Cognitive behavioural therapy is making me look like a complete fruit loop, not to mention costing me a bloody fortune. The sessions themselves are totally gratis thanks to Auntie NHS – but it’s the ‘homework’ I have to carry out in-between sessions to challenge my anxious thoughts and behaviours that’s burning a hole in my wallet and causing me to behave like an amnesiac nomad.
A few weeks ago I paid six pounds to travel to Reading by train, only to cross over to the other side of the platform and ride back home. The next day I travelled to Reading again, had a cup of tea (£1.90) in the station cafe before again heading straight home (another £6). To the untrained eye I must have looked like a) a lost goat b) a terrorist or c) someone who just really, really likes train journeys.
I’ve paid £2.20 to go and sit on a tube platform at Paddington Underground station and simply watch Bakerloo line train carriages rumble past, before heading back above ground without making any journey whatsoever. To the confused security staff watching me on CCTV – I’M SORRY.
Why does any (sort of) sane person do these things?
I’ll tell you. Part of cognitive behavioural therapy involves plotting graded activity hierarchies around an area that causes you considerable anxiety, and gradually exposing yourself to these anxiety-inducing situations until your frazzled nervous system realises they’re not so terrifying after all.
It’s the psychology world’s answer to ‘learning by doing’ and the wonderful thing about graded hierarchies is that they allow you to take things at the pace of a disabled snail. Thanks to previous bad experiences when I was severely depressed, and having been unwell for a long time, I’m pant-wettingly afraid of navigating public transport solo – but in order to conquer this fear there’s no need to immediately fling yourself onto a train to Aberdeen. The first step of my graded hierarchy was to ride my local bus just three stops on my own, and the last step was to travel into London on the train and get on the underground by myself. There were many, many steps in-between and I never moved onto the next level until I felt truly ready.
Don’t get me wrong, forcing yourself to do something that frightens you over and over again is horrible and exhausting, but it works. After having many panic attacks on public transport in the past, my body had learned that being out and about by myself in crowds was a Bad Thing. The inevitable racing heart, sweating, shaking and dry mouth that appeared every single time I tried something new and mildly exciting would not dissipate no matter how many times I told myself that simply catching a seven-minute local train was nothing to get jelly-legs over. I learned that by staying with my anxiety and discomfort on these journeys until it shrank to a more manageable level, I could reprogramme my frightened brain. Forcing myself back into those situations and re-writing my experience of them compelled my nerves to admit defeat and accept it was safe for me to get back on tubes, trains and buses by myself again.
Anyone that’s going through CBT exposure therapy will know that the slow and necessary steps you must take to rebuild confidence and get back out in society following mental illness are some of the hardest, most gruelling strides you can ever make. And it often feels like an utterly thankless task. When a friend asks you what you did today and you proudly reply: ‘I went to Sainsbury’s, forced myself to stay in there for five minutes, stared at some kiwis and went home, weeping,’ you will be all too aware just how far depression or anxiety made you fall.
But you will be proud, and each minor victory will spur you on to your next challenge, and you’ll know that one day things will be back to normal. But you’ll never take being able to catch the bus alone for granted again, and before jumping to suspicious conclusions about that lone stranger loitering for far too long on the train station platform, you’ll wonder if, maybe, instead of planning a devastating terrorist attack, they’re just working through an anxiety disorder.