My experience with Behavioural Activation Therapy

After writing about my previous experiences with Cognitive Behavioural Therapy, I surprisingly found it really difficult to find the words to talk about Behavioural Activation Therapy.

Behavioural Activation Therapy - My Experience

The Backstory

For a quick recap, at the start of 2018 I was diagnosed with depression and anxiety, and put on a group course of CBT. You can read my experiences with group CBT here if you want, or all my mental health-related posts can be found here! It was just after the group therapy that my doctor and I together came to the conclusion that we think what I actually have is Borderline Personality Disorder. However, somewhat unfortunately I’d already been recommended more treatment and put on the wait list for one-on-one CBT.

The One-On-One CBT

One finally offered a slot I could make, I went into one-on-one CBT with my therapist and I both under the impression that I needed more CBT, as that was what had been recommended. Throughout the course of five sessions this turned into Behavioural Activation, which is essentially a type of therapy that focuses on changing your behaviours to stop feeling so low.

My therapist Laura and I met once a week for about 40 minutes to basically talk about things including how I’d been feeling that week, what had triggered those feelings (be it good or bad), and where to go from there. If there were bad feelings we looked at the trigger and my reaction to see how I can tackle similar issues in the future and if I was putting myself in negative situations which I could avoid to stop the low moods. If I’d been feeling pretty ok, we looked at what it was that made me feel like that and if I can incorporate more of it.

We also set goals for me to try and achieve that we think would help improve my general wellbeing and mental health, which I can safely say I’ve utterly failed at maintaining.

My issues with therapy

My issue with the therapy sessions is at no point throughout the year I was in and out of therapy do I think the BPD theory was taken seriously. Even though agreed by my doctor, it was kind of pushed to the side and not really touched upon in my therapy sessions. Unfortunately this made me feel like they were kind of a waste of time even though I picked up some useful tips along the way.

After some traumatic events throughout the course of the therapy, when I had a good week I was pretty much instantly dismissed as being “not mentally unwell anymore” and pretty much discharged straight after that, even though since then I’ve been feeling more unstable despite the “mentally well” diagnosis. All in all, I feel thoroughly let down by the system.

What’s even more difficult is that I know I’m going to have to go back and go through the whole rigmarole of getting a referral and going on the waitlist again for a condition that my doctor doesn’t even seem to be taking seriously, which makes me question if a therapist is actually going to help again or just dismiss me as soon as I have a week where I’m not feeling passively suicidal. A lot of people I know who suffer with BPD feel the same that it’s not taken seriously by the system, so I can’t say I’m filled with hope.

The Positives

Even with all that in mind, there were some positives to come out of Behavioural Activation Therapy. I did learn some tips to help me cope with my crazy mood swings, as I mentioned earlier. I do feel like a lot of what was covered was bullshit (sorry Laura) as I think we should be covering a lot of WHY I feel the way that I do, whereas behavioural activation is more about tackling the feelings in the present to get them to go away without looking at the cause. However, I know I’m going to have to go back into therapy to actual deal with the causes of my problems. In the meantime the tips I did pick up have been helping, even if only briefly, but it’s something.

The Future

For now, I’m just going to have to accept that that’s the best I’ve got right now and just work on things myself. Until I get myself back into the system in the new year, I’m going to keep trying my hardest to deal with my issues and hope it works!

This post has largely been me moaning about being let down by the system, which I didn’t want to do. I’m HUGELY appreciative of the NHS and all the services they offer. Only in this instance, it seems neither myself or my doctor were listened to properly so I’ve wasted my own time and the NHS’ time in therapy which was never going to properly work from me for the start. I can only take the positives away and hope for the best for 2019.

Photo credit: Red Lens Photographic

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