Update on CBT

[sarahfl]

Hi all-


Had my first session with a psychologist today and I think it went great! We mainly discussed me, my parents and my brother. She agreed with what I said I thought was at the stem of my emet - that it comes down to a fear of loss of control. She said that I have always been control of almost everything and that I'm an intellectualizer. She was impressed by the fact that I had already started to give up control of some things in my life that I would usually try to take control of. I'm feeling good about this so far and am really excited to be rid of this fear. Sage - what do you think about what she said? My "homework" for the week is to keep a little list and write down everytime I feel nauseous, what time it is, what I was doing and how I felt.


Sarah

[sage]

sounds like you're moving forward - good stuff!

[laneyb]

Sarah, Im glad it went well for you, would love to hear about your progress as I am a complete control freak and have to be in control, over everything - I am sure this is the major cause of my emet and have thought this for some time, just havent got round to doing anything about it!!!


Laney xx

[sage]

My theory is that all people are "control freaks", meaning that it's terribly frightening to feel out of control. However, for most people, when others are in control, then they feel confident that things are under control. But for some (like phobics) we do NOT feel in control in the least...in fact, if other people are controlling something, our experience is that we will be victimized. So we're terrified unless we're in control. I also think this is true for those people we call "control freaks" at the office.


The feeling of being out of control is absolutely terrifying for everyone. It's just that not everyone feels this way. But if they did - they'd be scared too

[sarahfl]

Just wanted to give everyone a quick update on my experience so far with CBT. I have to say that my psychologist is incredible and the CBT is helping SO much. I was finally able to drive for 8 hours straight and instead of not eating anything but crackers the whole time, I was able to stop 3 hours into the drive and eat fast food and then keep driving the rest of the 5 hours!! That was huge for me! She has me rating anxiety-inducing situations on a scale of 0-100, 0 being no anxiety and 100 being the worst possible anxiety. Whenever I have a panic attack, I'm supposed to rate it on the scale of 0-100 and see how that number ALWAYS comes down, that the panic goes away. I've noticed that situations that used to cause a level of 80, now only get up to maybe 45 or 50. I was able to take care of my Mom after she had surgery even though I was scared of her getting sick, something I was terrified of doing. We've discovered that my phobia is not only based on fear of loss of control, but also on my fear of being vulnerable. Hope this helps, just wanted to let everyone know how I was progressing and that CBT is working for me!!





Sarah

[sage]

sounds brilliant - good work!


thanks for sharing.

[banditjamie]

Hi Sarahfl,


I live in the United Kingdom and am waiting for CBT therapy on the free National Health Service, got to wait about a year though because of waiting lists.


I have had one session with EFT though and while talking about it and thinking about the root cause I had a bit of a revelation. I've always thought of my Emet as just a fear rooted in the physical trauma of V#.


It's hard to break out of that feeling but we are told that its more likely an emotional factor that our sub-conscious is trying to protect us from.


With my Emet Iam only afraid of myself V# and I only have extreme anxiety when around other people. I realised this is because I am afraidhow I will react and how people will see me if I V#. (A loss of control)


I then remembered that when Ilast V# (15 years ago when I was 8 and never since) I criedmy eyes outand had to be showered naked by aunte. I realised of course that this might be what my sub-conscious was hiding... that if I'm sick I will cry and feel naked in front ofanyone who is around me. Obviously that is pretty scary for anyone but I think especially for a boyin terms of the crying.


The thing is that I was excited when I realised this, but it hasn't really changed about how I feel about being sick. I only thought of it today though, maye I need to explore it with a therapist and do some restructuring!


Thanks for listening, thanks for your post.


Jamie

[sage]

Jamie - that really is a brilliant insight on your part. And you're right that insight alone won't help much. That's cuz your brain's "wiring" is pretty set now, regardless of WHY you developed the phobia. There are two ways to approach your treatment, however (and of course I'd recommend professional help, but I understand you can't get that just now). 1) work on the feelings of shame. There's a great book called "Healing the Child Within" and another by John Bradshaw on Shame (can't remember the exact title). The first book is by Charles W.... something (sorry). But these books have exercises in them that could help you. If you can think through the feelings of shame back at the time you were showered by auntie, and all the things related to that then this will go a long way. Don't be afraid to re-experience the shame feelings in a safe environment. If you can't talk to a therapist yet then perhaps you can find a clergy-person who will just listen or even a good friend (tell them you don't want advice, just an ear).


2) work away at the phobic response , and you'll "come at it the other way 'round". Once the phobic response is less, the shame feelings will dissipate as well. The point is that your brain has them wired together ("cells that fire together wire together"), and one way or the other will help separate them. So vomiting will not any longer be associated with shame, fear and trauma.


Good luck!

[banditjamie]

Thanks Sage,


I think it is all about control but it seems to be on two levels.


If I'm around people I will panick because I don't want to lose control and them see me breaking down. I think this is where my actual rational brain plays a part because I don't want to be seen breaking down.


If I remove myself so that I am alone, the actual panick attack subsides but I'm still terrified of the actual physical experience of V#. Perhapsthis is where its pure unconscious mind, that I've linked the physical process ofV# with the emotional trauma of felling shame and embarrasment. It must be the emotional trauma becausewhen I'm aloneI know thatV# doesn't mean I will be naked and cry.


Its so frustrating when you understand what the problem is but can't do anything about it yourself, have to accept that theres two parts of the brain and one is more powerful. Its as if they both can't operate together, as if the switch for one automatically turns off the other. Kind of makes me feel schizophrenic in a way.

[sage]

yes it's very true that the switch for one turns controls the other. Specifically, the amygdala (at the very back of our brains - a very ancient, "reptilian" part) is the fear centre and it's incredibly powerful. This is to preserve us from harm - pure survival! So it SLOWS DOWN the "thinking" part of the brain - the neocortex in the front (a partunique to human beings).


HOWEVER, the good news is that the neocortex CAN INDEED control the amygdala, ...it just takes a long time. This is why treatment for phobias actually works - if you keep at it and are willing to invest the time. The trick is not to overwhelm the brain with so much fear that it can't learn anything. So little by little, the brain can be RE-TRAINED to learn something new (i.e., vomiting is NOT scary!)


All the best!

[catherine s]

It's very motivating to read about people moving towards an end to their phobias. I am right in the middle of it and am currently feeling quite demotivated.


Basically, I recognised my problem when I first visited this site in March 2006. I have always been frightened of others being sick, and almost never vomit myself (last time I really v** was in 1983!). I got traumatised when I was pregnant and after the birth of my child, I began having horrible periods of upset stomach and nausea. My daughter also v** a couple of times. I gradually became completely phobic about myself and anyone else vomitting. The worst thing was being frighened of my own child and not wanting to spend too much time with her in case she was sick.


Since then I have taken time off work to concentrate on destressing my life, and to start working with a therapist. I have found a nice therapist who listens and gives good sensible advise on how to be happier with myself (problems of low self-esteem, marital problems, etc) but she is very puzzled by the emet. So I have been to see a CBT, but she wasn't very sympathetic and was quite cross with me when I admitted to taking anti-emetic medication when I thought I was going to be sick. I understand that avoidance perpetuates the problem, but I am so far from being able to vomit without terror that it'll take me a long time to be able to face it without the drugs. After this I lost confidence in her, and have stopped going to see her.


On the positive side, I have been working with Bourne's 'The anxiety and phobia workbook' which I have found useful and sensible. It is impossible to do all he recommends just because it would take up all my time. But I have made good progress by myself on the CBT and refuting negative self-talk. I do relaxation based on sophrology and am trying meditation (difficult!). I am also working through the gradual exposure pictures on recommended in the Treatment section of this site. This has also been helping.


My current demotivation stems from a food poisioning episode two days ago when I felt horrible and sat and shook for hours. I didn't v* and somehow I managed to hold it in. During and afterwards, I managed to reconnect my brain and actually think about the reality of what was happening. THis is a big advance, because usually my brain stays in a dissociated state for a long time, even days because I worry about others around me also catching what I have had. However, little by little, the episode seems to have retraumatised me and I am feeling useless and anxious about every little stomach twinge. I thought I was over the worst, but at the moment it feels like the progress I thought I'd made was an illusion.


Could this be because I have not made any efforts to understand the reasons behind my emet? Neither of my therapists thought it was necessary, and I can't put my finger on any particular event or group of events that might have triggered it. I think I will try and find another therapist but am lacking much confidence in finding the right one.


I would appreciate any advice on what you think is important or what I should be looking for in a therapist.

[banditjamie]

Hi Catherine,


I am very new to all this and am not sure how much help I can be!


As you can see from my above posts, I am able to pinpoint when my phobia started and am even able to work out why I have to be alone when I feel sick.


Some theories subscribe to the idea that all phobia's are purely emotional. Thats hard for us to understand because V# is so physical, when we are in our phobic states all we are thinking about is the physical discomfort of feeling S# and being s#.


When you get a bit of perspective on it though it all becomes alot more simple but at thesame time very complex!!!


Whyare some people terrified of spiders when we know they can't hurt us?


More importantly for us.... why we we choose to do alot things worse than V#? e.g when I feel ill I think I would rather cut my arm off rather than be S#, some people sincerely report that they would rather die!


I think we need to look at it from both sides, that is the emotional and physical brain factors that play a part in our phobia.


By understanding how the brain works we can change its irrational thought processes:


e.g Changing....... If I am S# I will (Die, cry, breakdown etc etc) to If I am S# I will not enjoy it but once it is over I will be fine and back to normal.


For me the emotional side only helps to re-inforce the rational part of my brain in thinking that this phobia is irrational. So I do not think that understanding where your's came from is as important as CBT, it could help though but probably only as a compliment to CBT.


The emotional aspect for me is as follows.... when I think I'm going to V# my brain regresses me back to when I was a terrified child. It's trying to protect me from feeling naked, crying and feeling ashamed. By realising this I was able to re-inforce theidea that these feelings are irrational and that helps in trying to overcome it. By combining this with CBTI can begin to reprogram my brain to believe that I WILL NOT FEEL NAKED IF I AM S# I WILL NOT BREAK DOWN ETC ETC.


But likeI saidit is hard to do that with the emotional side alone, we don't know enough aboutour brains to restructure these thought processes that have become so engrained.Thats why we need books and therapists.


I think the most sensible technique is the refuting negative self talk stuff. If we can learn to positive self talk we can stop the viscous circle of anxiety.


Whether its stopping it by thinking 'feelingS# is all in my head'


Or 'even though I am going to be S# I will be ok afterwards'.


Most of that was me rambling but hope it helps in some way!


My advice is to do everything you can, look at it from all angles in a safe environment!

[sage]

Hi guys - welcome Catherine! My immediate response to your post is that you need a better therapist. Anyone who's "cross" with a client is an idiot,in my opinion. The most important thing in therapy and in all therapy techniques is "unconditional positive regard" for the client. Sounds to me like this woman has never suffered from a disorder and has little capacity for empathy. Your first therapist who was "puzzled" by the phobia again sounds inexperienced to me - she runs up against something she's never heard of and instead of researching it or asking a supervisor for help, she refers you elsewhere. These "broken relationships" actually ADD to a client's anxiety.


So please don't lose hope. Refer to my paper on a sticky post at the top of this section about how to choose a professional, and give it another try. If Bourne's book is helping you, then you're a prime candidate for really being able to get over this completely.


Take care and good luck!