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  • Writer's pictureRachel Chan

Out there....

Since I last wrote about my agoraphobia, I’ve been thinking to myself that I’m glad I wrote a blog post at the start of my CBT (cognitive behavioural therapy) journey, so that I can look back and see how much progress I’ve made, even though I still have a long way to go. After twenty sessions of CBT, I’m feeling quite different about it all, and am now able to leave the house independently in a limited number of situations. I can walk the dog (up to a certain distance), go for a walk by myself (up to a certain distance), drive a short distance to a friend’s house, and go into a small shop if my husband is waiting outside for me. I couldn’t have even contemplated any of that a year ago. In fact, I’ve been feeling so good, that a few months ago I started to let go of some of the self-care techniques I’d been cultivating. Big mistake.

Recently, I managed to go for a short walk with my friend. It was the first time I’d been out walking with anyone other than my dog and my husband in almost twelve months. It was a step I probably wasn’t ready for and given that I’d stopped some of my self-care techniques, was inadvisable. In the week that followed, I started to feel those familiar feelings of anxiety creeping in. The muscles in my neck and shoulders tightened so much that I had to take pain relief on a few occasions just to feel comfortable in bed. I lost my appetite and walking outside became difficult even when I was with my husband. I knew recovery wasn’t going to be easy, but I was devastated to feel like I hadn’t made any progress at all. I blamed myself. I shouldn’t have stopped my daily exercise/breathing techniques/relaxation etc. The truth however, is that even if I had continued to do those things, I probably would still have had bit of a relapse at some point and I probably will again. Progress is rarely straight forward. It’s easy to take the view in life that progress should always mean exponential improvement. The reality I’ve found, in mental health and also in any sort of recovery, is more of a snakes and ladders type of effect. Speaking to the psychiatrist about it, she drew two lines to illustrate the point. One line, which was straight, to represent the way we imagine recovery should be, and one wavy line with twists and turns showing how recovery really is.

It’s the way we treat ourselves (and others) when this happens that counts. Try compassion. My tendency when my mental health isn’t quite up to scratch is to be overly critical of myself and get lost in a spiral of self-loathing. After my CBT therapy sessions, I can now be kinder to myself, and thus aid my recovery. For example, a few weeks ago I had to drive to an appointment which was about twenty minutes away, by myself. In the days beforehand I employed all my usual techniques to help prepare myself mentally, and felt pretty good about it. On the day however, I wasn’t feeling particularly good. In fact, I was feeling very not good. I still made it to the appointment but just before I reached my destination, the fuel gage on my car showed up ‘low fuel’. I never usually let the fuel get so low, but in spending so much time preparing mentally, I’d let the practical side of things slip. My instinct would have been to force myself to get fuel in the town I was in, in an unfamiliar fuel station. A step I wasn’t yet ready to make alone. I weighed up the risks and the benefits and worked out I had enough fuel to get home after the appointment. I decided I would drive past my usual fuel station in the village and then decide if I wanted to stop there or go straight home and wait until later to get fuel, when I would hopefully feel better, and my husband could help. I decided in the end to stop at my usual station on the way home and managed to get fuel and go into the shop to pay for it, by myself, and with no problems. Self-compassion in action, resulting in a small victory.

Sometimes it’s hard to know what constitutes being kind to yourself and what constitutes avoidance (avoidance being effective fuel for agoraphobia). Through trial and error, this eventually becomes clearer for each individual, but it’s true that you can’t really know you’ve done too much until you’ve done it. There is a theory about chronic pain recovery which states that if we temper our activity on good days rather than doing too much catching up with everything we wanted to do on the days we weren’t able, we’ve a better chance of overall long-term improvement rather than keep setting ourselves back by overdoing it, and then having to recover before we can progress. I think the same works for mental health recovery.

So, there it is. I had a week where my progress not only stopped, but felt like it was going backwards, and I had to rest. The world didn’t stop and I didn’t spiral into another breakdown, or go back to the beginning. I had the luxury of being able to rest and I’m now ready to resume. It’s always difficult to get back into any kind of training after a setback, but it’s not impossible. My goals now are to increase my walking distances, introduce going outside with other people, and introduce going to shops by myself.

Let’s go.

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