My Second Session Of Cognitive Behavioral Therapy

I had my appointment at eleven which was a good time for me as it meant I got it over and done with early on in the day and could have the afternoon to relax. I walked over which meant I could hopefully reduce my anxiety a bit before having to sit for an hour with my therapist. So I first talked about what had happened since I had last seen me therapist, such as, feeling anxious just sitting watching TV, fear of phone calls, going into Superdrug, being at an energetic friend’s house, going on the Motorway and being in a café. They reassured me that everything I was feeling was because of anxiety.










I then showed them my Hierarchy of Feared Situations:

1 Being at home (Don’t Avoid) (Stress level 3-6)
2 Sitting in a room of people (Sometime Avoid) (Stress level 3-8)
3 Walking in public (Don’t Avoid) (Stress level 5)
4 Walking through town (Sometimes Avoid) (Stress level 8)
5 Making phone calls (Do Avoid) (Stress level 7-8)
6 Going into a shop in town (Do avoid) (Stress level 6-8)
7 Cafes (Do avoid) (Stress level 6-8)
8 In a car not driving myself (Don’t avoid) (Stress level 3-10)
9 Supermarkets (Do avoid) (Stress level 8)
10 Checkouts/Tills (Do avoid) (Stress level 8-9)
11 Theatre, Cinema, Lecture Hall, Sports centre (Do avoid) (Stress level 9-10)
12 Train (Do avoid) (Stress level 9-10)
13 Me driving car (Do avoid) (Stress level 9-10)

We talked these through and it was clear that it was fear of being trapped within a place and unable to get out and that I could have a panic attack. 

So we began at the beginning of the list, my therapist asked me to think about an anxious time when I was at home. I gave the example of that very morning, I had woken up after eating too much the previous day with indigestion and this was making me feel nauseous. I have a fear/massive dislike of being sick despite not being ill since a young child. When I feel nauseous I begin to swallow a lot which triggers my saliva glands to over work and my mouth feels full, as a child this use to make me upset as I didn’t know how to stop it and use to spit it into the sink, which made it worse. I have now learnt however that by just stopping myself from swallowing and breathing deeply for a few minutes makes it stop. I keep telling myself I must not be sick, and that I have to do everything I can not to be. I was also thinking I should tell my therapist I would have to cancel as I was ill, however, as time passed it went off and I was able to make it to my session.

From everything I had explained in the session my therapist realised that I was always asking myself ‘what if?’ which is good from an academic point of view as I am curious, however, as my recent post 'Fear Of Motorways' illustrated I used what if statements to build up a negative events that is unlikely to happen.

My therapist also recognised my need for certainty ‘I must know/I have to be certain at all times’. For example, that morning I needed to be certain I wasn’t going to be sick and therefore I focused on it. Rather I should be saying there is a possibility it might happen however I haven’t been ill in years so why would it happen now and if it does I will and can deal with it. Over time I therefore need to realise that you can never be certain about anything and that I should accept it might but look for evidence/a reason why it is unlikely.

Another issues I keep facing is that I sometimes I feel I can’t breathe very well despite my airways being clear. Once I latch onto this thought I then look for signs it’s going to get worse and I start to play around with my breathing speeds. I get annoyed as I was subconsciously breathing on my own a few seconds ago and now I am trying out a number of different ways to find one that feels best. I told my therapist this and she reassured me that I can’t stop myself from breathing if I run out of breath by body with automatically make me take in a great gulp of air, like when you hold your breath. This makes me feel better about it; however it’s going to take some getting use to.

For next week I have been given two template thought records which I will fill in and explain in a different post.

Sisters School Christmas Concert

My sister had her schools Christmas show in the local church in the evening, I hadn’t made the decision on whether to go because it was a public space that I would be trapped in and everyone puts this lets be posh and polite attitude on and I just wanted to blend into the crowd. I was irritable and quiet all afternoon as I subconsciously knew that I wanted to go and was worrying about it. I still hadn’t got ready until half an hour before and my sister had gone off not knowing if I would or wouldn’t make it. I felt breathless, tired, dizzy, headachy and was very frustrated with myself that I couldn’t just go like any normal person. I got dressed and decided I would at least try. I took a spare pair of car keys and a blanket so that I could leave the concert and sit in the car if I needed to. I walked into the church and found a space near the back and behind a pillar, this was good as it meant less people were watching me but it also meant that I couldn’t see the show. I really struggled for the first hour I felt breathless and wanted to lie down or run away. These feelings came in surges one second I was in control the next I was ready to leave. Each time this feeling came I kept saying I will leave in a minute then the feeling would reduce enough that I could calm myself before the next one. I then began to pick off my nail varnish and this made me immediately relax I was able to hold a conversation, listen to the music and to some extent relax. I guess it just took my mind off everything. I enjoyed the show and was glad I went but I still don’t get a great sense of achievement for something I could have easily done a few months ago, just a sense of frustration. Once I had relaxed nearer the end of the concert I then began to feel really tired, it’s like you feel after you have eaten too much of Christmas day and just want to have a nap after all the effort your body and mind has just been through. I certainly slept well that night.