CBT hasn't worked - what next???

[bluedaisy]

CBT hasn’t really worked for me. It's definitely helped a bit, but hasn't enabled me to get back to anything resembling a normal life!

I’ve tried very hard - at least a £1000 on private treatment (which I can no longer afford), loads of very difficult sessions pushing myself to the limit trying to meet the challenges set with my therapist e.g. first time on a bus in a year, returning to scenes of previous panic attacks etc, doing all my homework between sessions, even when it’s been terrifying, going over and over all the thought reframing and balanced thinking exercises … and yet no relief from the anxiety when I try to go out on my own.

My therapist ended our sessions, as I had ‘made no substantial progress’. I don’t want to get into meds, and am determined to beat my agoraphobia without them, but think I need some form of therapy/support to help me get there.

Anyone had any joy with referrals from their GP for different forms of treatment?

Mine has offered me nothing, except for meds of course, hence the expensive CBT. I’d like to be able to go and see her and request some form of therapy/help, so any advice on what to try next would be very welcome.

[bet]

Hi bluedaisy,

sorry to hear the CBT didnt work for you.It didnt work for me either,but in my case the therapist I was referred to had just trained in it.

What I have found excellent is EFT(emotional freedom technique).Its so easy and actually very enjoyable.You can download the manual for free at www.emofree.com
I use the "basic recipe" and find it great.

Carl Dourish who we are so lucky to have uses EFT in his practice has done a good few posts on it.

Give it a try hun and let us know how you get on.

p.s. dont be hard on yourself that CBT didnt help you achieve the results you hoped for.

Bet

[honeybee3939]

Hi There


I myself had CBT and it did help, i was actually vertually housebound when my CBT sessions started, i did make good progress with CBT but was far from cured. I had my CBT through the NHS and as he could see i had made progress but still needed support i was then referred onto the Community Mental Health services in my area where i was assigned a community support worker whom i saw once or twice a week. This seemed to help me the most because while i was doing challenging things like walking futhur away from home or standing at bus stops there was someone actually there to talk me through the panic when need be. I found this therapy to be the best of all but listening to other members on this site there can be quite a long waiting list for this kind of support which really annoys me because i feel if i had this therapy at the begining of my illness im sure it wouldnt have lasted the 12 years that it did!

When suffering with agorophobia in my case anyway, it was a matter of getting my confidence back and thats one thing the support worker helped me gain.

Andrea

xxxxx

[joannap]

hi bluedaisy

i am just wondering whether your cbt exercises have been approached in the right frame of mind - it sounds as if you felt forced or pushed out of your comfort zone too quickly. what has helped me is total acceptance but this only works if you can truly accept and not just think you are! i have felt absolutely consumed by panic at times when i have been out but i literally 100% give into it - i have felt the adrenalin burning through my body and i have not been able to speak but i just hold acceptance in my mind and eventually it subsides. Once you have done this once - the panic begins to loose its edge. I would advise setting small targets everyday and no matter how you feel - DO NOT run home or try to escape from the feelings - simply let them wash over you - no matter how bad you will feel because if you do this - i can promise you that a lightbulb will be switched on in your mind.

all the cbt in the world will not help your instinctual fear of fear - although it should help with calming self talk and stopping the negative thought patterns that spiral out of control in an attack. the only thing to stop panic and defuse it is to go through it. xx

[Alabasterlyn]

I'm surprised that your GP didn't offer you CBT on the NHS as I know it's available as I had it for a year. However like you I didn't find that it helped me either. The theory of CBT makes very good sense but putting it into practice was the bit I found hard. I also think if you don't have a therapist who understands agoraphobia then it's going to be pretty hard to get anywhere.

When I had my therapy I was quite surprised at how much more I knew about agoraphobia than my therapist did and it did make me feel less confident about her ability to help me. She would do stupid things like take me out for a walk around a huge open field in temperatures of 96f and then wonder why I didn't want to do it again! Fact was I felt more anxious after doing that than I had before and I have never been able to face doing something like that again as all she did was reinforce my fears not allay them.

On another occasion she wanted to meet me in the middle of town in the centre of a 140 store shopping mall. I was supposed to get there on my own, walk around the mall with her then go home on my own. As an agoraphobic who can't even go out on her own this to me was just plain stupid and just showed me how little she understood my condition.

I think at times we have to stop blaming ourselves for treatments not working and realise that sometimes it's down to the therapists lack of knowledge and not always our fault.

[bluedaisy]

Hi,

Thanks for all your replies. It really helps to be in contact with other people who understand what I'm going through.

Bet - Thanks for the tip. I will have a look at the EFT info. I did try it once or twice last year, but didn't get very far. I'll try and stick to it for longer this time and see if it helps.

Andrea - It certainly sounds like a good idea to ask for referral to a community mental health support worker. I will see if my GP can help. I have to admit that I've given up going to see her because she usually just tries to push meds and pretty much says it's my own fault for not getting any better because I won't take them! I requested NHS counselling in April 2005 - still waiting!

joannap - I understand your point and I do try very hard to accept the panic and stay in a situation, rather than running away from it. Sometimes it works and I get calmer, other times it doesn't and I end up heading home and feeling as though I don't want to ever venture out of the front door again. I've not had a lightbulb moment yet, but hopefully I'll get there...

Alabasterlyn - I completely agree. My CBT therapist refused to accept I was agoraphobic for ages, because I could go out with her and with my partner. She only accepted that I was after she watched 'house of agoraphobics' on TV!!! Sometimes, the experts just aren't as expert as they think they are.

I'm very glad some of you have found success with your therapies and support workers. I've reached a point where after several months of giving up in the battle against my agoraphobia (following the end of CBT and no more cash to pay for private help), where I really feel determined to start working hard again to get better.

So, I will try my GP again, get out the CBT manual and start doing the exercises, have another look at EFT, and use this forum as a source of inspiration and support to give me the kick up the bum I need to get on with it!

Wish me luck ...

[honeybee3939]

Hi Bluedaisy

Just wanted to wish you luck hun, and to say never stop asking your GP for help that is what they are there for. you are so entitled to get the therapy you need to help in your recovery.

My GP im sure is sick of the site of me..lol, but i dont give a dam, just keep pestering him/her and dont take no for a answer.

Good luck hun.

Andrea
xxxxx

[bluedaisy]

Thanks Andrea. I will go and see her next week and see if she can help. Fingers crossed.

[Richie]

HI i think anyone who has had CBT on the NHS is ever so fortunate.
Especially if the therapist actually goes with you, that is almost" UNHEARD OF" i had CBT in Swindon in my early 20's and he was "Gods Gift" he virtually cured me in about 6-8 sessions, but i had to it alone no one holding my hand.
You didn't mention Bluedaisy if you went with a "safeperson" all the time or if you did these things on your own, reporting back say once a week?
But it really sounds as if you DID make progress like going on a bus, going back to previous panic scenes etc and meeting all the challenges. But it does have to be sustained continuously, can't just do it once and then think ah well thats that one ticked off the list. These challenges have to be practiced constantly, daily if possible for them to carry on working for you.
It's the same with hynotherapy and NLP techniques, breathing exercises they all have to be done over and over again clich'e which i wish i could do too but practice does make perfect Y'know and even if all the anx doesn't disappear then at least you are left with coping skills which you must use yourself.
Only wish i could have CBT again as i have been trying to remember what my swindon therapist taught me and make out my own worksheets
Richiex

[bluedaisy]

Hi Richie,

My CBT sessions were a mixture of behavioural therapy, tackling difficult things with my therapist's support, e.g. bus journeys etc, and cognitive therapy sessions in my home where I'd report back on things I'd done alone and plan activity schedules with her.

It did help me to some extent, because at one point I was able to go out alone every day, usually a walk to the local shop for a newspaper, and I frequently cycled 1.5 miles alone to meet my partner after work in the evenings. (That was easy during the winter as it was dark and I felt safe.)

But, it was always very hard work to keep going, and the approach of my therapist seemed to be 'you've proved you can do that now because we did it together, e.g. going on the bus, so lets move on to the next thing'. I found it very frustrating that she didn't understand that managing to do one short bus journey with her didn't mean I was able to start using buses again alone!

In the end my therapist ended our sessions because I hadn't made sufficient progress. She was used to 'curing' people after six to eight sessions, but unfortunately that just didn't happen for me. As I said in my earlier post though, she knew nothing about agoraphobia, so I think she mainly worked with people whose anxiety problems had not stopped them working or prevented them going out etc. I really wish I'd discovered CBT when my anxiety was still within manageable levels and I was working full time etc, as I'm sure it would've helped me enormously.

Obviously people with more debilitating anxiety conditions like agoraphobia still can get a lot of benefit from CBT though, like you did. Probably it's a mixture of getting a good therapist and responding well to CBT techniques - I guess no therapy works for everyone.

I can recommend Mind Over Mood by Dennis Greenberger if you're looking for a good book with worksheets etc. All my CBT was based on that (probably should've just bought the book and not bothered with the therapist ...lol).

Good luck with your CBT practice Richie -I'm going to get on with mine again too.