In many articles, I have recommended using cognitive behavioral therapy as a way to address a range of mental health problems. I recommend this form of therapy/self-help in part because - after studying several different types of therapy during my degree and reading and writing about it in depth since - CBT stands out to me as the most logical and appears to be the most effective. But there is also another, more personal reason that I advocate CBT and that is that it has helped me greatly in the past. Specifically it helped me to get over a particular social anxiety that I had about using public urinals. By sharing my story, hopefully I can illustrate the effectiveness of this form of treatment and the general principles as they can be applied to a variety of mental health problems.
My inability to use public urinals when I was younger can probably partly be traced back to the delightful habit of children at my old school to push people whenever they were going to the toilet. We had one of those urinals that was essentially a big metal trough and so kids would run in and push you, forcing you to put your hand out to stop yourself falling and thus get it covered in toilet water. Charming.
This didn’t exactly help my mental state when peeing in public toilets and neither did my first experience of using one – when I unwittingly pulled by pants and trousers down and got laughed at. I’d only used cubicles up until the age of two or whatever… how was I supposed to know?
This then developed into a general heightened sense of anxiousness when using public loos which made me tell myself to hurry. This in turn resulted in me not being able to hurry and I then developed this script in my head that if I couldn’t pee quickly, people would start to think I was a weirdo. I got the idea in my brain that if I was just standing there, not peeing, people would think I was mad and had opted just to hang out in the men’s toilets for giggles.
Thus I would often end up going into the toilets, standing at the urinal for ten minutes, not using the loo and then doing my flies up to return to whatever I was doing still needing the loo. Then I had this whole other problem of not being able to go within the next hour in case my friends noticed. Yep, I was the picture of mental health. Eventually I just decided to always use cubicles, which was hardly particularly practical but did at least eliminate the problem.
Then in psychology I learned about cognitive behavioral therapy and how it worked. The idea was to identify the negative thought patterns that caused various unhealthy behaviors and then replace them with more positive beliefs. You could do this by first identifying the issues (mindfulness), then introducing healthier thought patterns (cognitive restructuring) and proving to yourself that your old ideas were nonsense (hypothesis testing).
I first applied this to my urinal issues while in the pub when I realized everyone was drunk and hardly likely to care how long I’d been in the toilet. Once I realized this I was able to pee freely and so I decided to tell myself that the people in the urinal were always drunk. In other words I would just imagine they were all wasted even if that weren’t true and this would then help to give me the confidence to urinate in public.
Then I realized that if I was willing to do that, then it obviously meant I couldn’t have been all that bothered about what people thought. I realized this was a) because I was never going to see these people again b) I’ve never minded making an idiot of myself and c) I’m fairly big and strong and if someone got offended by me hanging around in there I’d probably be okay…
I then decided to also remind myself of these facts every time I was in the toilet – it really didn’t matter how long I was in there because I wasn’t in there to make friends. That would be what would really be strange…
Half on purpose, half by accident, I had used CBT to treat my own difficulty going to the toilet in public…
Another aspect of CBT is ‘hypothesis testing’. This essentially involves proving to yourself that your negative thought patterns are inaccurate and unhelpful by just putting them to the test. In the case of using public urinals I knew that this meant actually seeing what would happen if I just stood there not using the toilet for ages. This was a pretty awkward thing to do, but as I suspected the result was… nothing. After standing there for a quarter of an hour, people came and went and no one even knew that I had been in there that long. The only person who would know I had been standing around would be someone else doing the exact same thing and they’d understand…
Once I’d done this my problem well and truly disappeared and now I can go to the toilet in seconds in pretty much any environment.
Other Times I’ve Used CBT
But that’s not the only time CBT has helped me to overcome difficulties. I actually used it by accident when I was about 9 or 10 years old in order to overcome insomnia. My Dad died when I was 9 which was obviously devastating for me at the time and one of the difficulties I faced as a result was the inability to get to sleep. I did see two therapists, but they were psychodynamic therapists (who have their uses but were not right for me in this scenario) and didn’t suggest anything that could help.
The only thing that eventually did help was my Mum telling me that lying in bed resting was almost as good for you as sleeping. While this isn’t technically true, there’s certainly some truth in it but more importantly this belief took all the pressure away from getting to sleep so I no longer got stressed about the fact I wasn’t sleeping. I then realized I actually enjoyed just lying there and as soon as that happened, I started falling asleep instantly. This is effectively an example of CBT.
I also used hypothesis testing to help myself overcome difficulty driving. I used to constantly stall when I was at the front at red lights because I was worried that the cars behind me would get angry if I didn’t take off immediately. Again, it was that concern that ironically meant I would stall. I say I helped myself, but actually in this case it was my driving instructor (who was otherwise useless) who slammed the handbrake on and said we were going to sit there until the lights changed again. This was highly stressful and the cars behind honked their horns angrily… but that’s all that happened. And after I had faced up to my fears I realized that the worst case scenario wasn’t as bad as I thought it would be. Again, I had tested the hypothesis and it turned out to be wanting.
My friend also used cognitive behavioral therapy in order to treat his panic attacks. Panic attacks are often made worse by the fact that the patient thinks they might be having a heart attack or are otherwise in danger. The symptoms of the panic make them panic and this then causes the issue to escalate. My friend was also a psychology student though and he was able to understand this process and then to convince himself to stay calm during the problem. By understanding the basics of CBT he managed to solve the problem after only his second attack – and normally it takes much longer.
The Take Home Lesson
Not everyone is going to have the same success with CBT. This technique is more effective for some people than it is for others and it’s something that takes practice and doesn’t apply in every situation. Nevertheless, I’ve experienced first-hand proof that it can work and when you start to understand the basics you can actually use it in every aspect of your life. CBT is now a part of the way I think about problems and I’m constantly looking at challenges as an opportunity to change my thinking, to test my assumptions and to help develop healthier and more positive thought patterns.
So if you’re struggling from anxiety issues similar to mine, if you have problems with any access of your day-to-day life or even if you just want to gain better control of your own thinking… consider looking into CBT.