Post 25 – Let’s talk…

Having referred to therapy so many times in previous posts I thought it might be useful to share my experience. From reading this I hope to increase awareness of what it may be like based on my experience and share some of the things I find fascinating and helpful.

There is a caveat here – I only have experience of one therapist, although some experience of telephone counselling and have interacted via social media with a number of therapists as I try to learn more. Also my experience relates to the approach to depression, with a side order of anxiety and worry.

One thing I find interesting is my reaction to the idea of therapy. As I have written about before, I was deeply uncomfortable and ashamed with taking medication. That was not my reaction to therapy. Not sure why that is, maybe because there is an interaction and an element of control, which is not there with medication. I’ll quote from post 7 to perhaps explain that (get me, quoting myself!):

Medication works on me, whereas meditation and mindfulness require work from me.

The title of the post is deliberately misleading. There is a lot of doing alongside the talking – in fact more doing than talking. Because of that I think talking therapy is a slightly misleading title. You don’t just turn up, talk for a bit and that’s it. Well you do talk, but for it to be successful requires involvement and commitment outside of the sessions.

Now that is a challenge for people with depression, requiring effort and the strength to focus on things which are challenging and upsetting. At the start that seems incredibly hard to do. I can recall one session where I sat in the car afterwards, very upset and not wanting to ever do another session. In hindsight that session was an important one, albeit that wasn’t clear at the time.

In a way you can picture the therapist as Yoda or Mr Miyagi (am sure my therapist is going to love that description!). Sounds a bit of a cliche. What I mean is that they are someone with understanding and experience, who both challenges and supports you, often with subtle nudges to help direct you towards things that may help. It may not always be clear at the time why they say something or make a suggestion, but it makes sense later.

The thing I love most about therapists : ask a question & you get back either “it depends” or a harder question that makes you think.

(As an aside the second thing I most love about therapists is that they seem to like to take selfies of each other when at conferences and workshops, which shows the humanity behind the word therapist, a word which sounds so clinical.)

One aim from therapy I think is to help you develop the ability to be your own therapist. To achieve this takes time and it brings in skills which we can often use with others but not ourselves. Replacing self-criticism with self-compassion, reducing the judgemental tone with a motivational tone, the ability to find humour in a situation. Depression steals those abilities away, but here is the good news- you can get them back, probably in a different, more useful way than before.

In future posts I plan to write about three words which I now have a deeper understanding of and more importantly apply in a helpful way to life – compassion, acceptance and values. Each deserves a post on their own, the meaning of each may not be what you expect.

For me the understanding of those three words really opened up the ability to start to manage depression. That is what therapy gave me.

Having worked in technology I am used to TLA’s … you know those three letter acronyms which themselves become words, such as PIN. Let’s face it I introduced one for myself – remember DAB, meaning deliberate, aware, balanced from Post 7 – Meditation, mindfulness and me.

Well turns out the world of therapy is full of them-

• CBT – Cognitive Behavioural Therapy
• CFT – Compassion Focussed Therapy
• ACT – Acceptance and Commitment Therapy
• MBCT – Mindfulness Based Cognitive Therapy (okay, that’s not a TLA)

Then there is RFT (Relational Frame Theory), DBT (Dialectical Behaviour Therapy) which I haven’t (yet) read about. There are probably loads more.

A key theme to them is context, with associated behaviour and actions. I started off with CBT, but fairly quickly moved onto CFT, without really knowing it. CFT is a fabulous approach for depression. Personally it really helped to understand and address the self-critic and self-perfection.

As a patient the name of the therapeutic approach is irrelevant. If it makes sense to you and helps you then it does not matter if it’s called CBT, CFT, ACT or XYZ.

I have just started the MBCT course, which really builds upon the core skills of mindfulness – paying attention to the moment, experiencing the actual and building the habit/skills to do so through structured meditation. Sound a bit “hippy” – couldn’t be further from the truth. It’s hard work, using parts of the brain which we tend to let run on automatic. Mindfulness is such a buzzword at the moment, it’s losing some of it’s core meaning as it’s adopted commercially. The course really brings home the essence of it.

Recently, initially through social media, I have started to look at and read about ACT. Many of the therapies have cross-over with each other. From my reading I think the application is based on where the person is at, which is why it takes a few sessions to gain the understanding on what will help. That sounds obvious I guess, but it’s an important point that therapy experience is highly individual and it’s not a quick process. In the depths of depression I couldn’t have followed some of the suggestions of ACT, it would have taken too much. Now it feels like, alongside the MBCT, that it will strengthen my management of depression.

I would highlight my belief that the principles of CFT and ACT, underpinned by a more mindful approach, are applicable to anyone with mental health…..oh, that is everyone. In my opinion they provide a counterbalance to many of the challenges we all face in what can be a fast paced, technology driven culture. That is why compassion, acceptance and values are such key words.

I was once asked, of the things I have tried, which is the one that made the difference or was most helpful. There is no one answer to depression, it’s different for each person and some things work differently for others.

However it’s through therapy that I have learnt so much about myself that I believe it has been fundamental to managing my brain.

I hope you found this post useful and I would love to hear any thoughts, comments or experiences you might wish to share. Hopefully the stigma around support such as therapy can continue to be eroded.

Chris

Related and highly recommended material if you want to learn more

• Professor Paul Gilbert ” The Compassionate Mind” book
• Joe Olivier, Jon Hill and Eric Morris “ACTivate Your Life” book
• Jim Lucas, Openforwards Self-help Sat Nav Podcasts – specifically episode 16 on compassion with Dr Mary Welford, episode 14 on values with Dr Ray Owen (who gets special credit for bringing in a Dr Who reference!) and episode 2 on ACT with Joe Olivier