The CBT Session That Wasn’t.

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I was meant to start CBT today. We didn’t, though.

I am really impressed by A. She is thoughtful and insightful and she gives me a lot of courage. I was in tears when I arrived, G’s news is all a bit too much really, and she let me offload for a few minutes which was sweet.

During the week we spoke by email about boundaries. She has written a list of boundaries she feels will keep me contained within our sessions. They were very good, but they weren’t clear enough – for example, she’d written that “I requested..” she tell me when she speaks to T – it isn’t a request at all, it’s an absolute. Talking behind my back is never going to end well, so it’s not a request at all. Other than that, though, I was really impressed. Today she brought the list and pretty much feels that I am so anxious and trying to control everything I possibly can, including A’s boundaries, and obviously my food. So instead of starting CBT today, we looked at whether I was ready for CBT at all.

I was pretty impressed that she had decided I was ‘terrified’ rather than ‘difficult’. To read the emotion rather than the behaviour is something that rarely happens around me.

We talked about my fear of starting and what underpins it. Mostly I am terrified of undoing the really hard work I have already put into place. If we stick to the 20 sessions, which is a clear boundary, what happens if I can’t cope with the ending in the time, we rush it and then it’s painful? Will it ruin all the work T2 and I did? That is all I have left of T2 – our lovely ending – if A’s boundaries mess up our ending, will I lose T2 too? It’s all I have left of her, I don’t want to forget it. Likewise, I cannot cope with my attachment issues getting any worse, I’m horrendously sore with them as it is, and I really like A – what if she puts me back to square one? This would NEVER be intentional, never, but the boundaries of CBT might damage it…… And so on and so forth.

I am so worried that I convince myself almost hourly that CBT isn’t right for me. But then I think of my feelings around my body, my fear of food, my restriction, all the times I’m bent double throwing up blood from wrenching… and I know there isn’t a plan B. There is no ‘let’s try this’. This is it. If this doesn’t work, I guess I go privately, but then I couldn’t see T as I am barely affording her as it is. I am trapped; this is my only plan.

A clearly heard this, and so we made two brief plans. The first is that she would like a meeting with T, me and her all in the same place. This makes my kneecaps shiver with fear, but I can see her point. I can’t cope with the meeting, but then, I can see the benefits of a more open and honest approach. Them talking on the phone doesn’t involve me, and our sessions don’t involve whoever I’m not currently with. A is suggesting that this will help me feel more secure in who is looking after what, when and where – which I can see would be super helpful.

The next part of the plan is to start CBT on Thursday this week, but to be looking at the planning, tracking and evaluating of my food only. This should take approximately 7 sessions. At the end of 7 sessions, I should be eating regularly and into the process of tracking again. A is suggesting we review at that point, and then potentially that could be where we finish – we won’t go on to the more painful look at shape and size, or the underlying issues, if I’m not ok to. We could just end there with me eating regularly, and maybe T and I could then, at my own pace, deal with the reasons why. If I am doing ok by then, however, we could keep going, with regular reviews. This possible stepped approach feels a little more containing and supportive than looking at 20 weeks in one go.

So I need to speak to T tomorrow, see whether she’ll meet with A at all, then I suppose the logistics of it. Then I need to try not to melt down at the idea of them sat in a room together… and then I need to get my mind in gear to start eating on Thursday. I lost nearly 1kg this week, despite feeling like I’d doubled in size. Even I couldn’t avoid today how screwed up my sense of my body is.

A said something really interesting to me at the end of our session. She said that I am incredibly self aware and full of resources to keep myself safe; but she senses that right now, I am lacking the strong adult part of me to take control of my (or our…) needs and use those resources to support and care for us. She is so right. I can talk the talk, but I don’t trust my adult part at all, to make the right choices. Which is what T has been saying all along. They’re both on the same wavelength, and that makes me feel safe.

So why am I still so scared.

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