Happy (belated) birthday to me!

My 27th birthday was on Thursday, but I did most of the celebrating the day before – I met Jonathan after work and he took me to the nicest hotel I’d ever seen in my life, then we went out for dinner and to the cinema to see Tinker Tailor Soldier Spy. My mum and sister are coming to visit me next month so they’re going to bring presents from my family up then, but mum posted me a little gift card and the Bear of general awesomeness sent me a Starbucks card, which means more coffee for me! Although my birthday is over now I have a lot to look forward to in the next six weeks too, including the long-awaited trip to the USA, so I’m feeling quite positive at the moment 🙂

I wanted to post some photos of the hotel room we stayed in and the views of the river, but I didn’t have my camera so I’m going to have to wait until Jonathan sends me his.

I spent most of my actual birthday in a little cramped classroom with 23 other trainee counsellors. God, I love college. I would go every day if I could. We started our core modules this week, so we sent the psychodynamic trainees off into another room, and one of the first exercises we did was on the myths around CBT. Our tutor went off into this amazing rant about how CBT was designed to be a long term intervention, and that the vast majority of the myths around the therapy relate to the shit way that the government has misappropriated CBT for financial reasons. The stereotypical six sessions of skills teaching often foisted on people with mental health problems who need and deserve more bears very little resemblance to proper CBT. Current research seems to be showing that this bastardised version doesn’t really help anyone – people don’t stay well if you just throw worksheets at them and hope something sticks. It’s not something which any counsellor from any orientation would call therapy, and it’s not very true to CBT in it’s original form.

In fact, from reading Aaron Beck (the founder of cognitive therapy), it seems like CT at least is extremely person centred. Not only did he really value the therapeutic relationship and see that as necessary for change, he was also the first person to take notice of the client’s beliefs about their problems. In the sixties this was a new thing: psychoanalysts traditionally saw conscious thoughts as reflections of unconscious drives which only professionals could interpret, behaviourists didn’t value anything which wasn’t observable by another person and neurologists and psychiatrists only asked about thoughts and feelings as a method of diagnosis. Beck believed that the client’s conscious thoughts could inform him about what was actually going on in their heads and provide them both with insight into how the issue could be resolved. Basically he was one of the first professionals to treat clients like they were potential experts on themselves, rather than trying to squish people into theories. He didn’t treat clients like victims of forces beyond their control who were incapable of doing a thing to help themselves, which was a big deviation from psychiatric theories of the time. It’s horribly ironic that various political forces have given CBT a reputation for being the least client-centred and individualised approach, when in reality CBT was founded on those principles – principles which most of the other approaches of the time (obviously excepting humanistic!) didn’t really value at all.

*gets off soapbox* *returns to recounting past week*

So my birthday was great and I love college. I also spent a lot of this week at the ED charity I volunteer for. The development officer and I started a new group, aimed at people in recovery who wanted to take a role in campaigning, activism and other practical work around eating disorders. I was really happy that three people I didn’t know turned up to our first group because I wasn’t convinced that anyone would come! The other big event was the away day, which was basically six hours of management meeting – I won’t go into what we decided, but I’m quite excited about some of the ideas which came out of it. I never knew it was possible to enjoy a six hour committee meeting! I’m back there again on Monday for our usual six-weekly trustee meeting and I’m planning a proposition to put to them, so wish me luck. I’ll let you know what it was if they say yes 😛

I think I’ve worked out which aspects of my job are the most stressful. I know I’ve talked about this a lot recently but I’m an analytical person, and I think writing my blog helps me to get things straight in my head, which can really help decrease my anxiety. The stress is mostly from performance anxiety, with a bit of keeping up appearances and having to be all things to all people mixed in. Every day I walk into a room full of tired, grumpy elderly people with dementia, and I have to motivate them to do some exercise, chat and get involved with my activities – because otherwise they or their families will complain that they have nothing to do. I have to be constantly cheerful and upbeat while I’m running groups, and during one to one chats I need to be sensitive and focused regardless of whether the person is telling me about a petty grievance they’ve repeated to me a hundred times before (in the last hour) or something truly heartbreaking about missing their dead parents or having to sell their beloved family home. It’s not hard being empathic towards those who are upset, but it IS hard visiting a lady who is dying and holding her hand, and then immediately switching to cheerful banter while I’m playing card games in a big group. I am quite a sociable person, but I’m not used to being a leader and I am very thin skinned. Hopefully this will all become second nature in time (although I don’t think death should ever become something you just brush off when you leave work), but it’s a tough role to adapt to. I’m far more determined to stick with it now I know how helpful the new manager is though – she’s not just dumping me with a thousand responsibilities and expecting me to do it all alone, she’s taking a much more active role in things than the last lady. It’s good to know I have back-up! And working out which aspects of my job I find the hardest helps me decide in which areas I need to concentrate on improving my skills.

And now I am off to watch Doctor Who, followed by an early night. Sorry this post jumps about all other the place and suffers from appalling grammar, I’m completely knackered and could really do with sleeping for most of tomorrow!

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11 responses to “Happy (belated) birthday to me!

  1. Sounds like a good night in 😉 I’m really happy your birthday was such a wonderful one!

    You seem to have worked through things really well and I’m very pleased for you! I hope you get some shut-eye and a well-earned lie-in tomorrow.

    Oh, and: ‘if you just throw worksheets at them and hope something sticks’ reminded me of every CBT therapist I ever saw. Just shows how daft the government’s (governments’ even…more than one?) (mis)use of it is.

    xxx

    • I’ve seen a therapist like that before too 😉 but then again Jess, I don’t think you’ve ever had any luck with therapists – that psychodynamic lady you just got rid of sounded awful! One day hopefully you’ll come across a really good therapist.

  2. It sounds like your birthday was really special, and relaxing!

    Really interesting to hear about proper CBT. (bububut I thought it was all about the worksheets…;) )
    Great to hear that you’re sorting out stresses at work, or at least identifying them. I guess getting them written down is a relief for you, even if the hard bits are inherent parts of the job!

    • I always loved getting homework and asked every therapist of every orientation I ever saw to give me worksheets 😛 I think the difference is whether you give someone worksheets which they are happy to do and are applicable to their situation, or whether you’re just throwing the same stuff at every client you see. In IAPT and primary care it is more often the latter (although that doesn’t make those people bad therapists, it’s just what the job demands – if they were working privately they might work differently). For some people that kind of condensed and rather impersonal approach is all they need, but for many people it just makes them think that CBT is a load of positive thinking BS. It depends on the personalities of the client and the therapist really!

      • Haha, not really trying to bash worksheets. Actually I think I had a pretty good experience with my therapist (at least the one I saw at ‘high intensity’). Although quite a bit of what I did with her was based around worksheets, we spent some time rewriting the sheets/headings to make sure I understood them and that they matched what would be useful for me. Much better and 100 times more useful than just being shown a book that everyone else is given and when something didn’t fit, just told, ‘sorry, it doesn’t suit everyone’!

  3. Really glad you had a smashing birthday 🙂 You sound soooo busy, and happily busy, which is great!

    Really interested about the history of CBT. I’ve done the worksheet thing in the past and found it crap. I’ve always found person-centred therapy much more helpful so I’m surprised to learn that CBT is supposed to be person-centred!

    xx

    • Beck specifically states that Rogers’ core conditions (empathy, congruence and unconditional positive regard – the things the therapist should show towards the client to build the relationship) are absolutely necessary for the client to be able to change, but they are not sufficient. So he thought humanistic therapy was great, he just wanted to add some tools and a different way of looking at the development of mental health issues to it. I didn’t know that was where it came from either until I started looking into it. The problem is that most people get turned off after bad experiences with crap CBT and dismiss the whole approach.

  4. Happy Belated Bday lovely!
    Sounds like you had quite the day! im so glad my bday is in the holidays tho, i couldnt face being stuck in a classroom on the ONE day i can justify getting to do everything my way! :-p
    Another year another step forwards, im right behind you tho, my 27th is in April… when did i get so old?!?! i swear i still feel about 15 most days!!

  5. Happy belated birthday 🙂 Sounds like you had a nice time.

    I was especially interested to read about CBT in this post. I haven’t yet started therapy and on Friday I am going for a meeting to discuss what therapy is suitable for me. They have already mentioned CBT. I’ll be interested to see whether their program is real CBT or the hashed version.

    It’s also my birthday on Friday!

  6. Glad to hear that you had a great birthday, and sounds as if you are enjoying your studies just as much as I am mine 😛 x

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