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.
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………….
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.
If the idea of CBT was to help people by teaching them to ‘think positive’ then cognitive behavioural therapy would not exist. CBT definitely is not about positive thinking. I promise you. This is a huge misconception. Actually in my opinion the cognitive (thought) element CBT is about teaching people to think factually, realistically, logically and reasonably, whilst taking into account feelings and behaviours. A few months ago I needed CBT therapy after going through a difficult time. I said to my therapist. ‘Things in my life at the moment are shit’. She agreed, there was no refuting the fact that in the current circumstances, things were ‘shit’ this was not a thinking error, or distortion. The amount of trauma I had and was continuing to experience and having just been diagnosed with several medical conditions and not long having been in hospital culminated in a state of what most people would agree was shittiness (does that have one or two t’s?). However, if I had just broken a nail but everything else in my life was relatively ok and then said ‘things in my life at the moment are shit’ this would be an example of a cognitive distortion, namely overgeneralisation and catastrophising. You can read more about cognitive distortions in this article from Harley Therapy. Nonethleses, in both of these situations, being told to ‘think positive’ would have absolutely no effect whatsoever. It’s as much use as telling somebody to fall in love with a washing machine, it just isn’t going to happen. CBT is about whether you believe or ‘buy into your thoughts’. We are all in the habit of believing our own thoughts, unfortunately we cannot always be relied upon to think logically or factually. We often engage in emotional reasoning ‘I feel bad therefore things must be bad’ or ‘I feel fantastic therefore everything is fantastic’. Yes we do get it right sometimes, but as in the case of depression, or OCD we cannot always trust the validity of our thoughts. So if we can’t just ‘think positive’ what do we do? We QUESTION our thoughts, we challenge them, we change our behaviour. Overtime this process can actually lead to a change in the type or frequency of the thoughts we have, hopefully they will be more realistic, and as a bonus more positive. This is what CBT is really about. It’s not about thinking positive. However, sometimes when things are shitty we need to learn to accept that, and that is a whole other blog post in itself, so I shall sign off now.
In this video I talk about some of the reasons I think people have a bad experience with, or don’t like CBT. It touches on various things such as the way CBT is delivered, people’s expectations and cognitive behavioural therapy for chronic pain and chronic illness. I’d be really interested to get people feedback on it, and wonder if anyone who has had CBT can relate to any of the issues that I address.
It’s been a while hasn’t it folks! As some of you may know I live with quite a few chronic illnesses. Unfortunately I have had a flare up of some of them, whilst other symptoms are still being investigated. I am currently not well enough to practice CBT and have not been for the majority of this year. I wanted to blog about this not only to give an update, but to remind everybody how important it is when you work in a caring profession to be aware of your fitness to practice. Put as concisely as I possibly can, I am not fit to practice as my symptoms currently affect my ability to be able to travel, and my ability to be able to concentrate for various different reasons. Mental health work and CBT is my absolute passion (something I have dedicated many hours to in training and work) and it hurts deeply not to be able to practice. However, I have reached a certain level of acceptance meaning I finally felt able to write this blog post. I am not going to expand on my feelings about this here as it is very personal and it would be inappropriate in a public setting. I am looking to the future to hopefully finding answers to some of my symptoms and finding effective treatment, and for those conditions already diagnosed, adjusting treatment to get them back under control. For any other people with chronic illnesses
Please send any spare spoons my way!
(or Spoonies as we are affectionately known see Spoon Theory as to why) you may relate that a flare up of one condition often sets off another! The road to being able to be fit to practice again is probably going to be a long journey. I sincerely hope that going through all of this will make me a better therapist one day, and if nothing else I am certainly getting a great opportunity to practice what I preach. CBT may not ‘cure’ long term health conditions, but for me personally, it helps me to cope with the impact of them somewhat. In the meantime, if anyone has any spare spoons…. please send them my way!!!
There are academic research studies published about the various reasons why people choose to become therapists. Have a Google, it is rather interesting. If you would like to know why I became a therapist read on…….
Aged 19 I had a very promising career in opera and classical music ahead of me. The pleasure I got from singing gradually reduced over time as the pressure increased. I became more and more disillusioned with the classical singing world and eventually decided that despite my talent, this it was not what I wanted for my career anymore. I was then at a loss. Even if I had wanted to pursue a musical career it had started to become apparent that it was too physically demanding for me (I now know this is due to Ehlers-Danlos Syndrome although I was undiagnosed at the time) My life had revolved around music from the age of six. What on earth was I going to do now?
I remember getting out a piece of paper and a pen. I thought that if I made a list of all the things I enjoyed, that it might be helpful. The first two things I wrote down were;
I briefly entertained the idea of becoming a veterinary receptionist, but did not know where my career would go after that. I then realised I was more of a dog person than an animal person.
I was then left with just people. I love people. I really do. I have always been fascinated by why people behave or think in certain ways. Just for my own pleasure I would watch anything to do with psychology on television and read anything I could get my hands on. I don’t remember but apparently when I was in infant school, before I started studying music, I would tell people I wanted to be a psychiatrist. People very close to me had experienced psychosis and depression, so I was also aware that mental health problems were very real. One of the main issues I had with my career as a classical singer, is that I did not find it meaningful. Although I greatly appreciate the benefits of entertainment for others, I was so wrapped up in my own performance nerves that I could not appreciate it. I had this urge, and still do – to help people. I did not feel I was helping people with my singing voice.
The next natural step was to find a way to combine psychology with my love of people. I did some career research and decided that I would like to go into psychological therapy. I did not feel that a counselling course would provide me with enough depth or breadth to enable me to make informed decisions about which type of therapy I’d like to study (that is not to say I do not think counselling can be helpful for others. I sometimes refer people on to counselling if I feel it may more appropriate for them than CBT, and during my career in mental health I have met many people who have found counselling beneficial). It was very important for me to become and member of the British Psychological Society and so I enrolled to start BSc Psychology. Ironically before beginning my degree I became very depressed. This was before IAPTs existed and I saw a psychologist within the NHS and had what I now realise was CBT based therapy. I then went on to have cognitive-behavioural therapy to try and help manage chronic fatigue. I kind of fell in love with it (CBT not the fatigue!). People close to me had also had CBT. Whilst it is not a miraculous cure, it really had a meaningful effect on my life and my nearest and dearest. I wanted to offer the same support to others, with a therapy grounded in a solid evidence base. I still kept an open mind and studied many different perspectives during my degree. I graduated and worked in different roles in mental health. I got to witness the impact of CBT on lots of different people. My love and respect for CBT only deepened, so I took the plunge and trained did my post graduate diploma in cognitive behavioural therapy – and the rest as they say is history!