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It has been about 3 months since my previous post about my experiences with Cognitive Behavioural Therapy for Psychosis often abbreviated to CBT-p. CBT-p is a collection of psychological techniques and practices that have been proven to be effective for helping people with psychotic mental health problems such as schizophrenia and bipolar disorder.
I have now had 8 sessions since late February this year (2022). After my 6th session I had to go back to my general practitioner to get my mental health plan updated so that I would continue to receive Medicare rebates.
My partner came with me to the doctors and when the doctor asked me how it was all going I just said “Ask her. She has to live with it as much as I do”. My partner told the doctor that there had been significant improvements but then went on to say how some “homework” that the psychologist had given me to share with her had made a big difference to the way she looked at and responded to situations. The idea was pretty simple. Instead of taking the attitude that this was just my problem, it was suggested that we look at schizophrenia as a shared problem to work on together. This has resulted in a significant reduction in problem interactions between us that have on occasions triggered psychotic episodes.
I am lucky that my partner was willing to take on some of the responsibility of this work.
The doctor then gave me the same mental health test that she had given me before I started the CBT-p sessions. She reported that the latest tests showed a significant improvement.
Then the doctor asked me about my anti-psychotic medication. Her eyes nearly popped out of her head in surprise when I told her I hadn’t taken any for some months and that the psychologist had told me quite early in our sessions that she hoped to get me entirely off medication for good. My doctor seemed pleased but also somewhat amazed at these results in less than 6 months.
CBT-p is not talk therapy. It is work therapy and it will only work if a person is sufficiently motivated to put in a significant amount of effort. A good psychologist can see the problem and point the way but the client has to do the work.
One exercise that seemed to work well for me is called the Passengers on the Bus metaphor. It helped me to understand how thoughts, feelings and in my case voice hallucinations prevent me from living a full and worthwhile life. Furthermore this metaphor shows how to go about changing the situation.
Here is a YouTube link to a five minute animation that my psychologist showed me.
And here is the worksheet I am using to identify the characters on my own life bus.
The first few characters were obvious and easy enough to identify but what I am finding is that it becomes increasingly harder and requires more effort to investigate and identify the deeply buried characters who often create the biggest problems.
When I first saw this video in the psychologists consulting room I ‘got it’ straight away. Then I went home and showed it to my partner and a few days later to a young relative who has recently been diagnosed with a psychotic illness. Both just shrugged their shoulders and said it meant nothing to them. Perhaps it is a matter of being introduced to the right exercise at the right time.
The biggest problem that I can see with CBT-p and similar psychological therapies is that they are not available under the public health system in Australia. There also seem to be very few experienced and qualified private practitioners around and even if you find one they tend to be fairly expensive, even after the Medicare rebate.
The situation is a lot better in the UK and numerous European countries. Australia seems to be very backward when it comes to helping people with mental health problems.
Many concerned people are trying to do something about this but it is a tough job.
The most common way of treating mental illness in Australia is known as the biomedical approach which claims that mental illness is the result of unbalanced brain chemistry which is best fixed with psychiatric drugs. The people who support this approach seem to have done a very effective job of convincing governments, medical professionals and even many people who suffer from mental health problems that this is the best and in many cases the only viable way of dealing with mental illness, particularly serious mental illness.
As my own experience has so far shown, this simply is not true.
Here is a link to the first article in this series
Finally Found A CBT-p Practitioner
Here is a link to the previous article in this series
Finally Found A CBT-p Practitioner Part 3
Regards
Willy
This is a video I helped to create based on the Acceptance & Commitment Therapy metaphor: Passengers on the Buss. It sets out how you can relate differently to unwanted or difficult thoughts, feelings and emotions so that they are less impactful and you can continue with your chosen life ...
