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why I am still awake at 9 am - helen-louise
baratron
baratron
why I am still awake at 9 am
One of the reasons I described the CBT I've been doing for sleep problems as "useless" is the fact that every Thursday night, I end up staying awake the whole night because I'm procrastinating doing the exercises I'm supposed to have done during the week. The obvious question is "Why don't you just get started, as starting is always the hardest thing?", but if I knew why I get too stressed out to start, I'd be able to do something about it.

It doesn't help that I really resent having to keep a sleep diary. There's a recovering anorexic who writes a column called "An Apple A Day" in the Body & Soul section of The Times, and she was saying only the other day how many therapists recommend people with eating disorders to keep a food diary. But she finds that the food diary focuses her mind on how much she's eating, and it makes her feel worse. I have exactly the same problem with a sleep diary. It emphasises the fact I haven't managed to go to bed before 5am any day in the week, and makes me feel wretched - which is hardly a good state to try to recover in!

And I wrote all over the forms before I even started seeing this therapist that I didn't want to sleep at the same hours as other people in my timezone. 3 am-midday works for me, as long as I can keep it stable. The problem is that illness, chronic fatigue, or - yes, distraction or lack of willpower makes my bedtime drift later, so my waking up time drifts later, and I end up not getting out of bed until 5 pm. That is a problem. Getting up at noon isn't. Focusing on the hours I sleep as the problem totally misses the things I need to work on. I didn't appreciate being bullied into agreeing to "try" going to bed between 2 am and 4 am and getting up between noon and 2 pm (he wanted noon to 1pm, I said "Why is the going to bed window 2 hours but the getting up window 1 hour? That doesn't make sense"). Oh yeah, he wanted the going to bed window to be 1 am to 3am and I freaked - I love those couple of hours after midnight when it's quiet and I can think.

I'm pissed off because I don't think I've been doing any of the things that CBT is supposed to be about. One of my friends is going through CBT exercises in his livejournal about difficult situations, each time looking at: Action --> Belief --> Consequences --> Disputing Belief. That looks like useful and valid work. I was under the impression that CBT is about teasing out negative thoughts at the back of your brain and then challenging them with positive beliefs. Well, I haven't even done any thought challenging - nothing serious enough for me to remember, take home and be able to use. It's just been arguing about why I go to bed so late. A few useful things have come out of that, but telling me to go to bed earlier doesn't make me get tired earlier!

And today is supposed to be my last session - apparently you only get 6 sessions now, not 8. I am quite thoroughly pissed off and considering finding a private therapist, one who is properly experienced in CBT for sleep difficulties and understands what delayed sleep phase syndrome is instead of trying to fob me off with the same bloody "sleep hygiene" stuff that Does Not Work.

I wish the therapist I saw for medical phobia was still around - she was brilliant.

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Current Mood: pissed off pissed off

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Comments
firecat From: firecat Date: 22nd July 2011 09:06 (UTC) (Link)
But she finds that the food diary focuses her mind on how much she's eating, and it makes her feel worse. I have exactly the same problem with a sleep diary.

That seems like a sufficient explanation for the too-stressed-out-to-start-ness.
alexmc From: alexmc Date: 22nd July 2011 10:04 (UTC) (Link)
I'm not sure I understand how CBT can help with sleep problems. annafdd tells me it can help if the problem is anxiety - which it seems to be in your case.

But if it helps to reduce your anxiety over time that may not have positive effects on your sleep for ages.
baratron From: baratron Date: 22nd July 2011 12:31 (UTC) (Link)
Exactly! And my level of anxiety about getting to sleep is the same no matter what hour I try to sleep! (It's slightly reduced if I go to sleep at the time I prefer, since I have lots of past evidence that I can sleep at that time and only negative evidence about getting to sleep earlier in the night.)

I'm not happy about what I'm perceiving as bullying from my therapist, but we'll see how today goes.
mjl From: mjl Date: 22nd July 2011 13:01 (UTC) (Link)
"I was under the impression that CBT is about teasing out negative thoughts at the back of your brain and then challenging them with positive beliefs"

I'm not an expert, but that would be the "C" bit. The "B" bit is about changing or replacing "problem" behaviours. But it's supposed to deal with both. I guess that may not be possible in 6 sessions - the Royal College of Psychiatrists page says 6 weeks to 6 months, depending on the person and the problem. So, being generous to the therapist, maybe they've decided they need to shortcut the process in order to achieve anything in 6 sessions.

I also read somewhere that there's a study showing that CBT tends to be most effective for people that have not previously had any therapy (can't find again now where I read that...), which I don't think applies to you...
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