So I have started CBT proper. So far, so good. In summary, here is what I have learnt after my first session.
Short-term coping strategies prevent long-term healing.
My short term strategies to deal with panic disorder, such as carrying medication, not straying far from home and avoiding long journeys, means that I am not getting a chance to ‘update’ my thinking. I am not challenging my catastrophic misinterpretations. By not testing them, they are given immense power by the imagination. Until I put myself into the situation I dread, I cannot come to realize that it is nothing to be feared.
What is it I have been dreading? Firstly, fear itself. The dread of dread – a wholly pointless, but understandable, fear. Another thing I dread is shame. I have carried with me a long standing prejudice that panic, being different, being perceived as ill, is a weakness and shameful. This fear of not being able to cope, of humiliation in a public place is so powerful that, even though it is a myth, I am avoiding going into the situation. I have coped with some of the hardest shit you can imagine, time and time again. And when I have really needed help, I have almost always received it from friends and trusted people. But even so, I have a belief that I can’t cope, can’t rely on people, and need to hide from shame.
Well its time to test those beliefs and update my false perceptions!
It is illusion that keeps us most powerfully chained, hidden in fear. Truth must be allowed to prevail.
There is no shame on panicking in public transport and asking for help. Think – if someone was having an episode of panic opposite you on a bus, would you do everything in your power to help that person, show them compassion and strive to understand their situation? I would! I would go out of my way for a stranger, and try and be useful in helping them. There would be no judgement in my heart for such a person.
So why am I so hard on myself, and why can’t I turn that compassion inwards? Because I have these impossible standards and expectations which find their root in having to be ‘perfect’ to avoid abuse – standards and expectations that need to be ‘updated’ (to say the least!) And why am I so doubtful of others, and so untrusting? Perhaps because I never allow myself to be put into a situation where I might have to trust people.
In some respects this is wise – caution is there for a reason. I have had a fucking hard life , especially emotionally. It has not been easy to trust people, least of all those in authority or positions of ‘care’. But to lose your trust in humanity is the absolute worse thing you can do. Without being naïve, one must have a general faith in humanity in order to live at all. Without that faith, we become hermits – paranoid, isolated, self-serving, self-confirming. It is a deeply sad, soul-draining state to be in.
CBT is giving me the courage to challenge my negative thought patterns, going deeper beneath them, rooting out the hidden shame beneath the surface.
It is also showing me in detail that the fight or flight response is not something to be feared, and that bodily sensations should not be misinterpreted as danger signals (at least when there is no danger around!) It is opening my eyes to the truth.
I strongly recommend that anyone who has anxiety problems seeks out cognitive behavioural therapy. It is not designed to go deep into your emotional world – psychotherapy is there for that. But challenging our thinking patterns and changing our behaviours is just as important as the deep emotional shit, make no bones about it.