So, therapy assessment. I went, I talked, I made self-deprecating jokes. :)
I really did talk, once I got past my initial fright. I decided it was best to be as honest as possible so she had a fighting chance of figuring out what might help me best. And I can do talking as long as emotions are left out of it. So I ran her through the highlights of my life, what my life is like now and told her I’m desperate for help. I can’t live like this indefinitely, or at least, I don’t want to and that’s why I often want to kill myself.
I told her about my previous therapy. Technically CBT-based but actually not so much. I told her I have little patience for it and that I don’t think it’s good for me. The CBT elements of the therapy I’ve had were like a sticking plaster that lasted a while and then fell off when the rain got too heavy.
She asked me towards the end if I’ve thought about what sort of therapy might be good for me. I was stumped at first because I don’t really understand therapy, which is partially why I haven’t made effort to pursue it. There are so many different types, how am I supposed to know what is best for me? But I thought for a minute and managed to explain that I don’t think I’m ever going to be free of anxiety. There are things in my life that have contributed to the way I am now, but it seems to me that they merely exacerbate the anxiety I was born with. I was a placid baby, even tempered and pretty chilled out, as long as my life was nice and quiet and gentle. I was afraid of everything outside my home right from the start. How do you fight that? So I’m not interested in fighting it, and I don’t see the point in trying to get rid of it. I need to learn to handle it better.
I have made more effort to watch myself recently, particularly since Soul Survivor, when it really started to make sense to me that I have to stop fighting the way I am. I am a scaredy-cat. As I have watched myself since then I’ve noticed how obsessive I am in how I deal with anxiety. How repetitive. The things I do are useless and fuel the anxiety instead of controlling it but I can’t stop. It goes on and on until I’m rigid with fear or curled up in a ball crying. It becomes this tangled ball of
yarn thoughts and images in my head, consuming everything else and refusing to stop. I can get an image in my head, counter it with something else but it pops back and no matter what I do it won’t leave. Same with NO, THOUGHT, YOU’RE WRONG. Same with listing ALL THE THINGS to prove the thought is wrong. Same with BUT WHAT IF. Same with MUST PREPARE FOR THE WORST. Same with I CAN’T FACE THIS. Same with IF I JUST DO THIS ONE THING IT’LL GO AWAY. So I run around in circles trying to force myself to feel better and make the bad things go away, until eventually the only option left to me is avoidance, which is the most futile option of all but does at least temporarily allow me to not feel like a steaming pile of shit. I know myself, I know what I’m doing, I know it’s counter-productive but I can’t stop.
Amongst all this I’m tightly controlling myself whenever I’m in public (11 hours a day on weekdays) and often at home as well, living like a coiled spring. This week has been so bad that I made my ribcage and abdomen ache because I’ve been holding myself physically so tightly, as well as emotionally, once an afternoon of crying was out of the way.
So I told the therapist woman that I need to stop doing all these things. If I can’t make the anxiety go away then I really need to learn to live with it better or I might as well just kill myself now and get it over with rather than living like this for another I’d-rather-not-think-how-many years.
She nodded, smiled and said that our time was nearly up so would I like to come back next week to hear her thoughts? So back I duly went this afternoon, smiling politely, hiding the preemptive scepticism. She has suggested Acceptance and Commitment Therapy, which I’ve never heard of before. Turns out it’s group therapy, for 16 weeks, with a mindfulness element. Well, I expected mindfulness. I’ll try not to throw up as I breathe calmly and focus mindfully on whatever it is I’m supposed to focus mindfully on. Group therapy gives me the heebie-jeebies. Other people? Really? What if I just sit there unable to speak? What if they take up all the time or derail the therapy, wasting my 16 weeks? 16 weeks isn’t very long.
But, right, she explained what this thing is and it actually seems like it could be spot on for me. She gave me an article with a case study*, which I haven’t read yet because I’ve been too busy avoiding it, but here’s some snippets from its introduction:
ACT is one of the recent mindfulness-based behaviour therapies … in contrast to the assumption of ‘healthy normality’ of Western psychology, ACT assumes that the psychological processes of a normal human mind are often destructive … symptom reduction is not a goal of ACT … overview of ACT against a background of the suffering generated by experiential avoidance and emotional control … six core principles … developing psychological flexibility … defusion, acceptance, contact with the present moment, the observing self, values and committed action.
I actually quite like the sound of this. Destructive human mind, that’s a given and I’m glad they don’t bother fighting it. Oh look, it mentions avoidance and emotional control. Defusion, not sure what that means yet. Acceptance, yep, good. Present moment, that sounds like wanky mindfulness shit. The observing self, no idea what that is. Values strikes me as interesting, because my MBTI profile (I like MBTI so much I named my blog after my profile) is INFP and it’s all about living a life guided by my values. I’ve been thinking often that all the anxiety, depression, whatever it is that’s wrong with me, might have derailed me enough to not know what it is I value anymore, and it’s getting bad enough to erode my sense of who I am. I’ve written before about being a nothing. I’m just a walking, knitting blob of functioning disfunction. Committed action, I think that’s about the therapy helping you figure out what your values are and then driving your life in their direction. but I have to admit, I wonder if they just shoved the commitment bit in there so they could get an acronym they liked.
So I’ll read the article and try to work out if this thing is wanky bollocks or not.
In the meantime, my concerns are:
1) Group therapy. People. Do we have to sit in a circle? Am I going to be stuck with twats for 16 weeks?
2) From what the therapist woman says, this is quite practical therapy. She made it sound more like a training course than anything else. I suppose there’s nothing wrong with that, but I’m worried about it being too inflexible for me.
2) 16 weeks. It’s not like I want to be in therapy forever, I’d actually rather avoid it entirely. Getting things over in 16 weeks would be ideal. But what if it’s just another sticking plaster?
If anyone knows about this thing, feel free to pass your wisdom this way. :)
*Embracing Your Demons: an Overview of Acceptance and Commitment Therapy, Russell Harris