Yeeting CBT

Close up of timber grain ©

Ugh, anxiety. It’s such a tentacled THING. And rather embarrassingly, my experience of it only partly overlaps with what the books say. But this week a friend shared a long article accurately describing the other part, and I’m so vindicated, I’m inspired to share.

Everyone I’m related to is a jittery ball of nerves, okay? Partially, we’re just HSPs. At three months of age when Mum first took me to the supermarket, we learned that too much stimulation made me projectile vomit. (Quite happily, Mum reports.) By six I’d spewed so spectacularly in so many places, the paediatrician ordered a barium X-ray to check it wasn’t structural. Nope, just excitement – ‘positive’ or ‘negative’, same result. By adolescence I’d outgrown it, thankfully, though I have on occasion lost 10kgs to nervous nausea.

Mum couldn’t help. She had a traumatic, repressed upbringing which led to anxious, authoritarian parenting. “One mistake can ruin your whole life,” she’d say, and no that’s not a helpful thing to say to bright, sensitive kids. You bet we developed unhelpful thinking styles.

To me, though, that was always separate from the panic, which seemed to arrive in my psyche fully detonated. It never felt as though it followed the unhelpful thoughts. Quite the reverse: I’d feel sick and then, freaking out, the unhelpful thought processes kick in. Which sure, makes things worse, but didn’t come first. (A psychologist/friend once insisted, “Yes they do, they’re just too fast for you to notice”. We’re no longer friends.)

Sadly for me, this is the age of cognitive hegemony. Thus, as a kid in the 70s, they told me to “just think about something else,” rather than the fact I felt like puking, to “make it go away”.

By the late 80s/early 90s, psychologists had elaborated that into “cognitive behavioural therapy” (CBT). Back then, this was promoted as replacing anxiety’s habitual spiral by choosing ‘positive’ thoughts that would, theoretically and with enough practice, build new neural networks.

Neat, huh?

Except this not only didn’t work for me, it projected me faster into the pit. Inside my head speedily became a chaotic game of whack-a-mole: trying to catch all eight tracks of thought, stop them, and replace their blunders with something more useful, while they raced around, whacking back: Why should I believe this thought over that one? Where’s the evidence?? WHO AM I TRYING TO KID???

Then shame boosted the anxiety: “What the fuck is wrong with me that I cannot master this?!” In 1998 a psychologist finally told me, they knew CBT didn’t work for highly analytical people. (Alas, no reference, though I’ve since found this useful summary.) Phew. True, it left me with no tools for a couple decades, but it was better than persisting with something guaranteed to make things worse:

Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute. Fyodor DostoevskyWinter Notes on Summer Impressions, 1863

I mean, seriously. Anxiety makes you hyper-vigilant, so trying to police unhelpful thoughts is, firstly, pouring more energy into a behaviour that’s already causing trouble.

Secondly, we now know how unbalanced anxious brains are: the primitive limbic system fires up, shutting down the more recently developed frontal lobe. So whereas Broca’s area (responsible for speech, including inner speech) does help regulate emotion when we’re calm, when we’re anxious the amygdala drop-kicks it back to the stone age. If words form, they’re gibberish, and trying to force some sort of coherence only adds struggle to struggle.

Thirdly – and most importantly, IMHO – cognitivist approaches put the cart before the horse; they do not address the whole person. Was it unhelpful thought patterns that had me barfing in the produce aisle at Raley’s, age three months? OF COURSE IT BLOODY WASN’T.

It was a trigger-happy nervous system, simple as that.

And no matter how much brain power I threw at it, thoughts were never, ever, going to fix that, any more than you can use them to put out a fire, because mind over matter is ableist, patriarchal bullshit (lecture redacted). Instead I have learned to see unhelpful thought styles not as the cause but as symptoms of anxiety. Soon as I hear them in my head, I know I need to address what’s out of kilter:

Too much work, not enough sun?

Too much caring, not enough writing?

Too much caffeine, not enough sleep?

Too much company, not enough solitude?

Too many carbs, not enough greens? (Turns out, this one’s really important. Like, HUGE. Who knew?!)

If that stuff is off, your thoughts will be off, too. (And certainly not up to the job of self-repair.) Conversely, fix that and your brain chemistry will – well, possibly not right itself, but certainly do better. THEN you can start with the mental work. As one wise friend put it, “Biology before psychology, always.”

Of course, that all becomes much more difficult, if not impossible, when you’re already swamped – but then, so does CBT. I’m not discounting CBT altogether; it’s clearly effective for quite a lot of people, and some of the new versions seem potentially, far more useful.

But for me the main takeaway has been a kind of gentle, absent-minded mindfulness: I eavesdrop on the tracks every once in a while, while spending some time every day watering the garden, hanging out with the chooks and making sure I don’t go too long without looking at the sea or down from a mountain. Anywhere with a different perspective, off the hamster wheel. All that does far, FAR more to keep my head from going off-piste, than any mental practice would ever do. The trick is to let other systems drive for a while.

And now, finally, psychology is catching up. Cool, eh?

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