The first part of the therapy developed our self awareness. This included writing our fears and anxieties down when they occurred, and also identifying the negative thought patterns. For example, were we catastrophizing? Labeling? Using mental filters? Mind reading? Discounting the positives? We had learnt to acknowledge our thinking errors in the class.
The homework was demanding, but I got stuck in and relished the opportunity to do some self- discovery. Almost everyone attempted the homework each week, with one exception. Thinking retrospectively, this patient was too depressed to engage in group therapy. It became tense when the two leaders, who ran the therapy sessions, questioned her. I hope she has had the opportunity for one to one sessions.
We were introduced the the model of low self-esteem; a complex diagram where we delved into early experiences and made links to our core beliefs and negative thoughts. This brought back some painful memories, but I recognized that these experiences have shaped the way I view myself and the world around me. They are still too close for comfort and I can recall certain situations like they were yesterday. Hopefully one day, I will be able to let those memories go.
To encourage us to speak out in the group, the group leaders encouraged us to work in smaller groups first. I was still surprised that there were eight women and one man. Perhaps it is easier for a woman to admit they suffer from self-esteem issues than a man? We started to bond as a group. We listened to each others ideas and suggestions. This bond grew stronger each week.
We started to learn about challenging our negative thoughts or our ‘inner bully’, by writing down alternative, more compassionate thoughts. Generally, when we feel depressed, being compassionate to yourself is an alien concept. We all felt uncomfortable with this. What does being compassionate to yourself even mean? Well, to be compassionate is to accept yourself; to take care, and as cheesy as it sounds, to love yourself. After years of beating myself up, I had to retrain this part of me.
Changing the way we think is difficult. We are creatures of habit. Instead of challenging the thoughts themselves, it was now time to address challenging behaviour. I introduce to you the behavioral experiment. Our self-esteem is maintained through our ‘safety’ behaviours. Change the behaviour, and you eventually start to see a change in your thinking. I kept my behaviour experiments simple – going for a jog is just one example. The experiment is split into two parts – pre and post. I wrote down my negative thoughts surrounding the activity (I am lazy; people will look and laugh at me etc) and then noted the predictions. After the activity, I had to write down what had actually happened. No one laughed at me or made rude comments. I didn’t trip over my own feet or bottle out. So, what did I learn from this? I learnt that my negative views are skewed due to past events. Just doing the behaviour experiement is not enough to get rid of the deeply ingrained beliefs. It has to be practiced and repeated several times before any re-programming takes place. CBT is no easy fix.
In the final weeks, I became anxious that it was coming to an end, and that I would be left to deal with my feelings on my own again. We all wondered what was going to happen, how we were going to cope and reflected on the journey so far. Our group leaders used an analogy of being on a bus, in our last week of therapy, that would stick with me forever. The passengers on the bus represented all our negative thoughts and our inner bully. We were the drivers and in control of the bus. It is up to us to not listen to the negative thoughts and our inner bully, but to steer the bus in the direction we wish to go to.
The class gave us the tools to help, now I know I have to continue that and practice each day. I have made some wonderful friends and we contact each other regularly. It is wonderful to message them when things take a darker turn and my feelings become overwhelming. We have all learnt something new. I now need to continue this journey and use the resources to take care of my mental health. I just need to keep going.