Punctuating the conclusion of my Cognitive Behavioural Therapy (CBT), I got a letter in the mail this morning telling me I wasn’t mad anymore.

Dealing with anxiety has claimed two years of my life. It destroyed a loving relationship and derailed my career. It left me feeling emotionally crippled, robbed me of my confidence, and devastated my sense of self.

The CBT alone was a marathon endeavour. Twelve months on the waiting list, and a further twelve weeks of intensive contemplation about who I am, how I act, and how I approach life in general.

My CBT experience was a unique one in that I had two therapists. This wasn’t by design. It’s not as if all 6’6 of me walked through the door and they were said “this guy’s pretty big, we’re going to need another therapist”. My first therapist, Helen, went on maternity leave half way through my course, and while I appreciated the rapport we had built, I could see how it would be disruptive to the session had she given birth in the middle of it.

Given the twelve months of waiting, I had plenty of time to research CBT and do some preliminary self-CBT. Going into it, I knew that it was key to approach it with an open mind and that using a little divergent thinking – a.k.a. thinking outside the box – was going to be in order.

Helen taught me how anxiety (and through association, depression) works in your mind. Much of this I’ve touched on before – the circular thinking, the feedback loops, the mental reinforcement of negativity. But what I’d failed to realise is that hacking at these circles wasn’t enough – you needed to prove to yourself that the new thoughts you were trying to install were the correct ones. You need to walk the walk, not just talk the talk.

We also worked on uncovering the underlying drivers of my anxiety. Yeah, I could point to my work and a number of other factors of why it became overwhelming. But those negative thought loops didn’t appear from anywhere – they were deep inside me and had been there for most of my life. All that’s happened in the past two years is that they became overloaded.

With Helen, I had a cognitive shift. I saw that the defeatist, self-hating, worthlessness which has dominated me for two decades was all bullshit; hardened bullshit protected by a ton of biases, fallacies, and falsehoods, all of which I’d largely invented myself.

I only had a couple of sessions with Charles, my second therapist, who’s essentially psychology’s answer to Mark from Peep Show. Our time together may have been brief, but Charles shattered worthlessness. It wasn’t just me seeing myself as worthless that he challenged, but the very concept of worth itself.

He asked me to describe what someone of worth is. I managed to force out some descriptors: powerful, determined, motivated, etc. Once I’d finished my list, he told me that I’d just described Joseph Stalin. What he showed me is that worth, much like beauty, is a subjective concept that’s ultimately meaningless (as is the notion of having meaning). It is something that I’ve judged myself with for years, but how can you judge yourself with a metric as intangible as worth?

The letter isn’t the end of my struggle against anxiety. But it is a milestone; proof that I’ve been travelling in the right direction.

In tracking your mental health during CBT, they have two questionnaires you complete each time you go in. One, the PHQ9, tracks depression. The other, GAD, tracks anxiety (or general anxiety disorder). Here’s what the letter says about my progress:

Initial PHQ9 score: 21. Completion PHQ9 Score: 1.

Initial GAD Score: 17. Completion GAD Score: 6.

When I first completed the PHQ9, I was surprised to hear I was depressed. I had become so caught up in thinking about anxiety that I’d barely noticed it creep in. Upon reflection, I noticed the apathy, lethargy, and all the leftfield dark suicidal thoughts that seemingly struck from nowhere.

As for the GAD score, I’ve been somewhat preoccupied of late. A project I’ve been working on all summer overran, largely due to my anxiety paralysing me. I’m completely out of money and have no idea when I’m next getting paid. At the end of this week, I’ll have nowhere to live and will likely be headed for an extended stay on my mum’s sofa. I’m a 31-year-old man who’s worked his arse off the past five years to make something of himself, and all I have to show for it is a blog about how the whole affair has pushed me to the brink of insanity.

The fact that my score is so low is a massive testament to CBT. I’ve pretty much worked every day for the past month, hence the lack of posts. But instead of succumbing to panic during that time, I’ve kept my head. The fact that I managed to start writing at all is down to the CBT. The end result is that I saw the near-finished report back over the weekend, and it is the finest work of my career.

Returning to my mum’s sofa – a potent metaphor for hitting rock bottom from my graduating during the recession days – should be a source of major humiliation and the manifestation of all my failures, both professionally and personally. I should be freaking out. I should be mad at the world. I should want to turn the gun on myself, and let the rapids of my self-destructive spiral take over as I sink into a pit of shame, self-hatred, and despair.

But I don’t care. If anything, I’m looking forward to the chance to spend more time with my family. I’m actually positive about the concept. I’m a broke joke, got no idea what I’m going to do for work and a roof over my head, my immediate future is about as clear as a lead brick to the face, and I’m loving it.

Yeah, there’s been some mild anxiety, as the score reflects. What it doesn’t tell you is that each time it rose up to claim me, I was able to effectively neutralise it and put it back down. The thought processes in which my anxiety lies are still there, but their power has been severely diminished. The false logic I used to fuel them has been exposed for what it is. Meanwhile, new thought processes, new concepts about myself, are taking their place and grow stronger by the day.

After my first session with Charles, I took a month out from my CBT. When I returned, I told him about everything that was happening: the hardcore month of writing, the endless wait for my next payday, moving back in with my mum, and all the rest.

“But is it bothering you all that much?” he asked.

“Nope,” I replied, and signed off on CBT with three sessions to spare.

—

CBT isn’t the be all and end all of treating anxiety. It’s been incredibly useful for me, but so have many other techniques, which I’ll be sharing in future posts.

As always, please feel free to like, share, and comment. Not only does this show people enjoy my writing (and thanks for reading!) but it also helps extend the reach of my work to people who may take something from it.

—

Resources:

If you are interested in doing CBT yourself, here’s some resources to get you started. If you are in the UK, you can get CBT free through the NHS as I did. Best approach there is to go to your GP and ask for referral to CBT. I had to refer myself, but this might be different in your area.

CBT wiki: https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

CBT self-help: http://www.getselfhelp.co.uk/step1.htm

CBT worksheets: http://psychology.tools/cbt.html

Finding a CBT therapist: http://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/finding-a-therapist/