Thursday, 1 February 2018

The Truth about CBT (Cognitive Behavioural Therapy)

I've wanted to write this piece for a a long time, but I needed the dust to settle before I felt fully able to turn back and reflect on my own personal experiences with CBT. It stands for Cognitive Behavioural Therapy, and it's a kind of psychological therapy used to treat mental health problems, trauma, phobias and more.

I've found that, especially in the media, CBT and other therapies are misrepresented. Sometimes they are presented as clinical and sterile, and sometimes (particularly in print press) they are presented as woolly and fluffy solutions. I found the reality to be very different. My experiences of CBT have been positive, but the process itself is an emotional roller-coaster. I want to share with you a few realities, from someone that's been there more than once.

How does CBT actually work? 

Your therapist will work with you to question your thoughts and behaviour and the reasons behind them, and provide you with strategies to practice that are designed to change your thoughts and behaviour for the better. It's designed to break the negative cycle by encouraging you to interrupt those thoughts and behaviours one step at a time. Each week you will discuss how the previous week went, and get some 'homework' (for example mine included include practicing a new coping strategy and observing my thoughts in a particular situation and writing them down).

Every therapist will have different techniques but the idea is essentially the same. It's a proactive form of therapy that I found very empowering. It helped me to feel more in control of my mind and to stop dwelling on past experiences. You can access CBT in person with your therapist, and depending on the area you can also use an online service where you have a Facetime-style call with them. I've used both and can say there is little difference and that the online service has a shorter waiting list as well as a greater choice of therapists and appointment times.

CBT and me (a little disclaimer)

The first time I took a course of CBT was back in 2010 while at university. It stopped me from quitting and moving back home and I went on to do brilliantly in my studies. I've been back for more CBT since, but despite it being a huge part of my life I've never talked about it much online. Although I think we're much better at talking about this stuff now than we were back then, I know that many are still reluctant to share their own stories and that intense stigma still exists in some homes, workplaces and social circles.

Most of my close friends and family are aware that I've struggled with anxiety and at times depression since I was a teenager, but that doesn't mean I find it easy to talk about. I don't feel the need to go into all of the nitty gritty details of what goes on in my head in this post because a) no blog post in the world could ever be long enough and b) I firmly believe that you can be honest and open about your personal experiences without baring your entire soul and turning your skull inside out.

It's not for everyone

Cognitive Behavioural Therapy (and other kinds of therapy that generally speaking involve sitting on a big, badly upholstered chair and crying a lot) requires you to be open enough and accepting enough of your current situation to want to change. CBT gives you the tools to understand your mental health and take steps to changing it for the better. It doesn't do all of the work for you. If you don't get on with it and feel like you're not ready, then that's OK. Other forms of therapy do exist, some of which are available through the NHS. Medication can also help - whether you use it short term to get over a bad patch or (like me) on a long term basis to keep your brain on an even keel there is absolutely nothing wrong with doing so.

It's not a 'nice' experience

Therapy is incredibly cathartic and can be very empowering, but not in the way that a good wardrobe clear out will make you feel fresh and shiny and new. You're here to exorcise a few demons and put the foundations in place to actively bring about a change in your brain. It can be uncomfortable and emotionally exhausting. Although you will always work progressively towards your end goal, each step involves breaking down a rigid pattern of thoughts and behaviours that you may have been practicing your entire life. Every single session we would uncover some way in which I had been mentally sabotaging myself and set about creating ways for me to face up to my biggest fears and deepest denials. 

It's not a quick fix

The courses of CBT I've been on have been anywhere from 6-10 sessions. You can't undo years of anxiety in a 45 minute session. Expect set backs, expect tears, but above all take your homework seriously and you can also expect to make slow, postive progress towards getting better. Like me, you may end up finding yourself needing to go back into therapy at some point, or you may choose to see someone regularly long-term. That doesn't mean that you've failed. This is a process. This is a journey.

Not all therapists are created equal

Some people describe finding the right therapist as being a little like dating. You may need to talk to a few different therapists or counsellors to find one that you're comfortable opening up to and who you 'click' with. They are not there to be your friend or your shoulder to cry on, but you need to feel like you can talk to them about the deep, dark crap in your brain. It's also completely ok to specific whether or not you would like a male or female therapist/counseller - the person providing you with treatment should be someone you feel can understand and relate to your problems.

The outcome is worth it

It might seem like I've made CBT sound like a brutal process, but if you're at the point in your mental health journey where you want to change and start healing, it's also a very rewarding experience. If you're going through CBT or counselling of any kind then I would recommend keeping a journal or diary (or even just typing into the Notes app) to record your progress. You'll look back and be surprised at how far you've come and how much you've learnt about yourself.

A note on how to get CBT sessions in the UK

When at university I accessed CBT through my GP, who referred me to the student union's welfare service. They provided me with sessions for free and the waiting list was only a couple of weeks. If you're a student you should also be able to go directly to your student welfare service to access help with mental health problems.

As a proper "grown up" in the real world I accessed CBT for a second time through my GP when things got really bad. The reality is though that unless you're determined an immediate safety risk to yourself or others you will be either put onto a waiting list that is months long or directed to a local charity with a slightly shorter waiting list and very awkward appointment times. The UK government doesn't take mental health seriously, so if you can afford to access private counselling or CBT while you're waiting for a referral to come through then don't wait. I got worse and worse while I waited for an appointment letter and although I got my treatment in the end, it is crystal clear to me that our government doesn't see mental health as a priority.

Sunday, 21 January 2018

Review: The Power by Naomi Alderman

We've all heard tales of women using their bodies as weapons, but what if they really were deadly? What if Women were something to be feared? Naomi Alderman asks these questions and more in The Power.

It's not hard to see why this book has attracted so much attention. In an age that many are describing as a 'fourth wave' of feminism, The Power plays out an alternative scenario to modern history, one that tears down the patriarchal constructs we know all too well. It was awarded the Baileys Women's Prize for Fiction last year and is by all accounts a critically acclaimed best seller.

So what's it all about?

The book centres around 4 main characters, switching perspectives every few chapters. Young girls are suddenly beginning to find that they can awaken an almost supernatural ability to inflict extreme pain on others using a kind of electrical current, generated from a previously undiscovered gland called a 'skein'. Men everywhere are terrified, and the power is beginning to spread across the globe.

The novel is presented as a historical account, book-ended by letters between its male author and his female editor. There are even diagrams of historical artifacts between chapters - read the descriptions, they're pretty clever. As each section of the book passes, we inch closer to a cataclysmic event (which I won't go into detail about for spoilers' sake). As the power provides women with the means to take control of society and governments attempt to regulate its use, underground religious movements spring up across the globe, a drug lord's daughter finds ways to take advantage of the new order, and a male journalist finds himself helplessly trapped in a country on the verge of collapse.

As much as it pains me to quote cheesy superhero films in a book review, "with great power comes great responsibility". As previously oppressed groups of women begin to realise they can easily manipulate, injure and kill the men that once kept them in chains, the tables are turned and things get out of hand. Thousands of years if sexism and misogyny are reversed in the course of only a few years, resulting in sheer chaos. After years of lying dormant, the power is difficult to contain.

The Power begins as a kind of feminist sci-fi/fantasy tale, but as the pace intensifies (and rarely lets up for more than a beat) things turn violent, and at times graphic. It morphs into a bold fable against the dangers of oppression. Let it shock you - it's meant to.

Naomi Alderman's writing is page-turning. It's action-packed enough to push the story along at lightning pace, but at times is also beautifully descriptive, slowing down occasionally to let the message sink in. It's also packed with humour and sarcasm, which balances out the seriousness and makes it a truly entertaining read. The perspectives used each have distinct personalities and voices, and Alderman uses them with finesse to imply powerful observations about human nature and, of course, gender.

Like most, I expected to read The Power and come away feeling empowered. I definitely enjoyed (in an almost sadistic way) seeing women take control in situations where they would otherwise have been powerless. But also felt as though Alderman was warning us that it will take difficult and by all accounts extraordinary events to truly chance the state of play. This is more than just a revenge story.

I urge you all (whether you're a woman or not) to read this book, if only so I can talk at length with more people about it. This is a book that forces you to hold a mirror up to the current state of play  and to question the unwritten rules of modern society. How acceptable would the atrocious acts of oppression committed against women every day in the present day be if the roles were suddenly reversed?

Thursday, 11 January 2018

Budapest Diaries - Day Two

So, I left it a little longer than intended to continue my account of our trip to Budapest. I became a bit of a couch potato over Christmas (which was bliss) and then I contracted a cold-flu-plague hybrid virus that's only now exorcising itself from my body, so let's leave that there and move swiftly on now that we're back in the swing of things. Here's what we got up to on day two of our Budapest city break.

The Thermal Baths

I am now a firm believer than you cannot visit Budapest without indulging in the local tradition of heading to an outdoor (or underground) thermal bath for a good soak and a steam. On the morning of our second day we headed up to perhaps the most well known, the Szechenyi baths. Built in 1913, the huge but ornate yellow building has some serious Wes Anderson vibes going on and is consequently not hard to locate once you get out of the metro.

Sitting around in warm water with the locals might not be to everyone's taste, but personally I enjoyed it. It was a quite morning without too many tourists around, just a few locals. It was about 16 degrees outdoors so it did feel odd to walk out in a swimming costume, but I wasn't freezing either. We booked online through this website - although you don't strictly have to we wanted to make sure we didn't get caught in a queue if it was busy.

There are pools of different temperatures, with the warmest around 40 degrees centigrade. This was my favourite as it felt like a very hot bath. You can feel your pores opening and muscles relaxing as you step in. There are also medicinal baths that are prescribed by Hungarian doctors, as well as traditional spa treatments available indoors. I can see why the locals think this stuff is good for you because I hadn't felt that relaxed in months.

The Best Donuts in Town

I knew we'd be digging into a traditional chimney cake or two while in Budapest, but another delicious find on our travels was The Box Donut. There are at least two of these bakeries in the city, with a variety of these signature square donuts available. They were bloody delicious, and to be quite honest with you they didn't actually make it into their box before we'd scoffed the lot. I'd highly recommend swinging by. If you fancy trying to get some home with you then they fit snugly (some might say deliberately) inside a small box. I'd recommend the Creme Brulee flavour. The smoothies are good, too.

The Shoes on the Danube

We decided to visit this particular part of the Danube after walking around the impressive parliament buildings. If you know the story of what happened on the Danube during the Second World War then you will also know how deeply moving it is to walk along this riverside memorial. This blog provides some more details on what happened in the city during that time period. The Shoes on the Danube is one of many monuments to Hungary's bloody modern history that you'll find across Budapest. More on that later. 

It was sad to see that even to this day, members of the Jewish faith come to leave flowers, candles and ribbons in the 60 pairs of iron shoes tacked to the river's edge. While many WWII monuments are grand and impressive, the shoes are life-size and hard to spot until you're upon them. I think that gives them even more of an impact.

The Unexpected Journey

We left our second afternoon free since we weren't sure what the weather might do. We walked across from the Shoes on the Danube to a nearby boat stop (covered by our 72hr travel passes) and decided to hitch a ride to Margaret Island. 

The island is a piece of land in between the Buda and Pest sides of the river, and while it is mainly home to a hotel and casino, the vast park grounds are open to the public. An old water tower at the centre of the island keeps the Wes Anderson vibes going, and there's also an old church, rose gardens and a huge singing water fountain. Although each area of Budapest is beautiful in its own way, the island was so unique.

The best way to see the island is to rent a tandem bike or covered bike (the one's that the Chuckle Brothers used to ride?!). For a small fee you can easily cycle around the whole thing in 30-60 minutes, depending on whether or not you stop at one of the many bars/stalls for a drink and a Langos. These deep fried bread snacks really are the stuff of dreams when you're a little worn out from peddling! 

The Ruin Bars

At sunset we made our way back to the Air Bnb to change, and then we headed out to explore the district of trendy 'ruin bars'. These bars began popping up about 15 or so years ago in abandoned apartment buildings, and are probably the coolest places I've ever had a beer in my life.

Szimpla Kert is considered the original ruin bar, with a huge maze of connected rooms on multiple floors all filled with mismatched furniture, street art and festoon lights. The busy, vibrant atmosphere is something to really soak up in this place.

As Szimpla Kert got busier we walked a little way up the street to another huge ruin bar called Instant. This place is made up of smaller club and bar-like rooms, each with a slightly different vibe. We heard some music we liked coming from the basement (a dive bar called Robot) so we wandered down. It terms out that a band called DLRM were playing and the whole underground tunnel vibe made me feel like I was in a Kerrang music video! Check out my dodgy phone pic...

Since we hadn't yet had dinner we took a walk in search of food, which didn't disappoint. We found a street food park called Karavan where we went slightly overboard at all the different food trucks, enjoying fried cheese, goulash and chimney cake, washed down with some locally brewed beer. It was so cheap, insanely tasty and the long picnic benches filled with people created a great atmosphere.

I'd like to say we partied on into the night but if I'm honest with you guys it was about 10pm at this point and we were pooped! We went back to the apartment to bed and I don't regret it one bit - party animal I am not.


Monday, 1 January 2018

New Year, New Rules: How I'm Taking on 2018

If you didn't read the title of this post and end up with Dua Lipa stuck in your head then I just don't know how else to lead into this post. It's a new year, and despite my best efforts to stay the hell away from outlandish revolutions, carb-free diets and shiny, overpriced planners, here I am writing this. Let's go with it.

I know that Kylie Jenner said 2016 was the year of 'realising stuff', but I've learnt a lot about myself in 2017. It seems mad that even after spending every second of every day of 25 years on this planet with my very own brain, soul and body, that I continue to be surprised by what I find beneath the surface. I think I know myself a little better now, and I feel more sure of myself than I have in a good few years. 

I want to take the experiences I've had in the past 12 months and make sure that I exercise the lessons they've taught me about myself. I am already starting to put this stuff into practice, but I think it'll do me some good to have a set of commandments to live by, to remind me that in order to make progress I have to be consistent.

1. I will not grow by staying in my comfort zone

One of the things I hated the most about how I felt when I let my anxiety get the better of me last year was the way it would leave me paralysed. I mean this in both the literal and metaphorical sense. I would often feel like I was allowing myself to stagnate, staying in a place that felt comfortable and avoiding pushing myself and putting myself out there for fear of failure. 

Over time I became so pissed off with myself for ending up in that kind of mindset that by the time I'd pulled myself out of the metaphorical hole I'd already vowed never to go back there. Although it can be hard, I'm trying to always push forward and make progress within myself even it it feels alien and uncomfortable. That's how you grow! Complacency and procrastination are so last year.

2. I will not give my energy to negative thought processes

One unexpected thing that came up again and again during my CBT sessions last year was just how easily I would collect up the negative things people said and carry them around on my shoulders, like heavy little pieces of evidence that proved I wasn't good enough - that others were somehow better than me. Even if there were a million other positives I could have taken from the conversation, I would let the bad parts preoccupy me. 

I'm sure there are many of you out there that do this without even realising. It took someone completely external to my life pointing it out to me for me to fully acknowledge just how much time and energy I was giving to worrying about what others might think. It made me shy and retiring to the point that even my voice got quieter. I became a self-fulfilling prophecy.

I'm slowly learning to shake it off and let my 'real' self take the floor without fearing judgement. There is power in being able to brush the negative thoughts to one side, and remind myself how awesome I am. No one else is gonna do it for me. 

3. I will not treat personal growth like an afterthought

Something else I was forced to come face-to-face with in 2017 is that although I can reel you off a 'to do' list as long as my arm, the things that really benefit me are usually at the bottom. I will always want the perfect desk set up, a full fridge and a clean bathroom before I can 'allow' myself to sit down and read a book, look at an online course or even just chill the hell out. It's partly the procrastination demons coming out to play, and partly my need for everything to be juuuuust right before I make a start on the next thing. It's not just procrastination, it's completely self-sabotaging.

This year I've made it my mantra to mentally reorder these lists and put the genuinely worthwhile stuff at the very top. I want to develop my skills to give my career a bit of a boost, but I can't do that if my focus is on irrelevant aesthetic details. Life can't be 100% perfect and under control unless you live in a safe little bubble - it's time to let go of that idea. Hopefully in a few months time you'll find me knee deep in some kind of coursework while the dishes pile up in the kitchen!

I'm going to be journalling and blogging more this year, which will help me to document my experiences putting all of this into practice. Look out for an update or two and wish me luck!


Sunday, 31 December 2017

The Things I'm Really Grateful for This Year

If you've read any of my 'end of year' blog posts before, you'll know I'm not the biggest fan of faddy resolution posts. This year I've also been watching people scramble to pick their three biggest achievements to post on a viral quote tweet, and I'm not sure I dig that either. It's great to shout about your successes if you're proud, so don't let me stop you. But if you're feeling pressured to come up with something impressive or you're finding that despite being happy for others, you can't help but compare your personal story with theirs, then know that you're not alone.

I don't want to shout about the fact that my only real achievement this year was that I completed a second course of CBT, after my mental health got pretty out of control, and that the panic attacks don't snatch my breath away from me nearly as often as they did only a few months ago. I don't want to talk about how much I've struggled. I'm just glad I've come out the other side of it, whether it's the end of the year or not.

I don't talk about this stuff a huge amount online because I feel like there are already plenty of people sharing their similar stories more articulately than I ever could. I've already allowed anxiety and depression to dominate my life and thoughts outside of this space and I finally feel like I'm on top of it, so I'll be damned if I let the bastard invade all of my writing too. 

So yes, I found 2017 pretty rough going, but there will be plenty who found it far worse. I'm grateful for my own resilience, and I'm grateful for the people who have supported me. I feel like I've changed and grown an awful lot, so I'm thankful for that, too. I've learned what I should and shouldn't give my time and energy to in order to stay 'sane' and get back on track. I've realised my own worth and am starting to embrace the fact that I'll always feel like a black sheep. I'm also grateful for medication and therapy and YouTube yoga routines and endless Netflix reruns of That '70s Show'. And Krispy Kreme donuts - whoever said you can't eat your problems was totally wrong.

Despite the above probably reading a little bit like the 3am tumblr post of an emo teenager, I'm actually feeling positive about 2018. I'm going to spend the first few months of the new year working on my confidence and trying new things, making up for all the time I spent in a negative head-space this year. 

© kelly anne rist

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