Group Therapy – Week 3

Once again we started off going round each member of the group and doing a check in, seeing how our weeks had been and any issues that had arisen. I said I had positively had a few good days (or better days), however my anxiety has got much worse over the past few days. I was asked why this was, and I said I kept procrastinating on things I needed to do. I was asked why do I struggle so much to do things for me and is it a form of self punishment on myself.

I said I had always been used to being there and supporting other people, I find it hard to do things that would benefit me. Number 1 it’s belief in myself, I am always putting myself down, which is part of the problem. I don’t think I am good enough or I won’t be any good or what is the point in doing it. It’s the same if a task is given to me, my brain goes into freeze mode and instantly says ‘no I can’t do it’ because I don’t believe I can, I then get very overwhelmed. The therapist said whether you believe you can, or you believe you can’t the thoughts exactly the same.

We then spoke about the anxiety side of things, about having a good day, and me not imagining it is going to last because I am not worthy, and then I get overwhelmed. I was then asked how my anxiety plays out. I said I just feel really stressed about everything, and catastrophise everything. I get very tense, and then I avoid certain things I know do me good. I was asked if I punish myself?! I said yes I do.

A few other members also admitted punishing themselves and also the struggle with procrastination, our minds are so busy and overwhelmed, so we end up doing things that aren’t so helpful. We think are soothing ourselves with things such as smoking or social media scrolling, because it stops us facing reality, but you end up feeling like you are just wasting your life. There can be so many things to do, that it is difficult to know where to start. Someone also made the great point that if your mind is already trying to compute a 100 things at the same time, of course you are going to be exhausted and unable to do what needs doing because you are already doing stuff in your mind all the time. Your brain is just on the go about everything, and there may things that warrant worrying about, but that I can’t control anyway.

I was asked if I worry myself out of good things which I said ‘definitely, all the time’. One of the focuses will be to build up self-esteem. I was told next time I have a good day, every single person sat in the group thinks I deserve that day, so accept it. Also a rubbish day doesn’t equal a rubbish week. A rubbish week isn’t a rubbish month, and a rubbish month isn’t a rubbish life.

I spoke about feeling scared to feel better because my anxiety and depression is my protection, I have known this feeling for so long that I do not know who I am without it, you can feel like you are in a danger zone, when you are in a good zone. Apparently this is completely normal when you start to do work with feelings. Happy is scary, because what happens if I am not happy. Sad is scary because what if I am never happy again and you go from drive to threat mode, back and forth constantly. I cannot do that for myself because it feels good, but I don’t like feeling that because I don’t understand it, and I’m not worthy of it.

We then finished by watching a video on butterfly tapping, a technique that uses bilateral stimulation to provide soothing comfort to people who are feeling anxious, upset or overwhelmed, a lot of us found this very helpful and said we will continue to practice this technique throughout the week.

Group Therapy – Week 2

Parts of group therapy can be difficult, sometimes quite distressing, because you are hearing other people’s stories and their pain coming out, sometimes for the first time in years. Any stories I hear is not something I will go into in any blogs, because the important part of group therapy is the ability to feel safe to share in a safe environment.

I felt much less nervous going to this week’s therapy. I strangely already feel like I have known the group ages, and everyone has already began opening up so much, which shows a feeling of safety.

Today we began with going round each person and explaining what our weeks had been like if it was the weather. Some people had wintry, foggy, drizzly, sunny.

I described my week as towards the end of last week beginning of week, feeling very bleak, like rain with fog, struggling to see ahead. I mentioned that I had a much better day the day before. I was asked why?! I explained I felt like I was getting more support, beginning to understand myself a bit more and why I am feeling the way I am. I’m recognising certain emotions and what has happened in my life, and there being a reason why I am feeling the way I am.

I was then asked if I felt it is okay to feel the way I am. I hesitantly responded yes, but that I had also been punishing myself a lot recently for feeling this way, however I’m trying to be more understanding of myself.

Yesterday I also saw a very dark rain cloud, and a very slight rainbow coming through the clouds, and the rainbow felt like there could be a little bit of hope on the horizon, but that it is hard to see at the moment.

The therapist explained about the fear I may feel of however hard I work, is this going to work?! Life can feel like one thing after another, if it isn’t that, it’s this and how will I deal with all of this?! and if I go back there I will have to feel all these emotions. What will happen to me?! will I be okay?!

We can’t change our pasts or what has happened in our lives, but we can work through the trauma of it. Sometimes painful things do happen and we can’t change that, what we can change is how isolating it feels, and how we experience it.

We also spoke about how much we worry about what people think about us. This is where the compassion focused therapy will come in, learning how to build from within us. Sometimes we all doubt ourselves, and many of the group recognise they are doing this a lot of the time.

Another discussion was emotions, how so many of us are afraid to show emotion, or confront them, yet how unhelpful it is to suppress them. One of the hardest things you go through in therapy is learning to feel, and experiencing what that is like. We need to accept that sometimes we are angry and sometimes we are sad, beyond sad, and we need to be able to sit with it and not berate ourselves or others for it, because the feeling isn’t the problem however awful it makes you feel the other stuff.

Getting an understanding and acceptance that our emotions can influence our mood is powerful, because often emotions can come from nowhere.

At the end of the session we had to think of a time in our lives where someone was really kind to us, and to focus on that feeling. It shows we have an ability to feel compassion. Those defining moments that showed us we are valid, and we matter.

Eventually our brain will go into ‘I know I was cared about’ which helps to begin to build self compassion. We know the feeling does exist within us of being okay being ourselves.

At the end of the session we had to think of

Notes from Carolyn Spring podcast on suicide.

For anyone who has ever suffered the distressing effects of suicidal thoughts, this podcast by Carolyn Spring is amazing.

I had fallen deep deep down within myself, utterly bereft, hopeless, empty and despairing. All I could think about was wanting to die. It was like I got wrapped up in those thoughts and fell down a chasm deep within myself. Escape, the need to get out is such a common theme to suicide.

You cannot understand suicide unless you understand how trapped you feel. You are in this place of deep deep pain and it feels like there is no way out. It feels like you don’t have a future. It feels unbearable, absolutely terrible like you are in a tiny little prison cell within your own mind, you are being tortured to death by your own emotion. It is just a place of intolerable suffering.

It wasn’t about a cry for help, attention seeking or being melodramatic, which is what we often get accused of. It was the unbearability of it, the sense that you are in so much pain that it is intolerable, so you have to do something about it, but you do not know what. It is like all your options have just closed off. You cannot think of any options, and the only option that presents itself to your mind, which is why your mind gets fixated on is suicide.

Looking back now it is very clear that it was a very obsessional thinking for me, that my brain got a hold of this thing called suicide as an escape from intolerable psychic pain and it just kept on obsessing about it. There was some kind of comfort in that obsession, that it gave me some kind of control so that i could manage the pain while I had the option to kill myself, but actually thinking about suicide reduced the pain.

I think that is what a lot of people do not understand. They think that if you are thinking about suicide it is because you have decided to do it, but that is not how I experienced it a lot of the time. I would think about suicide the great escape, and it would decrease my distress at some level in the short term and make it a little bit more bearable. Looking back then, I would say I wasn’t actually intending to kill myself to be dead, it was more about these obsessive thoughts, but at the time it is like you are not thinking, your brain is shut down. There is a brain science explanation for what it felt like.

When I was suicidal I couldn’t think about anything else, like literally couldn’t. I guess there was an experience of it being quite a dissociative experience because I felt like I was lost within myself, like I had fallen down into a big hole. I think it is called a ‘pit of despair’ for a reason because there is a very real sense of falling down within yourself of being enclosed and in darkness. The metaphors are a really good description of the visceral experience I had, was I serious when thinking suicidal thoughts, absolutely yes because this is the point, I was in unbearable emotional pain, and suicide seemed like the only option.

I know now not to engage with them or fight them, I just acknowledge them. I know now where they are coming from. I know they are trying to help me. I know those thoughts are trying to help me find a solution to be rid of the pain, but I also know I don’t want to choose that option, because although it is effective, suicide is extremely effective at ending pain, it is by far the worst option.

I think it is key when talking to a suicidal person that you don’t rubbish it as an option, that you don’t tell them that ‘no suicide is not an option’, because we know it is, it will always be an option. Telling someone it isn’t an option can increase their distress. They are in terrible pain and it is the only option they can think about right now to reduce that pain, and then you tell them that it is not an option. What effect will it have?! it will increase this distress, you have all this pain and there is no way out, how does that decrease our sense of helplessness and hopelessness. I always find it much more helpful to be told, yes it is an option, suicide is always and option, but it is not the only option, but it is by far the worst option.

My recovery really has been about discovering those other options for reducing my distress and alongside that what i really began to learn is that although suicide takes the pain away it doesn’t eradicate it, it just passes it on. I am in unbearable pain, I choose suicide as the way of dealing with that, but that doesn’t mean the pain is gone, I’ve just passed it on to everyone around me.

When someone kills themselves it causes immense suffering. It is caused by suffering and then it multiplies and causes suffering to other people. That is why it is the worst option. I think a much better way or reducing the pain and distress is to do it in a way that does actually reduce the pain, rather than just pass it along. But obviously for a long time, I didn’t think there was anything I could do. I saw the pain as irremediable. I saw it is as this big evil, this big enemy in my life. I saw it as bigger than me. I did not know the first think about how to deal with pain. I thought the only way was to kill myself so I didn’t feel the pain anymore.

My recovery has been based on learning that suffering can be resolved. Pain can be reduced. It can be handled. We can do that in ways that doesn’t then cause pain to others and that seems like a win win to me.

“Being suicidal offers a temporary reprieve from distress, a glimmer of hope of a way out”, so it can become addictive as a result, but overall all it does is serve to increase that distress. The brain science shows that when we are in what researchers the suicidal mode, we are in the same state as when we are traumatised, it is almost that carbon copy of a brain scan.

We go into a traumatic state of mind when we are in a life threatening situation, how when we are faced with a threat, the front brain switches off, the back brain lights up and we shift from daily life mode to danger mode, we can’t think clearly with our front brain, we act on instinct, we go into fight flight or freeze, the very sequence of events.

When we threaten to kill ourselves we are activating that same sequence, because it is a threat to our life. We are effectively traumatising ourselves, that is distressing, and when we get distressed we contemplate suicide as the way out and as the escape and that starts the cycle all over again, so it is a horrendous ambitious cycle. Instead we have to find ways of soothing our distress, rather than threatening ourselves all the time. The foundation of it a complete about turn in our approach to dealing with pain. We continue to abuse ourselves, and that can be by threatening to kill ourselves too.

Recovery is not about the absence of suicidal thoughts or the absence or disorders, that is not life, life doesn’t consist of not wanting to kill ourselves, life is full of health, joy, passion, and goodness and love and freedom. Life is good, it is not just absence of the bad, it is so much more.

Being happy is unimaginable for someone feeling suicidal, because the suicidal mode like the traumatic state of mind shuts down our imagination. Parts of the brain involved in imagination literally don’t fire, we cannot imagine a better future for ourselves. We need to get the parts of the brain that are shut down to fire up again.

Group Therapy Week 1

Today I started Group Therapy for the first time. Having had therapy including 1-1 counselling and CBT, it’s actually been very stressful and very isolating to say the least. Group therapy is not something I wanted to do before, but there is something about being in a group that is really supportive. You can have so much support around you when suffering from mental health, but when you are inside your own head 24/7 it is tough, and after attending the first session I am pleased to say I am glad I went. This is a 21 week course and I thought it would be good to blog in case other people are considering this type of therapy.

The first thing we did in the group, and what we will do each week, is go round and rate our mood from 0 to 10, some people put themselves at a 7, some 5, two of us were probably the lowest at about a 3, we then said what we would like to get out of the course. My answer was to not be a burden on other people, to take that pressure off, and to find support with people going through similar things.

The first part of this course will be on ‘compassion focused therapy’, and how we need to learn to empathise with ourselves like we do with other people. The therapist started off by saying, which of you would be willing to sit here and call me worthless, selfish and uncaring, thankfully none of us could. She then asked then why is it okay to berate ourselves in this way, and punish ourselves for whatever trauma each person has gone through.

We then talked about the ‘threat system’ the fight, flight or freeze response. Basically anyone who has suffered any type of trauma, may have a heightened threat response. In the threat response you cannot think because it switches off, which is what keeps us safe. When you become anxious, your world becomes much smaller, because you start avoiding things. You get into a state of constant heightened arousal, looking around and sweating The human brain is so complicated it is amazing any of us function at all.

We also for 30 seconds clenched our fists as hard as we could, and we had to notice what was happening. We then shook our hands out. Some people felt their whole body tense up, or made them feel angry. Our muscles cannot be tense and relaxed at the same time. When you are tense, you will clench your fists or feel your jaw go. This then puts you into fight, flight or freeze.

Another system we have is a drive system. When our drive system is in overdrive we are exhausted and you break. The drive system gets you up in the morning, washed and dressed. Some people have high drives and some low drives. A symptom of depression is our drive system shrinks, a system of anxiety is it increases.

We also have a soothing system, which we have in each other, but not to ourselves. The compassion element of this type of therapy includes increasing your soothing system to reduce or inflate the drive and threat system (balance it out).

The aim of compassion focused therapy is to process things that have happened. Trauma memories are categorised in a very different way from ordinary memories, we process our pasts right the way back (inner child) and be kinder to ourselves. When we are kind to others, we get something back ourselves. Oxytocin is released when you give someone a cuddle, it is released when you are kind to someone, it makes you feel good. It is released when stroking a pet or any skin to skin contact. It makes you feel happy, loved and compassionate. Most people offer compassion to others as a transaction. It makes you feel good and it makes them feel better.

When you’ve spent your whole life being mean and harsh on yourself, being compassionate doesn’t come easily. It’s a mindset shift to start being kind to yourself when your immediate response is to criticise or beat yourself up. We can all benefit from cutting ourselves a bit of slack.

Some good quotes to help start the journey about self compassion.

“Self-compassion is simply giving the same kindness to ourselves that we would give to others” – Christopher Germer

“This is a moment of suffering. Suffering is part of life. May I be kind to myself in this moment. May I give myself the compassion I need”. Kristin Neff

Speak to yourself with self compassion on the inside and you will radiate peace on the outside”. Amy Leigh Mercree

“Feeling compassion for ourselves in no way releases us from responsibility for our actions. Rather, it releases us from the self-hatred that prevents us from responding our life with clarity and balance”. – Tara Brach