Have you done CBT?

[kyle1989]

what have been your results in trying CBT?

to me i have had to call the concept into question for emetophobia, since the basis of CBT is to challenge your anxious thoughts while generally exposing yourself to the situations you're least afraid of to the ones you're most afraid of.

that approach to me, makes sense with things like heights, spiders, when the situation is external to self. It becomes more difficult when covering issues such as Social Anxiety - but i believe it still achieves great results for issues such as SA and Agoraphobia.

but..

with emetophobia? how do you do that?

i mean, lets take for example my social anxiety, one of the smaller fears i avoid might be travelling by bus; having to board infront of what feels like an audience of faces looking at you. Or another example might be using a cash machine in front of others and fearing that i might not be able to do what i need to do in a reasonable length of time. If i expose myself to those situations, and the worse case scenario happens (someone makes comments or something) thats not hitting the limit of my worse fears of SA.

But with Emetophobia, our 1 single fear / outcome is not something that has different levels! N* and V* don't offer a level of intensity or exposure we can control and expose our selves to. Its an all or nothing situation of either you're terrified or just a little anxious, no in-between. And since the situation is within yourself internally, you cannot walk away from it.

thats the conundrum of the issue i have with CBT, i have little faith it can help overcome the phobia, only the avoiding behaviours which seems to be pretty pointless to me because when you've started taking risks and say "yeah i don't get sick when i eat after handling that door handle or shaking that persons hand or touching this" but eventually it is bound to happen and you're back to square one.

does anyone else see what I'm saying? maybe i am just too fixed in refusing to believe it can work well with Emetophobia. I just can't help but see it as pointless since it will only bring you to a point where you stop avoiding behaviours and end up facing you worse fear (N* or V*) but when you do, its not something you can control the exposure level to or walk away from when you're at that point where facing it is doing more harm than good. It doesn't seem possible to work with the ground rules of CBT recovery..

[AoD]

CBT is training the brain to alter thought patterns, you're talking about exposure therapy for desensitisation there, it's a bit different. Both are often used together, but they serve different purposes. For example, CBT is used to treat insomnia, by forcing the brain to re-learn proper sleep routines and thought patterns relating to sleep, it doesn't have anything to do with exposure and phobia treatment.

For emet CBT works as well, so does exposure therapy. CBT can help you to teach your brain to break the unhelpful thought patterns (to stop thinking vomiting is the most fearful thing in the world) while exposure therapy can help you to re-learn that the activities you avoid because you think they will make you vomit aren't likely to cause that.

Of course if you start the treatment by being convinced it won't help you, you're off to a bad start, because CBT requires a lot of self-work to change ingrained habits and thoughts. If you don't put in the effort (and you're not likely to if you already think it's futile) it won't work. You ARE too fixated on thinking it won't work, so you're setting yourself up for failure. Like I said, CBT will help you lessen fear of the outcome by learning that vomiting isn't scary and it isn't dangerous, while exposure therapy works to lessen your avoidance behaviors and learning that the risk of getting sick from those activities isn't that high.

[kyle1989]

CBT is training the brain to alter thought patterns, you're talking about exposure therapy for desensitisation there, it's a bit different. Both are often used together, but they serve different purposes. For example, CBT is used to treat insomnia, by forcing the brain to re-learn proper sleep routines and thought patterns relating to sleep, it doesn't have anything to do with exposure and phobia treatment.

For emet CBT works as well, so does exposure therapy. CBT can help you to teach your brain to break the unhelpful thought patterns (to stop thinking vomiting is the most fearful thing in the world) while exposure therapy can help you to re-learn that the activities you avoid because you think they will make you vomit aren't likely to cause that.

Of course if you start the treatment by being convinced it won't help you, you're off to a bad start, because CBT requires a lot of self-work to change ingrained habits and thoughts. If you don't put in the effort (and you're not likely to if you already think it's futile) it won't work. You ARE too fixated on thinking it won't work, so you're setting yourself up for failure. Like I said, CBT will help you lessen fear of the outcome by learning that vomiting isn't scary and it isn't dangerous, while exposure therapy works to lessen your avoidance behaviors and learning that the risk of getting sick from those activities isn't that high.

Maybe. doesn't fit my experience of trying CBT for my other anxieties though. As far as I'm aware, its not established if altering your thoughts truly regulates how you feel overtime. It can go the other way around: Your feelings regulating your thoughts. When i get N* my body goes into fight or flight regardless if i think vomit isn't the end of the world.

Like you mentioned there with exposure therapy for Emet, it seems to achieve breaking habits in the short run but in the long run improving your chances of having to face your worst fear. which if CBT has failed to improve the thought pattern part of the problem, its more likely to leave me and probably quite a few others into a relapse of rock bottom emetophobia.

You're right, i really have no faith in CBT for this phobia, i will keep seeking out a specialist therapist in the treatment of the phobia and maybe they will get through to me on why it can work.

has anyone got any stories to share of CBT curing their phobia? i mean not being terrified / panic attacks of N* and so forth. I do not refer to 'semi recovered' or 'quasi recovered' emetophobes who simply learned to cope with the phobia and not let it completely control their life.

[AoD]

Well phobias in general don't really get cured. They can be treated to be nearly cured, but the general sentiment in psychology is that it can't be eliminated completely. You can, however, get it down to a level where you don't worry about it everyday and where the fear is nearly insignificant when faced with it.

I've done CBT and it has helped reduce the fear response in my case, so that when I do feel bad enough that I think I may vomit, I don't freak out as much as I used to. I don't get full blown panic attacks these days, when I feel really sick, I worry and say I don't want to be sick, but I stay relatively calm. Then again, my phobia stems from PTSD, so it might be different.