I’m having something of a tough time at the moment. I’m struggling with my work and as that is all I have in my life right now, that has an enormous knock on impact on my mood.
At about 3am last night (insomnia ho!) I was reflecting on my experience of CBT; why was it so useless to me? I thought about a typical interaction I had in any of the 6 sessions at either of the three times I had CBT. It would go something like this;
CBT Practioner: “So, what is difficult for you at the moment?”
Me: “I can’t sleep”
CBT P: “What stops you sleeping?”
M: “I feel tired, I go to bed, but as soon as the light is off my mind gets noisy and I can’t relax.”
CBT P: “What thoughts keep you awake?”
M: “That I’m a bad person. I think of all the bad things I’ve ever done and my stomach turns to a knot of anxiety and I go over and over and think about how people must think of me as a terrible, stupid, useless person”
CBT P: “Can you give me an example?”
M: [after some hesitation at saying these things aloud] “Yes. I phoned work the other day, my boss answered the phone. I said ‘hi, it’s me’ like I would to a friend, not a colleague, and she didn’t answer, so I immediately said “it’s [my name], it’s me.” And then we had our conversation”
CBT P: “So what makes you anxious about that?”
M: “I imagine she thinks I am an idiot, that I can’t even deal with a simple phone transaction properly. I embarrassed myself”
CBT P: “That one small thing?”
CBT P: “Do you think [your boss] thinks about that? Did she say anything? Has she indicated she thought it was odd?”
M: “No. I know that, logically, on the balance of probability, she doesn’t even remember it. I am sure even if she did, she wouldn’t care enough to keep thinking about it or make any conclusions about me. I’d be surprised if she even remembered it, it happened more than 6 months ago [insert time spans of up to 15 years in this for different things that keep me awake]”
And that is precisely the problem I have with CBT. I can identify my thought processes as irrational, I can imagine the most likely and rational response other people have to all these imagined faux pas, I can even have confirmation from people that, no, they don’t hate me because I didn’t hold the door open for them 6 years ago that one time. But I am perfectly capable of – skilled at, even – holding two pieces of contradictory information in my mind at once. I can know, be 99.9% certain that people on the street aren’t talking about me, laughing at me, but I’ll still hurry home and slam the door closed behind me, heart pounding, because there are two parts of my brain – one sane, one insane.
Insane. A strong word, but in it’s purest, most precise meaning, that can be the only description of the thoughts that drive my anxiety and unhappiness. It is apart from rationality, it is apart from reasoning, and thinking it out. As I told the final CBT Practitioner I met (who was disillusioned with CBT too, and enabled me to voice my problems with it, for which I am grateful): “if I could think myself out of this, I would have done it already. I’ve been trying to think my way out of it since I was 14”.
He smiled and agreed, ‘yes, it has limitations’.
I can understand I am wrong, and still feel with every fibre of my being, the wrong thing to be true. When I went private, very briefly, for therapy/counselling, I discussed this with the counsellor. She kept saying, with a bit of surprise, “it’s like there’s a split, you have a split in your thinking, two halves”.*
But I still feel like I failed at CBT and not the other way round.
Right now, for example, I am very unhappy and very demotivated. I’m not getting any work done and I’m angry with myself for that, and that anger isn’t translating into action. I look at my life; I am financially set for the next 12 months, I have a nice home, enough food, enough clothes, I am doing the thing I supposedly love (PhD) and I’m doing it in one of my favourite cities in the world. I am unburdened by serious responsibility or serious health problems. What on earth have I got to be depressed about? How dare I?!
And I know, of course, as everyone bleats and shares and reassures “depression isn’t about circumstance, it’s not about how great your life is, anyone can be depressed”.
But, as we established above, I am really good at holding two conflicting pieces of information in my mind at once. I’d never judge a friend for saying they are depressed when I think that they have a good, or enviable life; I’d just offer support and love and help in anyway I could. But me? I look at my life, all the opportunities I have, all the opportunities I am sitting in the middle of failing to take advantage of, failing to ‘grab the moment’, failing to do things people would give their eye teeth for that are sitting open to me and I cannot understand why I am not happy.
Why aren’t I living the wonderful life that is sitting open to me?
Why aren’t I happy with all the great things in front of me? Why can’t I think myself out of this?
And more than that, if I’m not happy now with what I have, and I pursue and attain the next list of things I think will make me happy, how can I ever be happy? There is no pot of gold at the end of the rainbow. Just more “oh, it’s not this pile of things and people and opportunities I need to make me happy, it’s that pile of things and people and opportunities I need, I’ll go chase them”.
It’s unending. It’s always going to be me saying “just a little further, then I’ll be happy”.
What I need is to be happy here. I have no idea how to do that. I just know I should be already.
* I didn’t care much for this as a response because that’s diagnostic of schizophrenia, and no, my mind isn’t split – the two contradictory parts talk to each other – that’s the conversation which keeps me awake at night. It’s also a really unhelpful comment – yes, I know it’s odd I can hold such polar opposite thoughts, how do I stop doing it?