CBT in the Guardian

The Guardian have this rather funky little video explaining about CBT.
I watched it – I think it’s important that information like that is put out there – and then I felt a pang of anxiety.
The lady who has kindly allowed the BMJ (who made the film) into her OCD world describes some of the tasks that she was given to show her that nothing bad would happen if she didn’t was her hands ten million times. The example they show in the film is of her putting her hand down the toilet, then eating without washing her hands.
Now, I’ve been told I have “OCD tendencies” but I don’t know ANYONE that wouldn’t be knocked a bit sick by that. It’s the equivalent of throwing a tarantula at someone with a spider phobia and saying pleasantly, “now, how did that make you feel?”
I’m aware that they don’t have a huge amount of time to show everything, and there is a risk that people could have “information overload” but how hard would it be to say “this process is done gradually, exploring your feelings and actions as you go, with goals and tasks being managable” See? How long did that take?
If I had OCD and saw that film, I’d probably think “holy fucking shit, there’s no way I can do that” and resign myself to a lifetime of chapped skin and a clean loo.
CBT is done GRADUALLY, people, and if you really really struggle with a task, they look at doing it a bit differently, or more slowly.
Now, how did that make you feel?

Don’t Panic!

About a hundred years ago, I was sitting in A&E waiting for Mr D who had dropped something heavy on his foot. We had to wait an age, and while we were sitting there, three women came in. One was considerably younger than the other two, and seemed to be in distress. One of the two older women told the receptionist that the girl was having a panic attack.
I can remember initially feeling a great pang of empathy for this girl, now sitting in the waiting room near me, her white knuckles clamped to her chair. However, my feelings soon turned to frustration – what on earth did they think A&E could do?
This is why it is with a tinge of frustration and irritation I read on Twitter that EMT blogger Tom Reynolds got sent to someone having a panic attack – and this was their SECOND ambulance. Obviously I don’t know who called the ambo, although I’m inclined to think it wasn’t the panicker (unless it was a mild panic attack, and if so, I think he has bigger problems than a panic attack itself) but it bothers me. Of course, I don’t know the whole story, and indeed, shouldn’t. Patient confidentiality, and all that.
I have the greatest respect for people like Tom Reynolds, who deal with the unknown every day, often putting their lives on the line and dealing with every patient with courtesy and empathy. I know that a good chunk of their job is spent dealing with crap – the drunks, the “stubbed toes” and the vague sniffles. I read Random Reality and I too wonder what on earth society is coming to when people call ambulances out for such mundane things. As such, I think it’s only natural that Tom would roll his eyes and wonder what on earth he’s doing there when his patient is having a panic attack. I am, too.
One of my biggest fears when I was having panic attacks was that people would make a massive fuss when all I wanted to do was disappear. I think someone calling an ambulance would have freaked me out even more – the fear experienced during a panic attack magnifies the fear of everything else, including things like being sectioned, being out of control – even fear of dying.
I can imagine what was going through this patient’s mind. “I can’t breathe” “my chest hurts” “I’m going to faint” “I’m going to be sick” . If these are conveyed to someone nearby who doesn’t know what to do, I can see how instinctive it would be to dial 999. Plus, although ambulance control are incredibly skilled, I believe things like chest pain and difficulty breathing automatically elevate the category of the emergency. If it was the patient himself who called, then perhaps at least the wheels will have been set in motion for him to get further help. One can only hope.
So, what do you do if you’re with someone and they have a panic attack? I guess the easiest answer is talk to them. Hold their hand and tell them it’ll pass. Distract them by doing a simple breathing exercise with them, counting in and out. The adrenaline will subside, and things will calm down. There’s no need for an ambulance. As my CPN used to say – nobody ever died of a panic attack.
(I should add that when my CPN said that, I could have thumped him, along with “it’s only adrenaline” – true, but not very helpful.)

I love my GP

Okay, don’t get a nosebleed or anything but yes, I am posting two days in a row. Someone fan me.
I had my monthly GP appointment this morning, and we chatted a bit about the benefits thing, and she told me about another patient (very vaguely to maintain confidentiality, of course) who was going through the same thing. I told her that my worry at the moment is about the new IB reforms, and how claimants are likely to be sent on training courses etc – see two posts down for the sort of thing I said.
Dr H was as always, lovely and supportive. She told me that yes, it was likely I would be caught up in these new proposals, but my best bet was to tell them in very simple language exactly what I can and can’t do, and if the worst happens she will be happy to back me up with a letter.
I’m writing this for the benefit of the people who read my blog and (as I mentioned before) have emailed me worrying about the ‘what ifs’. I felt better knowing that Dr H is completely on my side and totally understands me. She told me about a patient who had agoraphobia and got caught up in a similar scheme a few years ago. The patient was too ashamed of her condition to say something to the BA, and it resulted in her anxiety levels soaring. People, get a good GP who understands you. Then if you do need to fight the Benefits Agency, you have a damn good weapon.

oh, how we laughed

I was early for my appointment on Thursday, a combination of determination to tell J how I felt and the usual being over prepared for something. As I sat in the waiting room I looked at the posters on the wall. Among the usual posters for the domestic violence group and the fibromyalgia group were a series of new posters proclaiming “there’s no healthwithout mental health – how’s yours?” (just peachy, which is why I’m in the psychology department…) I love these ‘stating the obvious’ type of poster. One said, “there are many things you can do to improve your mental health, try: meeting new people.” Other suggestions were “relaxing and making time for yourself” and “developing new hobbies and interests”. While I appreciate why they make these things and put them up, I can’t help thinking that they’re just making blanket and rather vague statements suggesting things that the patient is probably *way* beyond.
J is a very approachable guy, which is why I have been so torn about this. I get the feeling that we are on the same wavelength, and that I can talk to him and be honest and open. That, as any therapist will tell you, is incredibly important. I talked to him about how I felt, even that I’d had difficulty writing down all the anxious stuff – and he sat and listened, then said that it was all understandable and made sense (thank god he doesn’t think I’m a flake) and that I could “see how it goes” before deciding. It wouldn’t be failure, it would be being honest with myself.
We also talked about the tape – which was sitting on the table mocking me. As soon as I saw it, I’d said something like “oh shitting buggery” before advising J that I was liable to swear a lot. J told me that I was in control, that I could withdraw my consent at any time, or he would stop the tape whenever I asked him. At this stage, I was more worried about how I would feel if I didn’t give it a go than anything else, so I consented and he pressed the button.
We talked about stuff, about my panic and how I react to stressful situations. As usual, there’s a lot that I promptly forgot once I’d left the room. Towards the end of my appointment, when J had switched the tape off and we were talking about me coming back again he said something like “…and there’ll be no more of that”.
“No more of what?” I asked, puzzled. “The tape” J said. “You’ve got the hard part over with.”
Somehow, in the midst of my anxiety last time, I’d decided that he would be taping more than one meeting. He only needed to do one…

oh boy… oh boy…

I’m meeting my CPN here at home for the first time this afternoon. He’s due here at two.
I’ve met him once before, at the doctor’s surgery. We had a long chat about my anxiety and panic, and his aim is to get me to face my fears.
Well, him being in my house is facing one fear. By choice, I opted for an appointment with him here, because I need to get used to people being in my house. I need to feel comfortable with that. So, here I am, at one thirty, with chest pains and palps, and I can’t sit still. I think I am going to wear out my hoover. I have cleaned the upstairs and downstairs bathrooms, the kitchen, and the hall. The lounge was okay, but I have hoovered for England.
The fun part is, he doesn’t like cats. I have let the cats upstairs, where they are happily sleeping on my bed (except Minnie is on top of the wardrobe with her feet in the air) They’ll not bother coming downstairs, especially if there’s a stranger. I’m not sure how to take people who don’t like cats. It’s almost like they don’t like something about me – as my cats are such a big part of my life.
I’ll keep you posted…