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Cognitive Behavioural Therapy (CBT)

Following other blogs and reading about how other people challenge their experiences of depression and bi-polar is helpful and one of the best websites and blogs is that written by Natasha Tracy http://www.natshatracy.com who has achieved recognition as an excellent mental health blogger. Indeed she has received awards for her work in raising awareness and fighting the stigma that still exists in our society. A recent post raised several questions about CBT so it is worth discussing the value of this here and how it can be accessible to all, not just for those referred by GPs or psychiatrists. Resources are still scarce for mental health intervention and the cuts cannot be helping. Somehow we all have to be our own mental health expert, our own doctor, our own psychiatrist. The afore-mentioned will not be there with you in the middle of the night or on a bad day. One has to wait for appointments and things often look different then. So what can be do for ourselves?

CBT is a method of changing the way we think about our experiences. Depression arises from negative thinking or what is sometimes known as unhelpful thinking styles. Those with depression have low self esteem and see their life experiences as black and white. For example, if someone you know passes by on the opposite side of the street without acknowledging you, the negative unhelpful thought will be that they ‘don’t like me’ or ‘don’t want to talk to me’. An alternative, more positive, thought could be ‘perhaps she did not see me’ or ‘perhaps she had something on her mind’ and, even more helpful, ‘next time I see her I will speak first’. This is the essence of CBT replacing negative thoughts with a more positive alternative – thought or action. It can be habit forming and before long you will realise you are doing it without thinking. To help me over a difficult phase I made some cue cards with my most usual negative thoughts written on one side and an alternative (even two) on the reverse. By reviewing these cards at low times I am reminded of how I can change my thought in the same way that I might use revision cards prior to a written examination.

Natasha refers to the process of re-wiring the brain and likens it to the negative thoughts making a groove in the brain which, when repeated, increase the depth of the groove until it is a ditch you can fall into. Negative thoughts can bring you down very quickly and none of us wants to fall into the pitch black ditch.

CBT requires no therapist  as you can work from books and websites and, if you understand the underlying theories and practice, you can work through it yourself. Of course, a face to face person will help and the more skilled the practitioner the better. I was referred for CBT about six years ago but found the counsellor let me indulge in free association and ramble through my life and present problems without any guidance. Because I was about to visit relatives in Bavaria, he told me I had  a really good life which showed his assumptions and lack of understanding of bi-polar and depression. These illnesses affect poor and rich alike, the lonely as well as those with families. His view and expressing it was unhelpful. He did eventually give me homework (this should have been from week 1). He asked me to list what I was proud of about myself. At last, I thought, we re getting to CBT but positive affirmations and raising self esteem is not CBT. He did not encourage me to make a diary of negative thoughts. In the end I did it myself after working through a DBT book.

You can borrow books on CBT from the library and also googling CBT will bring up websites. Make sure you choose a website which does not ask you to pay. There are plenty of websites which offer worksheets and information on the technique. All of this is free.

Here is one website. You will see it does advertise some books which cost money but it gives useful information for those seeking to understand more about themselves and their symptoms.

http://www.get.gg/cbtstep1.htm

WebMD is a good website. This is the US link to CBT and makes good reading.

http://www.webmd.com/depression/guide/cognitive-behavioral-therapy-for-depression

A book I now have on my bookshelf is Brilliant Cognitive Behavioural Therapy by Dr Stephen Briers.

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