Example of successful CBT in practice from yesterday

As you know, to help overcome my acute anxiety issues that remain following my therapy for PTSD (Post Traumatic Stress Disorder) (as a result of training my brain to realise that my son has recovered from anorexia and is not still in the throes of it).... I have been using a combination of CBT tools learned through therapy and further CBT tools from the excellent Anxiety & Worry Workbook. Yesterday was a superb example of CBT in practice - and how it can be very successful. It may be of use to anyone else going through episodes like this.


Situation: Loud swearing and banging from Ben's attic bedroom. I froze - a carbon-copy response of how I reacted when Ben was sick with anorexia. "What's up?" I called. "I am having an 'angry moment'," he said, "I don't know why or where it's come from, but please don't come up here, just leave me alone until I get over it". More swearing, banging and crashing... I freeze again, head in hands, tears smarting behind eyes plus my mind pinging into 'blank mode' in a bid to feel nothing.

All of this is exactly how I would behave when my son would bang and crash around as a result of the anorexia driving him crazy. I recognised the reaction instantly.

What I did next: I grabbed a pen and paper and got to work with a CBT exercise.

The idea is that you write down the most catastrophic outcome of an anxiety-provoking situation. Next, you write down the most ideal outcome. Finally, you write down the most likely outcome based on evidence for and against any of these outcomes actually happening. Then you distract yourself by doing something else. In my case, I drove off to the gym.

Here is what I wrote.

Catastrophic outcome: That Ben is relapsing back into his eating disorder without realising it and this is why he is angry - it's just the start of it all again and this time it will kill him. I couldn't cope with facing the eating disorder again. I couldn't handle it. I will implode. Aaarrrggghhh!!

Ideal outcome: It is just a one-off 'man thing', probably hormonal / testosterone / frustration fuelled, maybe stress of academic work (tons of reading and three essays to write in succession). It may mean a few effs and crashes while he gets it out of his system and, yes, this may trigger me into my classic 'red alert' mode, but I'll just accept that this is the case, accept the anxiety rather than fighting it and be mindful about how my body is reacting. It is a temporary situation, like a train that arrives in a station, stops and then leaves - and is gone.

Most likely outcome: Not sure, but hopefully close to the 'ideal outcome', but I do know that I am best steering clear of him while the red mist is down. Men get like this on occasions. He just needs to get it out of his system. At least Ben warned me to stay clear, which was thoughtful of him! He will come through this and will probably talk to me about what happened, later when he's calmed down. But I will let him know I find it frightening and triggering. It is probably caused by a mix of stuff, as above, and probably work pressure, but this is something people need to learn to deal with, so I'll just let him get on with it.

Followed by...

Evidence FOR the catastrophic outcome: None, not for a year or so.

Evidence AGAINST the catastrophic outcome: He has been fine for the past year or so. Sure, he has his moods; we all do; it's only natural. No way would he let himself succumb to the eating disorder again; he knows what it stole from him and he has too much to lose. This is likely to be a combination of hormones and frustration plus the pressure of work.

So I went to the gym and when I came back he was fine. He explained to me that he had no idea where the anger came from, but he wondered if it was something to do with his own delayed development because of the eating disorder i.e. the kind of anger an adolescent might experience, delayed because his development was 'on hold' for all those years. It also might be the pressure of work.

He was still a bit wound up for the remainder of yesterday, but this morning he was back singing at the top of his voice.

And, as I have said before, when Ben sings, all is right with the world.

Oh, and he said my reaction (i.e. to leave him alone and go out) was the best one!

CBT success!