CBT Fail

My therapy ended a few weeks ago. It was useless, to be honest. I know that this is because the therapist just didn't get it though, had I been working with a therapist experienced in emetophobia, I think I would have felt more positive about the whole thing. The last few sessions literally just went round in circles with her telling me patronising things like "But if we vomit, it's because the body needs to get the bugs out of our system, so it's helping us". Oh really? But how do you think you telling me that is helping me? It isn't. I am perfectly capable of rationalising, just the same as you are, but PHOBIAS DON'T WORK LIKE THAT. It's like when people say to someone who's scared of spiders "But it's far more scared of you than you are of it" *facepalm*

Don't get me wrong, she was a really nice woman and we got on well but my time with her was a waste.

So what will I try next? I think it's going to have to be exposure therapy. The thought of it makes me grimace. I'm probably ok with pictures, it'll be the videos that freak me out I think. I don't think I know of anyone who's ever had exposure therapy so I've got noone to ask advice from. A close friend of mine is a mental health nurse so I may ask her if she's any information on it.

Tomorrow is my 35th birthday, I'm going out to eat. I'm going to EAT MEAT and NOT WORRY ABOUT IT.

Sound of Silence

Well, not sure what's been going on the last couple of months but I've not been able to get in to my blog to publish anything at all. Infuriating. But it looks like it's finally up and running again. Lots to tell since I last posted, my therapy is now finished and I've had a stomach bug! I'll be back shortly to update now I can finally post again! Hope you're all having happy, healthy summers...

Dreaded Exposure

I've not posted in a while, to tell the truth, there's not really been much to update. I've had a few sessions since I last posted but it seems to be at a stalemate. Unfortunately, she (therapist) just doesn't get it. And I know that you know what I mean when I say that because we've all had people say they understand - and probably really try to understand - but who we know in our hearts just don't.

Something funny that did come up actually, is that from practically our first session she's been going on about this one restaurant in our area that she thinks is amazing and really enjoys going to. I told her I'd heard bad reviews about it but she was adamant it is the best place! Well, in our last session, she sheepishly tells me it was closed down for hygiene reasons. I had to laugh really.

I had a major challenge at work yesterday. A young woman came in who had been vomiting since 4am and couldn't keep water down. She said it was 'pregnancy vomiting' but the doctor didn't think it was and I really don't think it was either. Obviously I was (and still am) terrified that it was noro or the like. I had to do all her observations, touch her loads, touch things she'd handled loads, and at one point I went into her room and there was a bowl with a little vomit in it. We admitted her and put her on a drip and some IV anti-emetics and ran a load of tests. I'm back in tomorrow so I'll find out what it was then as the test results will be back. I'm on high alert though, just waiting to develop the symptoms. MEH! It's been 27 hours so far...

The Brick Wall

It's been a few weeks since I posted, so I've got a couple of sessions to update you on (it's been three weeks but S missed a session because she had annual leave).

The session three weeks ago was looking at OCD models of behaviour and beginning Exposure Therapy. The up-shot was that she wanted me to go to a restaurant and order something containing meat or fish, as I always order vegetarian as I consider it safer. I came away from that session feeling a little deflated as she seemed to get stuck at times as I'd challenge her with my knowledge of emetophobia and it felt like she didn't know how to respond. This in turn, lead me to feel like she didn't really understand the mind of an emet at all which is a huge blow after our first couple of sessions were so successful.

So I did as she asked and ordered meat the next time I ate out which was a couple of weeks later. I ordered Bunny Chow (a South African mutton curry - delicious - I'd recommend it!). Mutton! I was very pleased with myself as this seemed extremely adventurous! But I can't really see how 'challenging' myself like this is going to lessen my anxiety of vomiting. You see, I could eat meat in a restaurant 30 times, yet on the 31st I could get sick from it. This is why our phobia is so complicated. For arachnaphobes, they could hold a spider 30 times and by that 30th time, their anxiety is probably minimal as they've realised that spiders aren't that scary. It's just not like that with vomiting.

Anyway, we had the weeks break as she was on leave and then had our next session today. And today REAAAAALLY deflated me. S had supervision with her senior and had spent an hour discussing my case and they had decided that I wasn't actually afraid of vomiting, I was afraid of germs and contamination and OCD was my problem, not emetophobia. This is seriously the biggest load of bullshit I've ever heard in my life. I challenged her on this and again, it seemed to go around in circles not really getting anywhere. So now I know she doesn't get me. OCD isn't my problem. In fact, I've probably dropped all my OCD rituals by about 80% (so I guess I've got something out of therapy, at least). And germs aren't my fear. I could quite happily lick up a whole load of influenza germs and not think anything of it. The only germs I fear are the ones that cause norovirus and salmonella and things like that. So yes, very deflated and a bit down about it.

The challenge she's set me this week is to cook and eat some meat that is the day before its use-by date. You see, I like to buy the food that is the furthest away from its use-by date and am happiest when I can cook and eat stuff that's still 3 or 4 days away from 'going off' as that's the freshest, right? I get funny about stuff that's the day before its use-by date so I must challenge that. As above though, this could be fine 62 times but on the 63 time, it could be 'off'.

Arrrrggggggghh! You know where I'm coming from, right?!

Knock on Wood

I've had a further two sessions of CBT since I last posted. During last week's session, S showed me a model of OCD behaviour and how it works and part of my homework was to go home and re-design the model and tailor it to my own behaviours. This exercise was designed to highlight how avoidance of certain situations only perpetuates the phobia. This I already knew. However, one thing it did show me is that a lot of my phobia and the anxiety around it, feeds on superstition. For example, I hate it when someone asks me when the last time I had a bug was because I feel like if I say it out loud, it will 'jinx' me and my luck will somehow run out and I'll become sick. I've noticed on the Emet Forum I frequent that a lot of emets are similar and there is a lot of superstitious thought around 'anniversaries' and the like. In analysing my own behaviour, I also noticed how EVERYONE is the same to some extent. I pointed this observation out to S, that everyone has these funny little superstition quirks and lo-and-behold, not five minutes later she said something, followed quickly with "touch wood" and started looking for wood to touch so as not to 'jinx' herself. I guess the thing with us emets is that we put too much emphasis on un-jinxing ourselves and it occupies more of our brain and daily thoughts than it should.

At the end of last weeks session, my other homework was to test some of my behaviour and attempt to stop doing it, go with the anxiety it causes, and see if after a number of times the anxiety decreased. So, one of the little things I do is cross my fingers when certain thoughts come into my head. I KNOW it's ridiculous, I KNOW that even though my brain says "if you cross your fingers you'll be 'safe' today" that this is not the case, yet I can't risk jinxing myself. So, I did as she asked and tried to stop myself crossing my fingers. It was surprisingly easy. There were definitely times where I couldn't do it because the 'risk' felt too great but I've managed a considerable reduction in my un-jinxing behaviour which is very encouraging.

This weeks session concentrated on starting Exposure Therapy. There mere thought of which strikes dread through my very soul! I'll update in a few days or so.

The Red Phonebox

My first appointment with my new therapist left me feeling positive, excited and a little apprehensive. Not to take anything away from the trainee therapist I met in December, but this new therapist has a lot of experience, knows the score and I felt like on the whole she got where I was coming from, which is rare. I asked her if she'd had any experience with treating anyone with emetophobia and she told me she once worked with a guy who was emet. He was a little different to me in that his problems were mainly around going out to places like restaurants as he was scared of vomiting in public. He'd never go to public eating places and if he ever did (against his will) he would be planning escape routes and how long it would take him to get to the nearest bathroom etc. His girlfriend was at the point of leaving him as he refused to get married because he couldn't bare the thought of having to sit through a 'public' wedding breakfast... Well, after therapy his situation improved a lot and his anxiety around eating out lessened hugely. Eventually he got married and ate his wedding breakfast in a big marquee full of people. HURRAH!

The therapist - we'll call her S - likened our journey through therapy to climbing a mountain. Right now we're at the bottom but we'll gradually ascend and when we get to 3/4 of the way up, she'll start coming back down and I'll keep climbing to the top. She said there'll be lots of challenges and lots of exercises that push my boundaries and make me uncomfortable. I'm ready for it though, bring it on!!

She has split our work into two parts, 1) OCD and 2) vomit phobia, and she said we'll tackle the one which causes me less distress first (which is the OCD). I've got a book which I have to write in every week and she said it'll be an important tool in the future as if there are any wobbles or re-lapses, I can look back over my work and use the techniques over and over again. For the next week, I have to keep a diary of my thoughts and feelings: when I get an emet thought; how long it lasts; what OCD rituals I undertake to 'cancel' that thought out or 'un-jinx' myself. She explained that when you're trying not to think bad thoughts, you think of them even more. And you know what, she used the little example I gave in my last blog about pink elephants!! Only she used a red phonebox (phonebooth, for all those of you who are Stateside) as the metaphor.

So I'll start my diary today. I'll definitely be having emet thoughts as I'm taking my daughter to one of her little friends' first birthday parties so there'll be lots of kids and potential for germs etc.

My next appointment is Friday week and I'll be back with a run-down. Have a good week, guys.

My Next Appointment

After being on the waiting list for 9 months, an appointment came up for me to start CBT in December but as you'll know if you've been reading, it didn't work out and I went back on the waiting list. I was told another place would come up around March but lo-and-behold I got a letter in the post at the weekend to let me know I have an assessment with a new therapist on Friday (11th)!

So, having secured childcare for Friday - no mean feat, I can tell you - I am all set to meet Ms Warren and once again, go through the history of my phobia and work out where to take it from there...

I'm about 1/6th of the way through the book I was telling you about, written by the lead expert in the field of emetophobia (aka, GOD). It's more about health anxiety in general and using CBT techniques to combat it but there is a chapter concentrating on emetophobia. It's nice to see it acknowledged for once. I'll share a little snippet of the book with you, as you may find it helpful:

Close your eyes and think of a pink elephant. Now try really hard not to think of pink elephants, push all thoughts of pink elephants from your mind. What do you notice?

This is called the 'White Bear Effect' and research consistently shows that when people are asked not to think of a white bear, they can think of nothing but! This is the key to understanding health anxiety as anyone experiencing it will be plagued with constantly trying to rid themselves of thoughts/doubts which actually has the opposite effect. Now try a more real experiment...

1) Spend a day dealing with your thoughts related to emet in your usual way, record their frequency and the distress they cause you.
2) Spend the next day trying even harder to try and rid yourself of these thoughts and record their frequency and the distress they cause you. Try as hard as you can to suppress them.
3) Repeat step 1.
4) Repeat step 2.

Review the results of your four day experiment. What do you make of them? Most people find their thoughts become even more disturbing and frequent the more they try and suppress them.

Stop trying so hard not to have the thought or image that's bothering you and it will bother you much less.

I'd be interested to hear from you if you try this. Good luck if you do decide to give it a go.

In other news, we're almost mid-February now! Noro seasons is almost over, one might think. I won't be getting complacent though, as I caught some nasty stomach bug (no vomiting but still awful) at the end of last Feb so I don't quite feel we're on the home stretch yet. I hope you're all having happy, healthy winters!