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cosmolinguistThe cognitive-behavioral therapy didn't work out for me last time.
I genuinely wrote the appointment down for the wrong day. Right day, right time... wrong week. The letter telling me I'd missed my appointment was late; by the time I got it, I couldn't explain my mistake in time to reschdule; I'd have had to be re-referred.
That was last autumn.
Last time I went to the doctor, it wasn't one of the ones I usually see. I told him my meds weren't really working any more; he told me you have to take them for a few weeks for them to start working. I told him I'd been taking them for nine months. He told me he didn't like tablets, preferring counselling. I clearly wasn't being listened to, but I prefer counselling to drugs anyway. I had struggled to get to the appointment and was relieved to leave. I really had been geting worse lately, and in that state didn't want the meds anyway. I took this as the seal of approval, though I knew it was really just a miscommunication.
I had the luxury of forgetting about it for a few months. I was doing okay.
Lots happened to me in that time. I was working a few hours a week. Someone I love told me he no longer loves me. I spent the holidays with my family. Through all my stresses, ups and downs, I felt fundamentally normal, my reactions to things reasonable and not too debilitating.
That was fun. Wish I'd enjoyed it more while it lasted.
Today was my day of reckoning. I went to see my usual GP (lovely usual GP! unfortunately everyone else knows he's ace too and so he's very popular and hard to see; he was rushed off his feet already this morning when I was there at 9:15) and owned up to the fact that I have been the kind of mentalist I know is the worst: the non-compliant with treatment type.
So I caught him up on what had happened in recent months. He seemed unimpressed by what even very high doses of meds were doing (i.e. very little) for my anxiety, so Andrew will be relieved: the medical establishment has come around to his way of thinking on anti-depressants, at least as concerns me.
My doctor's also re-referring me for counselling.
This is good, in a way: while meds can reduce the imposition of symptoms enough to give you time and space to pull your life back together, you still have to pull. And the meds don't help me, everyone is agreed on that now, so I am going to do it by myself. So counselling is there to help you figure out which direction to pull it in.
This is clearly what my life is lacking: direction.
And this is sort of the problem I had with the counselling I have had before. The cognitive-behavioral therapy depends on you, the patient, to do most of the work. The idea is that you think about your thoughts and feelings, what causes them and what they cause, and find places in that cycle of cause and effect where you can change negative stuff into more positive stuff.
The first thing I remember being asked to do, once I'd had this explained to me, is think about the goals I have for my life. My understanding was that these can be quite small-scale (leaving the house, physically looking after oneself with things like eating properly and getting dressed). Making them too big is obviously prone to overwhelm someone and thus lead to failure, disappointment, self-loathing, and another of the exact type of cycle that we want to avoid.
But I'm a funny old bird.
I don't really have any goals. I'm pretty good (this time; it hasn't always been the case, but I think with every cycle of deep depression I get better at coping and knowing what to look out for) at eating and washing and going out and other such basic things.
But beyond that...?
I don't really have any goals.
I don't. On any kind of scale, nothing springs to mind.
Sent home with a worksheet and the task of writing about some goals, I... genuinely lost the sheet, must have tossed it in the bin at some point before the next week's appointment. Without any conscious intent, but I must admit I wasn't much concerned about that piece of paper. I was, if anything, avoiding it.
And the stress of "not having done my homework," not even having looked at it or having the paper to bring with me, plus the stress of the subject itself, kept me from going to that second CBT appointment.
I might have written about this at the time (I don't have the heart to go back and check), because I got a message from one of my LJ friends. I hope that person doesn't mind me quoting a bit of it here; I really appreciate the way it puts words to things I feel so strongly I cannot step back far enough from them to impose language.
Yet I've absorbed the motivational rhetoric myself to such an extent I'd be bound to suggest it to anyone in a position like mine. It makes for catchy slogans and the kind of cheerful vagueness that leaves a troubling disquiet in its wake: these people who really believe "If you don't know where you're going, you'll never get there" or "Aim for the stars and maybe you'll reach the sky" (if you type "goal" into Google, one of the things it suggests most highly is "goal quotes," and those are two such quotes I really found that way; the title of this entry is another).
I mean, more power to 'em and everything, but to expect that to work on everybody, I find, is a little bit alienating.
And now I find myself faced again with the prospect of jumping through these hoops. I am happy to do it if it makes me better, of course, but for now it is just something else I am stressing about.
Ah well. Onwards and upwards, eh? "Life is full of obstacle illusions." Apparently.
I genuinely wrote the appointment down for the wrong day. Right day, right time... wrong week. The letter telling me I'd missed my appointment was late; by the time I got it, I couldn't explain my mistake in time to reschdule; I'd have had to be re-referred.
That was last autumn.
Last time I went to the doctor, it wasn't one of the ones I usually see. I told him my meds weren't really working any more; he told me you have to take them for a few weeks for them to start working. I told him I'd been taking them for nine months. He told me he didn't like tablets, preferring counselling. I clearly wasn't being listened to, but I prefer counselling to drugs anyway. I had struggled to get to the appointment and was relieved to leave. I really had been geting worse lately, and in that state didn't want the meds anyway. I took this as the seal of approval, though I knew it was really just a miscommunication.
I had the luxury of forgetting about it for a few months. I was doing okay.
Lots happened to me in that time. I was working a few hours a week. Someone I love told me he no longer loves me. I spent the holidays with my family. Through all my stresses, ups and downs, I felt fundamentally normal, my reactions to things reasonable and not too debilitating.
That was fun. Wish I'd enjoyed it more while it lasted.
Today was my day of reckoning. I went to see my usual GP (lovely usual GP! unfortunately everyone else knows he's ace too and so he's very popular and hard to see; he was rushed off his feet already this morning when I was there at 9:15) and owned up to the fact that I have been the kind of mentalist I know is the worst: the non-compliant with treatment type.
So I caught him up on what had happened in recent months. He seemed unimpressed by what even very high doses of meds were doing (i.e. very little) for my anxiety, so Andrew will be relieved: the medical establishment has come around to his way of thinking on anti-depressants, at least as concerns me.
My doctor's also re-referring me for counselling.
This is good, in a way: while meds can reduce the imposition of symptoms enough to give you time and space to pull your life back together, you still have to pull. And the meds don't help me, everyone is agreed on that now, so I am going to do it by myself. So counselling is there to help you figure out which direction to pull it in.
This is clearly what my life is lacking: direction.
And this is sort of the problem I had with the counselling I have had before. The cognitive-behavioral therapy depends on you, the patient, to do most of the work. The idea is that you think about your thoughts and feelings, what causes them and what they cause, and find places in that cycle of cause and effect where you can change negative stuff into more positive stuff.
The first thing I remember being asked to do, once I'd had this explained to me, is think about the goals I have for my life. My understanding was that these can be quite small-scale (leaving the house, physically looking after oneself with things like eating properly and getting dressed). Making them too big is obviously prone to overwhelm someone and thus lead to failure, disappointment, self-loathing, and another of the exact type of cycle that we want to avoid.
But I'm a funny old bird.
I don't really have any goals. I'm pretty good (this time; it hasn't always been the case, but I think with every cycle of deep depression I get better at coping and knowing what to look out for) at eating and washing and going out and other such basic things.
But beyond that...?
I don't really have any goals.
I don't. On any kind of scale, nothing springs to mind.
Sent home with a worksheet and the task of writing about some goals, I... genuinely lost the sheet, must have tossed it in the bin at some point before the next week's appointment. Without any conscious intent, but I must admit I wasn't much concerned about that piece of paper. I was, if anything, avoiding it.
And the stress of "not having done my homework," not even having looked at it or having the paper to bring with me, plus the stress of the subject itself, kept me from going to that second CBT appointment.
I might have written about this at the time (I don't have the heart to go back and check), because I got a message from one of my LJ friends. I hope that person doesn't mind me quoting a bit of it here; I really appreciate the way it puts words to things I feel so strongly I cannot step back far enough from them to impose language.
I sometimes wonder about the emphasis so many people place on the idea of "having goals makes life better". I hate goals, and avoid them at any and every opportunity....My issues with goals and how to approach life are not quite the same as my friend's -- I've never been aware of doing poorly on something intentionally -- but there is a lot of overlap. It's external evidence that the pressure to set goals can backfire.
The thing about goals, is that while they give you something to strive for, they also give you something to be afraid of - failing. I sometimes hate myself for it, but sometimes I find myself more willing to do poorly through not trying and then excuse myself along the lines of "I could've done better if I'd wanted to", than actually try hard and risk discovering I'm not capable of achieving the goal...
The very concept of failure terrifies me, and I'm likely to ignore a task until the last minute and then panic, and push out the bare minimum to succeed...
If somebody was to force me to make lots of goals to aim for on a regular basis, my life could rapidly collapse into a series of panicky stressful botched attempts at last minute lunges to avoid failure.
Yet I've absorbed the motivational rhetoric myself to such an extent I'd be bound to suggest it to anyone in a position like mine. It makes for catchy slogans and the kind of cheerful vagueness that leaves a troubling disquiet in its wake: these people who really believe "If you don't know where you're going, you'll never get there" or "Aim for the stars and maybe you'll reach the sky" (if you type "goal" into Google, one of the things it suggests most highly is "goal quotes," and those are two such quotes I really found that way; the title of this entry is another).
I mean, more power to 'em and everything, but to expect that to work on everybody, I find, is a little bit alienating.
And now I find myself faced again with the prospect of jumping through these hoops. I am happy to do it if it makes me better, of course, but for now it is just something else I am stressing about.
Ah well. Onwards and upwards, eh? "Life is full of obstacle illusions." Apparently.