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Here's MY question, which may or may not have been addressed already--my apologies if it has.
How in the WORLD does looking at pictures and listening to sounds of sick cure one who is only afraid of being sick themselves??
Sage, you say that after your initial therapy, you were rid of the fear
of getting sick yourself. This was acccomplished using exposure
therapy as you've outlined in your excellent articles on this site,
correct?
Well, um...how IS that?? How can you not fear yourself getting
sick without experiencing it directly during exposure therapy?
The reason I'm asking? My psychiatrist recently recommended that
I use ipecac to cure myself of the phobia--to give him a little credit,
he did suggest I do that only after completing a hierarchy of other
exposures, but...! My phobia is pretty mild
compared to some others I've been reading about here, but the intrusive
and unwanted daily thoughts drive me CRAZY.
Anyway, that's it. I'm new here, so I apologize for any protocol
I haven't followed. If anyone has any questions about my doctor,
my meds, or what my sessions have been like, feel free to ask. I
know I didn't know what to expect when I started therapy, so if I can
ease the uncertainty for others, I'm happy to do it.
LostAngeleno
Edited by: lostangeleno
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is the therapy working for you ?
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I would seriously question whether seeing this therapist is a good idea. From everything I've heard, using ipecac could re-traumatize you.
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I've been sick from stomach viruses a couple times in the past few years, and it has only made me more scared. Vomiting is definitely not the cure for me[img]smileys/smilies_06.gif[/img]
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It's really a good question. Hopefully I can explain it without taking 10 pages.
The thing is that although your biggest fear is vomiting yourself, nevertheless, the idea of vomit altogether probably triggers anxiety in your brain. So...looking at pictures of other people vomiting or videos will probably get your anxiety up. The "cure" is through getting your anxiety up SLIGHTLY, then calming yourself down AND talking about what it reminds you of, your early family life, all the emotions areound that, etc. IN a very safe environment/relationship. So it all "works out" well, and your anxiety only goes up a very little bit.
This RE-TRAINS your brain so that the "vomit" stimulus does not equal the "panic" response. It will not be necessary to take ipecac (which would indeed re-traumatize you cuz your anxiety would go WAY TOO HIGH for it to be helpful).
This takes a long time, of course. Your brain wasn't wired in a day, and it won't be re-wired in a day. But over time, slowly but surely, the wires will be "loose" enough that you can insert some positive cognitions into the process (things like "I am not in any danger" or "I'm afraid but I'm ok" or "I am perfectly safe".) You can't "insert" those things now cuz the panic response is too fast and too strong. But once you "open up a little space" it will be possible.
People who fear flying can be cured without being in plane crashes and those who fear sexual intimacy can be cured without having to engage in non-consentual sex. (I equate ipecac treatments with these two things)
I hope this helps. Believeit or not, most psychiatrists and psychologists don't get this. that's because most of the research on phobias is done on spiders. Someone can sit with a spider on their lap until they don't fear it anymore. But somone cannot vomit (constantly) until they don't fear it anymore. It's just not possible. They also can't keep crashing their airplane or being raped until they no longer fear it. This is f***** up. (sorry - but I feel strongly about this).
Nevertheless, there IS a way to use gradual exposure to cure this phobia. The trick is to really get into looking at the pictures, etc. as opposed to just saying "oh I'm not afraid of that". You can't just flip through them and not really think about them. You have to really act like you believe the person in the picture is you, etc.
Anyway, I hope this helps. Post again if I can clear up anything else.
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Jodi,
For me, the therapy has worked about halfway (but I do not consider
myself finished with it yet). Mind you, I went into therapy for
panic disorder and generalized anxiety disorder, not emet, but to me
they all seem to be intertwined. My panic attacks revolved not
around a fear of having a heart attack, going crazy, dying, or any of
the other usual suspects--I knew none of those things would happen to
me. My panic attacks were about suddenly becoming ill and nothing
else--I'd feel (or imagine I felt) a twinge of nausea, which brought on
anxiety, which brought on more nausea, which brought on more
anxiety--it took just a few seconds for it to snowball into a
full-fledged panic attack, during which I was so sure I was about to be
sick that I could barely move.
Anyway, since I have not recently put myself into a triggering
situation, I cannot say for sure whether or not the panic attacks are
entirely gone. I do get little surges of anxiety from time to
time, but they last only a second or two. Now it's time to work
on the generalized anxiety, which for me involves (among other things)
daily worries about becoming ill...even when I feel perfectly
fine! Tres irrational, no?
The bottom line, though, is that everything you've heard about CBT is
true--you absolutely MUST be highly motivated and completely committed
to the treatment. You must perservere through all the setbacks
(and there will be plenty), you must be patient with yourself (because
all this noise about being "cured" of anxiety in only 8-10 sessions is
BULL) and you must be able to trust your therapist. He or she
will need to know just about everything about you except for your shoe
size!
Sage, thanks for replying so quickly! I know you're busy and I
appreciate it. Everything you said made perfect sense (maybe this
would be something to add to your personal Q & A section?) and was
what I had suspected already. Luckily, when my doc brought up the
ipecac, I had already read what you had to say on the subject and was
ready not only to flat out refuse, but to be the one to educate HIM for
once. I may give him your article. He admitted to me that
he didn't know a lot about emet and I think having a copy of your
article may come in handy if he ever sees a full-fledged emet.
LostAngeleno
Edited by: lostangeleno
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hey thanks for that response, lostangeleno - on all counts. It's good for folks to hear someone speak so articulately about their treatment and the approach they've taken with their therapist. Cool.
I wonder if therapy almost always seems to work "half-way". It's only when you look back on it over a long period of time that you realize your life is so much better than it used to be. For the longest time in treatment I wondered "why aren't I cured - why arent' I cured"? Then I started to slowly see how cured I actually was!
I'll put this up under SAGE ADVICE.
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"For the longest time in treatment I wondered "why aren't I cured - why arent' I cured"?"
Oh, wow! I go through that every day, Sage! I think that
the changes that occur through CBT are too gradual to be noticed right
away. You take baby steps to get well, and you only notice your
own improvement in baby steps as well! I am forever wondering why
I am not yet well. I go, okay, it's been so many sessions and I
SHOULD be fine but I'm NOT! (No "shoulds," LostAngeleno, no
"shoulds," honey.) Even now, after 8 months of treatment, I still
have frustrating, miserable, I-feel-so-sick-how-could-this-EVER-go-away
periods.
But that is why it's so important to keep up with the dysfunctional
thought records (for those who don't know, that's sort of like keeping
a journal of your negative thoughts, labeling them as irrational, and
replacing them with positive thoughts that make you feel better.
The idea is to do it every day for a long time so that it becomes
ingrained). I know I don't do mine as often as I should...they're
still good to do even when you don't have to show them to your doc
anymore. [img]smileys/smilies_01.gif[/img]
I do notice, though, that my physical symptoms do not last as long and
are
not as severe as they were before I started treatment! I am
prepared
to give this years if I have to, though--I want to be as well as I can
get, but as long as no one makes me travel or get a job outside of my
home (and no one who knows me would!), I can be pretty happy in the
meantime!
LostAngeleno
