CBT: Am I Doing It All Wrong?
I know I cannot predict it, but I want to believe that “everything is going to be alright”.
Reviewing a mental health service that on multiple occasions let me down…although it might have been my fault.
When I first moved to the UK, two years ago, I started a new chapter and for a while everything was going for the best. Then, the anxiety that had been haunting me for years hit again and I decided to contact a therapy service to see if they would be able to help me. The doctor had provided me with a few leaflets, listing all major (free) services available in my area.
I did not know much about any of them and consequently, I chose the only one which could grant me the privacy I needed — since it was entirely led online and based on a chat with a specialist that oftentimes would sound more like a series of copy-and-paste texts, rather than something the therapist had come up with on the spot.
I dropped it
Was it the right thing to do? Did I have the best approach? Should I have put more effort into it?…No; No; YES.
The thing about CBT (Cognitive Behavioral Therapy) is that it takes time and a lot of work on the part of the patient, who is asked to self-analyze themselves in order to get to any kind of amelioration. I simply did not put much — if any — effort into it and was expecting the therapist to do all the work: telling me what I should think, do, say, etc.
That merely does not happen as, while we might be affected and influenced by somebody else, they cannot put thoughts into our mind if we do not want them to. For this reason, you are continuously prompted to observe what happens during the day and how different situations make you feel. Is it hard to complete a certain task? or, can you individuate the triggers to your anxiety? Rather than, why would you think that? Why don’t you try to be more positive…
I did not try just once
In total, I had 5 attempts at CBT with 3 different providers, 6 therapists and all of this within 14 months. Now, I have embarked on a new series of sessions with another clinic and it is still hard to tell whether this time will be effective.
I was even tricked into it!
As many trans individuals living in the UK know, getting help here is excessively hard. It can take up to X years, before getting contacted by a Gender Clinic that will then provide you with an appointment for several weeks/months after. On top of that (being already quite disgusting), we have to deal with medical professionals who are not prepared to deal with our situation and can easily lead to additional frustration!
Think that, since I am already on hormones and treated abroad, but constrained to remain in England because of the COVID-19 situation, I managed to finally get a prescription for my routine blood tests (which are currently 2 months overdue), after almost a year spent begging various GPs to prescribe them to me — so to avoid having to board on a plane back to Italy, which eventually I had to do a few times.
This being said, how I was played was during one visit at the doctor’s, the very first time I brought myself to tell somebody that I wanted to transition and that I needed their help, because I knew very little about it and was afraid to make a tremendous mistake. He replied that I might have been confused, that that was not what I actually desired and that in order for him to place a referral, I should have had CBT again.
Furious, but hopeful, I left and on the way back home, I googled the service that I had previously used, so that I could have just submitted a new request using my old profile. Before the sun set, I had already arranged everything, submitted a request and gone through all the paperwork necessary. The following day, my appointment was scheduled and I was getting ready for it.
It did not work
There they could see that my feelings were real and that further steps — which they could not offer — were needed. So, the therapist sent a letter to my GP to inform them about it. Yet again, this was not enough. I had to go 5 times to the GP, before (4 months after that very first appointment) a doctor decided to agree on the referral.
Why did I say that it did not work, though? Because even though they referred me, I knew that it would have taken almost two years to hear from them. What is more, my anxiety still kept me awake, while my depression knocked me out for the rest of the time.
I was to find a solution: I tried again!
Third, fourth and fifth time. I would not say that there was no improvement whatsoever; in fact, the horrible monster that for years had taken over me (bulimia), finally left and although it remains as one of the voices from my past, it has now lost its power over me and I am immensely grateful for that!
A few days have now passed since I first started writing this piece and I must admit that they have not been easy at all. Every time I relapse, I fear from the deepest part of my soul that I am going to lose everyone who loves me. This feeling takes over and I can no longer keep thinking straight; the thing is, I cannot talk it out of my mind and I start acting as though that had already happened. Maybe, it is the sense of guilt that cripples from within upwards, towards all of those who have to bear with me.
I have deliberately missed my third session and would not try to fix this — not even if I were given the chance to go back in time. I do not feel like it and although the “I”s have so far been many (this making me highly uncomfortable for some reason), I am the one suffering and I want to tell how it feels. Since nobody else might explain it without a substantial degree of subjective interpretation.
Whenever I find myself writing during a downfall — may this be on therapeutic grounds or for commitment — , I always experience this kind of flow of emotions. It feels like perishing, I believe. Nothing seems to matter anymore, yet everything becomes invaluable. It makes no sense to someone “fine” or “normal”, I suppose. It will make perfect sense to those who know what I am talking about — obviously.
As I previously said, the fright is real and it makes me want to do everything not to lose those I love; so much so that I end up getting flooded by such feelings. Once again, the fear of not being right, enough or good for them tides up and my body, paralyzed, blacks out at the mercy of the waves. It gets so cold and dreary that no words I know could be sufficient to describe it. I wish they could enter my mind for an instant and take a glance at it; not because I wish them any harm, only so that they might eventually understand the motive for those “moods”.
I wish I could say that “everything is going to be alright”
I know that good days and bad days alternate in a continuous cycle that ceaselessly goes on and that is as subjective as many of us are on this planet. And I also know that the only person that will ever take care of me is myself. We are lonely: like it or not, humanity dwells on a communal loneliness that affects the most sensitive and deceives the most social ones.
Consequently, I oftentimes find myself looking for others and rejecting most of them. It makes poor sense and although there are people in my life who — on various levels — look after and care for me, I do not strive to ameliorate; instead, I usually take advantage of those happy moments and cherish them throughout during gloomier times.
I cannot predict the future and this destabilizes me psychologically — perhaps this being a trait of my OCD. And I wish I could say that “everything is going to be alright”, as I read on a sign once at the Tate Modern in London. But I cannot do this; I cannot foresee what it is yet to come and trust me, if I could, I would do it straightaway!
Maybe I just need more time
In the view of my next and last session, I will try to actually work on my attitude and on what makes me both uncomfortable and touchy. I will do it for myself in the first place, but always having in mind who is actually supporting me against my own mind when I need it; since there are very few people in every person’s life who can be hugged, screamed at, laugh and cry, gossip, shop, eat and live with you without this leading to a sense of drowning or suffocating.