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Therapy

What is fear? Fear is old people sat in a shed with the keys to the lawnmower. Fear is what theyll say if you let your allotment get overgrown. Fear is what youll do to avoid asking for the lawnmower. Fear is irrational, complicated and, quite frankly, a bit of a turd.

Out of the fear of making you feel uncomfortable I was going to write this article as a story about someone else and at the end I would write SURPRISE! It was me all along, sucker!. Not only would that have been rather dickish, it would have contradicted my parting wisdom: it should be as easy to talk about mental health as it is to talk about bodily health.

So, dear readers, are we sitting uncomfortably? Even I rolled my eyes at that one.

(Dont Fear) The Reaper

Once, whilst lying in bed I imagined a rope hanging in my room, I knew deep down I didnt want to kill myself but I imagined the rope nonetheless. This would happen occasionally, it could be a gunshot or a knife cut. Nothing gory and always just a flash of imagery in my mind. Ive heard people say flippant comments like oh, kill me now when theyre working on a tiresome task and I felt that these thoughts were a bit like that, but obviously more involved.

I can remember having these thoughts for a few years, and how they were particularly frequent around a time when I was having a bit of relationship trouble. I wasnt afraid of the thoughts, although they were distressing and tiring, I was more afraid of them not being normal. They certainly didnt seem normal. Who in their right mind fantasizes about suicide? I thought to myself.

Of course, this is why I never told anyone about them and instead, did what everyone advises not to do, but secretly does do when they might be ill and arent being watched - searched the internet.

No One Knows

Not really knowing what to search for, I stumped for is fantasizing about suicide normal? I took it as a good sign that there were no results from the Daily Mail proclaiming I had cancer, or indeed, the cure for cancer. Most of the info however, related to people who had attempted suicide, were deeply depressed or were fantasizing about how to kill themselves. I had never attempted to kill myself (other than nearly boring myself to death attending lessons on compilers at uni), I knew I wasnt depressed and in my thoughts I have no control over the method.

Next stop, Reddits suicide support group where I found this gem:

Its not fantasizing about suicide but fantasizing about change.

Ah, so these thoughts may be a manifestation of my desire to change?. If I was laying in bed, thinking about spending part of the day with someone who is overly opinionated about politics, which was then accompanied by a quick flash of a knife to the throat, then it was only a sign that I wanted to get out of the situation and not that I wanted to hurt myself. Relief.

But what if? Ive heard it said that people shouldnt commit suicide because its selfish. That when someone has decided to end their time on this world, pinch the flame of the match of their life, to no longer exist for eternity, that in a fit of realisation theyll suddenly think Stop! I was going to action that marketing report for Bob! How inconsiderate am I? I should continue suffering until at least end of play today. I think the very fact that someone has rationalised themselves into suicide means theyre not in the right frame of mind to stop themselves.

So what if? to me was what if I get deeply depressed, am not in the right frame of mind and do something I would regret?

Another great piece of advice from Reddit which they regularly dish out - Go and see your GP!

Which is why I found myself, very early in the morning, rubbing sleep out of my eyes and sitting with a GP:

"Is there anything else I can help you with?" said the doctor - after softening her up with some of my getting old ailments.

Sorry to spoil your early morning but here comes a heavy hitter - I thought.

Is it normal for people to fantasize about suicide?

"Hmm No"

Cue my best Captain Picard facepalm impression.

It was hard enough asking the doctor that question, but when she asked me to describe my thoughts - to actually vocalise and describe them - was in my opinion up there with character building, social extreme sports such as attending an all female Zumba class (which I have done), or announcing to a lecture hall that youve got piles (which Ive yet to do). My face was clenched (not from piles), I hesitated on every word and in anyway possible made sure it didnt sound like a big deal. I dont feel any pain, theres no blood, its just like what other people say but I visualise it, Im not depressed - no biggie. Just wanted make sure everything is tickety boo.

The doctor was actually very good about it, gave me a sheet to fill in to check for symptoms for depression (all clear) and referred me to a wellness clinic, of which I had no idea was even a thing.

The Passenger

A month or so later, I was hastily walking around a carpark trying to avoid people who could hear me talking about my deepest, darkest problem over the phone. Whilst giving side glances to someone out for a cig break, I took a phone call from a rather friendly therapist (who will forevermore be known as Jane Doe) who quizzed me for an hour on all sorts of things to get a grasp of the situation. She then offered a couple options, if I was up for it: counselling to explore the emotional side, or some CBT (cognitive behavioural therapy) sessions to help me manage my problem. I opted for the Silver Plan in the hope it might come with a complimentary car air freshener, or You dont have to be crazy to work here tote bags. But, little did I know, I was having my first session there and then.

This was also the first time I heard about Intrusive Thoughts.

Intrusive thoughts

Jane told me about thoughts which were out of a persons control, went against their very nature, which made the thoughts quite distressing. Thoughts such as driving along a road, getting to a corner and thinking I could just keep on going and I would end up crashing. Thoughts like I wonder what would happen if I punched this person in the face whilst talking to someone. Thoughts which everybody gets from time to time, but very rarely speak about.

This was the key. During face to face sessions there was a moment when the Jane handed me a sheet on which was listed the stats on the percentage of people who have normal, intrusive thoughts. For example 34% of people think about fatally pushing a stranger, the same amount think about swearing in public, 50% have thought about hurting a family member or 55% swerving into traffic, 48% thought about having sex with an unacceptable person. What all of these thoughts have in common is that they disturb the person who has them and instead of the thoughts floating past on a stream of consciousness, they get stuck, drawing the persons attention. This can make the person distressed because its hard for them to see these as harmless thoughts.

Knowing this was such a relief. I learnt not to pay intrusive thoughts too much attention, and that in my case they were also tied to anxiety.

So how do I go about managing anxiety?

Cognition, autonomic and behaviour (i.e. the cycle of shit)

Thinking shit makes you feel shit which makes you behave like shit which in turn makes you think shitter shit. All the while outside shit adds to your shit. Taking lawnmower-gate as an example: fear of the unknown about what will happen when I ask for a lawnmower will make me feel anxious which makes me more likely to avoid the situation which makes me think Its a bloody lawnmower you should just be able to go and get it. Which leads to Why do I have to mow the bloody lawn and why do I have to work on an allotment where people will judge my grass cutting skills? Which is, in turn, irrational because they arent judgey people. Enter anger and frustration which might make me snap at my lovely lass and so it continues.

The techniques I learnt during CBT help me realise when Im in the cycle of shit and break it.

Worry and rumination

I was asked to keep a worry diary so I could see the type of things I was worrying about and for how long. This is a great exercise that I would recommend. It turns out that I dont worry about where Ill find the latest cat video to share with the world, but mainly about not being quick enough at the work I do and, surprise, surprise, social situations.

Next up was to practice worry postponement. Basically writing down any anxious thoughts you have, and reminding yourself youll worry about it later. Then during a designated period - of say 30 minutes - go through each worry and either cross it off if it was irrational or come up with an action plan to sort it. This is to help cut down on the amount of time spent worrying and although its really hard to stop worrying about something, having a plan on how to deal with it really does help.

I used this technique to stop getting ahead of myself when ruminating, for example telling myself I will worry about getting a puncture on my bike, when I get a puncture on my bike. Not before. or I only need to worry about a social situation once Im through the door. I dont need to worry up until that point. It would be like, if you were leaving your job, worrying about an interview before you even got an interview. In lawnmower-gate terms it would be focusing on getting to the door of the shed the old folks sit in, before going in and worrying about what happens.

Unhelpful thinking styles

There is a whole host of unhelpful thinking styles: labelling, overgeneralisation, emotional reasoning, personalisation and the one which jumped out for me was jumping to conclusions. I found that I was anticipating peoples reactions to things which, really I had no idea how they would react, this would lead to catastrophising and which would give me fuel to avoid the situation. I didnt even know I was doing it but once I had been made aware, I realised I was doing it quite often. This allowed me to challenge my assumptions about people.

Mindfulness

Oh dear, I thought, Mindfulness again. Id seen Mindfulness gradually seep into the mainstream over the past few years and it has become a bit of an overused buzzword. Mindful eating, mindful exercise, mindful business, even mindful birthing? I think if I told my lass to focus on the moment whilst she was giving birth I would soon be focusing on a well aimed slap. However, all though quite cynical, I do rather like the concept. Id read about flow - the process of being so fully involved with the task at hand that you forget about time passing. Gaming is great for this.

Id also read about the Stoics who thought that by focusing on the value of what you were doing, to know that you are doing something just, then others opinions become inconsequential:

How much time he gains who does not look to see what his neighbour says or does or thinks, but only at what he does himself, to make it just and holy. - Marcus Aurelius

So just focusing on the moment in a non-judgemental way can be a helpful technique in managing anxiety. Ive found it particularly useful in social situations in which I would look inwardly, focusing on where I should stand, who I should try and talk to, what would happen if I couldnt find anything say. Jane told me that in these situations I should just concentrate on the task at hand and try to enjoy it. Help out with the BBQ, set up the game or try to just focus on what other people are saying.

Times Like These

After 10 weeks and 6 CBT sessions Im less worried about intrusive thoughts, and they occur less frequently because Im less anxious. Theres still a way to go but I found the whole process invaluable. It led me to think that I could understand why people might cut themselves, it must feel like a pressure release from anxiety. I count myself lucky that I do not suffer from panic attacks, OCD or other ways anxiety can manifest.

The brain is such a complex thing with many paths to follow but its stupidly easy to run up against brick walls. Ive still not borrowed the lawnmower. Even though I know theres nothing there which will cause me ill-will, there is still a wall in my mind which needs some work and the thing about walls is that they do take work to break. Theres no manning up bullshit to help break through, they dont work like that. What does help is a leg up from someone else.

Its taken me a few weeks to write this post. Not that I was really afraid of putting myself out there, but that I needed to write it in such a way that it wouldn't scare people or make them worried. But, hey, maybe Im jumping to conclusions about how people will react. One day I hope it really will be as easy to talk about mental health as it is to talk about bodily health.

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