Why did I need 20 years of intensive psychotherapy to get where I am today, if I could have done it in just 12 weeks?

Last weekend I watched the first episode of Bedlam, a four-part series on mental health/mental illness on Channel 4, which – according to the programme information – seeks to ‘boldly challenge myths and taboos about mental illness, as well as promote better awareness and understanding of mental health issues, through unprecedented access to the patients and staff of the South London and Maudsley NHS Foundation Trust (SLaM) – the world’s oldest psychiatric institution’ (Link to programme).

Van_Gogh_Sorrowing Old Man
Van Gogh Sorrowing Old Man

The first episode of Bedlam focussed on acute anxiety which takes the form of what is known as ‘Obsessive Compulsive Disorder’ (OCD). We learned that at the Bethlem Royal Hospital in south London, a specialist anxiety unit treats some of the most extreme cases of  acute anxiety/OCD in Britain – the top 1 per cent. The unit is  residential, one of only two in the country.

I found watching the Bedlam episode on OCD acutely painful…the pain I felt had to do with seeing intelligent, creative and eloquent individuals –  the majority of them fairly young…individuals full of potential being tormented and paralysed by acute anxiety that renders them unable to function on a day to day basis, hold down a job, attend a University course they are interested in or maintain relationships.

Even though I have never had a diagnosis of OCD, acute anxiety has always been a critical part of my mental health difficulties. And I have often found myself paralysed by such anxiety – with catastrophic effects on all aspects of my life. Hence, my strong identification with the OCD sufferers in Bedlam and the deep sadness I felt whilst watching the programme…


Sorrowing Old Man (‘At Eternity’s Gate’) – Vincent van Gogh



One of the patients in the specialist anxiety unit in the Bethlem Royal Hospital in south London is 23-year-old James who has a profound fear that he will lose control of his bowel movements in public. Consequently, he spends up to seven hours a day in the toilet, too scared to leave his house in case he has an ‘accident’. He has  been in and out of psychiatric institutions since he was a teenager and last year had to drop out of his drama course at university because his OCD got so bad.


Helen, another patient in the unit, is a librarian at the British Museum. She has what she describes as ‘an irrational’ fear of harming strangers – she believes that somehow she is responsible for killing them in road traffic accidents or putting them in rubbish bins. For the last two years she has lived the life of a recluse, too worried to leave her house or go to work. Her  long-term relationship has also broken down.

The Head of the Anxiety Disorders Residential Unit (ADRU), Simon Darnley, indicated that the rituals and behaviours of people like James and Helen  are driven by a less well known aspect of OCD, ie intrusive thoughts. Simon Darnley explained that we all have unwanted, involuntary, fleeting thoughts and we are able to dismiss them.

His patients, however, become extremely worried and obsess about them. The more they try to ignore the thought, the stronger it becomes. The key to getting better, said Simon, lies in confronting the thoughts head on in practical, reality checking ‘experiments’. Apparently, the unit runs a 12-week therapy programme with a success rate of 3 in 4. The therapy follows a cognitive – behavioural approach to OCD.


Whilst watching the first episode of Bedlam  I was increasingly astounded by how dominant  the Cognitive Behavioural Therapy (CBT) model  seems to be  nowadays when it comes to dealing with acute anxiety/OCD…

12 weeks of therapy that follows a cognitive-behavioural approach  and people with severe OCD are supposed to get a handle on their paralysing difficulties…I am not convinced here…cognitive-behavioural techniques do have their place and can be helpful, I think, but only after you have worked with somebody’s life history and emotional experiences…it seemed to me that people in the first episode of Bedlam were not  helped in any way (no time!!!) to understand their excruciatingly intrusive and suspicious thoughts and their meaning in the context of their life histories…and intrusive thoughts were apparently talked about in the episode in question as something ‘irrational’ that you get at random and you can combat through practical, reality checking ‘experiments’…

Just dealing with symptoms and the surface’, I could not help thinking throughout the episode…but how meaningful  and helpful is that for people’s healing in the long-term?


I wonder why I  needed 20 years of intensive psychotherapy (of various kinds) to get where I am today, if I could have done it in just 12 weeks?


relief_just a swallow away-CBT


  • eileenwanda ,

    Hi Dina,

    Eileen here form little old NZ! was lovely to meet you when you were over. I enjoyed reading your thoughts. CBT really is seen as the holy grail these days – it would be interesting to hear from someone who has done CBT for OCD about what helped their recovery – was it the CBT in combination with other things? i have had a few go’s at CBT for depression – we can access 6 sessions here through our GP’s, sadly it wasn’t a quick fix for me!

    By the way- we absolutely love the latest edition of Asylum – just had time for a quick scan so far – we will subscribe

    • Dina ,

      Hi, Eileen
      so good to hear from you
      thanks for your thoughts on my blog post about CBT…people here in England are offered 6 sessions of CBT as well and very often this is the only talking therapy they are offered…even people who have been through secondary care, ie been hospitalised and acutely distressed…
      Really glad you liked the latest edition of Asylum and you are thinking of subscribing :-))
      You may even feel like contributing to Asylum as well? if you and everyone at Kites feel you would like to write something for Asylum or you would like to send us creative material, please get in touch with me and we can take it from there – my email is d_poursanidou@yahoo.co.uk

      thanks again for getting in touch
      have a good Xmas break
      take care