councelling

[june]

Hi,
I have been offered 6 councelling sessions.
It has been suggested that i make a list of what I want from these sessions:blush:
I have seen a councellor before and i found that they would - basically sit and wait for me to talk and they would say VERY little.
Now I am asking for your help to make this list.
I do have health anxiety ---
I panic and think I am dying.
They say "well you did not die the last time you panicked, why would you die this time????"
They say "what is the worst thing that can happen when you panic?" Considering my first answer - How can they be so stupid?
How do I explain my fear?
I want to be "normal" again (whatever 'normal' means)
1. I know about deep breathing (that sets off panic)
2. I know about visualisation (confusing)
3. I know about relaxation etc. etc How????? I hear the voice and I panic

I want to know what makes me giddy? - what makes my head hurt? - Why do the palpitations come so suddenly? - why when I am out shopping does the feeling of absolute terror come on me?? I want to know = what I am so afraid of - why am I so afraid.
I am sure many of you understand why I am so up tight about this.
Best wishes
June
Hope you can help:hugs:

[Stefan P]

Hi June

I went to some CBT sessions and found something similar - the guy would wait for me to say stuff quite a lot, which maybe is the point that I missed, I don't know, but what I actually wanted was for him to say "Tell me about ..X", or "How do you feel about Y", and for me to respond to him, rather than the other way around. I found that all I wanted was for him to say something like, "I bet you feel like <whatever> when you suffer anxiety", so I could say "YES! I DO!" and feel like he understood me. But that didn't happen, so CBT didn't work out for me.

But from your post it seems like you've got a great start to your list already!

I can see why they want you to make a list first, as it must be difficult with a new patient (client?) to know where to start. Perhaps you could start with explaining as far back as you remember when you started to suffer from your attacks, and then go from there? (Just to begin with)

[Emira7]

Hi June

What a good idea, I have just had a letter to say I am at the top of the list for counselling. And i have no idea what to expect. So its useful to see your post, I wonder if that will be the same approach.

Good luck
Emirax

[neptuno]

June,
I would recommend you read Claire Weekes "Self Help for Your Nerves" - you can get it out at the library. You need to understand where all your scary symptoms come from and this book will tell you - no messing. It will also help you put together a list for your CBT sessions.
Be kind to yourself

[june]

Stefan P Yes I think it would be better if they also asked some questions just to see which sorts of panic/anxiety we have. Often when they do talk you can almost tell which book they got their info from.
Emira 7 i hope you have a great councellor and that you do get the answers you need. (then you can share some good ideas with us (ha ha))
neptunoI have got Claire Weekes book and although I have found her VERY helpful (and your idea is useful) it is not quite the same as hearing a person say the answer you are hoping for. You can't really beat interaction, I can read and give other people the courage but I don't seem to beleive it myself (does that make sense).
Thank you all and
Best wishes
June

[eternally optimistic]

Hi June and morning

I was offered and accepted a six week course earlier in the year.

I found it really beneficial, it was like the counsellor was inside my head -
she was me, I think - if that makes sense.

My experience was totally positive. I talked the whole time, not always covering what I intended to cover but rambled onto other things that came to light.

I too have got one of the Claire Weeks books too, it all makes sense, the hard thing is putting into practice.

Whilst day to day I am fine, I do DEFINITELY gain confidence from coming onto this website, so that should help too, I suppose.

I think the list idea is good, its like when you go to the Doctors you sometimes forget what you really wanted to talk about.

I think you should give it a go, and if its not for you then you can pack it in.

Good luck June

[Catwoman]

I am on a list to have counselling and I am a bit worried. Its funny as I do communications as a job, and am also a public speaker but never know what to say when doctors talk to me about my anxiety or depression.
I usually come up with silly things. Like they ask me why am I depressed and I have to say I don't know why, maybe its hormonal / genetic? Then I always make a silly joke that I am not mad as I don't think I am Napoleon! I don't know why I say that!
They always sit quietly and sort of expect me to speak, but this is the one occassion when I do not know what to say, I want THEM to say something to me!
It can be very difficult! I am very worried about these counselling sessions, especially as I hope they don't impinge on my work, as I am not telling work about them. My work would not understand. So as I work full time I would have to somehow hide them.
It's not made easy for us eh? :shrug:

[june]

Just a quick thank you for now.
Like you I tend to ramble - I honestly do not know how the attacks started or why.
yet that seems to be their only question.
If we knew that we would be half way to our own cure (ha ha)
Best wishes
june

[Marginalia]

I'm seeing a counsellor at the moment and it is one of the most frustrating things not knowing what is causing the anxiety. I have always been prone to psychosomatic symptoms (i.e. psychologically-caused bodily sensations) which at the time I have not known where they came from (hence the mind's tendency to look for explanations ends up at the 'cancer' 'heart disease' 'Alzheimers' type of answers.

Often it's only been years later I've been able to make an intelligent guess at the 'real' cause. I seem to be so bad at listening to my mind's distress that the only way it has to communicate with me is to make parts of my body feel odd.

For example, I got excma when I was 16, then I suffered chest pains, breathlessness and fatigue when I was 18, and for a year when I was 21/22 I suffered free-floating anxiety, panic attacks and extreme insomnia. As it happens, those time periods corresponded with my 'O' levels, my 'A' levels and my final year at university. I was not aware of any worries or stress about my academic performance, but I suspect it was not a coincidence.

Now I'm working (weekdays) I have noticed that I frequently get insomnia on a Sunday night, and upset stomach on a Friday night. I used to get an upset stomach every Friday fortnightly when I used to edit a newsletter on Friday afternoons. So it seems that, for me, upset stomach tends to happen *after* a time of tension, whereas insomnia happens in anticipation. So therefore I deduce that I am a bit stressed at work.

What I am doing now with my counsellor is (trying to) ignoring the exact way the symptoms manifest, and to examine any aspect of my life, sifting through for the things which are possible sources of worry. This is taking some time. But how I work together with my counsellor is that I write down things which I think are worrying me each week, and when I run off the list with her, she picks out the ones which she thinks might be the significant ones, and I give her feedback (I weigh up and think if I agree with her assessment) - or sometimes I pick them out and she says if she agrees with me or not.

Gradually we're working through the main things which cause me stress. As a result I have now (with her support and encouragement) been able to get rid of two of the things which were getting to me the most (though it took me some time to realise my own ways of dealing with them weren't effectual and to take a more drastic solution). And onwards we go, looking at what my stress triggers are and where my coping mechanisms need work.

[june]

Hi Marginalia,
I am printing off your letter (i hope you don't mind) it is easier to read than on screen, and there is plenty to 'digest' in there.
Best wishes
June

[Marginalia]

Hi Marginalia,
I am printing off your letter (i hope you don't mind) it is easier to read than on screen, and there is plenty to 'digest' in there.
Best wishes
June
No worries. :)

The other thing I wanted to say (which is probably so obvious you'll do it anyway), it that you can always talk to your counsellor about how you want to be counselled and you can ask them to explain the approach they are taking.

When I came to my current counsellor I'd already been seeing a different one for 10 weeks, and just felt I'd been going round and round in circles with him (I felt he was 'too nice' and didn't challenge me. It was still good to have an hour a week of me-time, and a person guaranteed to be there for me, but I didn't feel I was getting any further in discovering what was wrong).

I found out about different types of counselling and decided that I wanted a more practical approach (CBT) rather than the humanistic client-centred approach my previous counsellor took. I chose my second counsellor (the first one I have paid for) because she is trained in CBT as well. She hasn't in fact taken a pure CBT approach with me, but seems to mix and match different approaches.

In my first session with her I said that I just wanted her to be honest with me and not mollycoddle me, and that I was looking for a more practical approach, and that if she made suggestions, I would evaluate whether I agreed with them or not (I'm an academic so I don't automatically 'believe' any so-called authority on a subject).

So although she does say "I am not in the business of giving advice", she does offer her opinions and make suggestions and it really works for me.

Just to add, one of her suggestions was that I took an introductory course in counselling skills (because I was lamenting my difficulties interacting with other people when they are in distress), and so I have now spent some time learning about the humanistic client-centred approach which the majority of counsellors use. So now I understand better why they (client-centred counsellors) seem to just sit there and make us (the client) do all the work, and I have read many moving stories about how and why this works for people. A skilled counsellor will paraphrase and summarise and ask questions from new angles, in such a way that it might cause you to see your situation differently, perhaps more objectively (but what they don't do is tell you how *they* see the situation - their aim is to see it the same way you do so they can explore it with you because the situation is a combination of the kind of person you are, with the world as you see it).

Recently I came across a book which said that once the basic relationship of trust is in place, the counsellor can take a more active role (which I hadn't realised). But the counsellor can only do this when they know that the client won't treat them as some kind of authority, because the fundamantal belief is that the client will discover themselves what to do (what is best at that time), and nobody can know that better than the client.

[N.B. don't take my words here as gospel, because I am only just starting to learn this stuff, and I have a long way to go before I fully understand the approach]

Marginalia


P.S. What I realised for myself having seen 5 counsellors in my life now, is that it's not only their particular approach to counselling which can be a better/worse fit for the individual (no psychodynamic counsellors for me, but the Freudian approach worked really well for a friend of mine), but also it depends on the individual counsellor. No counsellor is the same as any other because their individual personality factors into things, and I just feel my current counsellor is probably more 'my sort of person' than any of the others (though that could be her skill as a counsellor).

[june]

WOW!!!!!!
I think that most of us are in such a state by the time we get to see a councellor - plus the fact that we do not know what to expect - or that we can change to another councellor without "fear or prejudice". is a major part of so many failures at councelling sessions.
We wait months and our worries grow out of proportion and then we are suddenly 'in councelling' and are completely lost for words. As StefanP said he needed them to ask a few 'leading' questions to help him get started.
Thank you so much for all this info.
Best wishes
June

[Marginalia]

WOW!!!!!!
I think that most of us are in such a state by the time we get to see a councellor - plus the fact that we do not know what to expect - or that we can change to another councellor without "fear or prejudice". is a major part of so many failures at councelling sessions.
We wait months and our worries grow out of proportion and then we are suddenly 'in councelling' and are completely lost for words. As StefanP said he needed them to ask a few 'leading' questions to help him get started.
Thank you so much for all this info.
Best wishes
June

June - I don't know if you can change counsellors if you have been referred within a particular NHS service. What happened with me is:

(1) First time, I was 16, and my GP referred me to a place called the Tavistock Centre in London, which is psychodynamic in approach. I went to one session, hated it, and never went back. (In hindsight I never gave them a chance, but I'm really not a fan of psychodynamic approaches - but then, I haven't looked into them in a lot of detail so it's pure prejudice on my part).

(2) Second and third time I was at (two different) universities and went to the student counselling service. I just saw the person I was allocated and it didn't occur to me to ask for anything different. They were OK anyway. However I stopped seeing a counsellor when she said to me something like "You have to toe the line or nobody will accept you" and I thought this was her opinion. Now I have started the training course I realise now she was paraphrasing my own fears, and at the time I completely misunderstood.

(3) Fourth time (recently) my GP was hunting around for a counsellor for me, and found a local charity which offered counselling, and this bloke happened to have a free space, so I saw him.

(4) Fifth time, I went back to my GP and said that counsellor wasn't working for me and I wanted CBT. He gave me two options: wait for an NHS counsellor to become available at the local hospital (but there I'd have no choice and it would be pot luck who I'd get), or pay for a freelance counsellor. I ended up going for the freelance counsellor, because I felt guilty about taking up NHS resources for my silly worries, and because I decided whatever the cost money wasn't as important as my health. So of course since I'm able to pay I can pick and choose (I realise I am very lucky to be able to afford it). As it happened my doctor recommended this one and I am sticking with her. (I pay &#163;35 an hour but it's worth it)

Marginalia

[Marginalia]

Also want to add that (humanistic) counsellors are definitely trained not to ask leading questions - that would be completely against the philosophy of the approach. (Imagine if they put some idea in your head which was just totally inaccurate)

I know when you go in you're at your must vulnerable and just want a 'cure', but that's exactly why the counsellor mustn't offer you something, especially before they even know you. You can give them a chance to get to know and understand you, by you telling them what is important to you and what things mean to you.

I think what I have learned is that it doesn't work until you are able to 'give', and only then can you 'receive'. It takes a while to know what and how you can 'give' - and then you find that you are 'giving' to yourself what you are giving to the counsellor.

So you people who are thinking of making lists/taking notes beforehand are doing a good thing, I think. If the cause of your anxiety is not obvious (as has been my experience), it's going to take some trial and error to work out where it's coming from - and that sometimes means going back to things you learnt in childhood. As you start talking to your counsellor about the various possibilities, you might be able to eliminate some of them, and you or they might notice certain recurrent themes, that sort of thing, or you might suddenly find yourself angry or upset or shaky as you start to describe something. For everyone it's different, but the counsellor will be on that journey with you.

It does take work and it's not easy, but by just getting there to the counsellor you have started. If you keep a log of how happy (or unhappy) you feel each week, you may find a gradual improvement - though sometimes you have to get through a block - and sometimes it's two steps forward and one step back (if you feel you're getting better and then have a relapse, it doesn't mean the improvement was an illusion - it just happens sometimes) - and sometimes you feel stuck for ages, and sometimes you don't realise that something changed until years afterwards. And I guess sometimes it just doesn't work for an individual, and maybe then that person could try and different counsellor, a different counselling approach, or a different coping mechanism (e.g. medication) or will end up making changes to their life in any case... or maybe they're just not ready to change at that point, or they come to accept themselves as they are, anxiety and all. ;)

It does take time, and you do have to be willing to learn and change (e.g. being honest with yourself which can mean - in CBT - catching and stopping yourself thinking irrationally, and which can be really hard - actually thinking nice things about yourself sometimes, and not feeling guilty about it :p ). I think with CBT people can generally pick these things up quite quickly. With other forms of counselling, it depends on the individual and amounts of time needed can be very variable.

Marginalia