our control and sometimes feeling upset or sad is a completely natural response to events and circumstances. So, we should not feel bad or like we have failed for experiencing negative feelings at these times.

I've enjoyed 'chatting' with you today :) Take care and 'speak' soon :hugs: