Trigger Warning: self-harm, suicide.
You may have heard the saying “there’s more than one way to skin a rabbit” and I used to believe that this was true when it came to treating a disease. I’ve been through puberty since then, which is enough to make anyone a little cynical, although I have come to realise that the efficacy of a treatment is not always down to the treatment itself but how it is administered. At least, this is my personal experience of Cognitive Behavioural Therapy (CBT).
Graded Exercise Therapy had failed me but surely CBT would help me to control the depression that had blossomed from that experience? Nope.
The problems started when the therapist decided I wasn’t depressed (self-harm and a suicide attempt seem pretty indicative to me, but I’m not the expert), and that the CBT would somehow cure the physical symptoms of my CFS. While the behavioural aspect of CBT, which means making lifestyle changes, is undeniably beneficial for CFS sufferers, I had already been through all that as by this point I had had the condition for over 3 years.
The problems escalated when I was informed that the CFS wasn’t nearly as bad as I had said and that I was merely seeking attention. This was news to me but I could understand why someone might perceive my condition this way. The symptoms don’t visibly manifest themselves and I was smack in the middle of puberty which is a difficult and delicate time. I decided to ignore the warning signs and continue anyway, as it appeared I hadn’t learnt my lesson from the previous physiotherapy experiences.
More problems reared their ugly heads; I can’t say I was too surprised at this point. The therapy office was extremely difficult to get to as a wheelchair user but they refused to come out to me until we agreed to meet in my school during a break time. I also wasn’t being independent enough; I couldn’t afford a powered wheelchair so relied upon an assistant-propelled one, and at the time no other option was available to me. It was even implied during one particularly bad session that my family were holding me back and refusing to let me reach my full potential. By this point I considered the therapist to be somewhere between completely incompentent and Taylor Swift. To give that context, I don’t especially like Ms Swift. The therapy was actually making my mental health worse, not better.
Eventually the time came to review the effectiveness of the therapy, and I’ve never told such a big lie as I did then. I told them I was practically cured and no longer needed their support simply to get myself away from them. Perhaps I should have reported my concerns to the authorities, perhaps I should have spoken my mind. I don’t know. All I could think of at the time was my own self-preservation, and my need to get as far away from the CBT as I could. It became water under a bridge and I moved on.
About a year later I found a private counselling service. I was allowed to take a course that was described only as generic counselling and not CBT, but what I received matches the description of this far more closely than the actual CBT did. Given that it also targeted the depression instead of the CFS, which was what I really needed the help with, it’s not too surprising to say it worked wonders.
Unlike GET, I am not against CBTs’ use to treat CFS. What I am against is it being administered to address the CFS when help is needed for a different reason, and the case being handled with all the insensitivity of an anaesthetised slug. CBT is helpful but only when administered correctly.