You know in a sense, I do. I know it seems 'daft' but there we go. It all boils down to this notion - not mine - that in order to improve someone's quality of life it is important to at least challenge these things that could be holding them back. Like an examination of fears - are they realistic? are they not? That kind of thing.
Mum has for example osteoarthritis and is often screaming in pain and has very bad nights. When she went to see her therapist for work including CBT - this was also something they talked about. Of course when Mum returned I recall her saying pretty much the same as me "Huh! She doesn't know what's she talking about. Stupid woman!"
And then there's CBT with MS. I'd like to read a similar manual or study used for them, perhaps, or any other condition such as cancer - yes. Of course ME is still unfortunately attracting this "medically unexplained" moniker but I still feel that if the model was in any way 'good' it would have produced better results than it did.
Thing is - what's the alternative or what improvements could be made? Seems to me than improvements are made on the ground and in the clinical delivery - when all of this is personalised and made more relevant and realistic. But that's only based on my experience. I know others (friends) whose experience has been bad.
Seriously though, and whilst I would not have written the CBT manual using the words that they did - I think that at least in part we all visit and think about those 7 points anyway (page 68-9 I recall). "Am I staying at home because I fear going outside and hurting myself? And if so - to what extent is this reasonable?" You know? That sort of thing.
The Perfectionism thing - well when I read the Manual it did make me laugh. But then when I do do things am I trying to do too much and to do things perfectly? Again is this something that is reasonable - e.g. aiming to do my best and getting wound up about not being able to achieve that anymore or is it something that might be preventing me from doing anything. Am I thinking - "Well, there's no point me even trying that because I'll mess it up!"
It's hard to explain I suppose unless you've been in therapy that involves CBT. But even without any physical diagnosis the same methods I think are used. My last therapy that involved (I was assured) CBT lasted for 13 weeks - so 13 sessions - but I was really screwed up following yet another relapse and a saving by my family from my flat and return to the family home.
I was a mess. Were there things that I wasn't even attempting that might have improved my quality of life? Yes there was. Is this the same for everybody - No I don't believe it is. Sometimes I would get so worried about things that all I can see is the worry - especially matters relating to my future - and that worry is in itself paralysing.
I don't know, Wildcat, I tend to view all of this as a necessary thing to endure. Examining one's approach to living with a disability is bloody hard don't get me wrong - I mean 13 weeks for heaven's sake. And then they asked me to help trial a new NHS "CBT and Mindfulness" course in group.
That was actually quite interesting and again there was no sale of it being a cure or that our physical (and some mental) health problems were not 'real'. In fact - and I haven't just pulled this from my arse - one of the chaps who was in group with me had been in the Manchester plane crash and was one of the few who walked away (well in part).
A month after the sessions ended we were all still in touch - and he'd been back in a plane for the first time since that crash. Others there were dealing with pain - cancer and other problems. Basically, we'd all had everything medicine could really do for us and so Mindfulness and CBT was being tried. It helped. Would have helped me more had I not already studied the techniques previously I think, but it was good to see how the same stuff I wasn't dealing with, they weren't dealing with very well either.
Different diagnoses same kind of issues holding us back from a better quality of life. See what I mean? But that's not this manual is it. And yes it makes for harsh reading. I do wonder if this model had been compared to a model that fully recognised a person's physical illness and then went on to look at how they dealt with it - might not have produced better results under Trial conditions?
It's been a while since I read that manual though - so it could be that this positive reinforcement was part of it. Can you let me know? Am rather bushed tonight. Thanks
n.b. The 'perfectionist' in me suggests that I should also perhaps read the participants manual that accompanied the PACE Trial. Maybe contained in there there is more enlightenment or indeed more damning evidence. I haven't ever read it. Just wondered.
