During my long history of being ill (can you be a professional ill person?) I have undergone many ‘treatments’ and being the lucky girl I am I have managed to develop not one but two illnesses with no definitive cure and piss poor access to treatment on the NHS.

I am also lucky enough to have the wonder cure all CBT do fuck-all for me twice, for both my M.E and depression.

Though what really, REALLY annoys me is how I have been made to feel like the world’s most awkward patient and that the failure of certain treatments and therapies has been my fault for not ‘engaging’ with the therapy enough or ‘not trying hard enough’ or another assortment of excuses. What did I do that was so awkward? Well I asked questions,  I had doubts and I expressed them; something which I assumed was supposed to be a good thing during something billed as ‘therapy’.

During my latest bout of CBT for depression (which seeing as I’m still depressed as ever has been an amazing success) I made the mistake of uttering the word ‘existential’. I got threatened with having my treatment stopped as I wasn’t ‘engaging’ as I kept trying to get across that for the most part my depressive moods don’t tend to have any obvious external triggers, that they come on suddenly and for no reason. This was apparently not good enough. I couldn’t just come in and say I was depressed and I didn’t know why (I’d also like to point out I was given no help in trying to figure out any ‘hidden’ deeper reasons for my moods). I was patronisingly told ‘well obviously you’re intelligent’ (I think I mused about Descarte’s ‘cogit ergo sum’ on one of the forms, I may depressed but I can still be a pretentious arsehole), which seemed to be code for “stop questioning things now ! don’t reveal the holes in the treatment we didn’t ahve the time/money to think about! Shut up an fill in a sheet!  and no you can’t have ‘musing on my existence’ as an acitvity!”.  My depression didn’t fit into the narrow categories that the CBT seemed designed to cope with and I felt like I was made the scapegoat for this. I tried I really did, I racked my brains trying to think of things to put in the stupid little forms and make sure my mood-swings fitted into the little ‘thought pattern’ sheets. I went through the thought excercises and tried to make them work, sometimes they did but when they didn’t I was yet again made to feel bad that my ‘mood score’ hadn’t improved after doing the excercises, so by the end I was inflating my scores so I didn’t get ‘dismissed’. I tried and admittedly it did help with some  minor, more peripheral problems like being anxious about uni work etc. But the big looming problem which was my main problem? The mood-swings that come on so suddenly and without any obvious logic behind them, the problems that have been haunting me for as long as I can remember? Those were left untouched. Unless my moods had a ‘trigger’ or a ‘negative thought’ I could counteract I was left helpless. I tried to explain that the whole illogical, unknown  and unpredictable nature of my depression is what scares me the most; how those moods that seemingly come out of nowhere are the worst and most terrifying. Yet those were the problems that were ignored, I was told (not in so many words) that by drawing the focus on this I was being ‘unhelpful’. I started out being as honest as possible about my moods and by the end I was effectively lying. I was lying so I wouldn’t be chastised for not having a ‘trigger’ or some identifiable thought pattern.  In short I was trying to change my illness to fit in with their definition of what my illness should be as opposed to reflecting honestly on what actually was.

I’ll admit I wasn’t perfect, but as I was doing this treatment due to chronic mental health problems I think that can give me a bit of leeway in the whole ‘may not actually be thinking like a logical human being’ department. Why should someone with serious depression who obviously isn’t ‘thinking straight’, be under so much pressure to make a treatment ‘work’ even if it means their concerns are ignored? Is it really that much of a shock to a mental health professional that severly depressed people are sometimes really rather apathetic about things, that it’s not deliberate ‘awkwardness’ but a symptom of our illness? When you’re on the edge of despair and you just wish it would all go away, even if that means suicide, it’s safe to say that logically appraising things is not really something you’re finding easy and that filling in a form and rating things on a scale from 1-10 can often slip your mind.

Why should people be made to feel they cannot speak up about what is truly worrying them as they will be chastised for being ‘awkward’?

I am not saying my therapist was a bad guy: I feel the problems with this lie primarily in a lack of NHS funding. Even with the best therapist in the world 16 hours is nowhere near enough to treat someone with serious depression, but that was all I got.  I worry that if I apply for more benefits (atm I can’t work I’m far too unstable, unless anyone wants to employ a moody, unreliable, tired person with fuck all experience who will take a lot of sick days; in which case I can send a C.V) I will be penalised again for not ‘doing my best to access treatment’. If the treatment isn’t there and what is there has failed me, what the hell can I do? I’m even considering going private but as I have about 2p to my name this isn’t an option I can seriosuly consider beyond a short daydream about recalling my childhood on a Le Corbusier lounger.

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Comments

  1. You’ve done a really wonderful job of explaining some of the downsides about CBT here. It seems to sometimes help some people, but it definitely is not the panacea that people like to pretend it is.
    Have you tried some kind of psychodynamic therapy? Based on what I’ve read in this post it sounds like it might be more your kind of thing. No dumbed down worksheets and oversimplifying the human mind.

    • Chloë says:

      Thanks, I’m considering pyschodyanmic therapy but afaik it’s not available on the NHS and alas I don’t have the funds to fund it privately right now. A situation which is pretty typical sadly.

  2. I really like this post. I had a similar experience with the patronizing comments about my intelligence when I asked questions of my therapist. It is unfortunate that it happens like that sometimes.

    I hope it is okay if I read your blog and put it on my blogroll. If not, I understand.

  3. Hey! I thought your analysis of CBT was very interesting. I’ve been offered DBT (which includes CBT methods) and have read about the pitfalls a lot. Still trying to figure out what I’m going to do. Mind if I link you?

  4. Robert says:

    I often get the impression that my social worker thinks I could “pull myself together” if I invested more effort. I can tell she finds me awkward to deal with and that I don’t fit into a nice neat box for her. She also acts like it’s the end of the world when I have a setback and then she says “oh well there’s bound to be ups and downs”. I can tell she thinks I’m a malingerer who is content being a 30 something man living on incap benefit with his mother and wallowing in self pity.

  5. […] I know it’s highly unlikely ill be given anything but more short term cbt esque stuff which doesn’t do much/anything for me. It just seems so futile, as if no one actually cares about treating me and they view me as a […]

Feel free to comment, I do love a good debate

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