Let's Talk About CBT

Dr Lucy Maddox
Let's Talk About CBT

Let's Talk About CBT is a podcast about cognitive behavioural therapy: what it is, what it's not and how it can be useful. Listen to experts in the field and people who have experienced CBT for themselves.  A mix of interviews, myth-busting and CBT jargon explained, this accessible podcast is brought to you by the British Association of Behavioural and Cognitive Psychotherapies. www.babcp.com

  1. Let’s talk about…. mental fitness in sports

    APR 14

    Let’s talk about…. mental fitness in sports

    In this episode of Let’s Talk About CBT, Helen Macdonald speaks with Phil Cooper, mental health nurse and co-founder of the charity State of Mind Sport, and Ian Knott, former professional rugby league player and State of Mind presenter. Phil shares how State of Mind was born out of tragedy and developed into an award-winning mental fitness programme, now reaching thousands of athletes across the UK and beyond. Ian talks candidly about his experience of severe injury, depression, and suicidal thoughts after retiring from sport, and how CBT helped him to rebuild his life. We hear how sports settings are being used to break down stigma, encourage conversations, and promote mental health support—particularly among men—and how brief interactions and powerful personal stories can save lives. Resources & Links: State of Mind Sport website Information on CBT and how to find a therapist If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at podcasts@babcp.com Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen MacDonald, your host. I'm the senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies Today what we've got for you is an episode about mental health, mental fitness and sports, and I've got Phil and Ian here to talk to me today. Phil, will you just introduce yourself? Phil: My name's Phil Cooper. I’m a mental health nurse by background. I used to work as a nurse consultant in mental health and drug and alcohol misuse. I love sport. And, for some strange reason or quirk of random chaos, I became to be one of the co-founders of State of Mind Sport charity that focuses on mental fitness. Helen: Thank you, Phil. Ian, please, will you introduce yourself? Ian: My name's Ian Knott. I'm a former rugby league professional and I currently am a presenter for State of Mind. I talk about my story, my lived experience of having to retire through a serious injury and then developing mental illness. So I talk about that. Helen: Thanks very much, Ian, and I'm sure our listeners will want to hear more about that later in this episode. Firstly though, can I ask Phil to tell us a bit more? Phil, will you tell us about State of Mind and how it came to be and what it does? Phil: Sure State of Mind Sport began unfortunately on the back of a tragedy within the sport of rugby league, where a Great Britain Rugby League international called Terry Newton, unfortunately took his own life in September, 2010. Sent great shock waves, I think, through the whole sport for such a high profile player. At the time there was relatively little support or mental health support for players at that time. I suppose as a mental health nurse who loves rugby league and sport, I read a league paper on a Monday morning, somebody wrote an article saying how the NHS and the sport should get together to try and prevent suicide. Also, somebody also wrote a letter, again a mental health professional, called Malcolm Rae and Ernie Benbow had written the article and I saw this and thinking, wow, this is Monday morning, I shall write these two individuals- checked with my chief exec, of course, because obviously you have to be doing all these things- and then invited them to a meeting we were going to have in good old health style a conference, that soon changed when we invited a couple of players such as Ian, and they suggested, why didn't we ask the governing body for a round of fixtures to promote mental health at that time or mental fitness. I then found myself in the strange position being ferried to Hull Kingston Rovers Ground to be presented before all the chief execs of all the top divisions with clubs to say, this is a really good idea. It's free. So the sport love that bit and, we’ll deliver a session to your players before the season and then a round of fixtures themed around that. So we had a State of Mind round in 2011 and player bought into it. There was very little support, as I said, and they began to talk about it on social media. They wore t-shirts in the warmup before the round of fixtures, but crucially, they knew what it was about, and they were all bought in. Things have grown massively since that time, which has been great for us. And also promoting mental fitness in rugby league, one of the toughest sports on the planet. Helen: Thank you Phil. So can you tell us a little bit more about what you really mean by mental fitness? Phil: Certainly, okay. I think language is crucial, as I'm sure all your members will realise and will think about on a regular basis. So for me, to get into a situation of encouraging men or engaging men into something that will help them, if I say, if I used to say, well, we'll come in and deliver a mental health session for you into a local grassroots sports club. I can imagine the reaction would be flipping heck, I'm not going into that. However, when you can make the case that actually you are going to go to training for physical fitness, what a lot of athletes will tell you that the mental fitness is perhaps the most important aspect of being a professional sports person or being the best sports person you can be. So therefore, if we go in and say, well, we're going to try and improve your mental fitness, men tend to sort of buy into that, especially if you go to them in their grassroots club, they wouldn't come to me in a community mental health team, but they would certainly go training two nights a week in their local club. And you have a captive audience potentially, especially when the weather's bad and they can't train on the pitch. And the coaches will want something different to either entertain or, keep the players focused on what they want to achieve. So State of Mind deliver mental fitness sessions so we look at anxiety and depression using a GAD-7 and a PHQ-9, as I'm sure your members will be very familiar with and again, we deliver that in a style that's not sat down in front of somebody asking them to fill in a questionnaire with a pen or online or whatever. So we'll do that. We will have two presenters usually. So Ian being one of those, I might have been the clinical dude once or twice with Ian, of course, and I'll ask him about how he's been feeling over the last few weeks using a PHQ-9 or a GAD-7. He'll tell me some strange answers, which he never used to tell me what they were going to be, I would then ask the audience how anxious or how low in mood Ian was based on those answers. So you keep all the information away from your audience, but you involve them to use all the different learning styles, so audio visual, kinaesthetic, all of those learning styles to get to as many of those people as possible. So we've been doing that for 10 years. Hundreds of thousands of people have attended sessions, which is ridiculous when I think back, but also numerous people have told us that they changed their mind about taking their own life and that's the sort of thing that keeps you going every week. And going to wherever we're going of a Tuesday or a Thursday evening, or even as I found myself in a dressing room last Saturday, so before a football match, just talking to players. So all of those things, we do mental health first aid. You can look on stateofmindsport.org if you really want to know. I don't want to want too much about that, but that's what we do. And we go to people where they are. We try to engage people where they are. Helen: And I'm hearing you are reaching a huge number of people, probably people who wouldn't easily go and look for help, like perhaps men in maybe more traditional settings where we don't talk about mental health or mental fitness as you put it. That's really important. But also this work is saving lives and that seems to me as a really important piece of work that's happening here. And I wonder if I can ask Ian to come in now. And Ian, you said, about your lived experience and that's what's brought you into working with State of Mind Sport. Can you talk a bit about your experiences? Ian: So my kind of story started in 2004 while playing for Leigh Centurions. At the time I probably had about 12 years I think at professional rugby. I played at the highest-level barring international level, and after 12 years of playing at the highest level, I dropped down division to play for Leigh Centurions And at the time, Leigh were making a massive push to get into Super League. I never played in Super League before, and halfway through the season, I can remember we played against Halifax away from home, and I ran with the ball, and I got tackled and there was nothing wrong with this tackle at all, but I felt these god awful pains in my lower back and it felt like my leg was, I don't know, it's like tingling and my foot was in like a bucket of water or something like that. So it felt, which was strange because we are really hot summers day. So obviously I came off reluctantly, because we are a bit stupid, old rugby players, we do play with injuries. But I did come off, and then a couple of days later the pain got worse, so I got sent for a scan. And I got told in no certain terms had a very large disc prolapse at the bottom of my back. So they said you can't play, you need to obviously get treatment and then you'll be okay for the next season. So I went back and had a meeting with the club, and we all came to the sensible co

    44 min

  2. APR 7

    Let’s Talk about CBT: A solid return on investment

    In this special episode celebrating World CBT Day 2025, we explore this year’s theme: CBT: A Solid Return on Investment. Host Helen Macdonald, Senior Clinical Advisor at BABCP, is joined by a range of voices reflecting on the impact, value, and future of CBT. We hear from: Dr. Adrian Whittington, National Clinical Lead for Psychological Professions at NHS England, about the rollout and outcomes of NHS Talking Therapies. Dr. Stirling Moorey, BABCP President, on the historical development of CBT and its increasing relevance and recognition over the decades. Nic, a former CBT client, who shares how therapy helped him manage anxiety linked to a long-term health condition. Dr. Saiqa Naz, past president of BABCP, who discusses her personal journey into CBT and her commitment to inclusion, diversity, and working with underrepresented communities This episode offers a rich blend of lived experience, clinical insight, and future vision, showing how CBT continues to be a wise investment for individuals, services, and society as a whole. Further information and links: Visit BABCP to learn more about CBT Find support via NHS Talking Therapies Discover more about World CBT Day Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at podcasts@babcp.com Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't.  I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies. Welcome to this special episode of Let's Talk about CBT celebrating World CBT Day. World. CBT Day takes place every year on the 7th of April, and this year's theme is CBT: A Solid Return on Investment.  In this episode, we're exploring just what that means- I will be speaking with Adrian Whittington, who's the National Clinical Lead for Psychological Professions at NHS England and with Stirling Moorey, who's our current BABCP President about how CBT has developed over time and the importance of continued investment in it. We'll also hear a personal story from Nic, who is a former client of Stirling's, who shares how CBT helped him manage anxiety and improve his quality of life.  Finally, I sit down with Saiqa Naz who is past president of BABCP to talk about her journey into CBT from starting out in the Improving Access to Psychological Therapies services, to completing a clinical psychology doctorate, and how she embodies the idea of CBT being a real return on investment. We hope you enjoy this episode and the range of voices reflecting on the impact and value of CBT.  Let's get started! Here's my conversation with Adrian and Stirling…. Adrian, would you introduce yourself please? Adrian: Yes. Hi. I am Adrian Whittington. I'm National Clinical Lead for Psychological Professions at NHS England, which means within England I'm the professional lead for psychologists, psychological therapists, and psychological practitioners. Helen: Thank you, Stirling, please introduce yourself. Stirling: Hi, I'm Stirling Moorey. I am currently the president of the BABCP and I'm a retired psychiatrist and really have been around in the CBT world since 1979. So, Adrian is speaking about CBT today and in the UK particularly and I'll just give a bit of a view of what it's been like to be in the CBT world for this length of time. Helen: Thank you very much. And so Stirling, if we come to you first, that’s a long career- you must have seen a lot of developments over the years. Tell us a bit about what you've seen and how things have developed. Stirling: Indeed, I mean, so right at the very beginning when I was a medical student, cognitive therapy was just being invented. And so we had BT, Behaviour Therapy, but not the CBT that we have today. And so it was quite sort of revolutionary. The behaviour therapists look down their nose a little bit at it, the psychoanalytic therapists very much looked down their nose, and I remember at one point talking to a psychoanalyst who told me that being a CBT therapist was a bit like playing a tin whistle compared to being a concert violinist. I think things have changed since then. So, over the years, what's happened is that really from the work of pioneers like Isaac Marks in behaviour therapy, Aaron Beck in cognitive therapy, for the first time psychotherapists started to actually address what evidence do we have that this works? And using randomised control trials. And this has been really powerful. It was revolutionary at the time because people thought you couldn't manualise therapy but Beck and others managed to do that. I think that's been the legacy of that, is that the services that are recognised to be really effective and are spread out across the UK that Adrian will talk about, have resulted from us gathering evidence that CBT works. The other thing that's happened is that really up until the early 2000s, we were using CBT in a lot of contexts in the UK, evidence accumulating that it was effective for anxiety disorders, depression, but other things like eating disorders, psychosis, long-term conditions, various things but they were all being delivered within a hodgepodge of services really. And I remember when the IAPT services that Adrian will be talking about, were about to be developed, my chief executive in my trust said this is amazing, it's like moving cognitive therapy from being a cottage industry into therapy mills as he called them. So, we have therapy mills across the UK, which are proving very effective in helping people with anxiety and depression. And it was that revolutionary input of David Clarke and Lord Layard who said, actually, we can work this out as a way to deliver therapy effectively and efficiently, not just in these services here and there, but across the whole country. So there's been so much change and now CBT is there for everyone. I suppose just finally thinking about what its impact in public consciousness has been, although people maybe have heard of it and maybe witnessed people who've received it, there've been some subtle changes, I think in our perspective on the world that have been influenced by CBT. I think people from the behavioural side now are recognising that a lot of our behaviour is learned in our everyday life. We have habits and people notice they have bad habits and go to podcasts to try and get them to rid them of their bad habits. And people are really aware of cognitive bias- it's there in the media all the time, that recognition that our thinking is not always that rational and straight, for good or ill. And then the third thing is there's a new wave of CBT that's come along that's called the third wave of CBT is really looking at how we can look in and just be aware and notice our thought processes. And so the whole field of mindfulness is very popular these days. So CBT, I think even if people aren't aware of what CBT is as a therapy, it has perfused our consciousness. Helen: Thank you very much, Stirling. That sounds like a whole symphony orchestra, not just a tin whistle from what you've been saying during your career. And thank you because that perspective of many years in the field and how things have developed, it leads us nicely to speaking with Adrian about, you mentioned IAPT, which stood for Improving Access to Psychological Therapies. I'm going to hand over to Adrian to ask him a bit about that project, how it came about and what happened. Adrian: Absolutely. Thanks Helen. Well, of course I'm a relative newcomer to the field having been trained as a psychologist 30 years ago and done my additional CBT training, I think 19 years ago, including under Stirling's tutelage as one of my training supervisors. So, it's great to join this session today with Stirling. So, NHS Talking Therapies as it is now was called Improving Access to Psychological Therapies is really something we're very proud of and feel as a sort of world leading program in implementing psychological therapies at scale. As Stirling's mentioned, David Clark and Lord Richard Layard were instrumental in founding the service and arguing successfully for its initial funding and have really been sort of fundamental to its success ever since. It's received investment every year, under every government since 2008 in the UK and it is just an England service so it's important to also remember there's other parts of the UK that don't have the same sort of service at the moment. It really makes a public promise, which is that it will deliver NICE guided psychological treatments. So NICE are our evidence-based, practice guidelines in, in the UK and, sort of established by independent panels of experts for each type of condition. So it makes a public promise, it will only deliver NICE recommended treatments, psychological treatments, that the therapists that deliver them will be fully trained and properly supervised and that it will publicly reveal its outcome data, anonymised, of course, but for the whole country so that we can see at a national scale, but also locally, how the service is performing, and the service can learn and the best performers can show what they're doing that's being so successful, to produce the best outcomes and other services can, can seek to learn from that and implement some of the same strategies. So we now have a sort of situation where for a number of years, the service has met its objective of 50% of those who coming into the service, are recovering completely from anxiety or depression and about two third

    59 min
  3. Let’s Talk About…CBT for Gambling Addiction

    FEB 14

    Let’s Talk About…CBT for Gambling Addiction

    In this episode of Let’s Talk About CBT, Helen Macdonald speaks with James from the charity Gambling with Lives about the serious impact of gambling addiction, its links to mental health, and the role of CBT in recovery. What We Cover in This Episode: 🔹 How gambling has changed – From a backstreet niche to an industry making billions through addictive products. 🔹 Gambling addiction and mental health – How gambling harms go beyond financial loss and can lead to depression, anxiety, and even suicide. 🔹 The neuroscience of gambling – How gambling rewires the brain, making it difficult to stop. 🔹 Recognising the warning signs – What to look for in yourself or a loved one. 🔹 The role of CBT in recovery – How cognitive behavioural therapy is a key treatment approach in NHS gambling addiction services. 🔹 Breaking the stigma – Why gambling addiction is not just about personal responsibility and we need to talk about how it can harm people and the amount of gambling advertising that is out there. 🔹 Getting help – Resources for those affected, including training for healthcare professionals. Resources & Links: Find out more about Gambling with Lives: gamblingwithlives.org Visit Chapter One for training and resources: chapter-one.org NHS gambling support services: NHS gambling support If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at podcasts@babcp.com Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't.  I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies   Welcome to today's episode. I'm really pleased to have James with me today. He's from an organisation called Gambling with Lives, and I will ask him first to introduce himself. Hello, James. James: Hi Helen, thank you for having me on. I'm James. I live in Stockport, originally from Norfolk, hence I haven't got a Northern accent, but I'm here today representing the charity Gambling with Lives. The charity was set up by bereaved families who'd lost loved ones to gambling related suicide and I now oversee our prevention work, which includes education, training, information, and resources. And a lot of that stems from my own lived experience of a 12-year gambling addiction, which started as a young person, and which I'm sure we'll touch on today. Helen: Thank you, James. And so I'm very aware that a charity that's been very much grounded in the experiences of bereaved families, there's going to be some difficult things to talk about here. And just to say for our listeners, there will be links to where to find help and support on the show page and as well as anything that we talk about during today's episode. So can I ask you just to tell us a little bit more about gambling? What is it? You know, how people might get themselves into trouble with it, maybe? James: Yeah, it's a big question. And the first answer that comes to my head is that gambling is not what it was. I think a lot of people have a perception of what gambling is, and that's a weekly bet at the horses or going to the bingo on a Thursday night, or the football pools. Gambling has absolutely transformed over the last 10, 20, 30 years. And it all really started from a point in 2005 when the Gambling Act was created by the Labour government at the time, which changed gambling from being this thing that was, you know, quite hidden, quite behind closed doors, wasn't promoted, was quite hard to go and do, wasn't that easy or available or accessible, and that Gambling Act changed that completely and allowed for relentless advertising, sponsorship, marketing, and allowed for bookmakers in the high street to have really addictive electronic machines in their premises. And they were things like the fixed odds betting terminals, which were roulette machines, which at the time were called the crack cocaine of gambling because they were that addictive. And that was not what gambling was. I remember when I was a child, in our town, I'm from a quite a sleepy, small town in Norfolk. And the bookies in our town used to be this like really dingy, horrible place to be honest behind in a back alley that I used to walk past it and think I'm never going in there, that is a place not for me. It's for old men, smoke coming out the doors, did not have any interest in that. But then when I was 16, which was a couple of years after this Gambling Act, it changed into a massive Ladbrokes in the middle of the high street, you could see through there, you could see the machines and you could see all the advertised on the outside of the windows. And that's what's happened to gambling. And the impact on society is huge. We now know that 2. 5 percent of the adult population are experiencing so called “problem gambling”. And just to note on that terminology, it's not a term that we like to use, but this is what the statistics say. And we don't like to use it because we don't like to put the problem with the person. There are many reasons why people experience gambling harms, which is what I'll come on to later. But that figure alone. So that's the very sharp end of gambling harms, but then you've got many more impacted by somebody else's gambling. You've got widespread harms happening to young people. So, a really important point here is that these harms aren't just financial. Again, I think there's a perception that gambling addiction is a financial problem, and the harm is felt through debt and long-term financial worries. Actually, this is a mental health condition. This is a diagnosable mental health condition. Gambling disorder is in the DSM manual since 2013, and it's a mental health harm first and foremost. And that then causes anxiety, depression, and suicidal thoughts as well, which again, we'll come on to based on the work we do at Gambling with Lives. Helen: Thank you, James. So, what I've just heard you describe there, that it's gone from being a bit of a backstreet, rather unattractive niche thing, to being sort of very attractive and perhaps more widely, I don't know, more people participate in it. And you mentioned gambling machines and I'm also aware that people can gamble on the internet as well. They don't have to go out to do it necessarily. And I'm also aware that you used words like addiction, which most people would associate with substances, perhaps alcohol or drugs or something. And I wonder if you could say a bit more about, perhaps the difference between what I might have thought of as a harmless flutter and something that's harmful. James: Yeah, another good question and potentially asking the wrong person because I, obviously I experienced a gambling addiction myself, but I'll try to answer based on my own experiences. And on your first point, actually, probably the thing I forgot to say, which is most important is that the biggest change for gambling is, as you say, the fact that all of these products that are now available on our phones, in our pocket. At the time when the legislation was written, there was concerns about super casinos in places like Blackpool and on the coastal towns of England. And actually what's happened is we all now have a super casino, but it's in our pocket and anyone can access it over the age of 18. There's very little safeguards and protections on there. And that's where the harm is felt most on online gambling. And that's sort of the answer to the second question as well is that gambling is not just one product, and some products are more harmful, risky and addictive than others. And that's not to say you cannot be harmed by, as an example, buying a lottery ticket. Because if you've only got 5 pounds to last you for food that week and you spend 5 pounds on a lottery ticket, you are experiencing gambling harms. But evidence shows and experiences from people who have been there and been harmed are that the quickest, more attractive, the things that are designed to be addictive products like online slot games, online casino games, online bingo as well. These are the things that are really causing the harm and causing addiction. And the difference is the indication someone is experiencing gambling harm is how often someone is spending on those products and how much money someone is spending on those products and how quick all of those things are, those products. That's why people can get harmed quite quickly. Back in the day, again, you used to have to go somewhere to place a bet on, and you maybe did that once, twice a week. Now, because of how quickly you can do that, that creation of addiction is so much quicker and instant, and it can happen really quickly. I can give you examples of times where I spent five, six, seven hours just in bed spinning online roulette tables on online casinos. And that time I, it didn't feel like five, six, seven hours. It felt like I was just trapped in this zone. And that's because it's deliberately designed that way. So what happens is, and this is very medical and I'm not a scientist or a medical person, but this is a physiological change in the brain. So when you play these really fast paced products, these intense products like slots, like casino games, your pathways in your brain are rewired and it becomes a dopamine driven urge to do this thing again and again. And what's really worrying

    45 min

  4. JAN 15

    Let's talk about…how CBT can help manage living with long term health conditions and trauma

    In this episode, Helen talks with Lizzie, a beauty content creator and disability advocate, and Bex, a CBT therapist, about Lizzie’s journey navigating living with long term health conditions, trauma and the transformative impact of Cognitive Behavioural Therapy (CBT). Lizzie shares her experiences living with Crohn's disease, POTS (Postural Orthostatic Tachycardia Syndrome), and hypermobility spectrum disorder, alongside the emotional challenges of managing these conditions. She discusses her initial scepticism about therapy and how CBT helped her address anxiety, PTSD, and prioritising her own well-being. Bex offers insights into the therapeutic process, addressing common misconceptions about CBT, and highlights the importance of building trust and tailoring therapy to individual needs. Together, they discuss the interaction between physical and mental health and strategies for balancing driven lifestyles with well-being. Useful links: Explore Lizzie’s content on Instagram and TikTok (@slaywithsparkle). Listen to our sister podcasts: Let’s Talk About CBT - Practice Matters and Let’s Talk About CBT - Research Matters: https://babcp.com/Podcasts Find us on Instagram: https://www.instagram.com/babcppodcasts/ Learn more about CBT www.babcp.com Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't.  I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies   What we've got for you today is a conversation with Lizzie and Bex. Lizzie's going to talk about her experiences of having CBT and living with a number of conditions that she'll tell us more about in the episode. We're going to talk to Bex, who is a CBT therapist, and she's going to talk with us about working with Lizzie as well. Welcome to you both. Lizzie, would you like to introduce yourself? Lizzie: Hello! Thank you so much for having me. So as Helen's just said, my name is Lizzie. I am also a beauty content creator known as @slaywithsparkle on Instagram and TikTok and a little bit of YouTube and I'm also a speaker that talks about disability awareness. And I try and raise awareness about the health conditions I've got and general sort of disability awareness and activism about that. Helen: Thank you Lizzie, and welcome. Thank you for coming to talk to us today. And Bex, would you like to tell our listeners about you? Bex: Hi. Yes, I'm Bex. I'm a CBT therapist and worked with Lizzie a little time ago, when I worked in a physical health service for IAPT at the time. And I currently work more with trauma in Sheffield both in the NHS and privately. Helen Thank you, Bex. And maybe I should just say, when you said IAPT, we're now talking about NHS Talking Therapies. Bex: That's right. Yes. Thank you for providing the update. Helen: So Lizzie, can I ask you a bit about what was happening for you? What was going on that meant you ended up having CBT? Lizzie: So for me, I really had quite a negative opinion about any sort of talking therapy and had very much been brought up with the idea that if you have some sort of mental health problem, you should be able to solve it yourself. And if you just think positively and carry on, then everything should be fine. Because of my health conditions, so I will just mention just briefly so people are aware what my health conditions are just for context. So I have, Crohn's disease, which I was diagnosed with when I was 21 and then later about 9- 10 years later, I was diagnosed with hypermobile spectrum disorder and also POTS, which is a condition that affects my blood pressure and heart rate. And when I had a first flare of Crohn's disease. I'd obviously had it a long time without realising, but when I first flared with Crohn's disease, I really struggled with the concept of having a physical health condition that I couldn't push through. So with my Crohn's, I ended up ignoring a lot of the doctor's advice because I had this idea that I should be able to cure myself. I really pushed myself to look at alternative therapies. And then, because of that, I ended up ignoring what the doctor said and becoming a lot more ill. Unfortunately, because of a combination of the Crohn's having been misdiagnosed for a long time as IBS, and then because of all of those sorts of ideas about that I should be able to cure myself, my Crohn's did get so bad that I ended up having to go to hospital and have emergency surgery on my bowel. Years later, so about two or three years later, I started having real panic attacks, which I'd never had before. I was anxious all the time and I couldn't sleep. I would sometimes wake up in the middle of the night at like 4am and get the urge to clean the entire house and was sometimes just up in the middle of the night pacing up and down. And my partner at the time said to me, you know, this is not normal. Something's going on. You really need to think about getting some help for this. And I was devastated at that concept because I obviously had this idea that I should be able to fix myself. And so that was the sort of wakeup call that I had to go and get some help and I applied to IAPT at the time and had my first round of CBT. Since then I've had three rounds of CBT and a course of EMDR as well but yeah, that was the first thing that sort of led me to CBT. Helen: Thank you, Lizzie. And it just strikes me what a difficult combination of things you experienced that not only were you having a number of quite complicated and long-lasting physical symptoms, also the experiences you'd had when you were younger meant that it was really difficult to seek help for the panic attacks and the anxiety and so on. Can I ask you just to say, in case anybody's not familiar with the terms, can you just say a little bit about what the symptoms of Crohn's disease are? Lizzie: Yes, absolutely. So Crohn's disease is different for everybody. For me, I really struggled with pain and one of the biggest symptoms that I had was pain. I also struggle with diarrhoea. It's not the most glamorous disease. It's quite embarrassing sometimes. Some people have a lot of nausea and vomiting. For me, that's not been as much of a problem. To me, the biggest problem has been pain. And it got so bad that when I was actually in my final year of university, I'd been told by the doctors repeatedly that it was IBS, and it was just stress related IBS and I just needed to make sure I watch what I eat, tried to up my fibre, which made me a lot more ill. And eventually it got to the point where I literally couldn't even drink water because my oesophagus was closing up. I was in absolute agony and I finally went back to the doctor and I was like, really, honestly, there's something seriously wrong here and then they finally sent me for the right tests and they found the Crohn's disease. The other big symptom with Crohn's disease as well is fatigue. So, most people actually say that fatigue is the most debilitating symptom of Crohn's disease. And for me, I mean, at the moment I am in a flare and I am sleeping 14 hours. And if I don't get that 14 hours, I cannot function and I need a full day in bed to recover. Helen: And again, you've said about some of the symptoms being a little bit similar to IBS or Irritable Bowel Syndrome but having a really far reaching impact on every area of your life, really. You also mentioned that you had POTS, which can affect your blood pressure. And if I have this right, it's Postural Orthostatic Tachycardia Syndrome? Lizzie: Yeah, so it affects your, for me, it affects my blood pressure. Not everybody has problems with their blood pressure all the time. But what happens is your heart isn't getting the right signals. And so you end up having a really high heart rate when you stood up and then that can lead to you passing out. It also leads to symptoms again, like nausea, fatigue and for me, it just feels horrible. Like, it's just that feeling of like sometimes the world's sort of closing in on you and when you're about to go you just feel really sick, really like something's pulling you to the floor. It's a very frustrating condition. I think out of all of them, Crohn's is the most dangerous and that one is the one that when that's flaring, I'm always a little bit nervous because mine is quite severe, but POTS is definitely the one that is the most infuriating. I've had to lie down in the middle of shops. I once had to lie on the floor in the middle of Poundland because I was passing out and honestly, it's just mortifying. It's really embarrassing. Helen: And I'm noticing there as well, Lizzie, that you've just said that the Crohn's disease because of the symptoms of diarrhoea and you know that can be embarrassing. We all know that the impact of eating a lot of fibre, which you were advised to do can be, can lead to embarrassing symptoms and then the POTS as well, that having to lie down somewhere public, more embarrassment. And in addition to that, you also said that you have hypermobility syndrome. And again, can you just say a little bit about what that's like? Lizzie: Yes, so for me, I have a late diagnosis of hypermobile spectrum disorder. There are a couple of things that are related, so similar, sorry. So there's hypermobile EDS and then there's also hypermobile spectrum disorder and they're very similar conditions. But the one that I have is hypermobile spectrum disorder and with that, it just basically means that my joints are too floppy. They extend past the natural point where they should extend because my collagen is built in a way that means it can str

    54 min

  5. 11/28/2024

    Let’s talk about…how CBT can help with living well with pain

    In this episode of Let’s Talk About CBT, Helen Macdonald speaks with Pete Moore, author and creator of The Pain Toolkit, about his journey of living with long-term pain. Pete shares his experiences of how he was able to move from being overwhelmed by pain to learning CBT techniques and strategies which helped him learn to manage it effectively, regain control, and even help others do the same. Useful links: The Pain Toolkit website Live well with pain website Listen to our sister podcasts: Let’s Talk About CBT - Practice Matters and Let’s Talk About CBT - Research Matters: https://babcp.com/Podcasts Find us on Instagram: https://www.instagram.com/babcppodcasts/ Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow   Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't.  I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies   Today, I'm speaking with Pete Moore, who'll be sharing with us his journey living with long term pain.  Many years ago, Pete took part in an inpatient pain management program, which among other things uses cognitive and behavioural techniques to learn how to manage long term symptoms of pain.  Pete will tell us about his journey and where he is today in not only managing his own pain and staying active, but also how he helps other people to learn key ways of living successfully with long term pain.  Pete, would you like to introduce yourself to our listeners? Pete: Yes, well, hi everyone. My name's Pete Moore and I'm the author and originator of the Pain Toolkit. I just want to say, Helen, thanks very much for inviting me along to do this podcast and I'm really looking forward to having a chat with you. Helen: That's great. Thank you very much, Pete. I think a good place to start would be if I ask you just to tell me a bit about how you ended up living with long term pain. Pete: Yeah, it's, such a familiar story actually that of mine. Back then in the early nineties, I had back pain and such and I used to sort of manage it by taking over the counter medication, et cetera, or just having a rest. But I didn't really do a lot to help myself. I didn't really know what to do with it. I just, you know, it's like most people just get on with life. But I think it was about 92, back then I was a painter and decorator, and I was painting a house over in Windsor Castle. Anyway, I went home that night and the next day I couldn't get out of bed. I found out later on that I'd prolapsed some discs in my back, I think, two in the lower, and one in the middle. And I was pretty scared, really frightened, et cetera. And I found it difficult even going to the GP, really. And anyway, long story short, I was given medication and anti inflammatories but little was I to know that back then there was, you know, managing back pain or managing pain itself was like being put in something called the medical model. And I wasn't really given any guidance around what I could do for myself. It was just, “take these pills. If they haven't worked, come back and see me”. So I wasn't quite on Christmas card terms with the GP, but, you know, I was around there every month or so. Anyway, I had to stop working et cetera. And for me, movement was more pain. So I stopped moving. I was sent to the physiotherapist, but back then I don't think that they was quite well up to speed with managing pain or back pain and I was given exercises to do and which say do 10 of these, 10 of these, 15 of those and, and as you know yourself, when you've got subacute pain, as I did, then, I've got up to five or six repetitions and the pain went up so much I thought this can't be right. So, to me, I learned that, back then the exercise equalled more pain. So I just stopped moving. Helen: So I'm hearing you got lots of back pain. You did what most people would do, which is go and see your GP and you got prescribed medicines. And you said, medical models. So it's very much, you go and see somebody and they're going to prescribe some treatment and you expect to get better. But what you're telling me is that the medicines, the physiotherapy actually ended up probably not helping very much. And actually you were still struggling with the pain. And you also said that you were really scared as well. Pete: I guess I couldn't see any future for myself really and I was getting depressed and I just, I had no plan, you know, that was it and at the time I was only I think in my mid-forties, something like that back then. And I thought what's my future? I couldn't see any future for myself, and I went through a pretty, pretty sticky time really, you know. People that used to call and say how you doing, or they would pop around, but it was the same old story and then even people stopped ringing me, stopped calling me because all I could talk about was my back pain really. And they probably got their own problems to deal with, you know? And I did look around for seeing people privately, you know, the osteopaths and chiropractors and all them sort of guys and, and all in all I spent, I did actually spend all my savings really and, I was a doctor shopper, I was a therapy shopper and looking for something to fix me, and little was I to know that I had to learn how to fix myself. Helen: So I'm hearing it was having a huge impact on every area of your life. It changed, you know, sort of whether you could go to work. It was changing whether you could see your friends. It was changing how you felt about yourself and your mood went down. You felt angry, anxious, all of those things. So tell me how you started to change how you approach trying to manage this, and moved away from, what did you say? Being a therapy shopper? Pete: Yeah, therapy shopper, doctor shopper, serial shopper, serial health care. I was just looking for someone to fix me because as a child, you know, you don't feel well. So you go to the doctors, the doctor gives you something or do something. And then after 10 days or so you feel better, and you get on with your life. But, when it comes to long term, this back pain, it wasn't. I had a couple of turning points, really. One was, I thought, well, I'm not getting anywhere with the healthcare professionals. So, I always remember a little saying I learned years ago that, if you want to learn something to teach it, and I thought, I need to be around people like me, you know? So, I started up a back pain support group and I was quite surprised. I was contacted a local newspaper and said I'm starting this up, can you publicise it for me? And, I was quite surprised, the hall I booked, it was only, I think it's supposed to hold about 20 people, but I think it was over 50 people showed up, like, you know. They was all like me, you know, struggling, looking for answers and that's the thing we wasn't, none of us were getting answers. Anyway, someone told me about a woman in Norwich or Norfolk who'd been on a pain management program in London called Input and it really worked wonders with her. And so I contacted them asking if someone can come along to speak to the group about what they did, et cetera. Well that was, that was the turning point and a really nice lady called Amanda Williams. She was a clinical, she is a clinical psychologist. And she'd come along and spoke to the group about, you know, learning how to pace the activities, about graded activities, moving will actually help your pain, et cetera. Really positive, information. I thought this is, this is right up my street. This is for me. And so I applied to go on the course and sadly it was the NHS so I had to wait till, 96, but in between that time, I was really getting depressed as well. And, on the, I always remember the date as it’s my birthday, 31st December 94. I got so down with my pain, I had some friends wanted to come and take me out for the night, being New Year's Eve and my birthday and stuff like that. And that day I had my full quota of medication. I said, I just can't go out like, you have to go on your own. And that night I did actually consider ending my life really, because I just couldn't see any future for myself, you know. I think the only thing that kept me going really was knowing that I was on a waiting list to go to the Input program. And the program gave me the, not only the tools and the skills, but it gave me the confidence to manage my pain myself. Helen: So, what you were saying there, Pete, about reaching a point where really you almost lost hope. Even though you'd done everything you could and you'd started a support group even, and found other people with similar experiences, you were trying everything you could, and then you did find something that you've described as a turning point for you, but you still had to wait a long time for that. I mean, I'm very pleased that you're still with us and I'm particularly pleased that you've got this opportunity to tell our listeners about, you know, how you did reach that turning point and how it helped you. So please do tell us what happened when you went to the Input pain management program. Pete: Well, it was an inpatient program. So, it was spread over two weeks I think the very, the first day, it was the best day for me because, Charles Pyler, who was the medical director at a time, he went around all the people in the group. There was 18 of us there, I think. And, and we were split into two groups of nine and, but he went around to everybody in the group asking them how long they'd lived with pain. And I think for memory, it was nearly 400 years. You know, of the 18 people. But he said, he said something re

    42 min

  6. 10/25/2024

    Let’s talk about…how getting active, being in nature and having CBT can help after you’ve had a baby

    In this episode of Let’s Talk About CBT, host Helen Macdonald speaks with Sarah, Sally, and Leanne about Sarah’s experience of having Cognitive Behavioural Therapy (CBT) after giving birth. They explore how CBT helped Sarah regain control during a challenging postnatal period, addressing struggles such as insomnia, anxiety, and adjusting to new motherhood. Sarah shares her journey of balancing therapy with the therapeutic benefits of movement and time spent in nature. CBT therapists Sally and Leanne discuss the powerful combination of therapy, physical activity, and connecting with nature for improving mental health.  Useful links: NHS Choices- Insomnia-https://www.nhs.uk/conditions/insomnia/  NHS Guidance on feeling depressed after childbirth: https://www.nhs.uk/conditions/baby/support-and-services/feeling-depressed-after-childbirth/ MIND information on how nature can help mental health: https://www.mind.org.uk/information-support/tips-for-everyday-living/nature-and-mental-health/how-nature-benefits-mental-health/ For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com Listen to more episodes from Let’s Talk About CBT here. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced and edited by Steph Curnow   Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen MacDonald, your host. I'm the senior clinical advisor for the British Association for Behavioural and Cognitive Psychotherapies Today I'm very pleased to have Sarah, Sally and Leanne here to talk with me about having CBT, in Sarah's case, when you've recently had a baby and also the value of getting more active and getting outside into nature and how that can help when you're also having CBT. Sarah, would you like to introduce yourself, please? Sarah: Hi, I'm Sarah. I'm, 37 from Sheffield and like I said, just recently had a baby, and she's absolutely wonderful. She is a happy, loud little bundle of joy. I ended up having CBT though, because the experience of having the baby wasn't what I thought it was going to be, I think is the reason. And I, just went a little bit mad, so I got some help. Yeah, I'm normally a very happy, positive, active person. Lots of friends, very sociable, always like to be doing things, always like to be in control and have a plan. I like to know what I'm doing and what everyone else is doing. And all that changed a little bit and I didn't really know what to do about it. So yeah, got some therapy. Helen: Thank you Sarah. So, we'll talk with you a bit more about what that was like. And first, Sally, would you like to just briefly say who you are? Sally: Yeah, so I'm, my name's Sally. I am a Cognitive Behavioural Therapist, working both in the NHS and in, in private practice at the moment. Helen: Thank you. And Leanne, Leanne: Hi, I'm Leanne. and I'm a cognitive behavioural therapist as well. And I also work in the NHS and in private practice with Sally. Helen: Thank you all very much. What we're going to do is ask Sarah to tell us a bit more about, when you use the term mad, perhaps I could ask you to say a little bit more about what was happening for you that made you look for some therapy. Sarah: Wel the short answer to that is I developed insomnia about 12 weeks postnatally, didn't sleep for five days. Baby was sleeping better than most, you know, so it was equally frustrating because there was no real reason I didn't think that I should be awake. And sleep obviously is very important when you've had a baby. As I said, I like to be in control, like to prepare, like to know what's going on. So I did hypnobirthing, I prepared, I planned, I packed the biggest suitcase for this birth of this baby that I was really excited for and I thought I'd prepared mentally for every eventuality- what kind of birth, what would happen afterwards, but all very physical because they're the sorts of things that I could understand and imagine. And basically I ended up having an emergency C section, which in the moment I was fine with and I didn't think I was bothered by it, but the level of pain afterwards, that then again affected my level of control over looking after the baby. And the level of debilitation it created that I wasn't expecting- this is the key thing, I wasn't expecting it. That meant that I wasn't able to be me, really. I wasn't able to not least look after a baby, but get myself dressed, get myself showered, walk to the shop, drive a car, play netball, walk my dog. And I wasn't able to do any of that. I didn't appreciate that I was struggling with that, with accepting that. And because it went on for so long, and of course with this comes the baby blues that everyone talks about, but that's meant to only last apparently a couple of weeks. I, you know, you kind of just think, oh, well, I feel all this. I feel pain. I feel sad. I can't stop crying. But all that's meant to happen, all that's normal and it's sort of became the norm. So I was like, well, this is normal. This is how I'm going to feel forever. At this point I didn't have insomnia. I just could not stop crying. And I mean, like I couldn't, I didn't talk to anyone for two days at one point, because I knew if I opened my mouth to say anything, I would start crying. Like literally anything, I would just start crying. What the clincher for me was when I spoke to a doctor, I thought they were going to say get out and about, do some therapy, which at the time, I'm going to be honest, I thought, I can't sleep. I need a fix now. What I now know is I was doing a lot of behaviours that over time culminated in my body going, you're not listening to me, you're not well. Right I need to do something physical so that you wake up and do something about it. And that was the insomnia. So, I went to the doctor fully expecting them to say, do some mindfulness, do this, do that. And at that point I was just, you need to fix this now. I need to sleep. I need drugs. And yes, that's what they gave me, but they did say you need to do CBT- but what they did say what the first thing the doctor said was, you need antidepressants. Now, as a nurse working in GP surgery for them to jump all the self-help stuff and go take these tablets was like, Oh, right. I'm not okay. and it gave me that like allowance to say, I need to take tablets. But I already had said to myself, but I want to do not just mindfulness and helpfulness for myself. I want to do structured CBT because that way it is something I'm doing to give me back my control and I've got a plan. And because I already knew CBT was wonderful. Yeah, I didn't really understand what it was, how it worked, the structure of it. And I get that there's different types for different problems. but I knew that's what I wanted to do, once I had tablets to help me sleep and knew the antidepressants were going to work eventually, which did take a while. I was at least doing something myself that would help me forever. And I just thought, what have I got to lose? I need to do something. And until I started CBT, basically, I just felt like I was running around in circles in the dark. And the CBT gave me control and focus and, right, this is what we're doing going that way. Because until I started CBT, you know, I was Googling everything. Right, I'll try this. Right, I'll try that. And because it didn't work within 24 hours, I'd then try something else and try something else. Now it was making it worse, obviously. So, to have the CBT and have my therapist say, do this one thing for a whole week. I was like, all right, okay. That's quite a long time, but there's obviously a reason. Helen: Sarah, thank you for telling us all about that. What I'm hearing is that you had a combination of massive changes in your life, which will happen when you've had a baby, all sorts of things about the kind of person that you are, kind of added to all your really careful and sensible preparations for having this baby and then really being taken by surprise almost by all the other impact that it had on you and taking a while really to look for help and to look for a very specific kind of help then. And I'm just wondering in the context of all that, what it was like when you first went to see Sally for therapy? Sarah: Well, like I say, it was brilliant. It was like having someone turn the lights on and point me in the right direction and say, right, head that way and don't turn off and don't go any other direction. Just keep going that way. And it will eventually result in this. It's like if you go to the gym and you're running on the treadmill and you're thinking, well, is this going to achieve what I want it to achieve? And until it does start to, you've not got that positive reinforcement, to keep going. So quite often you stop, and that's what I was doing. I was trying one thing, trying the next, because I was so desperate for it to just go away, this insomnia. Which obviously at the time was one thing, but I understand now there was a whole other problem going on but the insomnia was what I needed fixing. I found CBT for insomnia, but Sally said, do you want to do a more generic anxiety control type approach and I said, yeah, because that's what if before this, you know, five, six years ago, little things would happen. And I think, Oh, I should do CBT for that. So it's clearly the same thing. So yeah. Why don't we just tackle it as a whole? And that was definitely the best thing to do. Helen: It sounds as if one of the things that was really helpful was looking at the bigger picture, as well as focusing on taking enough time to make changes. Okay. Can you tell us about the specific things that yo

    43 min
  7. Let's talk about... going to CBT for the first time

    05/17/2024

    Let's talk about... going to CBT for the first time

    We’re back! Let’s Talk about CBT has been on hiatus for a little while but now it is back with a brand-new host Helen Macdonald, the Senior Clinical Advisor for the BABCP. Each episode Helen will be talking to experts in the different fields of CBT and also to those who have experienced CBT, what it was like for them and how it helped. This episode Helen is talking to one of the BABCP’s Experts by Experience, Paul Edwards. Paul experienced PTSD after working for many years in the police. He talks to Helen about the first time he went for CBT and what you can expect when you first see a CBT therapist. The conversation covers various topics, including anxiety, depression, phobias, living with a long-term health condition, and the role of measures and outcomes in therapy. In this conversation, Helen MacDonald and Paul discuss the importance of seeking help for mental health struggles and the role of CBT in managing anxiety and other conditions. They also talk about the importance of finding an accredited and registered therapy and how you can find one. If you liked this episode and want to hear more, please do subscribe wherever you get your podcasts. You can follow us at @BABCPpodcasts on X or email us at podcasts@babcp.com. Useful links: For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF   Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the senior clinical advisor for the British Association for Behavioural and Cognitive Psychotherapies. I'm really delighted today to be joined by Paul Edwards, who is going to talk to us about his experience of CBT. And Paul, I would like to start by asking you to introduce yourself and tell us a bit about you. Paul: Helen, thank you. I guess the first thing it probably is important to tell the listeners is how we met and why I'm talking to you now. So, we originally met about four years ago when you were at the other side of a desk at a university doing an assessment on accreditation of a CBT course, and I was sitting there as somebody who uses his own lived experience, to talk to the students, about what it's like from this side of the fence or this side of the desk or this side of the couch, I suppose, And then from that I was asked if I'd like to apply for a role that was being advertised by the BABCP, as advising as a lived experience person. And I guess my background is, is a little bit that I actually was diagnosed with PTSD back in 2009 now, as a result of work that I undertook as a police officer and unfortunately, still suffered until 2016 when I had to retire and had to reach out. to another, another psychologist because I'd already had dealings with psychologists, but, they were no longer available to me. And I actually found what was called at the time, the IAPT service, which was the Improving Access to Psychological Therapies. And after about 18 months treatment, I said, can I give something back and can I volunteer? And my life just changed. So, we met. Yeah, four years ago, probably now. Helen: thank you so much, Paul. And we're really grateful to you for sharing those experiences. And you said about having PTSD, Post Traumatic Stress Disorder, and how it ultimately led to you having to retire. And then you found someone who could help. Would you like to just tell us a bit about what someone might not know about being on the receiving end of CBT? Paul: I feel that actual CBT is like a physiotherapy for the brain. And it's about if you go to the doctors and they diagnose you with a calf strain, they'll send you to the physio and they'll give you a series of exercises to do in between your sessions with your physio to hopefully make your calf better. And CBT is very much, for me, like that, in as much that you have your sessions with your therapist, but it's your hard work in between those sessions to utilize the tools and exercises that you've been given, to make you better. And then when you go back to your next session, you discuss that and you see, over time that you're honing those tools to actually sometimes realising that you're not using those tools at all, but you are, you're using them on a daily basis, but they become so ingrained in changing the way you think positively and also taking out the negativity about how you can improve. And, and yeah, it works sometimes, and it doesn't work sometimes and it's bloody hard work and it is shattering, but it works for me. Helen: Thank you, Paul. And I think it's really important when you say it's hard work, the way you described it there sounds like the therapist was like the coach telling you how to or working with you to. look at how you were thinking and what you were doing and agreeing things that you could change and practice that were going to lead to a better quality of life. At the same time though, you're thinking about things that are really difficult. Paul: Yeah. Helen: And when you say it was shattering and it was really difficult, was it worth it? Paul: Oh God. Yeah, absolutely. I remember way back in about 2018, it would be, that there was, there was a fantastic person who helped me when I was coming up for retirement. And we talked about what I was going to do when I, when I left the police and I was, you know, I said, you know, well, I don't know, but maybe I've always fancied being a TV extra and, That was it. And I saw her about 18 months later, and she said, God, Paul, you look so much better. You're not grey anymore. You know, what have you done about this? And it was like, she said I was a different person. Do I still struggle? Yes. Have I got a different outlook on life? Yes. Do I still have to take care of myself? Yes. But, I've got a great life now. I'm living the dream is my, is my phrase. It is such a better place to be where I am now. Helen: I'm really pleased to hear that, Paul. So, the hard work that you put into changing things for the better has really paid off and that doesn't mean that everything's perfect or that you're just doing positive thinking in the face of difficulty, you've got a different approach to handling those difficulties and you've got a better quality of life. Paul: Yeah, absolutely. And don't get me wrong, I had some great psychologists before 2016, but I concentrated on other things and we dealt with other traumas and dealt with it in other ways and using other, other ways of working. I became subjected to probably re traumatising myself because of the horrendous things I'd seen and heard. So, it was about just changing my thought processes and, and my psychologist said, Well, you know, we don't want to re traumatise you, let's look at something different. Let's look at a different part and see if we can change that. And, and that was, very difficult, but it meant that I had to look into myself again and be honest with myself and start thinking about my honesty and what I was going to tell my psychologist because I wanted to protect that psychologist because I didn't want them to hear and talk about the things that I'd had to witness because I didn't think it was fair, but I then understood that I needed to and that my psychologist would be taken care of. Which was, which was lovely. So, I became able to be honest with myself, which therefore I can be honest with my therapist. Helen: Thank you, Paul. And what I'm hearing there is that one of your instincts, if you like, in that situation was to protect the therapist from hearing difficult stuff. And actually the therapist themselves have their own opportunity to talk about what's difficult for them. So, the person who's coming for therapy can speak freely, although I'm saying that it's quite difficult to do. And certainly Post Traumatic Stress Disorder isn't the only thing that people go for CBT about, there are a number of different anxiety difficulties, depression, and also a wider range of things, including how to live well with a long term health condition and your experience could perhaps really help in terms of somebody going for their first session, not knowing what to expect. As a CBT therapist, I have never had somebody lie down on a couch. So, tell us a little bit about what you think people should know if they are thinking of going for CBT or if they think that somebody they care about might benefit from CBT. What's it like going for that first appointment? Paul: Bloody difficult. It's very difficult because by the very nature of the illnesses that we have that we want to go and speak to a psychologist, often we're either losing confidence or we're, we're anxious about going. So I have a phrase now and it's called smiley eyes and it, and it was developed because the very first time that I walked up to the, the place that I had my CBT in 2016, the receptionist opened the door and had these most amazing engaging smiley eyes and it, it drew me in. And I thought, wow. And then when I walked through the door and saw the psychologist again, it was like having a chat. It was, I feel that for me, I know now, I know now. And I've spoken to a number of psychologists who say it's not just having a chat. It is to me. And that is the gift of a very good psychologist, that they are giving you all these wonderful things. But it's got to be a collaboration. It's got to be like having a chat. We don't want to be lectured, often. I didn't want to have homework because I hated homework at school. So, it was a matter of going in and, and talking with my psychologist about how it worked for me as an individual, and that was the one thing that with the three psychologists that I

    47 min

  8. 07/19/2022

    How has CBT changed over the last 50 years?

    The British Association for Behavioural and Cognitive Psychotherapies, the lead organisation for cognitive behavioural therapy (CBT) in the UK and Ireland, is 50 years old this year. In this episode Dr Lucy Maddox explores how CBT has changed over the last 50 years. Lucy speaks to founding members Isaac Marks, Howard Lomas and Ivy Blackburn, previous President David Clark, outgoing President Andrew Beck and incoming President Saiqa Naz about changes through the years and possible future directions for CBT. Podcast episode produced by Dr Lucy Maddox for BABCP   Transcript  Dr Lucy Maddox:        Hello, my name is Dr Lucy Maddox and this is Let’s Talk about CBT, the podcast brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP. This episode is a bit unusual, it’s the 50th anniversary of the British Association for Behavioural and Cognitive Psychotherapies this year. And I thought this would be a nice opportunity to explore some of the history of cognitive behavioural therapy, especially the last 50 years.                                     Some of the roots of CBT can actually be traced way back. Epictetus, an ancient Greek Stoic philosopher wrote that man is disturbed not by things, but by the views he takes of them. This is pretty close to one of the main ideas of cognitive behavioural therapy, that it’s the meaning that we give to events, rather than the events themselves which is important. But actually, cognitive behavioural therapy started off without the C. To find out more, I made a few phone calls. Isaac Marks:               Hello, Isaac Marks here. Dr Lucy Maddox:        Isaac Marks was one of the founding members of BABCP and a key figure in the development of behavioural therapy in Britain. I asked him if he could remember what CBT was like 50 years ago. Isaac Marks:               Originally it was just BT and a few years later the cognitive was added. At the time, the main psychotherapy was dynamic psychotherapy, sort of Freudian and Jungian. But just a handful of us in Groote Schuur Hospital psychiatric department, that’s in Cape Town, developed an interest in brief psychotherapy. And I was advised if I was really interested in it and I was thinking of taking it up as a sub profession, that I should come to the Maudsley in London. Dr Lucy Maddox:        Isaac and his wife moved to London from South Africa and Isaac studied psychiatry at the Maudsley Hospital in Camberwell. What was it about CBT that had interested you so much? Isaac Marks:               Because it was a brief psychotherapy, much briefer than the analytic psychodynamic psychotherapy. We were short of therapists and there wasn’t that much money to pay for extended therapy, just a few sessions. Six or eight sessions something like that could achieve all what one needed to. They had quite a lot of article studies. Dr Lucy Maddox:        And I guess that’s still true today, that those are some of the real standout features of it, aren’t they? That it is a briefer intervention than some other longer-term therapies and that it’s got a really high quality evidence base. Isaac Marks:               I think that’s probably true, yes. Howard Lomas:          There was a group that met at the Middlesex Hospital every month. And that was set up by the likes of Vic Meyer, Isaac Marks, Derek Jayhugh. Dr Lucy Maddox:        That’s Howard Lomas, another founding member of BABCP remembering how the organisation got set up 50 years ago from lots of different interest groups coming together. Howard Lomas:          These various groups that got together and said, “Why don’t we have a national organisation?” So that was formed back in 1972. Dr Lucy Maddox:        Howard’s professional background was different to Isaac’s psychiatry training, but he found behaviour therapy just as useful. Howard Lomas:          I’d originally trained well in social work, but I was a childcare officer with Lancashire County Council. Dr Lucy Maddox:        And how were you using CBT or behaviour therapy in your practice? Howard Lomas:          Well, as a general approach to everything, thinking of everything in terms of learning theory. How do we learn to do what we do and maintain it with children? Things like non-attendance at school and other problems, behavioural problems with children and then later problems with adults. But I suppose when I moved to Bury in 1973, I was very much involved in resettlement of people with learning disability from the huge hospitals that we had up here in the north. We’d three hospitals within sight of each other, each with more than 2,000 patients. Dr Lucy Maddox:        Wow. Howard Lomas:          They’re all closed now long since, but yeah, the start of that whole closure programme of trying to get people out into the community. You learn normal behaviour by being in a normal environment, which people in institutions clearly aren’t and weren’t. So it’s trying to create that ordinary valued environment for people. And simply doing that would teach them ordinary behaviours, valued behaviours. It was evidence-based, it was also very effective.                                     It looked at behaviour for what it was rather than what might be inferred. I suppose I saw psychology as more of a science (laughs). I’m still in touch with some of the people that are resettled from way back. People who had been completely written off as there’s no way they could ever live in their own home are now thriving, absolutely. Dr Lucy Maddox:        Now, Howard’s and Isaac’s memories of CBT 50 years ago highlight that an important route of CBT is behavioural learning theory. This includes ideas of classical conditioning, where in a famous experiment which you’ve probably heard of, Pavlov, taught his dogs to salivate in response to the bell that he rang for their dinner rather than the dinner itself. And operant conditioning, where animals and humans learn to do more or less of a behaviour based on the consequences which happen in response to that behaviour. Howard Lomas:          Half a dozen of us sitting with Skinner, chatting for three hours. So that was quite influential (laughs). Dr Lucy Maddox:        Skinner was another of the early behaviourists, and Howard has memories of being lectured by Skinner at Keele University. The formation of BABCP was important for therapists at the time because behavioural therapy back then was quite a niche field. Howard Lomas:          It was publicly very unpopular indeed. Behaviour therapy was known very much as behaviour modification, which has got an involuntary feel about it, even the name that it was being thrust upon people. And even at that time, aversion therapy was being used for trying to change homosexuality in people, aversion therapy then. Which is quite topical now with the whole debate on conversion therapy. Dr Lucy Maddox:        Absolutely. We’ve signed up to the memorandum of understanding against conversion therapy. Howard Lomas:          The aversive is horrible. And there was a big scandal at I think it was Napsbury Hospital about their clinical programme, which was allegedly based on behaviour modification, more aversive techniques. So there was a big scandal and that led to a major government inquiry, and they asked for anyone to offer, submit evidence on the whole question of behaviour modification, which BABP did. And that then formed the basis of our guidelines for good practice. Dr Lucy Maddox:        Just a note, if you’re listening to this as a cognitive behavioural therapist, please do read the memorandum of understanding against conversion therapy online at www.babcp.com.  It makes it clear why we’re opposed to conversion therapy in any form. I’ll put the link in the show notes, too. Like Isaac, Howard remembered that shift from behaviour therapy to cognitive behavioural therapy. Howard Lomas:          Well, I was always against adding the C. I was always taught that behaviour has three components to it: motor behaviour, cognitive behaviour, and affective behaviour. So behaviour included cognitive, so why did you have to have it as a separate thing? Although in those early days I used to get told off if I spoke about thoughts and feelings. Dr Lucy Maddox:        Did you? Howard Lomas:          Yeah, because you can’t see them. You can’t measure them. Dr Lucy Maddox:        Yeah, interesting, although there’s still a lot of measurement, isn’t there? But maybe it’s like you say what we think we can measure has maybe changed. Howard Lomas:          That’s right, yeah. Yeah, I think the measurement and the evidence is so important. Ivy Blackburn:             We actually changed the name when we started it was called the British Association for Behaviour Psychotherapy. So at one of the conferences we passed a motion and added the C. Dr Lucy Maddox:        That’s Ivy Blackburn, another founding member of BABCP. Ivy Blackburn:             At that point well, I was a qualified clinical psychologist. I’d just finished my PhD, I trained in Edinburgh. And I was working in a research set up, an MRC unit called the Brain Metabolism Unit. Dr Lucy Maddox:        And so, CBT at that time was quite a new thing? Ivy Blackburn:             Very, very new. I actually had just discovered Beck as it was, while I was going the research for my PhD, which was in depression. And I used to correspond with him and he used to send me his early papers and things like that. Dr Lucy M

    39 min
See All (35)

    Ratings & Reviews

    4
    out of 5
    47 Ratings

    About

    Let's Talk About CBT is a podcast about cognitive behavioural therapy: what it is, what it's not and how it can be useful. Listen to experts in the field and people who have experienced CBT for themselves.  A mix of interviews, myth-busting and CBT jargon explained, this accessible podcast is brought to you by the British Association of Behavioural and Cognitive Psychotherapies. www.babcp.com

    Information

    • Creator
      Dr Lucy Maddox
    • Years Active
      2018 - 2025
    • Episodes
      35
    • Rating
      Clean
    • Copyright
      © All content copyright BABCP
    • Show Website
      Let's Talk About CBT

    You Might Also Like

    Content Restricted

    This episode can’t be played on the web in your country or region.

    To listen to explicit episodes, sign in.

    Stay up to date with this show

    Sign in or sign up to follow shows, save episodes, and get the latest updates.
    Select a country or region

    Africa, Middle East, and India

    Asia Pacific

    Europe

    Latin America and the Caribbean

    The United States and Canada