I was a confident child, believe it or not. I auditioned for every school play, always had my hand up in class and cultivated a loud speaking voice so that I would be given good parts in said plays. In fact I was a bit of a show off. As I got older, however, the differences between myself and my classmates became more obvious, and throughout secondary school I was very badly bullied. Instead of being a confident, extroverted teenager I retreated into myself and began to find fault with everything I did, because it seemed everybody else found fault with it too. And there began my journey with constant low self-esteem.
At the beginning of this year I didn’t like myself very much. It’s hard to admit that but it certainly isn’t untrue. I thought I was selfish, that I didn’t help myself, that I was lazy and that I never seemed to say the right thing. I didn’t believe other people liked me very much, and as a consequence, I felt this was a self-fulfilling prophecy at times. When you don’t like yourself it’s very difficult to understand that other people like you, and you push people away. Still I don’t make the effort I should with people because part of me believes it isn’t worthwhile and that I am not really worth knowing. And I absolutely know this is irrational but it’s hard to believe the rational when this part of my brain is shouting so loudly. I stopped writing because I didn’t think people would want to read what I wrote. However, I made some steps to change this and slowly but surely the above is becoming less true to me.
Back in April this year I started to get ill. I was constantly anxious, incredibly unhappy and couldn’t seem to focus on anything. I started crying for what felt like no reason and developed a fear of walking past the living room in my house due to a housemate who wasn’t very nice to me. I went to the doctors and was diagnosed with depression, although really I felt like the anxiety was the bigger issue. I was given the option of either a low dose of medication or talking therapy. Something about the medication scared me so I decided on the latter and joined a very long waiting list whilst concurrently managing to get a bit better without outside help. Whether this means I wasn’t actually depressed I don’t know, but all I know is that I felt very bad and had thoughts of hurting myself during this period, and I needed help.
By the time I got to see a Mental Health Practitioner from LIFT Psychology at my local surgery I was having a lot more good days. And when he asked me what I needed help with, I decided to go for a root cause and said that I had very low self-esteem and that I would like one to one Cognitive Behavioural Therapy. Unfortunately the MHP seemed to be under a remit to not put people on the waiting list for this and instead encouraged me to sign up to one of the group CBT sessions. I was getting a bit peeved at this point as I didn’t even need to have an assessment to go to one of the group sessions and could sign up for one under my own steam so I stood my ground and asked to be put on the waiting list for the one to one sessions. I am so grateful that I felt strong enough to do this; I am extremely worried for those people who approach the same service whose mental health may prevent them from asking for what they want in the same way.
So why did I opt for CBT? Well I’ve had person-centred counselling twice before now and have never found that it helped me very much. I am already an open person and able to talk about my issues and so I found that speaking to a counsellor just dragged up things from my past which weren’t helpful. I’m not saying it didn’t help at all, but it certainly didn’t help as much as it could have done and I always found myself feeling much worse when I came out of my sessions.
Whereas in counselling you should be lead to your own conclusions, in Cognitive Behavioural Therapy you are given the tools to change the way you see the world and the way you react to situations. Rather than talking about the past you discuss how you might handle a situation in the future, or you discuss in rational terms something which has been bothering you that week. It seems to work.
I was offered 6 sessions of CBT focussing on self-esteem. I soon discovered that the course was the same as the course offered in a group format, but being one to one it meant that we could discuss the way the tools could be applied to situations which were relevant to me. My therapist was young and relatable and very patient with me, and where as I dreaded going to see my counsellors I quite looked forward to CBT.
CBT is hard work; it requires homework and constant thinking about what you are thinking. If you think something negative you are encouraged to think about why you are having that thought. The main basis of CBT is described in the diagram below:
There are four ways you react to a situation; you have thoughts, emotions, behaviours and bodily sensations. So for example if you are scared of heights and you find yourself up a church tower you might experience the following:
Thoughts: “I am scared; I don’t like heights, what if I fall? What if someone else falls?”
Emotions: Fear, panic
Behaviours: Refusing to climb higher, clinging onto something
Bodily reactions: Crying, shaking, hyperventilating.
In CBT it is believed that by changing one of the above you can affect all four of the reactions, and usually the easiest reaction to change is either thoughts or behaviours. So in the situation above (and I have deliberately chosen something that doesn’t apply to me here) you might instead think “I won’t fall, I am safe, and I am with people who won’t let anything happen to me” and instantly you have reassured yourself about the situation. Sounds difficult? It is, and that’s why there’s so much homework involved in CBT.
You might also find you can change your behaviours, as I mentioned above. When you don’t feel comfortable with something then you tend to avoid situations which might make you uncomfortable. Using an example which is relevant to me, I don’t feel comfortable starting conversations with people online because I don’t believe people want to talk to me. However, through my CBT I was encouraged to start doing this as my irrational brain (my monkey brain as it is referred) was winning out over my rational brain. And so I am still trying to work up the courage to do this but I know that by changing this behaviour I will become more social and speak to the people I want to speak to.
Another issue I have, and apparently this is very common, is that I assign a lot of blame to myself when things go wrong. This can be a small thing like saying something that stops the flow of conversation, or a big thing like thinking I have fallen out with somebody. I was encouraged to draw pie charts and to think about not only my contribution to that situation, but that of other people who are involved and outside factors. For example if you say something and everybody stops talking it could be that something happened somewhere else in the room that distracted people. In some ways it is self-absorption which leads to people taking all the blame for a situation, but I have been told not to think of it that way.
When I began the course I was told that the biggest thing I needed to aim for was to become my own best friend. Because if I am not my own best friend, how can I show a version of myself that I like to other people? A few months on from my sessions and I don’t feel that I have achieved this, but I do feel that I am beginning to get there. I know the things I need to work on, and I know that I can’t attribute all blame to myself when things go wrong. I know that people do like me, and even if I still don’t like myself as much as I could do, that perhaps I am more worth knowing than I first thought. It is going to take years to undo the damage from school, but I feel I have some of the tools to tackle this. And so in 2015 my one hope is this: That I can become my own best friend. And I hope the rest will follow.