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Tackling anxiety: Cognitive Behavioural Therapy

~ Superfluous G ~ Leave a comment

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.

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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.

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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/

The anxiety of procrastination

~ Superfluous G ~ Leave a comment

I should probably apologise for the delay between posts. It’s been hot, I’ve been busy, and I’ve been putting it off.

I put a lot of things off.

In all aspects of my life, I am constantly kicking the can down the road to be picked up by future me.

I consider procrastination to be my single biggest flaw. I’m always thinking about what I could be doing instead, what I’d like to be doing, and what I’ve failed to do.

I’ve been writing for over twenty years, and still haven’t started writing a book. I’ve wanted to make music my whole adult life, and only picked up a bass guitar for the first time a couple of years ago. I want to travel, yet rarely get further than the sofa. I want to be fit and healthy, but I eat shit instead of putting effort into my diet. I want to find my perfect woman, and yet have done literally nothing in the year I’ve been single to meet her.

It’s not just the big ambitions, either. It’s the small things. I first wanted to write this post three weeks ago, but didn’t. And it’s not like I spurted out some gibberish and have been feverishly tinkering with it. I’ve barely thought about it, other than to boot it firmly into tomorrow’s problems. Even now, by writing it, I’m procrastinating – I should be working on a project I’m overdue on, another victim of my casual attitude to life.

It’s a snowball turning into an avalanche.

I despise feeling like this. Every time I procrastinate, it’s like being grabbed from behind with two gigantic hands. The pressure of the palms around my back, the fingers tightening around my ribcage, the thumbs pressing down on my neck and digging into the back of my head.

I am being suffocated by the weight of my own inaction, contorted by stress, asphyxiated by anxiety.

When something is weighing over you, everything you do in the meantime is tainted. Every distraction is hollow, anything you engage in is meaningless. Physically, you are doing nothing. Mentally, you go into overdrive. You question your ability, your talent, all the bullshit you tell yourself about the person you are.

I begin to knock myself. I tell myself that I’m no good, that my self-professed talent is just a lie, that the worthlessness I feel in myself is the only truth I know. My inaction serves to confirm that – if I’m not an imposter bullshitting myself about being a better person, then surely I’d be on top of things?

As the list of stuff that isn’t getting done goes up, my self-belief continues to spiral. The life I lead is a reflection of the person I truly am, and through a lack of achievement, I see that my life isn’t worth shit.

By this time, I’ve beaten myself black and blue. I’m as exhausted as I would be if I’d done a whole day’s work, and I haven’t even lifted a finger. All the good intentions and self-realisations and epiphanies about who I am – they don’t add up to anything. They are just words. I’m talking the talk, but not walking the walk.

Procrastination is a major catalyst for anxiety and, frustratingly, is also a symptom of both it and depression. In failing to get a handle on it, the stress goes through the roof, and anxiety gorges itself on the cortisol. I’d argue that procrastination should be recognised as a mental health condition in its own right, but I can’t be arsed.

To compound the issue, it’s an ingrained approach to how I deal with a problem. When I was growing up, I relied heavily on my intellect to get by. I still do. If you learn from an early age that you can coast to get by, chances are you’ll repeat the behaviour often and to great effect. The result is that concepts like hard work, applying myself, and discipline are somewhat alien to me.

From my point of view, this would be absolutely fine if I could just turn it on whenever I needed to kick it up a gear. I find that doing nothing is a great way to spend your time – in fact, down time is essential to achieving some sort of balance in life. But when I’m faced with a problem that needs consistent, sustained effort, I crumble.

I’ve read a ton on how to tackle procrastination. I’ve made to-do lists. I downloaded The Rock’s alarm clock so I can get called a jabroni in the morning. I’m always making plans for how to overcome procrastination. How this time it’ll be different. How I’ll finally crack it. That I’ll get going and become that productive, useful person I’ve always wanted to be.

But whenever the moment comes, I fall. I set my alarm clock early to get those exercises in, and just use the extra time to stay in bed. I clear the day to start writing my book, and spend the day abusing assclowns on Facebook. I put together my diet, buy all the groceries, and dial in a kebab when I get hungry.

However, I can see now where I have been going wrong. Whenever I make these plans, I leave it for the ever resourceful future-Gregg to sort out. He’ll have the energy. He’ll have the tenacity. He’ll feel how I feel now, and know we can no longer feel like that.

In short, I’m expecting someone who isn’t me.

When the time comes to face a problem, it’ll always be me who gets there. I can’t expect me to be someone who rises to the occasion overnight. To become that person requires effort, it requires discipline, it requires sustained focus. It requires all the things I lack.

Worse, I’m arriving at these situations with the weight of the world on my shoulders. I’ve beaten myself into a hole. I’m piling on all the pressure I can – I have to do it this time, I will be that different person.

Problem with talking to myself about it is that it’s just talk. It’s not walking the walk.

I realised this was a problem well before anxiety came along and took my life for a joyride, but it’s through understanding anxiety that I’ve begun to realise just how powerful an effect procrastination has on my life. Given the choice, I always take the easy route. I’m not challenging myself. I’m not being true to myself.

When I pull back the layers, I see that same familiar beast of worthlessness staring back at me. It’s telling me that I won’t succeed, so what’s the point? It’s telling me that I’ll fail, so just avoid the problem until it goes away. In listening to it, I confirm the worthlessness. In believing that I can’t, I’m ironically setting myself up to fail.

If you don’t try, you’ve already failed.

A few months back, along with giving anxiety the finger, I decided to say fuck you to procrastination.

The approach has been similar to anxiety – you cannot expect to be a different person instantaneously. Instead, you have to challenge your behaviour frequently, consistently, and patiently. You have to build up a body of evidence that says you are a person who can get a handle on things. You have to walk the walk.

In this, I came up with a simple yet effective approach. Each time I’m in the situation where I can either drift or jump on something, I tell myself “just act”.

Whenever I’m dithering on whether to go to the gym or not, just act. When I’m sat in front of a blank page watching the cursor blink back at me, just act. When I’m lying in bed unable to grasp a handle on things, just act.

I’m taking the time I’ve been spending sitting around criticising myself, and kicking that into the future instead of the experience directly in front of me. I see the self-doubt, the self-criticism, the apathy all lining up to take shots, so I get moving before they get the chance.

Sometimes it works, sometimes it doesn’t. The point here isn’t to beat myself up when I fail, but to celebrate when I succeed. I’m retraining myself, and that takes time. It takes patience. It takes a willingness to experiment, and to allow myself the opportunity to fail. It takes being challenged by every fucking thing that comes along looking to steal myself away from what I want to achieve, and saying “get fucked, I’m doing shit here”.

Leonardo Da Vinci – one of the greatest polymaths to have ever walked the face of the planet – once said “I have wasted my hours”. Not years, not days, but hours. At the time, I thought this incredible – how can a man who’s achieved so much believe he has wasted his hours? And should I be thinking in those terms?

I thought it was inspirational – a way to live my life by. Now I realise my folly. I’m judging myself on those terms. I’m spending my hours criticising myself and standing in my own way. What I should do is just act, and let the chips land where they may.

I don’t know if I’ll ever write that book, but I certainly won’t if I don’t put pen to paper. The probability is that I won’t be making the Olympics this year, but it’s certainly not going to happen when the only weight I’m carrying is my inaction. There’s a good chance I’ll never meet the woman of my dreams, but I’m damned sure it won’t happen while I’m curled up in a ball of self-doubt avoiding the world.

And it’s making the difference. This blog – despite its brief hiatus – is the most writing I’ve done for myself in years. I’ve got a copy of Ableton, and working on my first real attempts at making music. I’m hitting the gym three times a week, and feel stronger than ever. I tore into that project this week like a goddamn hurricane, and I’m just getting warmed up.

It’s a matter of perspective. It’s a matter of focus. It’s a matter of knowing what you want, and knowing that not working towards it will leave you feeling hollow, empty, and stressed.

Be brave. Take chances. Just act.

Sure, there’s other stuff I want to do, things I need to achieve, a life I want to lead just waiting for me to get my hands on it. But I shouldn’t expect or want it all to be done right now. After all, you’ve got to have something to do, right?

Thanks for reading. As always, likes help me see my work is appreciated, will do my best to respond to any comments, and encourage shares in case my battle with anxiety can help others.

I’ll get onto those coping strategies next week. Or maybe the week after 😉

Working towards mental collapse

~ Superfluous G ~ Leave a comment

There’s a modern day plague affecting the western world. It is isn’t ebola, or zika, or any number of disease-shaped boogiemen.

That plague is stress.

For me, there is no greater source of stress than my relationship with work, which has been the primary catalyst for all the anxiety I have experienced.

Work anxiety has so many avenues of attack; numerous meteorites striking to the core of a person. Becoming destitute. Your social standing. The time it robs you of. The pressure to deliver. Your future success. Dissatisfaction with what you do for work. Inadequacy. The constant competitive nature. Procrastination driving deep panic. Working too hard breaking you as a person.

Up until January this year, I’d been working at a media startup covering university innovation. While niche, I can’t help but love the sector. Robotics and prosthetics. Cancer cures and anti-ageing pills. Games companies and artificial intelligence. All the ground-breaking initiatives to get innovation out into the world and the pots of cash appearing to stimulate it.

The topic was perfect for me, and the way I covered it didn’t hurt either.

I worked from home, chose my own hours, worked at my own pace, had responsibilities and a very direct impact on the direction of the company, and got paid to travel all over the world.

But what goes unspoken about in the startup world is the excruciating toll the entrepreneurial lifestyle takes on you. There’s constant uncertainty about your work and its value to the outside world. You never know how long the company is going to ride any current waves of success. You fret over whether you are even going to get paid next month.

My old boss used to get up at 3 in the morning and work through to the late evenings seven days a week – I’m not sure he has a life away from his laptop.

This is the level of dedication which is expected of you.

I’d get up early, and work late. I’d throw my whole being into my work. Whenever I was supposed to be relaxing, I’d still be working in my head. I’d check emails at all hours. I’d take on new projects, more responsibility, and more work. In startup life, each team member has to be a star player, and I’d be damned if I was going to be the weak link.

At the time, I had no idea of anxiety. I didn’t know what stress could do to a person. I’m a big, powerful man who’d stumbled through life without a plan yet always landed on my feet – I figured I was the sort of person who could just carry it.

I was dead wrong.

The pressure began to find those cracks. Increasingly, I questioned myself, my talent, and my ability to withstand it all. I began to believe that I was an imposter who’d stumbled into this and that I would be found out. Instead of blowing off steam, I’d just take the stress and throw it back at my work.

As time went by, bad habits began to emerge and became entrenched. Top of this list was procrastination, which – of course – made things worse. The to-do list grew, and the time I had to do it in withered. In response, I became a master at the last minute delivery. These days, I hear people panicking over a 1,000 word essay with a month to write it, and laugh – I can knock out a 3,000 word feature in an afternoon.

When you take this approach, you spend 95% of the time you should be working stressing about doing work, and when you finally get down to write the damn thing, you’re undoubtedly cranked on coffee drenched in panic sweats. Ultimately, what you deliver may be on spec, but it’s never the sort of quality you wanted it to be. The whole process leaves you frazzled, and the end result is underwhelming and disappointing, giving you even more to work yourself up about.

I was always living under the threat of deadlines and living reactively, rushing from one disaster narrowly avoided to another fire to put out.

As fear about work increased, anxiety began to seep into the rest of life. It assaulted first my health before moving onto social anxiety, sex and my relationship, and fostering a deep, entrenched sense of dread about life in general.

It became unbearable. I had no idea on how to cope, no idea how to managed any of the stress, and felt like no one would understand. Worse, I felt that if I opened my mouth – if I even admitted to myself for just a second just how awful I felt – that I would be exposed and the whole thing would come crashing down.

Yet, I soldiered on. What ultimately broke me was a year-long battle to keep myself out of the redundancy firing line.

We took on seed investment in 2014, and the money was badly spent. We made a number of bad hires. We launched a title for which there was no interest in. When we got the website for the third title made, we went to the people who provided us server space, IT support, and designed our previous website – a bunch of clueless shinpads who only exist because they’d managed to sucker computer illiterates such as my old boss to come languish in them in development hell. We bled ourselves dry.

By the time 2015 rolled into view, the investors were cracking out the redundancy hammer. I was told at the start of the year that my job was at threat. The investors wanted to ditch our university coverage and focus on our corporate title, which I didn’t work too much on. I was going to be gone by February.

A catalyst for the underlying anxiety, redundancy brought to the forefront all the fears and anxieties that had been building up. I’d be seen as a failure. I’d run out of money and become destitute. My girlfriend – who I’d been financially supporting the whole time – would get sucked into the whole clusterfuck. I would have nowhere to go. No one would want to take me on. Everyone would know that I was just another imposter who got outed and got his comeuppance.

In short, I would be fucked.

But worse than anything was the thought that everything I’d spent all that time doing would be for nothing. I cared more about my stupid articles more than my own wellbeing.

At the very last minute, they decided to ditch our incompetent business manager instead. I had a reprieve, but at great cost to my mental health.

The month after saw me instantly getting to work on a major special report for the company, with a big trip to the US breaking it up. Upon returning to the UK, I was jetlagged and exhausted, but still had to pull four 15 hour days to get a special report finished on time. I filed the report, had a smoke, and instantly went into full mental collapse.

I should have taken a decent amount of time off. I should have instantly committed myself to getting better. I should have just put my hand up, admitted I was beaten, and walked away.

I didn’t.

Two weeks later, and I was back at work. Two weeks after that, and I was back in the redundancy process.

I wanted to just let it wash over me and carry me out to sea where I could finally die in peace.

Instead, I managed to cobble together a deal to stay on. It was reckless, foolish, and I should have just given up. But I couldn’t quit – I still felt obligated to stay with the team, I needed the cash to support myself and my relationship, I wasn’t ready to admit that I was beaten.

I needed it to mean something.

I didn’t want to be a failure.

I got a couple of words on my title, now Editor-at-Large, and a ton of new responsibilities to satisfy the vampire squid mother fuckers who lent us the cash and wanted my arse in return.

I was already a man dragging his dehydrated, broken frame through a desert. The deal was basically the investors coming over, breaking both my legs, chucking a bucket of water in my face, and cheerily saying “good luck!” before fucking off into the sunset.

In the months that followed, my relationship fell apart and I was left alone with an ever increasing mountain of stress and anxiety.

There was always more work.

One particular project was chronically mismanaged by my boss, and I became the kicking boy for his rage – fuelled, I suspect, by his own stress and anxiety.

I became deeply depressed, and gave up. I started smoking weed and drinking in working hours, and the only reason I filed a report at all was entirely down to cocaine.

It would ultimately be for nothing.

When redundancy came knocking a third time, I didn’t fight it.

I went into what I could only explain as withdrawal – my supply of work had been yanked from underneath me and I was clucking hard. It took me a good couple of weeks to even realise what had happened to me – I was still expecting there to be work to do despite full well knowing that there was none.

It was only when I was forced to stop that I finally realised the damage working like this had done to me.

Months later, and I’m still not recovered.

I’m working part time as a freelance journalist and consultant, doing what I need to get by. I’m currently working out a commission, and I’m getting it done, but it’s a constant struggle.

I remain terrified that accepting work is going to lead to failure. Each time I sit down to work, I become deeply uncomfortable, I’m unfocused, all those fears and insecurities knock around in my head, and I’m immobilised.

It is only through survival instincts that I put pen to paper.

As with the rest of my life, my confidence has been ravaged by anxiety. Those bad habits are still hard-wired.

But through taking anxiety by the balls, it’s beginning to come back. I’ve had to completely re-evaluate my relationship with work but I’m getting there.

I’ll be talking more about burnouts, our relationship with work as a society, and coping strategies I’ve used as this blog develops. But, for now, if any of this sounds like you, it’s critical to realise how stress can manifest as anxiety, and anxiety can lead to burnouts. It’s crucial that you take the time out from work, that you aren’t working all the time, and you make work a part of your life that you own, not a part of your life that owns you.

Also, know that jobs come and go. Opportunities are there for those who want them. If work becomes too much, you can always walk away and find something that works for you.

Everything is temporary.

 

Thanks for reading. As this is a new blog, I deeply appreciate every like, share, and comment I receive. As well as keeping me writing, it also helps the blog reach others suffering from anxiety, and lets them know that they aren’t alone. Please support this blog by helping me reach those people!

This is the first of a series of pieces all about work anxiety, with others planned in the coming weeks. But in the meantime, if you have a story about how you have dealt with pressure and stress at work, please feel free to talk about it in the comments below.