Cognitive Behavioural Therapy for Dummies
By Rob Willson and Rhena Branch
Many moons ago I would arrive in the kitchen to find my mother slaving away over a hot oven. This would occur frequently, often early in the morning before I was really awake. If I asked, ‘what are you cooking for supper,’ she would usually give the same answer, something along the lines of ‘I’m not sure…yet.’ I would look at this menopausal mother in her 1970’s caftan, ruler of my universe and wonder how this could be? Her hands were busy, her body moved about within the available space and she spoke and yet she made no sense at all.
Forty [plus] years later, it seems unduly harsh to criticize this woman knee deep in sautéd onions and hot flashes, but now, it seems to me that this would have been the ideal time to grasp what we now call a ‘learning opportunity.’ She might have said, ‘there’s this book that hasn’t been written yet because the authors haven’t been born yet, but in the future you could learn to accept that there is a whole slew of things over which you have absolutely no control. If you learn that now, your life will be a whole lot happier.’ So if, like me, you find that as a parent you spend a great deal of time telling your autistic child the same things many, many times, just be assured that you’re on the right path, not matter how futile it may sometimes seem.
This book may seem an odd choice for parents like us, after all, we’ve been dealing with variations on a theme for some while now, what else or more could we possibly learn from such a self-help book? The answer, for me at least, is quite sobering and twofold. Firstly, it’s an acknowledgement that our children are growing older and we are still dealing with the same underlying issues. Although they are coping much better, better than we could possibly have ever imagined, nonetheless, the underlying difficulties remain stubbornly in place and more importantly, they will probably stay there long after we are dead and buried.
This may seem a little gloomy, but it doesn’t necessarily have to be so. What it means is that we need to update our skills as parents so as to deliver a different set of coping strategies, those better suited to an older person with greater cognitive abilities. Star charts and tick down schedules are all well and good, but children move beyond such motivators and develop different skills.
I did learn something new. I learned about NATs:- Negative Automatic Thoughts. These are thought which enter your mind automatically, immediately. This is something we have been tackling forever, but it’s a slightly different approach. In the realm of autism we tend to describe this how we perceive it as parents: rigidity, inflexibility, a desire to maintain a strict routine, a resistance to anything that deviates from a well-worn regime. Do you recognize it now? I certainly do. When they were younger we tackled this in a variety of different ways but surprise, surprise it’s still there, writ large. This is just a different way of tackling the very same issue and I was grateful for the reminder.
If you take the acronym NAT and add a G for ‘General’ or ‘Global’ then you have GNAT – which is much easier to remember. Take some time to explain the concept, that those negative responses need to be curbed, but first they need to recognize what they’re doing. Quite often it’s become so ingrained that it just blends in. Then, every time someone says something negative, a first response, without any thought because it’s automatic, you can ‘snap that GNAT and be a smooth, cool cat.’ I snap my fingers at the same time, as it’s more likely to catch their attention. Pretty soon, I found out just how frequently this occurs.
Yes, it’s only the first stage:- recognition. What to do about it thereafter, replacing it with more proactive and helpful strategies, comes a bit later. Clever people can problem combine both strategies at the same time, but for now, we’re still working on it.
More later.
March 20th, 2011 at 12:28 pm
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March 20th, 2011 at 7:32 pm
Yep, I can feel a lot of gnattiness sometimes. But I am not even at the picture schedule level yet, though I see progress from plain old screaming to “WANT JUICE” and thennnn the meltdown when I don’t give it for whatever reason. Yay for progress lol.
March 20th, 2011 at 8:05 pm
When I was a teenager, long before my diagnosis, probably long before that book was printed, I was looking for a solution for my clinical depression and chronic anxiety I hadn’t tried before. I’d been through talking therapy for unrelated issues, and was pretty much sick of it. I had been on medication since I was sixteen, and while it took the edge off, it wasn’t the be all and end all so much as a bandaid. A lot of my issues, though I didn’t know it then, related back to my un-diagnosed Asperger’s. I had abysmally low self-esteem, fed by my inability to follow social cueing, make casual acquaintances and cope with situations that sent me into what I now know was sensory overload.
I found a book in my local bookshop on CBT. Bought it, took it home. Overcoming Depression by Paul Gilbert.
Reading about things like negative thought patterns was a revelation to me. I don’t mean them the way you do, in terms of fixed routine and rigidity, but thoughts of poor self-worth and self-recrimination at my own failure to blend in and assimilate with NT society. Breaking those down was difficult, and not perfect, of course, but it helped me to establish myself in adulthood. I started living for me, rather than trying to please all the other people around me at the expense of my own wants and needs.
It hasn’t fixed me, by any means, but I think it was useful in assisting me to have the stretches of med-free happiness between down-swings. In my mid twenties, I was med-free for three years. I’ve just come off them again, and so far, I’m holding steady. I’m always going to have bouts of depression and anxiety, just like I’ll always be autistic. But I’m a lot more at peace with it than I used to be. And just as my Asperger diagnosis gave me the tools to manage my sensory overload and other AS issues, this book helped me start to manage the depression and anxiety I’d been battling my whole life.
March 21st, 2011 at 4:07 pm
I have been out of the bloggy loop for quite some time. What a great post to come back to. It resonated with me in an awesome way. It seems to speak to the core of where we’re at right now.
As a side note- Patrick attended his first over night event without a one-on-one support person or parent present. Not sure why I felt the need to share that.
Cheers!
March 26th, 2011 at 5:49 am
Sheila from maviefolle here. I LOVE how you wrote this, starting with the story of your mom cooking! WONDERFUL! Do you watch that tv drama, Parenthood? I love that show. I love the storyline with the autistic son. I think it gives a glimpse into the life of a family living with autism. I also think that a lot of answers, big answers to the make up of the human brain, lie inside the research of autism.
March 27th, 2011 at 3:39 pm
Happy to see a new post from you!!!
Stephanie´s last [type] ..The Big One
March 28th, 2011 at 6:17 pm
You read more than anyone I know, Maddy! I would find this book interesting and would undoubtedly learn something useful from it – especially if I could relate it to both my own mother and to my parenting.
Barbara´s last [type] ..Technical Difficulties
April 18th, 2011 at 5:55 am
We went through CBT for self-injury. One of the boys had started self-injuring to manage anxiety, and that needed to be nipped in the bud before pain became an engrained management tool. He hated the therapy, but it did work.
The process was a revelation, and gave me a very valuable tool – but it was strictly a matter of watching the therapy, understanding the underlying idea, and reusing it in other places. I am sure that I would benefit from reading something about it instead of flying half blind! But the core seemed golden: figure out what the behavior is, break down what purpose it serves, find a replacement that can serve the purpose but lacks the negative features, habituate it.
You always think through things so much more methodically than I, and get much deeper. It’s a blessing to be able to have such clever people tackle the same hard tasks and share their hard-won insights.
July 5th, 2011 at 3:59 am
Hi, I REALLY like your blog
Cognitive Behavioural Therapist