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Making the right choices

March 11, 2009

Today, I feel, has brought progress in terms of my treatment. I saw CBT/MHW lady, who had read my Doctors’ notes from last week, taken it on board and decided that I probably do need more support. That’s great, but it’s going to be to CMHT, not something I *really* wanted. I mean more support is great, but I fear being just left in a dump bin with no hope of ever getting better. Just left to be, not helped, no therapy or anything. I’ve voiced my concerns, of being left, no more therapy and what not, and she’s assured me we’ll continue to see each other until I move to community. Great, however, her only being there for 3 hours a week and no doubt pressures in terms of waiting lists means that her boss may not allow it. In a way, I just want to take the therapy and go, do CBT and get things sorted. I feel if we concentrated on that, then progress would be made. That and if my next appointment wasn’t in 6 weeks’ time… a combination of her being on leave, meetings and me going home and on holiday have lead to this gap. I’m not happy about it, there’s no promise of communication in between or anything to be done; my doctor is leaving and counselling lady is well… crap. I’m getting more and more towards the stage of ditching it, IF I get other help, if not, then well, hmm.

Each time I go to CBT, I come out with a slip of paper of affirmations in a way, or things to do. They help, they give me reassurance. It’s like a ladder, it gives me hope. If I do these things, hopefully the rest will follow and I can get better. I know it’s not sure fire, but I need to believe something now to get me through, that if I can stay in primary care I will get better. Slips I have so far accumulated are:

  1. Plan an outline for everyday which promotes enjoyment and achievement
  2. If I don’t eat, I will feel more depressed/upset/angry with myself
  3. How can I be ‘fat’ when the most recent things I have bought are size ‘small’?

The last 2 are from todays session, ‘self talk’ strategies. The funny thing is, I remember all this kind of stuff from CBT in the past, I can identify with it, yet I can’t do it on my own. In a way I feel powerless, yet if I have this CBT, if I can do that, if someone can help me, I can become powerful and sort this out.

I need to start making the right choices. Doing the right things. Doing everything in my interests to stop me… just I don’t feel like it. Part of me is scared by this fact, that in a way I’m comfy here; it’s all I can remember. Just there’s no point in getting all this support, when I’m comfy, I moan and stuff but deep down, I’m not bothered. I’ll promise not to drink, then get blind drunk; promise to eat then not; It’s about making the right choices, trying to limit depression’s effect, try to let myself reign and not the depression. It’s not easy, though. And I guess that’s why I’m still here, still depressed, apetiteless, penniless and probably with a wrecked liver. This motivation needs to last more than a week, which is normally more than I can manage. It needs to last 6 weeks, I need to try and do this, try and get it right.

6 Comments leave one →
  1. Lola Snow permalink
    March 12, 2009 8:20 am

    Glad that you have got some more support Kate-Lapin. Have been a tad concerned about you. I guess the thing is about therapy, and making life changes, is that you have to want to. Want to meaning you have to have some motivation to do it, other than simply reporting back to someone to say “Yep, done it” because as soon as that someone is gone, you’ll probably stop doing it.

    I think I did that far too much in therapy, got a list of stuff to do, and did it, because of that sense of duty, but never really cared to do it for myself. So as soon as I had no one to report back to, I just binned the list, and gleaned no insight from the experience.

    The key is to try and find what it is UNDERNEATH that stops you from making long term changes, what is it that has you acting one way, instead of another?

    Is it just that you feel that nothing will change? Or is it that you don’t believe that you deserve things to be different?

    Lola x

  2. March 12, 2009 10:37 am

    Yes, you can become powerful and sort this out. Depression, appetite, pennies and livers can all be fixed. It happens every day. One of these days it will be your day.

    Lola-Corbeau knows that the key is always hidden underneath. This business with lists is not CBT — though if it helps, it helps. If you can get CBT (or any other kind of real therapy) from the CMHT, that will help you find the key, the key will help you find the want to, and everything else will follow.

  3. March 12, 2009 12:58 pm

    Lola: I’m thinking that’s true, that you have to want to or you’ll stop; when I had CBT for a phobia I had motivation, now what do I have? A vague wish every now and then to get better!
    Yesterday we discussed some possible underlying reasons, but well, having talked about my eating maybe being a control issue, she came up with numbers 2 and 3. Which, well, don’t exactly do much in terms of actually making a difference.
    I guess I feel a bit of both- I don’t think anything will change, and even if it does I don’t deserve it. More number 1 than 2 though.

    CBTish: I thought thought challenging was CBT? I don’t know what I will get from the CMHT, I’m 6weeks+ away from a referral and I missed a call from my doctor earlier who was going to work out who’s gonna do what… I’m hoping she doesn’t try again when I’m in a lecture, I have an answerphone I wish people would use!

  4. March 12, 2009 4:28 pm

    Well, yes, building a house requires some hammering, but just hammering things at random will not produce a house. In the same way, just challenging thoughts at random will not produce recovery and in my opinion it is misleading to call it CBT. The difficult part of CBT is finding the thought that needs to be challenged. It is never obvious. That’s why CBT can only be done by skilled therapists.

    For what it’s worth, I too am extremely cautious about leaving messages on answering machines because of the risk that something confidential will be overheard by someone who will then start asking the patient awkward questions.

    I wonder what would happen if you tell your GP that you want to be assessed by an accredited CBT therapist — someone who is actually fully trained and on the national register.

  5. March 12, 2009 5:46 pm

    That is true, random thought challenging is no good. And perhaps useless… I’ve had ‘proper’ CBT on the NHS before, but well, this isn’t you’re right.

    True about the answer machine, I could understand it if it was a house phone but a personal mobile? Maybe I’m just used to people leaving messages… It turns out the reason she didn’t was because she also needed to ask me some other stuff… I guess that lets me excuse her!

    Well, I think my GP may boggle, then go um, then get me to talk to the current MHW I’m seeing, because that’s what generally happens. MH related Q? Ask one of the MHWs… shameful, really, seeing as they probably don’t have time to keep answering peoples’ odd questions. Apparently there is a resource being written but will it ever be? Back to what you said anyway, I think chances of that on the NHS may be slim…

  6. Lola Snow permalink
    March 13, 2009 6:17 pm

    I suppose there is an element of needing to have proof that a leap of faith is rewarded. Proof that things can change, and that change is a good and enjoyable. Whereas that first blind leap of faith to change, must be done on just a promise. If you are told that do X and life will change (ie follow this list) and it does not “fix” the problem, then motivation swirls away down the plughole.

    I truly believe that is why taking the reins yourself is so important, but then as control freak I would say that!

    I think what I am trying to say, is that your “CBT” lady is making a lot of empty statements, and it doesn’t seem to be getting into the nitty gritty. You are effectively drowning, and she is describing the water. The word shallow springs to mind.

    Lola x

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