CBT: The first session

So last Friday I began a course of Cognitive Behavioural Therapy sessions, to help me deal with the social anxiety that I talked about in a previous blog post. 

I don't really expect to learn anything new from the course, to be honest. I'm pretty good at accepting, rationalising and challenging myself to face my fears, but what I'm finding more and more lately is that I reach breaking point more easily. I've always been able to keep the anxiety in check and have always just thought that I am shy, but various things- the bout of psoriasis I had, being single again, stuff happening with my friends etc has meant that I've been much less able to control it of late. So much of my brain is taken up by being anxious that there is little left over for anything else. My organization skills, which were poor at best anyway, are completely shot, and even the most basic problems at work leave me feeling totally overwhelmed. 

My friends are my world, and its hard for me to describe how much I love them and how much I love spending time with them. Since my divorce, when they rallied round and were totally amazing, I have made sure that they are the centre of everything I do. But this thing is getting in the way of that, and its making me miserable as a consequence. 

The best way I can think to describe it is like an energy bar in a computer game, but instead of life force, mine is a social bar. It gradually decreases, then eventually I run out and require recharging. In more stressful situations (like going to parties or meetings where I know no-one, or-horror of all horrors- dating, for example) it runs out a lot quicker than if I am spending time with by best friends. The recharging usually involves lying on my sofa watching old episodes of Dexter and not talking to anyone, although lately I've noticed a much more scary emptiness creeping in, and I can find myself lying on my bed staring at the ceiling with no thoughts or feelings or emotions at all. These hours are terrifying and are something that has never really happened to me before. 

So, having seen my GP, I got referred onto this group CBT course. The irony of being on a group course for social anxiety has not escaped me, and of course I found myself worrying about all aspects of the course. How will I get the time off work? Will I find the place? (this sort of anxiety stems from a fear of looking stupid if I don't know where I'm going) Will I have to make awkward small talk with the other people on the course? Will they think that my reasons for going are stupid? What if I have to speak about my emotions to them? etc etc etc. One of my biggest worries is whether I was bad enough to justify being on the course. The fact that I have spent several days if not weeks worrying about whether I am anxious enough to justify it has also tickled my sense of irony.

Anyway, I managed to find the place, and staggered in red-faced, dry mouthed, sweaty and with my heart beating (irregularly) out of my chest. The other folk in the waiting room looked serene and at home. The course started late due to technical problems, which rather than giving me time to calm down made me even worse.

Once I was in there, I felt somewhat better. The initial session is all about the causes and symptoms of anxiety and how it can manifest in different people, so we didn't really cover any CBT techniques. I was very pleased to hear the trainers talking about the evidence base for CBT, and they explained the pros and cons and process of what we would be doing over the next few weeks. I was starting to feel quite settled. It was nothing I didn't know already, of course, but its always good to know that there are other people suffering from the same thing as you.

Then came the two slides on medication. The slides just covered some really general points which I agreed with, but one of the women there talked about how she didn't want to try any medication as she was so worried about side effects. The trainers said they knew very little about specific medicines, and she should speak to her GP or pharmacist. Well, I tried to keep my mouth shut, I really did, but I couldn't help myself. I thought about just trying to make out like I was someone who knew a bit about medicines, but I could tell that this woman was really worried. She was wanting to try an antidepressant, and thought it could benefit her in the short term, but she was really concerned that they could amplify her anxiety permanently. I wanted to help and reassure her, and before I knew it, I could hear myself saying "I'm a pharmacist..." I explained a bit about how the drugs work, what sort of side effects could happen, and what the sort of terms used to describe how common a side effect is actually mean. She, the other attendees, and the trainers all listened attentively and said how great it was to have it all explained in context rather than to just look at a really long list of scary words on a patient information leaflet.

I left feeling happy that I had shared some of my expertise, but sort of worried about the rest of the course. I fully expect next week to walk in and be asked various different questions about the medicines people are taking. You get used to this happening when you tell people that you're a pharmacist. The problem comes from the fact that now I feel like I need to be "on", and in professional mode, when what I actually sort of want is a place that I can switch off my forcefield and fall apart, so I can put myself back together in a more rational, calmer way.

Hxxx