Counselling Dilemma

[Rinkosparrow]

Hi everyone,

So I'm having a counselling dilemma right now. I have severe emetophobia and have had it for the past 12 years. I severely restrict my food, abuse substances, don't go out, don't eat well, have panic attacks often, have very bad anemia. So, I've been seeing my counselor for about a year now. We talk about all sorts of things, not just my phobia. Right now, we're focusing on my phobia again because I relapsed bad.

So, I was looking through this forum and online and I know that it's generally a good idea to work with someone who is trained in the area that you're having trouble in (so, if I'm an emetophobic, I should be seeing someone who has training working with emetophobics). My counselor and I have a good relationship and she's done a lot of work with trauma and anxiety, but she hasn't had specialized training with emetophobia as far as I know. I think I might be her first case, maybe.

So we were talking and she said that she wants me to slowly try exposure therapy. Sometimes though, she says that if I were to throw up, she would be there to help me. I've read online that the goal in therapy for emetophobics isn't to make them s*, but to work on the anxiety surrounding the phobia. For me, when I was 11 years old, I had a traumatic incident where I was left pretty much alone to v* for a long time. And that's where my phobia began. My counselor says that she thinks the way for me to heal from that incident is to throw up, but with someone around to take care of me, because that's what I didn't receive when I was younger.

Does that make sense? So I'm wondering whether or not she's using the best approach with me and my condition, especially since I've been reading online that the goal of emetophobic therapy is working on the anxiety, not so much that you need to be s* and somewhat re-create the traumatic incident but what certain elements changed.

I'm on the waitlist for an emetophobic therapist right now, but the waitlist is 3-4 months. Anyways, what do you all think? Is she going to be using the right approach with me? Any therapists out there that can help? I'm just really unsure with the method she wants to try. I don't know a thing about healing from trauma.

[Heather_509]

I'm using a Thrive consultant via Skype for help workin specifically on the phobia and the program, and I'm seeing a local psychiatrist to help me with meds, the anxiety, and to help me develop a "re-feeding" program.
From what I understand, it's generally not helpful to make an emet v*, that it can be counterproductive... personally, I don't think I would continue seeing that therapist if they insisted on that "treatment".
I am curious though, where do you live that there are actually therapists who specialize in emet?? That would be amazing to see one in person!

[ChiliPep]

I think you should ask if you can work on both the phobia and the anxiety that comes with the phobia. I think it's important to work on both. Anxiety work like learning the signs of anxiety and working on ways of controlling the anxiety before you hit full blown panic attack because at that point your body takes over. And ask if you can work on the phobia/fear without actually having to v*. There is a ton of phobia work you can do that will help that doesn't include actually having to v*. If she/he isn't open to that then try another therapist. Does the therapist have experience with phobias in general? Because at the very least they should have experience working with phobia.

[HallieChristine]

Hello,
I also see a trauma therapist and he is helping me with my emet. I think it's absolutely incredible that you were able to get on a waitlist to see someone who is professionally trained in emet, we don't have anything like that here.
My emet stemmed from the exact experience you mentioned you had as a child, though this happened frequently throughout my childhood. I have learned in therapy that because of this, most of my panic regarding n* is due to emotional flashbacks to my childhood (ex, feeling as though I will be yelled at for being s*, worried that being s* will ruin everything, people will be angry, I will be left alone). Dealing with flashbacks is a whole different beast than dealing with anxiety. The step that my therapist and I use to cope with flashbacks are here.
As far as exposure therapy goes, we aren't doing that in the traditional sense due to the flashbacks. We are working on exposure to the memories of childhood, which are triggering in themselves - and building up a tolerance to that rather than actual instances of v*.
I hope that any of this helps you to guide your therapist in the right direction so you aren't so afraid. One of the things my therapist said is we can't do exposure therapy in the traditional sense because my own body is my biggest trigger. It has taken me a long time and lots of my own research to get him to do therapy in a way that I think would be beneficial to me, and though it has been slow going I believe it is helping.
Be well,
Hallie

[Rinkosparrow]

I'm using a Thrive consultant via Skype for help workin specifically on the phobia and the program, and I'm seeing a local psychiatrist to help me with meds, the anxiety, and to help me develop a "re-feeding" program.
From what I understand, it's generally not helpful to make an emet v*, that it can be counterproductive... personally, I don't think I would continue seeing that therapist if they insisted on that "treatment".
I am curious though, where do you live that there are actually therapists who specialize in emet?? That would be amazing to see one in person!

Hi, thanks for your reply. I live in Surrey, BC, close to Vancouver. I actually just started seeing a therapist who has training in working with trauma and emetophobia. I think I'll probably stop seeing my other counselor anyways.

[Rinkosparrow]

I think you should ask if you can work on both the phobia and the anxiety that comes with the phobia. I think it's important to work on both. Anxiety work like learning the signs of anxiety and working on ways of controlling the anxiety before you hit full blown panic attack because at that point your body takes over. And ask if you can work on the phobia/fear without actually having to v*. There is a ton of phobia work you can do that will help that doesn't include actually having to v*. If she/he isn't open to that then try another therapist. Does the therapist have experience with phobias in general? Because at the very least they should have experience working with phobia.

That's what I thought (working on the phobia without having to v*). I read on tons of sites that the goal for emetophobes shouldn't be to make this v*, as it can re-traumatize them. My counselor said she had a lot of experience in working with trauma, but for phobias, I'm not sure. I have a new therapist now anyways who works with phobias trauma and anxiety so I'm hoping it'll help.

[Rinkosparrow]

Hello,
I also see a trauma therapist and he is helping me with my emet. I think it's absolutely incredible that you were able to get on a waitlist to see someone who is professionally trained in emet, we don't have anything like that here.
My emet stemmed from the exact experience you mentioned you had as a child, though this happened frequently throughout my childhood. I have learned in therapy that because of this, most of my panic regarding n* is due to emotional flashbacks to my childhood (ex, feeling as though I will be yelled at for being s*, worried that being s* will ruin everything, people will be angry, I will be left alone). Dealing with flashbacks is a whole different beast than dealing with anxiety. The step that my therapist and I use to cope with flashbacks are here.
As far as exposure therapy goes, we aren't doing that in the traditional sense due to the flashbacks. We are working on exposure to the memories of childhood, which are triggering in themselves - and building up a tolerance to that rather than actual instances of v*.
I hope that any of this helps you to guide your therapist in the right direction so you aren't so afraid. One of the things my therapist said is we can't do exposure therapy in the traditional sense because my own body is my biggest trigger. It has taken me a long time and lots of my own research to get him to do therapy in a way that I think would be beneficial to me, and though it has been slow going I believe it is helping.
Be well,
Hallie

I ended up seeing my new therapist quick because there was a cancellation and I started work with her last week. It's so strange that you had a similar experience to me, it's hard to find people who have had similar experiences but it helps. I've met other people who claim they're afraid of v* but they seem normal...normal to the degree that it doesn't prevent them from living their lives, so it was always hard for me to connect with them. You posted on that other thread about your therapy, right? I understand what you're going through, I have to deal with PTSD and flashbacks as well. I'm not sure what kind of exposure therapy this new therapist will have me do, but I guess we'll see. I hope you're doing well.