Woke up today with a sore throat, sniffles, a minor case of the blues, and lo and behold, another letter from the CBT woman chasing me to arrange another appointment on my doormat.
This did not exactly enhance my mood. Just looking at it makes me want to tear it to bits with my teeth.
I open the envelope, chuck the letter and look at the leaflet.
On the cover are photo head shots of five people, with thought bubbles coming out of their heads. Each thought bubble contains one of the following questions:
Can’t Find Work?
Problems at Work?
For the record, these folk do not worried at all let alone depressed (indeed they look as if they just won the lottery), so unless they are on better fucking meds than I am, they might want to invest in different photos.
If they are, I want what they’re on, do you hear me, Dr B?
Inside left page is some blurb about who to contact if you’re a bit worried/stressed/etc/etc, what the procedure is, contact telephone numbers and the possible time line for getting an appointment.
Then on the following pages are examples of the forms and questionnaires you need to fill in every week before your appointment.
I can tell you right now, that I will never, ever fill out one of these forms again.
Let me take you through my experience of working with them.
The first Questionnaire box that you need to fill assesses how you are feeling at that time. These list from 1-9 and start with:
1. Do you l have little interest/pleasure in doing things?
9. Do you have thoughts that you would be better off dead?
You have to score these with one of four options ranging from ‘Not at all’ (1 point) to ‘Nearly ever day’ (3 points).
And that’s fine. I had no problem with this form in principle. People have to start somewhere when analysing a whole boroughs worth of nutters.
The next Questionnaire, addresses the potential symptoms resulting from these thoughts, ranging from:
1. Feeling nervous, anxious or on edge
7. Feeling afraid something terrible might happen
This is scored as per Questionnaire 1. Again, I get it. Knowing how much a patient’s life is impacted by their paranoia is imperative to understanding what needs to be addressed.
Then there is a Phobia Questionnaire, where situations and activities (going outside, meeting friends, chairing a meeting etc.) are listed and these are scored taking into account whether you would avoid them and the extent that you would avoid them, ranging from:
1. Would not avoid it
6. Always avoid it
I acknowledge that ALL of this stuff is valuable in assessing how a patient is feeling, how this manifests in their lives and how much it is inhibiting them from leading a normal life.
I’m not done yet.
In addition to this, every week I would also have to fill out a Weekly Activity Chart. The Weekly chart was broken down by days (Monday to Sunday) and then by hours, and this had to be populated as much as possible with how each hour was spent, along with a mark between 1-6 to indicate how much I enjoyed it.
Every hour. I’m not kidding.
But I was in a very bad place, so I thought hey, co-operate, they are only trying to help you. So I did. From breakfast to bed time. Hell, I even benchmarked my bowel movements (giving one a 6+ one day) might as well have some fun with it…
It was when I realised how this would be used that I lost my sense of humour.
Basically, I’ll do you the courtesy of cutting out the pie charts, PowerPoint presentation, medical clichés and other insulting, patronising crap and summarise it like this.
The first 3 charts would be compared week by week in order to monitor progress. Soo, if you go wanting to harm yourself to being a bit indifferent to everything, you were making progress.
If you went from thinking the sky was going to fall in, to worrying if you miss your bus, you were on the mend.
Please don’t leave and check your Facebook account. I know this is boring; I had to fucking live it.
OK, what was I saying? And if you went from not going outside to, yes, you’ve guessed it, going outside, things were going swimmingly.
Now, here’s the science bit 🙂 .
Are you ready?
When it came to the Weekly Activity Sheet, essentially the practitioner would look at the things you marked low (not counting those unavoidable unpleasantries that we all have to deal with like cleaning the oven) such as meeting a friend you no longer got on with, and advise that you do them less.
That’s not all! She then looked at the things I marked high (apart from eating crap and drinking myself into a stupor) such as having an aromatherapy bath and advised that I should do them more.
Do less of the things you don’t like, and more of the things you do like, and then you’ll get better. Genius.
Because that’s all there is to it; people really are that uncomplicated. And if you believe that and have a spare afternoon, lets meet up, enrol and we could all qualify as a CBT Counsellor at the School of Stating the Bleeding Obvious.
What pisses me off most is that, in my experience, these kinds of practitioners expect their patients to be (a) rational, (b) able to discern what is good for them and (c) able to implement these proposed changes to their day to day lives.
This kind of prescriptive, overly simplistic pop psychology is of no use whatsoever to people like me, because what they are using is mathematical, predictable logic, and in my current state, whilst I understand the rationale (I’m mad, not stupid) logic doesn’t even begin to come into it.
I know that running and gym work makes me feel better. Why don’t I do it? Not sure.
I know that, with my background of eating disorders that binging on ice cream makes me feel like a revolting, fat bitch. Will I do it again? Yes.
I know that being out of the workplace for a prolonged amount of time in this economic climate is ill advised, and being alone at home all day worrying about money is not helping me move forward. How many jobs have I actively applied for in the last year? Erm, Two.
I know that in order to carve out a new life as a yoga teacher I need to pass my exams this year with flying colours. Why am I neglecting my studies? Pass.
I know that digging away brutally at the wound in my hand serves no positive purpose whatsoever; indeed I am scarring myself and it hurts. Does that stop me doing it? Nope.
I know from experience that a significant other in my life does tend to make a difference to my wellbeing. Have I joined a dating website? Not yet. Maybe not ever.
And I know that if I am to date again I need to get my body back into shape in order to feel in any way attractive/sexual. Am I making any effort to that end? Fuck, no.
Seeing a trend here? Thought so. So why can’t supposedly qualified professionals understand that box ticking is not the answer here?
And looking over your glasses and sighing at me as if I’m being deliberately uncooperative and obtuse, when it’s taken every once of strength to drag my arse out of the house to get to your office makes me want to shove my face inches from yours and scream profanities at you until your face is pebble dashed with spittle and my throat is so raw it has started to bleed.
So benchmark that bitch, save yourself a stamp and leave me the fuck alone, as Aunty C makes you look like the rank amateur that you so obviously are.
Oh dear, I appear to be rather angry. Time to watch Real Housewives, as those crazy wenches make me look like Mother Teresa.