Motherhood, mental illness and beyond

Posts tagged ‘CBT’

The harshest critic

I’m not perfect. I know I have my faults and I’m honest about them. I’m honest about my bad habits too, and I don’t allow myself to make excuses. I know what my weaknesses are. I don’t like myself very much, but I think that’s pretty normal. I saw a CBT (cognitive behavioural therapy) specialist for a while and she was horrified by what she called my “character assassination”. She said I judge myself far too harshly and that I need to be kinder to myself.

But what she saw as harsh, I see as being realistic. After all, I’m the one inside my head. I’m the one thinking these thoughts, feeling these feelings. I need to be honest with myself. It’s taken 20 years for me to acknowledge that my depression is as much a physical illness as a mental one and that I will probably be taking medication for the rest of my life. I’ve made my peace with that. But I am less comfortable with other aspects of my mental health.

Take my anxiety, for example. While I know it’s a mental health problem I also know it’s ridiculous to be in a constant state of worry and consternation that my husband or children could die or be critically injured at any minute. I know that not wanting to meet new people, not feeling comfortable in social situations, is silly and limiting. I don’t feel like this about others who have anxiety, just myself. The therapist said this was self-stigmatising; I think it’s just being realistic.

The same is true of my disordered eating (I’ve blogged about this a few times). I admit that my eating is disordered and that I am struggling to cope with this. But the suggestion that I may have an eating disorder seems preposterous. So what if I tick all the diagnostic boxes? To say that I have an ED would be like making an excuse, absolving me of responsibility. In reality I am weak, greedy and lacking willpower – that’s what’s wrong, not an eating disorder. My eating problems are my own fault and nothing more.

I could go on – my self-loathing is deep and boundless. I am not the wonderful mother I assumed I would be. I’m not the successful career woman I assumed I would be. I’m not the sociable, popular individual that I used to be. The schism between who I should be and who I am seems almost unbridgable.

I know I am critical of myself, but who isn’t? Who doesn’t wish that they could change things about themselves? This post may seem self-pitying but it isn’t. I am brutally honest with myself because I need to be, I can’t allow myself to make excuses. I don’t like who I am and I need to confront myself and be truthful if I am to make changes.

Food glorious food…?

This post follows on from My big fat problem.

I have had issues with food for almost as long as I can remember. When I was a young child my mum kept a large tupperware box of chocolate biscuits (Club, Viscount, that kind of thing) on top of one of the kitchen cupboards. I used to wait until I was the only person downstairs then drag a chair into the kitchen, clamber up and get down the box. I would rummage through to find my favourites; sometimes one or two, sometimes half a dozen. It was a fairly big box so I knew I was unlikely to be discovered. At the first opportunity I would sneak my pilfered biscuits upstairs and hide them under my bed. Then after bedtime, when I should have been sleeping, I would sneak them out again and scoff them; I can vividly recall the glee, delight and guilty pleasure I felt. Then I would hide the wrappers in my shoes, and bury them at the bottom of the kitchen bin at the first opportunity.

I don’t know how old I was when I began doing this. I suspect it began around the same time as my self-harming so I would have been about 7. It makes sense to me that these behaviours probably began together as I have long suspected that my binge-eating is merely another manifestation of my urge to self-harm. Certainly the urge to binge and the urge to cut are both triggered by strongly negative emotions such as anger, despair, grief, unhappiness, frustration etc. Since I finally managed to stop cutting in early 2011 my binging has become more and more of a problem.

I’ve mentioned before that the psychiatrist I saw a while ago told me I was a compulsive binge-eater. After talking with some very kind and knowledgeable Twitter friends recently I found myself googling binge-eating today and was directed to this page on the NHS Choices website. It’s extremely informative and eerily familiar – every aspect of binge-eating that it describes applies to me. Eating excessively quickly, eating large amounts when not hungry, eating alone or secretly, feeling out of control, experiencing feelings of shame, guilt and disgust after a binge… This is what I do. This is me.

Despite having been given a good (and kind and helpful) talking-to by my knowledgeable friends on Twitter (you know who you are!) I still don’t feel that I have an eating disorder. Eating disorders are serious illnesses, while I just have no willpower. No self-control. I am greedy. I don’t have an eating disorder. Except… These experienced, knowledgeable, lovely people say that I do. The NHS website says that I do. The psychiatrist said that I do.

So. I may not be ready to admit that I have an eating disorder but I know that my eating is disordered. The difference just be semantics but for now that’s as much as I’m comfortable with. I’m waiting for a referral to a Cognitive Behavioural Therapist for my anxiety and I will definitely be mentioning my problems with food.

In the meantime I am not going to follow any faddy diets, no Atkins or Slimming World or 5:2 or anything like that. Partly because I can’t afford to but mostly because I know that they will not help me stop binging. I need to focus on my binging, not my diet as a whole. I need to arrest the impulse to binge before I act on it and I need to get into the habit of examining why I want to binge each time.

I’m not going to set myself any big scary weight-loss targets, even though that is a major part of why I need to get my eating under control – I am 5 stone overweight and that’s affecting my health as well as my happiness. For now though my only goal involving scales is to weigh less each week than I did before, even if it’s just a few ounces less.

I expect I shall blog about this again in the future but for now this is it. I know what I need to do. I know why I need to do it. I think I know how to begin doing it. So here I go…

Ladies and gentlemen, please fasten your seatbelts

At the moment I’m like an aeroplane tossed around in turbulence; dropping like a stone one moment and bouncing back up again the next. Never knowing when the next air pocket will take me by surprise. I just want a nice smooth journey where I can get up and stroll around and maybe have a drink from the trolley. Maybe even pilot my own aircraft for a while instead of having to rely on autopilot medication to give me a smoother journey.

I took the first step towards this today when had my psychiatric assessment. It was much easier than I had anticipated – I think I had built it up in my head as a big scary confrontation with a besuited bloke sitting in judgement behind a large desk. In fact the guy wore jeans and a shirt and was very affable and friendly.

He was very thorough and at the end of the assessment he told me that in his opinion I have generalised anxiety disorder. He’s pretty sure I don’t have bipolar 2 as my GP suggested but wants me to keep a mood diary for the next few weeks to check for possible cyclothymia. He’s going to refer me for CBT (hopefully the proper face-to-face one this time instead of the crappy computer one) and suggest to my GP that she increases the dosage of my anti-depressants.

We spent quite a long time discussing my mood cycles and their effects and at some point it dawned on me that I have no idea what it’s like to feel normal. I don’t know whether my upswings are what a regular person would call normal, or whether they take me higher than that. Fortunately the mood diary has a detailed scale in it so I just have to find the appropriate box to tick.

It did make me wonder though. I keep saying that I want to be normal, that I want to function normally. But somewhere along this road I lost sight of what ‘normal’ feels like. I have had depression off and on for nearly 20 years; I have self-harmed for about 25. Would I be happy being normal? Would I even recognise it? What is normal anyway? When it comes to mental health does ‘normal’ even exist?

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