Case Study: CBT Treatment – Abby

Case Study: CBT Treatment – Abby

Abby witnessed the suicide of a stranger and went on to develop PTSD along with enormous amounts of guilt. Realising she needed to do something, she started CBT treatment which she says ‘changed her life’ over the course of a few months. Here, Abby describes her initial trepidation about CBT, but how it’s allowed her to control her emotions and make huge progress.

“I witnessed a suicide. I did not know the person, I had never met them before, I had never spoken to them, I had never even exchanged a glance with them, but they changed my life.  I can recount every second of that morning,  I heard every single sound on repeat.  I felt guilt like I have never experienced.  If only I had known what that person had planned to do, I would have tried to stop them. 

For the first few weeks following, I felt relatively “normal”.  Until my sleep pattern began to get worse. I would sleep for 3 to 4 hours a night and I started to experience the worst nightmares.  I felt as if suicide was following me around, I dreamt of everyone I loved dying. I couldn’t shake the feeling that I was to blame.  I would wake up sweating and crying and I would be terrified to go back to sleep.

In day to day life, I tried to hide my feelings as much as possible.  I felt selfish for even having these feelings, a person had lost their life, a family had lost a loved one, and all I was thinking about was my nightmares.  I felt like I was grieving for a person I had never even met.  How do you explain that to anyone?  I thought about the situation all the time.  I thought if I had just done one thing slightly different, would the person have changed their mind.  The guilt felt like a weight on my chest at all times.

I couldn’t shake the feeling that it was my fault.  I was put in this position to make a difference, and I had failed.  I had failed this poor person and the guilt tormented me. 

I felt wherever I went, something awful would happen.  I was the bad omen following people around.

The nightmares and lack of sleep made everything so much worse, but sleeping was my biggest fear.  After a few months of feeling this tortured, I thought to myself I can’t take anymore of this, I either had to do something or my life is going to have to end.

I felt so paranoid that everyone I knew was going to commit suicide, or everywhere I went. It is such an odd feeling.  Hypersensitive to someone feeling sad and needing to protect them, then being sick with worry if you have to leave them, the feelings are very difficult to explain.

The final straw for me, was a Samaritans advert which was released around the same time.  This advert suggested that small talk can save lives.  It showed a railway station, and a person asking another if they were ok, the person then did not end their own life.  This triggered me hugely.   All the feelings of guilt multiplied (and they weren’t small to begin with!).  All I could think about was if I had just said hello, then I would have saved this person’s life – even the Samaritans said so! It broke my heart and it sent me into a massive spiral.

I spoke to a charity who reassured me that I needed to speak with someone about how I was feeling.  I still just believed how I felt was a normal reaction to trauma, of course I was going to feel sad.  I didn’t want to make this about me, a person had lost their life.  I was so conflicted.  When I first went to the counselling session and we discussed PTSD, this was the first time I realised what it was. 

When I first began the CBT counselling, I couldn’t see how it would work, it didn’t seem to make sense to me. I thought my reaction was so clearly connected to what I had seen and what I had felt, but, of course, as time progressed, I realised reactions are unique. 

At first, my faith in CBT working was very low.  I didn’t see how it would help, but I was so desperate, I would have tried anything.  I also knew it was only a matter of time before my urge to try and get better was worn out, and would leave me.  I had to try.

After a few sessions, it felt like a weight was being slowly lifted from me.  This made me feel slightly more positive. 

My friends and family were all really supportive, but suffering with PTSD is so isolating, it is so difficult to explain to others.  But the more sessions I had, the easier I found it to discuss, and this really helped my recovery.

Overall, my CBT experience was challenging (it wasn’t a walk in the park), it was emotional and often difficult.  I had my treatment through a specific NHS sector which deals with patients who have witnessed traumatic events.  It helped massively, and I learnt tactics on how to deal with my emotional trigger.  I learnt that dealing with trauma is not a one size fits all approach and you have to accept it won’t be over in a few sessions. 

Some of the sessions included activities I had no idea would work.  But anyone who is suffering, my only advice to you is to keep going.  Even when you are exhausted, you’re emotional and you can’t face it, these are the times you need it most.  It is always during our darkest times we have to focus to see the light.  There were times I could not face going, these thoughts plagued my mind 24 hours a day, why did I want to go and talk about them intensely – week in – week out.  But you have to try.

I felt so much better after a few months of sessions.  Then, I had a huge setback.   I woke up sweating, screaming and crying, a horrendous nightmare was back.  I felt dread.  There was no way I was ever going to escape this, no matter how hard I tried, it would keep coming back.  But when I discussed this during my therapy, I realised, I couldn’t be afraid of a setback, it was only natural and I had to keep trying.  Part of PTSD is the fear of a trigger, by not being afraid of a setback, I reduced my anxiety. 

My counsellor was amazing, I could not be more grateful to him.  He really saved my life.

At the end of my CBT treatment I was very nervous.  I thought without the crutch of therapy, I would fall.  But, I didn’t.  Everything I learnt helped me massively

I don’t have strong symptoms, and I haven’t for a while.  However, if I am at a station, and someone is close to the edge or looking a little “off” to me, I have an overwhelming feeling of dread, and I am taken straight back.  I can never be at a station, and not think this.  But I have accepted this and I don’t see it as a negative.   I am able to control it.  The progress I have made thanks to CBT is huge.

To anyone suffering, please remember that no feeling is final.  You don’t have to accept that this is the way that it will always be.  The hardest part for me, and probably still is, is trying to explain how PTSD can make you feel.  It is like an imposter is in your head and you are trapped trying to get back to normal life.   All I can say is keep going, and keep trying.  Life is always worth it.

Photo by Elias de Carvalho from Pexels
 

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