Electroconvulsive Treatment (ECT)
Talking treatments
Most of the people we spoke to had talking therapies as an additional or complementary treatment, rather than as a replacement for medication or ECT. However, at the right time in their recovery, some people felt that talking treatments could ultimately reduce the need for drugs and ECT in the future. More than this, some believed talking therapies were essential to their recovery. Suzanne had accessed counselling through her workplace and she felt that this had helped resolve a bout of depression, such that ECT wasn’t needed again. Jenny felt talking therapies helped address the problems she experienced more than ECT had done. Sue and Ian said there ought to be more psychological treatments available that are “backed up” by the use of medication.
Some felt frustrated that, while drugs were readily available through the NHS, talking treatments were not always offered, or there were long waiting lists. Some people said it was difficult to find out about what talking treatments were actually available.
After Tania had first been seriously unwell at university, having cognitive behavioural therapy helped her recover and stop taking sleeping tablets.
After Tania had first been seriously unwell at university, having cognitive behavioural therapy helped her recover and stop taking sleeping tablets.
And after that, I mean, it took some time, it took some time to make a full recovery, because, you know, after the experiences of the previous year and I was, I was really in pieces and I, I, you know, took a while, over the course of the next few months I needed to get my sleep sorted out and I just needed to come to terms with the anxiety that whole, the whole episode had produced for me. And I had some cognitive behaviour which really helped me, like, get sort of relaxed and face kind of getting back to life again and just kind of get over what happened. And I also, it helped, I managed to come off the sleeping pills and get back to sleeping again, and you know, that just took a couple of months because I wasn’t, I wouldn’t say I was really ill then, I just, it was more like the after effects of just having the sort of the trauma of the whole year, and then following that I went back to university the next year and I went back and did my final year at university and it was, you know, it was tough going back, a lot of my friends had left by then and I was pretty shaken about what had happened, but my department were lovely and really supportive and I went back to university and I, and it went really well and I ended up, yeah, I ended up getting a First, which is what I’d really hoped for all along and staying in academia.
Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it.Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it
Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it.Jane thinks psychotherapy should be readily available on the NHS. She thinks it’s unfair if only those who can afford it get it
Those who had had talking treatments often talked about the specific role it had played in their recovery. People credited talking therapies with a range of helpful results like helping them to better manage their feelings of anxiety and stress, coming to terms with difficult childhoods, finding ways to forgive those who had hurt them, and feeling better or “healed”. Tristan’s wife had counselling which helped with her recovery in particular ways. Counselling and learning about ‘mindfulness’ helped her become better equipped to stop her depressive and anxious thinking from reoccurring. She was able to see problems coming and avoid them. She didn’t have a substantial episode of mental illness after the talking therapy. Tristan and his wife are now very positive about the future. Helen had many years of counselling through a charity. She often had trainee councillors and felt able to “let out” the traumatic experiences she had gone through “in the safety of that room”. Her life had been a “living hell” but the counselling helped her to “get rid of all this horrible stuff” and get her sanity back.
At first Enid thought that Dialectical Behavioural Therapy (DBT) was “nonsense” but then found it made a lot of sense. She finds she’s able to live in the moment more and enjoy whatever she is doing and not worry.
At first Enid thought that Dialectical Behavioural Therapy (DBT) was “nonsense” but then found it made a lot of sense. She finds she’s able to live in the moment more and enjoy whatever she is doing and not worry.
What are the bits you tend to think of?
Well in the mornings I always think this is a new day it’s open to a lot of opportunities and you don’t have, you know, what’s gone is gone. What, don’t I spend all your time worrying about what’s going to happen tomorrow. Live now. And enjoy, you know, the things that you’re doing now and make the most of what you can do today. And I think for me that’s, that’s probably the best bit of it. Just live in the moment. Live now. This bit’s fantastic. You know, I’ve got a lovely house, I’ve got a lovely husband, I’ve, you know, everything’s absolutely fine. Why worry about all the dreadful things or kind of make things not good. Now is a good time to be, and I think that’s been an enormous help.
The people we spoke to had experienced different types of talking treatments. These included: CBT (cognitive behaviour therapy), DBT (dialectical behaviour therapy), psychotherapy, CAT (cognitive analytic therapy), different types of group therapy, hypnotherapy, mindfulness and counselling (see MIND website for an explanation of the different therapies). People accessed talking treatments through a charity or the NHS or paid for private therapy.
Helen had a lot of talking treatments over the years. Although there was one psychotherapist she didn’t think was very good, her overall experience was positive: “And it does work, yes, it does work. Talking I think is the most important thing”. Sue, Jenny, Yvonne and Helen all emphasised the importance of talking about what had happened to them as children in order to help with their well-being as adults (for more see ‘Childhood’).
Tracy had had varied experiences of talking treatments. She found group psychotherapy and CBT very good, but said the counsellors she’d seen weren’t very skilled.
Tracy had had varied experiences of talking treatments. She found group psychotherapy and CBT very good, but said the counsellors she’d seen weren’t very skilled.
The psychologist wanted me to carry on my treatment up here, it was never pursued either by the medical team or me, because I was better [laughs]. But yes, I do believe that cognitive behaviour therapy would be a really good thing, because it teaches you to think differently and I think people with depression need to think differently. And be taught not to be negative all the time. You know, when you hate yourself you’re not going to like anyone else either. And so life isn’t worth living and if you can be taught to like yourself then you’ll like other people and you’ll get on a bit better I think.
You were saying you’d had a better experience with psychotherapy?
Yes, it was a group psychotherapy meeting and we had lots of arguments because we were all very self-opinionated. But the psychotherapist really made me think about the way I think about things. Like she came in one day and she said, “Just to let you know I won’t be here for much, I won’t be here for much longer.” And we all had to go round the room saying why we thought that. What we thought about that and mine was, “Oh my goodness, are you okay?” I automatically thought she was dying. And in fact she was pregnant. But that didn’t come into my mind. And so she made me think about why I was thinking those things and I suppose that’s what the cognitive behavioural therapy does, it makes you think why you think, why you do the things that you do.
Yvonne was put into a children’s home when she was thirteen, after she was attacked by her mother. She felt that her psychologist should have “probed a bit deeper” so that her problems could have been dealt with at the time.
Yvonne was put into a children’s home when she was thirteen, after she was attacked by her mother. She felt that her psychologist should have “probed a bit deeper” so that her problems could have been dealt with at the time.
Sue has had long-term therapy for the trauma she went through as a child, and in her adult life. She felt her psychotherapist was the only person who understood why her past was causing her problems.
Sue has had long-term therapy for the trauma she went through as a child, and in her adult life. She felt her psychotherapist was the only person who understood why her past was causing her problems.
And I also lost heart. If this is the ultimate treatment and I haven’t responded [claps hands] what is there? And I became more suicidal, which was initially why I was in hospital. And I also, that has a knock on effect, because each time I’m sectioned, it’s usually because I’m highly suicidal and I reach the stage, well nothing’s worked and I’m still in this same place, and with people saying to me, oh, you know, like it might never happen again. How many times have I heard that? And I just sort of brush it off, thinking you don’t really know me. Especially new people who work with me, who don’t really know me. Its sort like seems like a throwaway comment and I think there’s very few people that have been with me all those seventeen, eighteen years, I’ve been within the mental health system here, who can actually follow the whole thing.
Mandie described different approaches taken by counsellors and psychotherapists. Psychotherapy on the NHS came too late for her and “[ripped her] open”, whereas counselling was “looking for solutions”.
Mandie described different approaches taken by counsellors and psychotherapists. Psychotherapy on the NHS came too late for her and “[ripped her] open”, whereas counselling was “looking for solutions”.
Ironically, I finally accessed the NHS’s psychological therapy, I was offered a ten-week course, just as I knew I was getting better. And I remember phoning them up and saying, “Look, I’m not being funny, I’ve waited like fourteen months for this. This would have been good, a long time ago.” And they said, “Well, if you turn this down, and if you ever got ill again, you wouldn’t get any help.” And so I then, went through their therapy as well, at the same time, which was really difficult, really, because they had a very different, their approach was looking back, and, “Where in your past has this been caused by?” Whereas the counselling with the CBT, and CAT, was very much about looking for the solutions, to help me adjust my thinking, so I could live in a better place. I mean I think the first thing the charity did, was they helped me understand that this is an illness, this isn’t me being lazy, or selfish, or can’t be bothered to clean up the house, or something, this is me. They used the analogy all the time, “This is like a broken leg. You wouldn’t try and drive a car with a broken leg. Stop trying to do it now.” And the NHS’s therapy, I remember saying to her one day, I said to her, “I’m sorry, but I’m finding this harrowing.” And she went, “Harrowing? That’s interesting. Do you know what the word harrowing means? Do you know what harrow means?” I said, “Well, it means to dig deep and break things up.” And she said, “Well, harrow does.” She said, “It means to turn the soil completely over.” I said, “Yes, you’re ripping me open, and opening me up.” And what was interesting, was at the end of the ten weeks, they kind of went, “Right, we’ve gone really deep.” And I went, “Yes, but you’ve broken me open. You’ve not fixed me.” “Well, you’ve had your ten sessions.” “Right, okay, well, I must be fixed then.” Whereas with the charity it was never, there wasn’t, I wasn’t on their agenda, they were on my agenda.
Timing of talking treatments
The timing of, and access to, talking treatments was seen as very important for some people we spoke to. Mandie turned down ECT because she felt talking treatments were what she needed. She waited fourteen months to have psychotherapy through her GP, which she said was too long to wait when so ill, although she managed to access counselling through a charity in the meantime. She felt that if she had had these therapies sooner, her illness would not have developed.
Yvonne went to counselling sometime after she had had ECT. She felt able to participate in counselling sessions at that time and felt that when she was first admitted she wouldn’t have been able to.
Yvonne went to counselling sometime after she had had ECT. She felt able to participate in counselling sessions at that time and felt that when she was first admitted she wouldn’t have been able to.
It was only after her mum died that Helen could acknowledge what had happened and begin to forgive her mum. Psychotherapy helped her to do this.
It was only after her mum died that Helen could acknowledge what had happened and begin to forgive her mum. Psychotherapy helped her to do this.
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