Cognitive Behavioural Therapy (CBT) is a type of talking therapy that examines the connection between what we think and how we feel. It is based on decades of evidence and it continues to develop and grow in its breadth like an umbrella slowly unfolding, shielding as many people as possible from the rain. It focuses on the way we think about things (cognition) and the way we do things (behaviour) to help break destructive cyclical ideas. For example, someone may feel themselves to be unworthy of love or of friendship which in turn affects how they socialise or chat to others which in turn can bring their mood down. This would then affect how they feel about themselves, that they may be unworthy of friendship, and so on and on in a negative cycle. CBT examines all this and cracks through the barriers that have been created. It is an extremely successful form of talking therapy and can positively address many different mental health issues from depression to phobias to psychosis. And it is used very successfully for people experiencing trauma and grief.
I recently said goodbye to my CBT therapist after four intense months of successful treatment focussing on the trauma of my grief and on my social anxiety (a decades-old problem). Psychologically I have felt stuck for two and a half years, since my mum died. I hadn't grieved for her (there is no such thing as normal grief- any old fashioned models of "stages of grief" having been superseded by new knowledge) but, most worrying for me and most affecting of my mood, was that I had not changed or progressed in my grieving for Ruby. My feelings about Ruby were no different now, in 2019, than they were when my mum died in early 2017. This was distinct from the first four years after Ruby's death (Ruby died in May 2013) when change, though not always linear, was consistent each week, each month, each year. It took me two years to realise I was now in a sedentary prison, I was stagnant, and I needed to move.
CBT hasn't made my grief vanish or done away with any of my experiences, it hasn't reduced any value of my love for Ruby or made me forget anything. CBT has reduced the sharpness of the trauma, the intensity of pain has diminished, I can cope more adequately. And this also means I can remember Ruby with greater clarity and with less distress. I hope, in time, to be able to think about Ruby without pangs of loss, without those little stabs that demand my attention in place of the joyous memories that should be my focus.
Undergoing CBT taught me many things which may be useful for other people to read. Here are some things I now know:
-Mum's death created a bottleneck in my mind. Trying to cope with my intense grief for Ruby, even four years after she died, and then coping with mum's death (and shortly after that the death of my aunt- her sister- and the near death of my sister from sepsis and coma) was too much to bear. I was incapable of processing that weight of work and so I stalled and came to halt. This can happen to anyone who may have been through one traumatic or difficult event and then has to undergo another one or more. CBT released that strain and let things flow, it let my brain do what it does best, naturally.
-CBT helped me come to terms with the way I grieve. I hadn't grieved too deeply for Mum since she died (about which I felt guilty and embarrassed) for one very good reason that took months of discussion to identify- I had already grieved for her. My mum was chronically ill all her life and all of mine too. Since I was young I had thought that she may die at anytime (or "leave me" are more accurate words, hence a great deal of separation anxiety as a child). I had 43 years of preparation of her death. When she died in 2017 it was the "natural order"of life and death, it was something I had mentally prepared for through my childhood and now, two years later when that bottleneck was opened and I had space to process her death, I am learning to allow myself to not be too affected or traumatised by it. There are as many ways to grieve as there are people on Earth and if we don't feel too badly affected or traumatised by death, this doesn't always mean it is "buried" or "latent" or that it will disable us later in life- sometimes it just means we have already done the work and that we deserve to be free from distress.
-My brain, all our brains, are extraordinarily complex and powerful machines. It can do amazing things and, most of the time, it works smoothly and elegantly. But when we experience trauma our brains don't always use the most appropriate section to process information. CBT, and some other forms of therapy, help our brains reprocess that difficult and traumatic information and so we become less negatively affected by it over time. The trauma becomes duller, more "ordinary", boring even. It becomes easier to think about and to cope with.
-I have to respect my brain and allow it the space it needs to work properly. For me this entails being alcohol-free which allows me to sleep deeper and to dream well which is extremely important to the subconscious processing of difficult information (I stopped drinking alcohol the day I started therapy for this exact purpose, I have no plans to start drinking again). To sleep well is more important than I had ever realised. I am now slightly obsessed with drinking huge amounts of white tea, partly to help me signify "nighttime" but also because the process of making it is as enjoyable as making the gin and tonic I used to drink.
-I needn't feel pain as a legacy to Ruby. I have earned the right to be free from this (in therapy, men are particularly prone to self-flagellation). No-one needs to deliberately increase their own suffering, it does no good, it is a waste of psychic space and has no value.
-I don't pointlessly and painfully ruminate anymore. I stop this process after it has barely started (I have distressing memories of the early days after Ruby died of ruminating for hours at a time over obsessive thoughts of boulders and fissures in cliffs and other overpowering immensities).
-I now reflect on her whole life, not only those last traumatic hours and days.
-Regarding my social anxiety, I now know that I am enough. I need not prepare for all social interactions as I used to do, my irrational anxiety has no use here, I am not the witless dullard I had thought, it suits me to be more spontaneous. I need practice but it is a process I am willing to adapt to.
-Thoughts are not facts. This is deeply and intensely important. It underpins much of CBT practice.
-I will make a deliberate decision to think about Ruby when and how I want to. Distress is a choice and I don't choose it.
-There exists vulnerability zones that I need to prepare for. This includes obvious times such as anniversaries but, almost ironically, also includes happier days when on holiday or when out running in the hills or cycling in the sunshine. I would think, as I am sure many people who are also grieving think, "do I deserve this" and of course the answer is "yes, I do" but it took time to realise this, it took time to allow myself to be happy again.
-I am enough. I am enough. I am enough.
-I can allow myself happiness again, I give myself permission. On some days I can decide that I will be happy for at least that full single day.
-I need creativity. I need movement. I need to be non-sedentary. I need non-routine.
-I can change the way I feel.
