A good CBT therapist is like a guide

 

Walkers on brow of hill - clipped

 

A good CBT therapist is like a guide

 

This photo is from a presentation I gave to the OCD-UK conference in 2014.  I took it on the way up to Grisedale Tarn in the Lake District. 

 

Advertisements

Thank you NHS

What an extraordinary organisation. Out of the millions of people living and working in London, it was able to put one person who’d been struggling with obsessive compulsive disorder (OCD) for the previous 25 years in contact with another person who had specialised in the psychological treatment of OCD for the previous 20 years. The organisation was the National Health Service, our NHS.

The first person was myself. The second was Prof Paul Salkovskis, a Consultant Clinical Psychologist and at that time one of the Clinical Directors of the Centre for Anxiety Disorders & Trauma (CADAT), a specialist NHS clinic at the Maudsley Hospital. Through the NHS, the whole community paid Paul’s salary so that he could work with me, and many others, using specialist cognitive behavioural therapy (CBT) specifically designed for OCD. He not only worked with me on my OCD but also on other problems I had, some of which had developed because I’d had OCD for such a long time. He worked with me until I was better. When I finished therapy I felt that all aspects of my mental health had been transformed. What a remarkable thing to be able to say. This service was completely free of charge. An extraordinary creation. Human society at its very best. Our NHS.

However, at the same time as writing this, I am acutely aware (through conversations with people and through my research) that there is huge variation in the availability of good quality CBT for OCD on the NHS. There are places where people can access excellent quality specialist CBT promptly, but many others where you can’t, or you have to wait a very long time. From my personal experience I know that the NHS is capable of absolutely extraordinary things. This makes me passionate about the NHS, about maintaining all that is wonderful about it and striving to make sure that the service it delivers is equally good for everyone.

When I started treatment I was very sceptical about CBT for OCD. A little later on, when I realised that the therapy was actually working, I struggled for words. Something which had plagued me for decades, permeated every nook and cranny of my life, something which had stopped me doing so much, was going. What could I say to my therapist? Thank you? That seemed woefully inadequate. I was being released from years of fear, from incarceration. I was being given back years of my life which I would otherwise have spent continuously cleaning and washing. It needed more than a thank you! I had that feeling again last week when I was struggling to encapsulate the experience in a few words for a placard to take on the People’s March for the NHS.

Clissold Park

I first read about, and was incredibly inspired by, the women behind the People’s March for the NHS back in the spring. They are a wonderful group of women from Darlington, County Durham, known on Twitter as the #darlomums. They decided to organise a march in support of the NHS, from Jarrow to Parliament. They were going to follow in the footsteps of the Jarrow Marchers who marched for jobs back in 1936. The women’s message was; ‘the NHS is owned by and loved by us and every effort will be made to stop it being sold off to those who put profit before people’.

I had been following their preparations, and then how their 3-week march had been received so warmly by so many different people, and was very keen to attend the last day of the march from Edmonton to central London.

In their press release they called for the repeal of the 2012 Health and Social Care Act and described their four aims; reversal of the closure of NHS services, halt of the privatisation of NHS care, return of responsibility for delivering NHS services to the Secretary of State for Health, and to inform the public about what is happening to the NHS and build support for the NHS.

Their aims reminded me of a very powerful and disturbing lecture I attended earlier this year by Prof Allyson Pollock entitled; ‘The End of the NHS? How the government is privatising healthcare in England’. Allyson is a public health expert and after describing the history of the NHS and explaining in detail what had happened under different governments, argued passionately that there was ‘still a chance to fight policy changes impacting on healthcare in this country’. You can hear Allyson’s lecture here.
http://www.bath.ac.uk/ipr/news/news-0104.html

On the way to central London on Saturday the march stopped to have lunch in Clissold Park, and we were welcomed by Diane Abbott, MP for Hackney and Stoke Newington. Diane spoke movingly about her mum who came from Jamaica to work as a nurse in the NHS. Later she said, ‘What NHS workers have given us over the years, money cannot buy’. Here is the march leaving the park for central London.

March leaving Clissold Park

In their campaign the women often referred to the history of the NHS; ‘the NHS was created to deliver free and equal healthcare for all irrespective of wealth and those principles are being easily dismantled – which is why the mums believe people should be prepared to fight for it’.

They produced a superb 9-minute film on the history and founding principles of the NHS, and what is happening now; ‘The People’s March Video’. http://999callfornhs.org.uk/videos/4585875143
Really recommend the film. Early on it describes the work of Nye Bevan, the Minister for Health and founder of the NHS in 1948; “He was a champion of social justice and the rights of working people. Despite fierce opposition from Winston Churchill, and doctors themselves, Nye fought fiercely for a fairer system of healthcare. He spoke passionately about a national health service for all, saying; ‘Despite our economic crisis we are still able to do the most civilised thing in the world; put the welfare of the sick in front of every other consideration'”.

One of the banners on the march took up the message with another quotation from Nye;
Nye Bevan

When we arrived in Trafalgar Square for the rally the organisers asked us to say ‘hello’ to the people of Tredegar, Nye Bevan’s birthplace, who had organised a sister rally to coincide with the march in London.

During the march a couple of people talked with me about their own OCD, a woman said she was moved by the placard, and others acknowledged it without words but glances of recognition and appreciation. Three young girls, aged between about 6 and 9, bounded up to me and asked me directly what the placard was about, especially the picture. I explained that this was me when I wasn’t very well, and this was an NHS worker who helped me. And now I’m better.

Thank you NHS.

NHS staff

Umbrella

This morning I was waiting at a bus stop in Bath in the rain.  It was gentle, refreshing and very wetting rain.  I was enjoying watching it while sheltering under my umbrella.  And I remembered a poem I wrote a few years ago now, when I was living in London and coming towards the end of my CBT.

Umbrella

Do you know what?
I could buy an umbrella …
my own umbrella …
luxurious.

Would be useful
living in London
lots of the year
it’s quite mild
don’t need
huge numbers of layers
especially in the underground.

But it does rain sometimes
and lots of umbrellas emerge
bobbing along
people walking briskly
looking very together
they don’t arrive at work
dripping

I’d like to be like them.

But before
an umbrella was impossible
cos it needed drying out
usually on the floor
and I couldn’t put things on the floor
very soon I would feel
it was contaminated
and I would have to
throw it away
not worth it.

But a year or so ago
well into therapy
no longer worried
about the floor
I thought
now’s the time
to buy an umbrella.

And I enjoyed it
feeling very swish.

But soon after
I folded it away wet
and left it for what
I thought was too long
before opening it up
to dry it out
no evidence but
thought it must be
riddled with
invisible
super-contaminating
mould spores.

No good
have to throw it away.

But now nearly end of therapy
really is time to try again
no excuses.

Would love to swish past
dry under my umbrella.

Going walking again

One of the things I used to love before my OCD started was walking in the country. I revelled in the trees, the ploughed fields, the morning and evening light, the views, the colours, the smells, the wind, the sounds, the rain.

Pic by Dave

Around the time this photo was taken I remember going camping in the Lake District for the first time and falling completely in love with the place.

However, as my OCD developed it became more and more difficult to go walking because of my contamination fears, not being able to use public loos, and the sheer exhaustion of having OCD. Over time going on holiday became much more stressful than staying at home.

Walk on the moors

Walking with group
on the moors
Peak District
favourite
favourite
type of landscape.

Trying as hard as I can
not to step
on any
sheep droppings

Beautiful view.

Tiny dark droppings
all over the place
other people
don’t give them
a second thought
they’re free
to enjoy.

Rolling hills.

I’ve stepped on some
too late
I’ve done it now
now watching my feet
like a hawk
long grasses
trampled underfoot
bounce back
and wave across my legs
so now
my trousers
are contaminated.

No-one knows
the contaminated zones
except me
constant mental noting
how far the contamination
has spread.

Will have to change clothes
and shower
when I get back.

Not enjoying
the walk
anymore.

In my forties I started cognitive behavioural therapy (CBT) for my OCD at a specialist NHS clinic. It proved completely life-changing.

While I was still having CBT I went to Grange-over-Sands for a work conference. I was aware that the Lake District was tantalisingly close. I longed to go. Longed, with my whole being. But my first thought was no, that’s too difficult at the moment. At that time I hadn’t been away walking, or owned a pair of walking boots, for decades.

However, the longing wouldn’t let me go. I decided that if I bought a pair of boots then, while I was still in Grange-over-Sands, it would be a first step, and one barrier less to me going walking in the future. There was a wonderful old-fashioned walking boot shop in the main street with a vast collection to choose from and a very kind and patient assistant. I got home to East London clutching my new walking boots and within a couple of months I was on my way back, this time to stay in the youth hostel near Windermere.

From then on nothing could stop me. I started going to the Lake District every few months. I decided I wanted to get to know the hills and valleys really slowly, savouring the process, staying at one hostel on each visit.

It’s impossible to adequately describe what I feel when I’m there. I walk and walk, absorbing the colours, the huge expanses of wildness, the sky, the wind, enjoying feeling incredibly small, and the feeling that any worries I’ve been dealing with in my everyday life are even smaller. Feeling deeply, deeply as if I belong there.

And I can’t stop taking photos! I decided to set up a photoblog to share them. It’s called Earth Hues; http://earthhues.wordpress.com

I hope the photos will be able to express something of my love for the place, and my joy and wonder and huge gratitude at being able to go walking again.

1.a. DSCF2286 - Langdale valley - contrasting light