When it was announced last week that Dr Aaron Beck, the eminent American psychiatrist, had died at the age of 100, my first thought was: ‘I’d so like to attend his funeral and pay my respects.’
He was not someone I knew, but the feeling came from gratitude. Thank you, Gratitude. He was known as the Father of Cognitive Behavioural Therapy (CBT). This therapy saved me from certain death when it seemed impossible to save myself. And when, essentially, I believed I wasn’t worth saving.
If this all sounds rather melodramatic, that’s because one of the effects of deep and lasting depression, alongside debilitating anxiety, is a downward spiral of negative and distorted thinking that robs you of the ability even to begin recovery.
Although pills might work, they are not the only option. It can take years to complete psychotherapy and it can be expensive.
Linda Kelsey (pictured), explains how CBT has helped her to regain control over her life following a breakup
While traditional talking therapy assumes you’re a victim of concealed, unconscious forces over which you have little or no control, CBT puts you firmly in the driving seat. You are encouraged to examine your negative thoughts and reflect on how they affect you.
The first step towards recovery is a shift in your self-evaluation. It’s no miracle cure, but if it works for you, then things can improve quickly. And as time goes by, you can use the techniques you’ve learned when you feel the black cloud descending or the panic rising.
For that, I — and the millions of others who have benefited from CBT — have to thank Dr Beck, who first developed his groundbreaking theories in the 1960s.
A breakdown occurred twenty-five years ago. It lasted for two years, and had knock-on consequences that continued on for many years. The breakdown came upon me at 44. My situation was not ideal in many aspects.
She magazine was a magazine for mothers who had to balance work and their families. Thomas, my adorable eight year old son, was my partner.
It is possible to appear deceitful. Even though I was in a highly visible job that required me to be able manage people and make editorial decisions and handle the daily business of staff management, it made the mundane stuff like making speeches and doing radio and TV interviews, frightening.
My impression was one of unfriendliness and insolence. Some found me intimidating. I am shy and socially awkward.
I also had a classic case of Imposter Syndrome, certain I’d be found out and found wanting at any minute. After all, I’d dropped out of university — was I even bright enough for the positions I’d been promoted into?
Linda claimed that sales began to decline and that her job as a partner was at risk. Linda, a prominent magazine editor during the 1980s
On Sundays, as I watched the clock tick down towards another week of work, I’d get a gnawing feeling in my stomach. For a while, I just about felt I had everything under control — but that all changed when my son was born. A raft of health problems, all of which he thankfully recovered from, kept me — and in those first few years, him too — awake at night. After getting out of my sleeping habits, it was impossible to get it back.
It was more challenging. Over five years, starting in 1990, I’d helped She’s circulation soar, but now sales were slightly dipping and the boss was on my back. All I need to do is sleep, catch my breathe.
Then my partner’s job appeared at risk. Get on with it, I’d tell myself: you are so lucky to do a job you love, lead a privileged lifestyle and be a mother to a gorgeous boy. It’s time to stop acting like a wimp, and start building your strength.
One lunchtime, I was in M&S buying supplies for supper when, quite suddenly, I felt the world spinning, my breath coming in gasps and a sense that I was about to collapse — or die. I ran to the end of the shop and dropped my wire basket. I don’t remember how I made it back to the office, but somehow I got there. My desk was covered in a small plastic water bottle and I contemplated whether or not I was seriously ill.
The therapy that put you in control YouIn control
American psychiatrist, Dr Aaron Beck, developed Cognitive Behavioural Therapy during his time at Pennsylvania University in 1960s.
Aaron Beck, (pictured), developed Cognitive Behavioural Therapy at Pennsylvania University during the 1960s.
Since then, more than 2,000 studies have verified its efficacy and it is now a mainstay of NHS mental health treatment with celebrity fans including singers Ellie Goulding and Cheryl, who praised it for ‘actively undoing all the bad thought patterns and traps I used to fall into’.
CBT, a type of talking therapy, aims at helping you to change your thoughts to become more constructive. The idea behind CBT is that thoughts, emotions, and actions all interact. You can alter the way that you think and feel by changing your thought patterns.
This is a predominately used for anxiety or depression. However, it can also be used to treat other mental and physical issues such as anorexia and irritable bowel disorder, panic attacks and obsessive-compulsive disorder (OCD), performance anxiety, insomnia, and anxiety.
Some common CBT techniques include exposure therapy where you face and accept what is causing anxiety and journaling. You can also wear an elastic bracelet on your wrist to challenge your negative thoughts. You can change a negative thought by pinging the elastic band each time.
You should see a CBT therapist at least five times a week, or every other day for 30-60 minutes.
Today celebrities and more people are being open with their mental health. According to figures from NHS England, reported in January 2020, one in six people were experiencing ‘a common mental disorder’ such as anxiety or depression in any given week. The problem was not exacerbated by the recent pandemic.
However, panic attacks were not something that was talked about much back in the middle of the 1990s. I had no idea what was happening to me in M&S. The worst part? I’d jerk awake several times a night, my heart pounding as though about to jump out of my chest.
As I sat in the middle row at a film premier with star-studded actors, it was my first time. As the panic struck, I had to jump up from my seat, work my way in front of everyone’s knees to the aisle and dash for air. The people laughed and tutted.
My GP prescribed beta-blockers which caused me to feel weak and dizzy. His suggestion of anti-depressants was rejected by me. I refused to believe he had depression. My mother had been depressed; my grandmother had been depressed and had committed suicide in her early 60s — but what had that got to do with me? My mother was depressed; my grandmother had been depressed and committed suicide in her early 60s. But what did that have to do with me? Genetics certainly plays a large part.
To be sure, my heart was checked. It wasn’t. It wasn’t. I tried acupuncture and hypnotherapy. But neither of them was very useful.
In the following nine months things fell apart and eventually I couldn’t carry on. My boss recommended that I take a longer leave and have someone else replace me as editor.
Following advice from my GP I went to the Nightingale Hospital in central London, a private psychiatric hospital.
The experience was strange and otherworldly. Two doors down from my room, a nurse was stationed round the clock outside one patient’s bedroom — a deeply troubled young man on suicide watch. A beautiful, young Asian girl wore designer clothes, full makeup, and was always in the room opposite me. However, her condition was not only severe, as she had suffered sexual abuse from relatives since childhood.
Then there was the problem of patients suffering from eating disorders, drug addiction and compulsions like jumping off bridges. Then I thought, “What the heck am I doing here?”
Slowly I accepted that this was what I needed to get away from my daily responsibilities. I did yoga, group therapy, and one-on-1 sessions with my consultant. Even the occasional outing to dinner was possible.
Christian, my partner in crime, was juggling work with caring for Thomas. We visited frequently, but I didn’t feel up to visiting other people.
I felt a total failure — useless as an editor, useless as a mother, and useless as a partner. Valium and sleeping pills, as well as the first antidepressant I took, kept me in hospital for many weeks. Frankly, by the end, I wasn’t a great deal better.
It was nearly as terrifying as coming out. I got myself a psychotherapist — CBT was not yet on my radar — and spent the sessions either crying or pointing out to the woman therapist that we both favoured similar black suede boots. I raked over my rather happy childhood but couldn’t trace my woes back to any neglect and abuse. I had a few blips. But nothing terrible.
The antidepressants caused so many side-effects — hallucinations, nausea and profound lassitude — that I felt I was not improving but getting worse.
Linda (pictured) received CBT sessions from Linda after she was introduced to it by a friend of a lawyer who experienced sessions when she suffered depressive episodes due overwork.
Although the Nightingale consultant psychiatrist suggested electroconvulsive treatment (ECT), I was skeptical that it would make me more zombie-like. I refused.
Then a lawyer friend, who’d been having a depressive episode triggered by overwork, told me about the CBT he was doing. ‘It involves lots of homework,’ he told me, ‘but I’m a bit of a nerd like that and it suits me.’
After twelve sessions, he had become a completely new person. I talked to my psychiatrist about it and he recommended that we have some sessions.
CBT is a therapy that focuses on the moment, which contrasts with many others. Dr Beck’s idea centres on distorted thinking. People who are depressed believe they have more to lose than their reality. People who are anxious believe that situations are more dangerous than they are.
You can learn to overcome these negative automatic thoughts and be more effective in dealing with any difficulties that life may throw at you. This is how you can make sense out of complex problems and break them down into manageable pieces. You do it in a methodical and structured way.
Linda (pictured) stated that the purpose of CBT was to make it easier for you to understand overwhelming problems and break them down into manageable parts.
It was difficult at first. I recall being asked by the clinical psychologist to separate a thought I had, that I’d become ‘a useless mother’ as a result of falling ill, from how I felt about it.
‘Useless, of course,’ I repeated, tight-lipped and dismissive. But then I paused and found myself saying ‘I feel ashamed’. I burst into tears.
After I had made myself whole, I was asked to provide evidence in support of my claim about being a useless mom.
In addition to naming what I couldn’t do right now — run around with my son, laugh and joke with him or even help him with homework — I found myself reluctantly listing what I could do: pick him up from school because I was on sick leave, curl up with him in front of the TV, give extra cuddles. Although it may be obvious to some, this isn’t the case when you are feeling depressed.
When it came to panic attacks, switching off that ‘I’m going to die’ thought — I’d had enough attacks to know they wouldn’t kill me by now — helped me to deal with them. My black-and-white thinking started to change over the following months into more useful shades of gray.
Linda (pictured) made the decision to lead a lower-powered life as a writer after her breakdown and began taking on challenges she never found time for before
After months of waiting, I finally decided to take the Tube. While I did experience some panic attacks and dizziness, I made it through two stops without getting off the Tube and walked home. I knew that CBT was working for me.
CBT is now the NHS’s preferred therapy. Cynics will say that’s because, being shorter in duration than on-going psychotherapy, it costs less money. But it’s also because there is plenty of evidence it works, and it can also be used to treat a range of disorders in addition to anxiety and depression, including eating disorders and OCD (obsessive compulsive disorder).
After my breakdown, I made the decision to lead a lower-powered life as a writer, and take on challenges — such as returning to learning — which I’d never have found time for before.
Are you 69 and feeling depressed now? Yes. Are you anxious? Often. But I’ve been practising challenging my negative thoughts for so long now that I can often nip them in the bud.
CBT has allowed me to regain control of my own life. It has enabled me to release myself from the tyranny of the ‘shoulds’ and negativity that dominated my thinking. I can manage my feelings far better than I used to — and for that I have Dr Beck to thank.