Tag Archives: cognitive behavioural therapy

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.

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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.

Why CBT isn’t about positive thinking.

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.

CBT – Why some people might not like it.

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.

Fitness to Practice – Why I’ve not been blogging.

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!

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!!!

What really goes through my head when I get dressed for work.

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What do you wear when you are working as a therapist? Read on to find out how I choose my clothes, and why I wear the things I do. Fashion and CBT not the most likely of topics, but a subject that I find quite intriguing. 

When I first started my CBT training, I asked my clinical supervisor ‘what should I wear when I start to see clients?’ He looked at me puzzled and replied ‘Clothes, Alieshia!’. ‘Very funny’, I said but seriously, I said, ‘how do I know what to wear?’. He looked at me again and could see I genuinely wanted advice. He said ‘as a woman you don’t want to wear anything that is too revealing, simply because it is too distracting for clients’. I said ‘yes, I had already thought that, I have never worn anything that shows my cleavage or is too short whenever I have worked in the caring profession. I agree. But apart from that how do I know what to wear?’ He looked at me again, surprised that I still was not satisfied with his answer. He looked down at himself and said, ‘I just wear this’. He was wearing a pair of jeans and a polo shirt. I looked at him and said ‘Yes, that is fine, but you have many years of experience and look your age, I don’t’.

My issue is that I look very young. Only the other week my new cardiologist started asking my Mum about my usual energy levels at home. My Mum had to turn round and say, sorry Dr S****** but Alieshia lives with her husband, she is actually 29. He turned round and apologised to me, he had thought I was still a teenager, living at home.

I feel that if I turned up to meet clients in a polo shirt and jeans that I would look so young that they may doubt my clinical capability and lose confidence in the therapeutic process, which would be counter-productive. For me personally it’s important for me to dress in a way that looks professional and choose an outfit that makes me look at least 20, I mean this sincerely, I do not jest. I have discussed clothing with some other therapists. My colleagues do not have the age issue to contend with but are honest with me, and can understand why it is important for me to dress in way which enhances my age.

So aside from the age issue, what other factors are there to consider when I dress for work?

For me I think it’s great that my first clinical supervisor wore casual clothes. On one level, I believe what you wear should not matter, CBT is a collaboration and not a platform for power dressing. By wearing jeans, it could convey the message that ‘I am relaxed, it’s ok for you to be too’. I can particularly appreciate how this might be great when working with children and young people. Business attire can sometimes be intimidating. However for me personally I believe that dressing smartly (not a three piece suit or anything, but smart trousers, top and shoes) conveys to my client ‘I respect you and have made an effort to dress this way. I am a professional and I want you to have confidence in that from everything, from the way I speak, the content of what I say, the way I conduct myself and what I wear’.

Some therapeutic approaches discourage from any personal expression and therapists will wear exactly the same outfit, or extremely similar clothing to each session. CBT is not like that, I have never come across any literature that discusses proper work attire! I still feel able to express my personality through my clothing and make-up without being distracting to my clients, whilst still being professional. What do you think about what your therapist wears? Are you a mental health professional, have you ever considered your work attire? Let me know in the comments below, or send me a tweet.

On a final note I shall leave you with this memory…… I wore a yellow top one day with matching yellow nail polish. In the morning my client said to me ‘Alieshia, you look like a ray of sunshine’. The next day my supervisor said to me (I had a different top on, but the same nail polish) ‘Alieshia, that is the most disgusting colour nail polish I have ever seen. It’s horrible’. Make of that what you will!