CBT - did it work for you?

[schnitzelvoncrum25]

I have anxiety surrounding a certain thing. I won't go into too much detail but basically I have a physical stress response that kicks in when I get anxious. It's gotten worse over the past ten years and now whenever I go anywhere I have obsessive thoughts about it happening which obviously then makes it worse.

To be honest it'll probably make more sense if I just explain the issue - it makes me need the toilet. I understand why. The fight or flight response makes you need to use the toilet so that you are lighter in the face of perceived danger and able to run away quicker. I do also have some mild IBS but I would guess that it's driven 80% by anxiety and stress and 20% by the actual physical nature of IBS.

So basically I obsess over toilets wherever I go. I can't go anywhere without thinking about it. I calculate how much time I have on the school run before I can get back to somewhere where a toilet is. I check motorway routes for services and count down the miles if I go anywhere (which I rarely bother with these days because it's too much stress). I see people camping and walking in the woods and think how are they doing that when there's no toilet nearby? It literally is there in my brain anytime I'm not at home or in a safe place.

I think I need CBT to completely change the way my brain currently works and processes these thoughts. I've tried it before on the NHS on two occasions and neither time it worked for me. I'm wondering at this point if I am actually 'curable' or if this is just how I am now.

It really is affecting my life. I actively avoid places where there are no toilets and when I do go places I am constantly thinking about where they are. I have been in so many panic stricken moments where I genuinely have had to dash to the loo that it's almost programmed in me now.

Has anyone used CBT to conquer this sort of thing? I've also tried anxiety medication but I find that really dulls the issue rather than solving it. I just don't want to think or be this way any more.

DH had CBT for anxiety a few years ago. His issue was that he has physical symptoms (breathlessness and excess sweating) in certain situations, which he found embarrassing, and so he became anxious about getting anxious. 12 sessions of NHS CBT (in person) worked wonders.

As others have said you need to really engage with it and believe it can work.

I did NHS online CBT for health anxiety-it didn’t help me at all and made no difference. I would try it again but this time would pay to see someone in person.

This is exactly it. You need to commit to it in order for it to work

CBT did work for me for many years - to a point. I was able to get a uni degree, hold down a job, drive etc.. but every day was still a challenge. I still stayed in a high state of anxiety but was ‘challenging’ myself all the time to stay at work and not leave, to take the quickest route home over the bridge in my car rather than avoid etc.. I wouldn’t let myself avoid anything. I did it for many many years . Then I developed a chronic illness. I do think all the stress of getting through each day and refusing to let myself avoid anything had something to do with getting ill.

I don’t practice it anymore. I was one of the people for whom CBT is problematic. When I first learned CBT, (under the tutelage/treatment of Gavin Andrews - a psychiatrist who was heavily involved in designing CBT courses and was the recipient of the highest official accolades for his CBT work in treatment of Snxiety Didorders - and his offsiders), I was told that if you followed the course it would absolutely work. It was in the early days of CBT becoming more common really. I was told if it didn’t work it was because I didn’t do it ‘right.’ They don’t say that anymore, apparently. They know it does not work for everyone..now.

I do wonder about the studies on CBT success rates. On paper, I’d look like I was a success at it. But I’m reality I was pushing myself.

I don’t completely regret it. But if I could go back in time I’d try and find a better way for myself and not be so influenced by the opinions (and sometimes dogma) of others. Nothing to lose in giving it a go, I’d say. Maybe it will be right for you. But don’t beat yourself up if, after learning how to do it, and applying it for a while, you find it’s not helpful. Anxiety is caused by many things. Not just ‘all in your head.’

BTW, I knew where every toilet was. And when I travelled overseas I came back jokingly saying that I had toured the great toilets of the world.

In the end really, if you piss or shit yourself it’s not the end of the world. It’s a very human thing to do. You may not know that some years ago, at a formal state dinner, a president of the United States vomited into the lap of the then Japanese Prime Minister? I mean, he survived. People are sometimes hostages to their bodies. I used to remind myself of the vomiting incident when I was racing for the loo.

Thank you for the replies it's given me a lot to think about. In regards to the CBT I had before, I did try to engage and knew I had to put effort in to see results. It just seemed a bit simplistic to me. They tried to make me understand the fear/anxiety cycle which I already knew and the link between my symptoms and emotional responses which again I already knew. I got on board with the exposure therapy but to be honest I have no choice but to expose myself daily otherwise I wouldn't be able to work or look after my kids. What I want is for my thoughts and physical actions to change. I can still live my life like this but nothing is very enjoyable. Things like days out or holidays which should be fun are major triggers and traumas for me.

It was absolutely brilliant for me changing my thoughts. Once I got my head around the fact that I was in charge of my thoughts I knew it was going to work.

I have delivered CBT via the NHS IAPT system. For 'entry level' (all providers have a 'scoring system') patients suffering either Depression or General Anxiety Disorder a 13 session course of CBT has the same efficacy as 'watchful waiting' ie it works for some & not for others. IME rhat is rarely linked to how much effort the patient puts in. By the time you've reached the top of the waiting list the patient is usually pretty motivated!
I did work with a number of younger people who had difficulties around toilets & Anxiety (High school often places restrictions on access plus bullying abounds in secondary school loos so problems are not unusual). Despite following CBT principles to the letter, I had mixed success. It may be worth trying EMDR if you can access it.
Good luck, it's a real problem for many.

Can I just add that if you go for EMDR I would advise face to face. I have also had EMDR but it’s was during Covid times so via zoom and sadly I didn’t find it effective delivered that way even though the practitioner was lovely. Maybe it’s just be though and no therapy works for me, I’ve tried so many and still in the same position!

I had CBT for anxiety- can't recommend it highly enough- you've got nothing to lose, go for it!