Need help creating exposure therapy hierarchy

[wccl]

Hi, This question is for those who have been in or are currently in exposure therapy. I am looking for ideas above the level of watching videos of v* on the internet. I have worked my way up to this level and now feel kind of stuck and not sure what the next level should be. And the phobia still seems severe to me, despite working on all this with a therapist for several months. I have been desensitized to the videos and finding them much easier to watch, but the prospect of v* in real life still terrifies me.

The challenging thing in my situation is that I really don't think I "avoid" certain situations because of the phobia, such as avoiding the doctor office, amusement parks, flying, bars, restaurants, etc. I still go to all these places and always have, but just have a high level of anxiety while I am there. I feel like I need to see v* happen in real life for exposure- but I don't know if this is possible or how to go about exposure. And I also don't know how to make the exposure of this kind GRADUAL- it seems "all or nothing" in real life.

Thank you for your responses and any ideas. Any insight to how you have worked on this in therapy would be helpful!
I am working with a very supportive therapist who is trying to come up with a plan for all this, but I wanted to do some research on my own as well. We are working on CBT as well. She treats phobias, but not specifically emet in the past.

[misslucy1590]

Hi there, I recently did quite a lot of reading about exposure therapy and interoceptive exposure (actions that induce symptoms of anxiety). Here are a few ideas I found:

-Spinning in a chair
- Simulating v in a toilet... (ie, pretending to v.. noises and actions)
-Over breathing

Also if you have certain things that you carry on your person for safety to do with emet then you could try leaving the house without them.

Hope this helps

Lucy

[MrsFox]

I'd be interested to read responses too, I'm several months out of CBT and totally fine with watching videos etc, but not sure how to progress because I'm still terrified of it happening to me.

[SoVerySorry]

I don't understand the mechanics of exposure if the fear involves the actual person vomiting, and forcing that act won't help so I wouldn't suggest doing anything that would cause nausea or vomiting...

How about your local hospital? Perhaps pursuing a temporary volunteering job there would help exposure.
Try going to an amusement park. Try heading out where much people will be and stuffs.

[KaydeeJayde]

I don't understand the mechanics of exposure if the fear involves the actual person vomiting, and forcing that act won't help so I wouldn't suggest doing anything that would cause nausea or vomiting...

How about your local hospital? Perhaps pursuing a temporary volunteering job there would help exposure.
Try going to an amusement park. Try heading out where much people will be and stuffs.

The volunteer thing actually isn't a terrible idea when you feel like you're ready. The only problem there is potentially having to bail out on someone who needs you if they do get ill and you don't feel like you can deal with it.

There's a specific reason behind exposure. I was given a pdf about it when I first started, and it goes into the process and the mechanics of it, I'm trying to find it, I'll post it here when I do, SVS

[SoVerySorry]

Oh cool! That'd be awesome! No hurry of course; I'll be here whenever