CBT

I've done CBT (Cognitive Behavioural Therapy) three times but lots of other people (counsellors, well meaning friends and family etc) have talked to me about aspects of it.

For those not aware of it, it basically involves identifying negative thoughts and addressing them with the aim of taking the power out of the thought and encouraging positive and more logical thinking.

For example, I often think I'm totally useless. CBT has taught me that when this thought comes to mind, I should say "STOP" (the therapist suggested saying it out loud as it gives it more power) and remind myself that:
1. I'm not "totally" anything - we all have shades of light and dark in everything
2. I'm not useless - I can do lots of useful things like looking after children, talking to people, learning new things, making jewellery
3. Who determines "usefulness"? - there are no rules to life, no "should be", no "have to" we're all different and what I consider useful is not the rule of life

The idea is that if you practice this skill often enough it will become automatic to think positively rather than negatively. During the therapy course we were told to write down any negative thoughts and this rethinking action to give it more weight and to reread it when you need encouragement. It is also a helpful tactic I've learnt to write down all the positive things that have happened during the day - however small, to encourage positive thinking to drown out the negative thoughts.

The problem with CBT I found is it is pretty impossible to do when you have full blown depression when the negative thoughts are at their strongest. (During my last bout of depression, I couldn't even write down the negative thoughts because I couldn't identify them as negative - they were just thoughts and writing them down seemed to validate them even more). And when you're "up" the negative thoughts are fewer and have less power and therefore don't feel like they warrant this re-wiring procedure.

However, the last couple of days, I have been thinking about my CBT training. Specifically with my tendency to fall into the "all or nothing" (which is one of the recognised negative thinking patterns) trap.

(Im a victim of all the different types of negative thoughts (of course - i wouldn't expect anything else from my "all or nothing" persona!). For your information, here is a rundown on them: Negative thoughts)

For example, I can't go running, I have to run a marathon; I can't write a blog, I have to write an award winning, salary earning blog.

The trouble with this thinking is that when the "all" doesn't happen then I feel like a failure, which is magnified because once I decide I want to do it, I feel I should be at the "all" point and therefore I have failed.
Looking back, I can see this happen in lots of places - i decided I wanted to be promoted and when I wasn't as soon as the thought entered my head, I was a failure.

But the one that sticks out and is perhaps what defines me today is that I always wanted a big family (and when I say "always" I'm fairly confident in the use of the word - I remember wanting babies as soon as I knew where they came from) but because I didn't have one, then I was miserable, I thought about it constantly and what a failure I was for not having children (I can remember this thought at least age 18) - I was unhappy when I had no children and when I had one I felt worse because it wasn't the dream I thought it would be and I ONLY had one. 'Normal' people would say "but you've got a big family now" but it doesn't work like that in my head - in my head I failed for 30-odd years and that's a lot of failing to make up for. :(

Logically, we can say a thought isn't valid - but logic and emotions are two different things. When I would "present" my thought journal to the therapy group, the therapist would ask "and do you believe the rational answer to your negative thought?" And I'd be puzzled - absolutely not: it's crazy talk, I AM totally useless, no amount of rationalising is going to change that. And that's the problem with CBT - it's good in theory but it's another solution dreamt up by non-depressed people. There is a lot of research done to back the benefits of CBT (for example see this BBC Science report) but its not the quick fix, the government want it to be.

They are funny things - thoughts. Where do they come from that can make us so miserable? Maybe we should identify the root cause and address that rather than the symptoms of how we feel when we think them. Where do these "should" rules come from? (A woman "should" be able to work and have children, A man "should" provide for his family) and how can we diffuse their power over us?

Mental health, or depression in my case, is something that needs to be opened up to discussion so we can reduce its stigma so we people can talk about it more and allow more positive thoughts circulate. Locked inside my own head I feel like a failure for having depression - if we talked about it more, I (and others less able to divulge their feelings) wouldnt feel like failures and negative thoughts would get less.

I've had GPs tell me anti-depressants aren't addictive (obviously said by someone who hasn't tried to come off them), family members tell me to "pull myself together" and co-workers ask me "but you're alright now though aren't you?" All scenarios that could be resolved (and make me feel a little less repulsive) by a little bit more education. That's why Im supporting Time to Change Wales to get us talking more about mental health - don't worry, its not catching (and anyway, you've probably already had it at one time and in some format)