To CBT or Not CBT

A friend of mine who also has depression has been under the care of our local Health In Mind service and has this week been discharged because "CBT isn't working for you".

CBT or Cognitive Behavioural Therapy in simple terms works on the basis of challenging depressive or anxious thoughts (more info here http://www.nhs.uk/Conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx) and seems to be the preferred way of working for most counsellors I've encountered. Whilst I am in no way attempting to discredit it as a therapy for other people (other friends of mine have had their lives turned around by it) I am uncomfortable that the theraputic world seems to be using it as a be all or end all of treatments.

When I was trying to access help from Health In Mind last year I too found that the counsellor assigned to me for a series of telephone sessions was only interested in using CBT and nothing else. Unfortunately I found the whole service incredibly poor and was quickly 'forgotten' with the telephone sessions ceasing for no reason and no follow up offered.

My personal experience (and I stress that this is my experience only and I thoroughly recommend that everyone tries CBT if it is offered to them as it may well work for you) with CBT is that despite many attempts over the years to engage with it, it simply isn't for me. I understand the theory of it, I understand how and why it should work. Unfortunately my depression overrides my attempts to challenge the negative thoughts it produces.

An example is as follows - I have long held the theory that I curse loved ones with ill-fate and bring them bad luck (e.g today a cash machine that a close friend tried to use malfunctioned and didn't dispense the money and now there's the worry that her card details may have been cloned and this all happened because I was there. Another example is 3 weeks after getting together with my now ex boyfriend his father passed away, this was the first time my curse struck). Now CBT would tell me to challenge this thought with logic but unfortunately my depression says "Hang on, I can give you at least 10 examples of you cursing people, it's your fault". This also applies to odd phobias I have about sitting in certain parts of my garden or eating pasta bake (really don't ask!).

I had an appointment with an Occupational Health person through work a few months ago to try and help my depression & anxiety and she tried to sell me CBT. I explained to her my previous experience with CBT and that it really hadn't worked for me, her suggestion was that I was not at a level of recovery where I could challenge my depression and left it at that. I'm lucky enough to have an excellent counsellor now who I pay for privately (No the NHS won't fund my treatment but that's another argument for another blog). But it does lead me to wonder what happens to others like me who can't work with CBT and are just dropped from the system as we don't fit with their treatment plan?

There are so many other therapy and treatment options out there but we aren't being given the opportunity to explore them. You have to search and search for alternatives. Surely something as personal as mental health should be approached on a patient by patient basis not a push into a therapy that doesn't work for them and then dropped like a stone. I'd really like to see other options being explained and discussed at the first consultation before the patient's current problems are explored so the already sensitive and unhappy person knows that they have other options should one not work out.

What do you all think? Have you have certain therapies that have or haven't worked?

Love Jen

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