CBT or bust

Yesterday, I saw a psychologist for the first time in nearly two years. I know the script by now. You sit in a drab, depressing waiting room, which looks as if its wallpaper and furnishings haven’t changed since the 1960s, before then going to an even more drab and decrepit consultation room, in which you attempt to explain your entire life history of mental illness in the space of an hour. You go through all the bother of filling in a CORE-10 and pre-assessment questionnaire but the psychologist will tell you absolutely nothing about what your score indicates. You tell the psychologist that you’d prefer if he read what you’ve written on the questionnaire as your anxiety means that you can express yourself more succinctly through writing than you can verbally, to which he gives a reluctant sigh, and then asks you questions which you clearly answered in the questionnaire anyway. You wonder what the point of telling someone a condensed version of your life story is when you know that all you will be offered is a few sessions of CBT. Like a plaster for a severed arm. You go home feeling exhausted from the anxiety and feeling more hopeless than you did before you arrived.

I don’t think it’s any secret that the mental health services in this country are a joke. It took over three months for me to actually see someone after I asked to be referred back to CMHT by my GP. For many people, it takes even longer than this. While I’m glad that they’re finally displaying the contact numbers of crisis centres, and other organisations that can help (see below), on appointment letters (they never used to, and I was extremely angered and annoyed that even suicidal people seemed to be expected to wait this long without being given any support whatsoever in the meantime), it’s still a long time to wait when your mental health condition/s are having a massively negative impact on your life.

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And even when you do finally see someone, you find that the NHS mental health services really aren’t of any use to those with severe and long-standing issues. And then there’s the way in which it is all handled. You have to phone up your GP surgery to make an appointment, to speak face-to-face with your GP about your anxiety, who in many cases will not understand social anxiety disorder one bit (thankfully I got lucky this time and saw someone who was very understanding about it). You anxiously try to explain the lifelong difficulties your SA has caused you, in the space of 5 minutes, before asking to be referred. You then get a letter back from CMHT asking you to phone to make an assessment appointment. (In my case, I got a letter back with an appointment time that wasn’t suitable, so had to phone them back to change it). If they offer you 2 different appointment times that are unsuitable for you (due to work, university, etcetera), you will lose your place on the waiting list and have to go through the referral process all over again. You then have to deal with the anxiety of speaking to a receptionist, being in the waiting room with other people, and then attempting to tell your life story to a complete stranger. In my experience, psychologists only ever seem to give you their phone number as a way of contacting them. So the whole process is set up in such a way that those with the most severe and incapacitating social anxiety (and consequently, those who need help the most) are effectively barred from treatment. The psychologist I saw also recommended group CBT. While this is something that (while I still feel extremely anxious about it) I now feel just about able to try, such a suggestion would have scared the life out of me a couple of years ago. It is very dishearting how poorly understood social anxiety disorder is.

When I asked the psychologist if there is anything besides CBT available on the NHS for anxiety, he said that CBT is usually all that is offered. He did mention another type of therapy known as Interpersonal Therapy, but said that this is not usually offered for anxiety. So in other words, if CBT doesn’t greatly help you (and CBT does not work for everyone), then tough shit. This is why I stopped seeing them in the first place. While doing CBT with a psychologist did help, it only helped mildy, and I was still very much struggling with my mental health. Despite this, my allotted number of CBT sessions were up, so they stopped seeing me. Can you imagine the outcry there would be if the same thing happened to people with severe physical health problems?  Oh, your cancer didn’t respond to the first treatment we tried? I suppose you’ll just have to deal with it all on your own then, as “you are an adult now and we expect you to be able to cope with this on your own” (yes, a psychiatrist did actually say that to me once). We have to stop seeing you now. Goodbye. 

The psychologist also recommended that I start taking the diazepam tablets that I was prescribed by my GP  a while ago, much in the same way that I have previously used propranolol. But I’m still worried about the possibility of them being addictive, and of becoming reliant on them. He recommended that I take one when I’m at home, to see what the effects are, before using them somewhere else. I’m still not keen on the idea. I agreed to go along to group CBT even though I don’t hold out much hope with it. But maybe working in a group will motivate me to push myself harder.

The one thing that still very much depresses me is how difficult I find it to make friends, and how impossible it seems that I will ever be in a relationship. I did mention that it’s really the friendships and relationships side of things (in addition to my fear/ distrust of men) that I would like to work on, as I feel that I’m better working through CBT on my own when it comes to all the other stuff, but can’t really do that with this stuff. The psychologist, however, seems to have completely ignored this request. Typical. If someone could truthfully tell me that in a few years, I’ll have a handful of friends and a boyfriend, I’d be very happy and could stop feeling so hopeless about it and worrying about it all the time. I ask myself what I’d do if some all-knowing, psychic person told me this. I would obviously continue to face my anxiety, would focus on getting through my final year of university, and then would somehow try to become more confident in myself and learn to love and value myself, while bettering myself to give as much as I could in friendships and in a relationship. I just hope that it will happen eventually. I don’t still want to be this way, or feel this lonely and left behind, in my thirties or forties, or even later than that.

I hope there are much-needed changes made to the mental health system soon, but given that we currently have a conservative government, I think that’s highly unlikely. I hope that one day, perhaps when I’m an old woman, mental illness will be taken as seriously as physical health, and people will receive the treatment they need, for as long as they need it. I will (somewhat reluctantly) try the group therapy, and that if that doesn’t help me, I will well and truly give the finger to the mental health services that have so far failed me miserably, and continue to do my best to work through things all on my own.

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7 Responses to CBT or bust

  1. Addy says:

    The mental health system isn’t much better in Australia. To see a psychologist without paying through the teeth for it, you need to: make an appointment with your GP, undertake a Mental Health Plan (which is basically your life story on a piece of paper), be referred to a suitable psychologist, wait for them to have an appointment available and then attend the psychologist, usually to retell your life story, even though they have it on the Mental Health Plan anyway. And once you get to see a psychologist, you have only six appointments with them as this is all that’s allowed under the program. So for those people with serious and long-lasting conditions, very little is actually achieved during the six appointments you’re allowed. Hence why very little has every helped me deal with my social anxiety. What can really be achieved in six hours to combat this condition?

    I completely understand what you say about friends and a boyfriend. I feel much the same way as you, and am hoping the psychologist I’ve recently started seeing could help me with this. It’s a shame your psychologist seemed to ignore your request, maybe consider bringing it up again when you see them next. That’s what I’ve done with psychologists in the past. Sooner or later they have to start taking notice of what you’re saying.

    Good luck with the group CBT. I wouldn’t be able to do that at the moment. It would freak me out far too much. But hopefully it will assist you with your battles with social anxiety.

    I’ve rambled enough. Sorry for the long comment! 🙂

    • Gemma says:

      Thank you for your comment, Addy. I’m sorry that I’ve taken so long to reply to you. For some reason, your comment ended up in my spam folder. Stupid spam filter! I’m not sure if I will see that psychologist again or if it will be someone different taking the group therapy sessions. I may try and mention it to them. I’m sorry to hear that things are just as bad in Australia. 😦

  2. Liberty says:

    I can definitely relate, I also did CBT for a while for my Social Anxiety, but didn’t find it very helpful i mean how can they expect someone to be free of Anxiety after 6 weeks! I am now on the waiting list for psychotherapy which is more long term, maybe suggest that to your Doctor? I also did counseling for a while, which was good just to have someone to talk to.
    I hope everything works out for you stay strong! xx

    http://www.libertylifeandselfhelp.com/

    • Gemma says:

      I know. And it’s not just the fact that so few sessions are offered, it’s also the fact that the CBT they offer is not specialised enough or comprehensive enough. Are you in the UK as well? I wasn’t even aware that psychotherapy was offered on the NHS. I will probably ask the psychologist I saw about it or about interpersonal therapy if group therapy doesn’t help me adequately. I never found counselling particularly helpful because I felt like I was just going round in circles. Thank you for your comment.

  3. This is such an apt portrayal of the hurdles and indifference people with SAD have to face when trying to get help. I didn’t contact the CBT therapist who was referred to me because, yes, she only offered a telephone number as a means of contact. (Never mind that in this day and age that is hopelessly backward.) I ended up thinking that if she didn’t understand why this would present a barrier to people with social anxiety disorder, then she probably wasn’t a very good therapist.

    • Gemma says:

      Indeed. I don’t understand why they can’t provide an email address or number that can receive texts. I have never met any psychologist or psychiatrist who understood why this – as well as many other things – might be difficult for people with social anxiety disorder.

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