I've stayed off here for a week but REALLY need some answers... CBT?

[verityvee]

Right, it's hard to put all this down into words because there are SO many thoughts going through my head right now...

Okay. So i've been anxious and emetophobic for nearly 10 years (i'm 17 now). I always remember being anxious at school and then i also remember worrying about being sick a lot. I have been on prozac for 2 years and i recently had a terrible relapse and am now having CBT and hypnotherapy. My therapist want me to stay off this website so I will do when I have got the answer to this question.

The question I wanted to ask was...
Sage and a lot of people on this website say that emetophobia is just a SYMPTOM of our anxiety disorder... So if this is correct, then why in CBT are we treating the symptom and not the underlying anxiety? My hypnotherapist is trying to help with the anxiety whereas my CBT therapist said that I should gradually expose myself to vomit. I gave her the FAQ's sheet on this website and my hypnotherapist has it as well. BUT the problem is... I used to be TERRIFIED of other people being sick because i thought it would make me feel sick. But because i'm a teenager, i've sort of got used to it. I've had SO many house parties where my friends have just puked EVERYWHERE all over my floor and stuff. At first I used to run away and put my fingers in my ears and cry. But i just sort of got used to it. It's the same with watching videos, when I was little I used to watch Casualty and if someone vomited on it, I would think about it all night long and have images for ages. But now, I can watch programmes with loads of vomit it. I can see vomit and not be too scared. I still don't WANT to watch it but I feel that i have got used to it. So in CBT, Alice (my therapist) said we are going to look at pictures and videos and build up a hierachy... and I said that i don't really know what scares me about being sick because i've sorta got used to seeing other people be sick so I can;t think of anything to put on my hierachy?! But i'm still SO scared of it! I have panic attacks ALL the time about it. So now i'm scared that CBT won't ever work for me because i've got used to vomit but i'm still not cured... So maybe i'll never be able to be cured because i'm different from everyone else?! I don't know what to do! Am i un treatable?! And why are we treating the symptom? Surely if emet goes away, my anxiety will just latch onto something else?


Or maybe my phobia has become less severe because i've done part of the therapy myself? As in, i've got used to other's vomiting. But then again, if it was less severe why do i still have LOADS of panic attacks about it and feel deathly afraid? And also how do I treat the bit I still have left?

Anyone got any ideas or similar experiences?


LONG RANT sorry

[Rebecca85]

Maybe for you, you need to concentrate on the c part of cbt. Ie cognitive (thinking). Like you said, you have basically done the exposure side of things. To treat a phobia of yourself vomiting, I think you need to change the way you think. Like you need to convince yourself that vomiting is harmless. Your therapist should show you how to train your thinking. This can be applied to all sorts of situations- I had this sort of cbt for depression.

[verityvee]

Also, I don;t just worry about vomiting! I have panic attacks about being in inclosed shopping centres that i can't easily get out of. I panic about lots of things... so if we're treating just the ONE symptom surely none of that is going to get any better?


Thanks for the reply Rebecca

I don't really know what to say back to it. I just feel i'm not ever going to get better because it's all so complex. I can't remember what is normal and what is not because i'm so used to being like this now. I can't even think of all the behaviours i do because they've become so normal

[Rebecca85]

That's what I'm trying to say- cbt should be able to help with all your anxiety, not just emet related! As for the behaviours, your therapist might be able to help you or you could ask a close friend/ family member to be brutally honest with you.

[verityvee]

But since she has mentioned exposure, my anxiety has gotten worse. I just don't want to do it at all. I know I HAVE to but i'm dreading it now. I have a friend who got completley better through just hypnotherapy! No exposure at all :S

i dont know what to do

[Rebecca85]

Why does the mention of exposure make your anxiety worse? You said you were used to seeing it with other people! Besides, you are in control of therapy. If you say no exposure, your therapist might not like it, but she should respect your wishes and try an alternative approach, and maybe you will be ready for expisure at a later date.

[verityvee]

I don't know what I am scared of and not scared of.

I think maybe i am still scared of watching videos etc i just ignore it?
Dunnoo
i just feel i'm never going to be able to get rid of this for good...
Can I?

[Rebecca85]

Only you can answer that question!

[verityvee]

I just keep thinking no... so does that mean i can't...

[verityvee]

also my CBT therapist said it wouldn't be any different if she was there or not. We'd still be doing the exposure... so surely if i've done all I can then I'm never going to get better??

Or can she help more than she says with the cognitive?

[Rebecca85]

It means you need to change your attitude before you can make progress. You need to believe you can get better. Like with the kids at school, you ask them to do something and they say 'I can't' before they've even tried. Are they going to be able to do the task? Of course not hecause they're expecting to fail, and not giving 100%! Your therapist can help with this too!

[Rebecca85]

The cbt therapist should be able to give you the tools you need, it is then up to you to use them correctly. At the moment you don't have the tools which is why you're struggling. Imagine you're rewiring a plug but you're using a knife instead of a screwdriver. You're not going to get very far! Your therapist has a screwdriver. She could do the plug for you but then you'd have to call up everytime you needed a plug doing. Or she could give you the screwdriver and let you get on with it.

[verityvee]

But whatever I do I just can't believe I can get better? I have been like this nearly all my life and my dad and grandma both have anxiety. I have TRIED and tried to make myself believe i can get better but i just dont seem to be able to believe it!

How can i make myself believe it? Can I REALLY change 17 years of thoughts into new ones?

[Rebecca85]

Of course you can. It's like learning anything new. At first it takes a lot of effort and concentration but it gets easier with practice and eventually you won't notice that you're doing it and that's when you'll be cured!

[griffdiz]

I am 24 and cant remember a time when I was not emetophobic. I recently decided to get therapy since it has gotten worse. I too am going to get CBT, but I havent started it yet. I understand exactly what you mean about thinking you cant get better. I CANNOT imagine what it will be like to be cured because I have always been afraid! I try and try to think of any way that I could not be scared and I cant think of a single way. I too have been exposed a lot and at times have felt less anxious and at other times had full blown anxiety attacks. Here is the thing: you have been exposed but not cured because you have not learned the proper way to cope yet when exposed. So instead of feeling like you are getting used to it, in the back of your mind it is retraumatizing you without you realizing it. That is what the therapist is for, so they can teach you how to retrain your mind. If we could just expose ourselves and that is all there is to it, we wouldnt need therapists at all!

The way I try to think of it is this: while I cant in my wildest dreams imagine that I will ever not be emetophobic, I trust that my therapist knows what he is doing, and that all the people from this site that have been cured are telling the truth. They are honestly not afraid anymore. So yes it does exist to be cured and if this therapist cant help me I will find one that can. I believe there is someone out there who can. Just believe in the fact that these people know what they are doing and can definitely help you, you just have to let them.

[ButterfliesInHerEyes]

Based on what you're saying I think this shows just how much your fear is of the fear (anxiety/panic attacks) and not about vomiting. Your brain has just attached the horrible feelings of a panic attack to vomit. You're right, if you don't deal with that (the root) then your fear will probably just attach itself to something else. So in CBT, don't worry so much about the hierarchy or even about vomit itself, concentrate on being gradually exposed to the thing that causes your anxiety (ie vomit) in whatever order, and work on lowering and eventually eliminating your anxiety.

Talk to your therapist about this.

And, of course you can overcome this. Everyone can. Fear is a LEARNED behaviour, so it can be unlearned, so to speak.

Good luck! You can do this.

[verityvee]

Thanks Butterflies, but the thing that causes it is vomit? So what could I gradually expose myself to other than vomit?

Also, i got slightly better and now i'm terrible again, i feel im back to square one, but it's just a set back isn't it? I haven't gone back to square one

[sage]

vv, while I appreciate everyone on here trying to be rational with you, and giving good advice (I love that screwdriver metaphor, Rebecca!) nevertheless if you look back at all your posts here and on other threads you'll see a pattern. And that is - you are continually asking questions. This constant desperate seeking of reassurance is futile. No one will ever say anything to you that will make you feel better. What would stop the questions? Us all saying there's no hope for you ever? Perhaps if we did that, instead of trying to reassure you and be logical with you, you would take up the opposing viewpoint. I don't know. But what I do know is that nothing we say either here or in your numerous pm's seems to make a hoot of difference.

I did suggest you stay off these boards, and off the internet as it relates to your anxieties in general. A week isn't long enough. Stay away for six months,do your therapy and then come back and touch base with us. Trust your therapist and work hard at the exercises she gives you.

btw, you might want to print out the "Get the Facts" section for them, not the Q&A section. The former is written for therapists.

[ButterfliesInHerEyes]

Thanks Butterflies, but the thing that causes it is vomit? So what could I gradually expose myself to other than vomit?

Also, i got slightly better and now i'm terrible again, i feel im back to square one, but it's just a set back isn't it? I haven't gone back to square one

You're not back to square one. It's just a setback.
You still have to expose yourself to vomit because that's what you've linked your fear to, but what you need to focus on is lowering your anxiety (fear) as you're being exposed to it. Do you understand what I mean?

In addition to exposure therapy, do daily relaxation therapy at home - 3x a day if you can. In the morning when you wake up, in the middle of the day, and at night before you fall asleep.

Your therapist will guide you. Trust her.

[verityvee]

Andrilla said i will never be 100 % cured on my " am i back to square " post. now im down

[kbscared]

I think everyone is so brave to be dealing with this ridiculous fear that cripples us.

[Andrilla]

Andrilla said i will never be 100 % cured on my " am i back to square " post. now im down

Sweetie, you know that you twisted my words. I said that I don't believe in a 100% cure because it is always possible for someone who has made amazing progress to fall back into their old routines. Like an alcoholic who has been sober for 30 years having a drink and then having trouble again. It is possible to get to where it doesn't control your life, where you DON'T spend so much time thinking about it, and where you can deal with vomit like a "normal" person, but there is always the possibility for relapse if you don't keep your eye on your behavior.

The fear is learned, and it can be un-learned, but it can also be re-learned. Phobias mostly revolve around negative reinforcement which is the removal or avoidance of an unwanted stimuli (vomit, it our case). Negative reinforcement is VERY strong, if you start reinforcing the old phobic behaviors, you can bring this phobia back no matter how long it has been gone. I view it as more of a remission than a true cure.

CBT takes a LOT of work, and you have to be willing to put yourself through it and dedicate yourself to it 100%. You can't go around looking for proof that you have failed, you have to look for proof that you have succeeded.

[verityvee]

Thanks everyone.
I will leave this site now as I know it isn't helping. It's just SO hard not to come on here when having the worst panic attack you've had in ages and feel like all your progress is lost. Thank you for everything

Sage thanks for putting up with me and my endless questions. My therapist has told me to stop texting her as well.

[verityvee]

One last thing,

no-one has answered why we're treating the symptom of my anxiety and not the root cause?

Do i just need to trust my therapists?