Author Archives: cbtwithalieshia

About cbtwithalieshia

I love an eclectic myriad of things, so does that make me eclectic myself?

Blocking on Social Media – When it is not OK

When you are being trolled by somebody online or are being flooded with messages it is completely understandable why you would choose to block that person. It is for your own emotional well-being. However when you are blocked when taking part in a discussion I think blocking them is the virtual equivalent to placing a gag over somebody’s mouth. It’s dismissive and you wouldn’t do it in real life, so I do not think it’s reputable behaviour online. Today I noticed I had been blocked on Twitter by Ted Greiner on after entering an online discussion with him about breastfeeding and leukaemia. Five days ago I responded one of his tweets in which he alluded to not breastfeeding enough being linked to higher child leukaemia rates and linked an article to it. I retweeted his tweet with a comment and I pointed out this is misleading and that the article talked about a link between lack of access to germs being linked with higher leukaemia rates and not a direct link between reduction in breastfeeding and higher leukaemia rates. You can see my tweet and his with the link to the article here. I called him out on this saying that “Parents feel guilty about enough things already and don’t need the burden of reading misleading statements like this thank you very much.”. His responses included a link to a meta-analysis which was inconclusive, which I also pointed out. A leukaemia researcher also replied to his original tweet describing it as misleading. Parents deserve to have evidence based information. Dr Greiner’s twitter account with the handle @_breastfeeding and titled Global Breastfeeding and has nearly twenty thousand followers. His bio states he has been involved in research and policy work on breastfeeding internationally for 40 years. It is understandable that parents and care givers would expect the information he is giving out to be supported by scientific evidence. However in the example I have given, this is not the case and if you follow the tweets thread you can see that he seems unable to admit error about several issues, including the fact he claims the article in question mentions breastfeeding separately from the hygiene hypothesis which it clearly does not. By blocking me he is silencing me from challenging his claims. Scientific enquiry, debate and discussion is very important and necessary. It’s how new research ideas come about, it’s the catalyst for scientific development. Surely with someone with his credentials would want to know if they are being misleading. One would hope that such an experienced and prolific researcher would welcome criticism and others pointing out when they are wrong. I find it scary that someone who may have influence over so many care givers of children can simply dismiss and block me because they do not like what I have to say. Has he considered the gravitas of his tweet? When I was ten years old my friend died from leukaemia. What if other parents of children who have died from leukaemia start questioning themselves for their choice to formula feed their child and wonder instead if breastfeeding their child could have saved them? All that pain and needless suffering from a misleading tweet. Social media is a part of everyday life for many people now and we need to be held accountable for not just what we say online but also by our behaviour. Blocking somebody to silence them actually speaks volumes about their integrity.

It came back.

So after a few months of great improvement my anxiety got worse again in February. I could have updated sooner on here, but writing it down makes it too real. I’ve still been using all the coping mechanisms and things aren’t as bad as they were a few months ago (when I was in a very dark place) but I still long for the joy I was experiencing in December and January. First thing in the morning is my worst time of day nearly invariably. I wake up with an intense feeling of dread in my abdomen pulling me down making it so hard to get out of bed as I just want to hide away. I do get up though, I have to for my little girl. I wonder if I didn’t have my daughter if I’d just lie in bed for hours not wanting to face the day. It’s not really the day I want to hide from though, it’s myself, the anxiety, but I can’t hide from myself.

Some of my friends remarked that they thought I was doing better. Unintentionally I hide how anxious I’m feeling. I don’t want to let it show because I hate it, I hate how it robs me of joy. It’s not that I purposefully try to hide it from my family and friends, it’s because by trying to behave as if it’s not there I think I feel like I stop it consuming me totally. I don’t think this is an entirely bad thing, if I let anxiety dominate how I behave I don’t think I’d ever get up or go out, but I think it would be better if those who knew me really realised how I feel. It’s very hard to explain but I’ll try. I feel on red alert and scared every second of the day. The intensity of the fear fluctuates but it’s always there, a monkey on my back that I can never shift. The fear is the first thing I feel in the mornings and before I go to sleep I dread the morning coming as I know it’s going to be worse when I wake up. I definitely experience what in CBT terms we describe as “fear of fear”. I’m frightened of my anxiety. I know it’s not going to kill me but I dread it getting worse as I hate how much I suffer. It feels so dreadful. I want to get back to how I was in December and January but I don’t know how, and if I’m honest at the moment it feels out of reach. I’m stuck in a strange place of on the one hand trying to accept my anxiety and on the other longing, striving and desperately hoping for a nice long calm period like I had for a few months last winter.

Never give up hope: The light at the end of the tunnel.

For those of you that have read my last blog post you’ll know I’ve been suffering with severe anxiety since the birth of my daughter in 2016. Suffering is defined the the Oxford English Dictionary as “The state of undergoing pain, distress, or hardship.” This is definitely the right word to describe what I’ve been enduring. I hadn’t even felt like I was living but merely existing.

However over the past 6 weeks things have been brighter. Yes, the anxiety is still there but not at the severity it was. I’m not counting my chickens before they hatch though as my husband has been off work a lot due to recovering from some surgery during this time. When my husband is home I feel the pressure is off me to feel solely responsible for my daughter, so I’m nervous about what will happen when he returns to work in a few weeks time.

However, for now, I am delighted to say I am experiencing moments of pure joy. I’ve been feeling happy. My daughter’s second birthday in December was one of the happiest days I’ve spent with her. Over the past few years anxiety has enveloped me so much I often said to my family, friends and mental health team that I couldn’t feel any other emotions. Now though, I finally can see light at the end of the tunnel of a life filled with a whole range of emotions, not just anxiety. Before, I honestly could only see a life of physical (I live with chronic pain) and mental pain ahead of me. I feel more optimistic now. I’ve been able to be present in the moment more rather than ruminating over the past or fearing the future constantly. There are times when I gave up hope, when I didn’t believe my husband, my friends or my mental health team that my anxiety levels would ever improve but for now they have. My anxiety hasn’t vanished, and it’s an unrealistic expectation to ever hope to your yourself completely of anxiety as it’s an emotion that is part of being human. Everybody experiences anxiety sometimes. My anxiety is still constantly there and at a level where it is impacting my quality of life negatively, but it’s not unwaveringly overwhelming me like it did for so long. For the first time in years I feel hopeful about my future. I’m thankful to myself for my constant dedication to my mental health and wellbeing. For me this means;

  1. Good sleep hygiene – I think the number one most important thing I think for anyones mental health is good sleep.
  2. Avoiding stimulants like caffeine.
  3. Daily meditation. I’ve been keeping up with my almost daily mediations (my prefered type are mindfulness body scan meditations).
  4. Trying my best to live mindfully (be present in the moment).
  5. Carrying on with activities even when I feel extremely anxious e.g. going to toddler groups, meeting up with friends.
  6. Being honest with my family and mental health team about how I feel, especially when I feel suicidal.
  7. Taking my medication.
  8. Having a most balanced view of things, noticing the good things not just the bad. Part of what helped me achieve this I believe, was for four months I recorded daily all the positive things that happened in my day. In CBT we talk about a negative filter, meaning sometimes people only notice the negative things in life and the positives pass them by. I was definitely viewing life through a negative filter, but not anymore.
  9. Challenging my thoughts. I filled in thought records, a tool we use in CBT to challenge negative automatic thoughts. Although this didn’t have an impact on my physical anxiety symptom of dread in my abdomen it helped to get the thoughts on paper and “out of my head”. When I get the same recurring thoughts, I tell myself they’re already on the paper. I used the Thought Record Sheet: 7 column (scroll down to download it) By clicking on this link you can also read about challenging your thoughts from the wonderful resource that is
  10. Eating three meals a day even when my appetite is very poor.
  11. Making time for things I enjoy, e.g. reading, watching television, eating out with friends and family, going to the cinema.
  12. Limiting the time I spend on screens so I can be more present in my life and in the moment.
  13. Remembering and putting into practice things I have learnt in therapy.

As ever I am so thankful for my ongoing support from my wonderful family, friends and mental health team. Thank you just doesn’t seem enough.

One of my favourite quotes that has kept me going in my darkest times is;

“If you’re going through hell, keep going.” – Winston Churchill

I wish that for anyone who is reading this that is hopeless, that by sharing my experience I can give you even the smallest shine of light at the end of your tunnel.

My secret shame for not being able to fix myself

I’ve been keeping a secret. Ever since the birth of my daughter nearly 2 years ago I have been suffering with severe, chronic and acute anxiety and still am. Along with this comes a deep embarrassment that as a qualified CBT therapist I haven’t been able to “fix myself”. On an endless refrain in my head I hear my old supervisor saying “teach your client to be their own therapist” which feeds into my shame of not being able to come out of the other side of this anxiety when I myself am a fully qualified therapist. I think I feel that as I have so many CBT skills that I should be doing much better than I actually am. My self-pressure and guilt of not being able to navigate the minefield of my own anxiety by “being my own therapist” is at some points suffocating.

My amazing mental health care coordinator has helped me to gradually see that I do an awful lot to help myself but I never feel it’s enough.

My psychiatrist printed off lots of CBT thought record sheets to try and help me manage my anxiety a bit better. Although this helped get many distressing thoughts out on paper rather than just in my head endlessly floating around, I am still left with my worst symptom, a constant feeling in the pit of my abdomen of complete fear.

I’m on several medications, I’d be on higher doses if I could but my physical medical conditions make this problematic.

I’ve seen an amazing psychologist yet am still so overwhelmed by crippling anxiety.

My anxiety revolves around fear of not being able to cope looking after my daughter. I have numerous disabling medical conditions meaning I’m reliant on my family and carers to assist me in my parenting role. It makes me feel so vulnerable. I suffer with awful chronic fatigue as a result of my medical conditions and my psychiatric medications only compound this. Combined with pain this means I can’t drive. I can’t use public transport without severe pain. I can’t lift my daughter up or down the stairs (and toddlers won’t always walk even when they can). I can’t hold her legs in the air to change her nappy and many other parenting tasks too. At my worst I feel suicidal and like a terrible person that was stupid to have a child. I go through phases of constantly berating myself for having a child knowing I’m disabled. I live in fear that something will happen to my relatives or my carers will be taken away (a real fear in light of social care cut backs) and I will be stranded with a child I can’t look after by myself. I’m all consumed by this fear. I’m scared my health will deteriorate further and that I’ll be able to do even less for her and in my eyes be even less of a mother.

I feel so guilty that I’m not “better”. It’s made me reflect on how I feel about CBT a lot. I have in fact used lots of CBT techniques without actually consciousluly realising. For example I’ve never avoided taking my daughter to baby or toddler groups however much I’ve wanted to hide away, even though I sometimes cry in them as I’m so consumed by anxiety. I think this is because I know that avoidance is a slippery slope to doing less and feeling even worse. However I’ve also had something confirmed I’ve always known, CBT isn’t a magic one-size-fits-all cure. I’ve always been passionate about the fact that CBT isn’t always the whole answer but it can help. I’m living proof of this. CBT alone isn’t enough for me, I need my medication, I need secondary mental health services input, I needed other types of therapy and still do in the future. Most of all though I want to learn not to be ashamed anymore. I don’t think this will be a quick process but I’m hoping on some level that writing this will go someway towards helping. I don’t know if I’ll ever be physically well enough to work as a CBT therapist again but if I do this experience will only go on to expand my compassion and empathy for others living with anxiety. My psychiatrist has reiterated several times how difficult it is to treat. I just never really appreciated someone (me) could be this difficult to treat. My psychiatrist is confident I will improve and says it’s a marathon not a race. I have improved somewhat but really wish I could sprint to the finish line.

Pollyanna Weekend

We were due to go away for a weekend break this weekend, just the two of us. Due to unforseen circumstances we weren’t able to go. Instead of getting down about it my husband said we were going to make the best of the situation.

So in the circumstances we had we decided to do some enjoyable things we wouldn’t usually be able to do. On Saturday a dear friend had our daughter for the night and so we got the opportunity to just be us and go out on and date night as husband and wife rather than Mummy and Daddy. I cannot remember the last time we did this. We also bumped into a friend whilst out which was really lovely. Today we went for a really yummy roast dinner and met a couple we really clicked with an enjoyed some great conversation. Later on we got to spend some really nice quality time with our daughter which we wouldn’t have had if we’d gone away for the weekend without her. We feel we got the best of both worlds; some well deserved husband and wife quality respite time and some quality family time. Also if we had gone away we would have probably spent a lot more money than we did just having two nice meals out. We flipped what could have been a negative situation on its head and made the best of the situation and have really enjoyed ourselves. As an added bonus we sold our holiday for a hugely reduced price to a lovely family who are having a fantastic time so it’s a win win situation. By making the best of not going away it has reminded me of the story Dr David Burns (one of my CBT idols)  tells in his book The Feeling Good Handbook about a couple who’s luggage got lost when they arrived at their holiday destination. Rather than focusing on how awful it was they turned it into a game of seeing how they could cope having so little. So just like Pollyanna who’s mindset is to always look on the brightside, we successfully enjoyed our Pollyanna Weekend. 

Daily or Weekly CBT insights. What do you think? 

It’s been a long time since I’ve blogged. I’ve really been missing it. I am thinking of doing a series of regular blog posts sharing how I am using CBT in my own life each day. I’m hoping this will serve as a reminder to those who have already received some form of CBT or introduce new people to the benefits of cognitive behavioural therapy.  Being a Mummy to a 10 month old baby means that committing to blogging every day probably isn’t realistic, as much as I’d like to. I might manage a daily insightful tweet but even that can be a chore with a baby.  Instead I was thinking of doing a weekly blog post sharing in which ways CBT has enhanced my wellbeing for each preceding week. I’d be really grateful for any feedback or suggestions anybody has about this idea. I’m really looking forward to connecting with my followers and a wider audience again.

How to prevent BURNOUT: 3 top tips.


Burnout is something we are all at risk from. Whether it be working too much, socialising too much, under stress or a combination of everything,  getting to the point where we are physically and mentally exhausted is something that we should try and prevent if we can.

Here are my 3 top tips for helping you to prevent burnout:

1. Make sleep a priority not a luxury.
Scientific research links sleep derivation not only to low mood but physical pain too, similar to that experienced by people with fibromyalgia. Sleep deprivation also lowers our immune system and also means we are less able to deal with stress. Sleep is essential for a healthy mind and body. If you need extra hours in the day to complete tasks try not to cut into your sleep time as this will make it harder to cope with things the next day. Sleep is like food and water- we need it to survive.

2. Ask for help.
When you are feeling overwhelmed and overworked reach out to others and ask for help. Many of us are hesitant to do this for fear of looking weak or incompetent, or perhaps worry about burdening others. However, you may be pleasantly surprised to find others are willing to help, they are just waiting to be asked. As for looking incompetent, ask yourself if you would feel the same way about someone asking for your help, in most cases you’d likely not think them weak. Sometimes we need to swallow our pride and admit that we aren’t coping very well with the demands of life. It’s surely better to keep swimming with the help of a float than to say nothing and drown.

3. Learn how to say no effectively.
Are you a people pleaser, do you take on too much because you don’t want to let others down? Saying yes in situations where we don’t have enough physical or emotional resources to help others can leave us feeling under pressure or even at times resentful towards the person we’ve said yes to. Learning how to say no is part of learning how to be assertive. There are some great resources online for learning assertiveness techniques such as this Assert Yourself course from the Centre of Clinical Interventions.

Try and find more balance in life by implementing these tips to prevent the boom and bust cycle that can often be a feature of conditions where chronic fatigue is a prominent symptom.

Why I think those three little words are so important – “I don’t know”.

I don't know

Those three little words. Depending on who says them or in which context, those words can provoke different responses in us. Sometimes we don’t want to hear those words, sometimes we expect something different. I think those three little words are so important. I am referring to “I don’t know”. I think this simple sentence can say so many things about a person. It’s often not the words we want to hear from our therapist. We go therapy most often seeking answers, wanting to be ‘cured’, to have our problems solved.

However, I think “I don’t know” is one of the most powerful sentences one can hear or say. For me it represents above all one of the most important qualities in a therapist: integrity. I think it speaks volumes about a person who is comfortable enough to admit they do not know something, has the integrity not to lie, to be truthful and honest. To be content enough with their own level of knowledge to admit when they do not know something shows confidence in their current abilities, it says to me that they are enough. I would much rather have somebody tell me they do not know something than try to pull the wool over my eyes or grab at straws trying to come up with an answer that makes them sound competent. Nobody has all the answers and that is ok. The realisation that we do not know something can be the catalyst to discovery of new knowledge or even prompt us to ask new questions, it can put us on new pathways. Nothing new would ever be discovered if nobody admitted they did not know something. I think saying “I don’t know” as well as being honest, can be liberating, it stops us having to try and “fake it” to pretend we know, when we don’t. The response “I don’t know” frees us of that certain type of stressor, the one we often put on ourselves – to always look like we know what we are doing. Human beings are fallible, we make mistakes, we are imperfect and flawed, and so is our knowledge and that’s ok. So next time you find yourself in a situation where you don’t know something but want to give an answer other than “I don’t know” perhaps wonder whether in fact I don’t know is possibly the best answer of all.

Why evaluation is the most important part of problem solving.

You may or may not be familiar with the concept of problem solving. It is an approach that can be applied to many problems in life, both practical and interpersonal (relationships with other people) ones.

There are 5 basic steps to problem solving and I beleive that from my experience it is the 5th step – evaluation, that most people forget to implement.

Here are the 5 steps:

1. Define your problem.

2. Brainstorm solutions.

3. Review and choose the most appropriate solution.

4.Put into action chosen solution.

5.Evaluate your progress.

I cannot tell you how many times I have encountered people who are ploughing away, often very diligently for weeks or months and never evaluate their progress. A good analogy is a diet for weight-loss. You wouldn’t stay on a diet on which you aren’t loosing weight. However, if you don’t weigh yourself you won’t know if you are losing, maintaining or gaining wait. Whatever your solution make sure you measure your progress. If after you have evaluated, things are not going to plan then you are in a position of awareness and can either make some adjustments or perhaps try a different solution on your list. It’s the same as this age old saying…………. Quote-Always do

So next time you are working on a solution, remember to evaluate your progress so that you aren’t using up your energy on something that is not actually helping you.