The First CBT Session

I had my first appointment a couple of days back. It was more of a getting-to-know-you session and we didn't really do any therapy as such. It was more about her trying to establish what's going on with me and how we can move forward. We spoke in-depth about my phobia and how it affects me but a number of issues came up. Mainly, this is Cognitive Behavioural Therapy and she had a hard time actually finding any behaviour that I do related to this, that could actually be worked on.

Most emets have avoidance or safety behaviours that they believe keep them safe from vomiting. I have very few.

Firstly, I'll actively avoid anyone who has a stomach bug, but surely that's just a normal safety measure. This is why emetophobia can be such a difficult phobia to treat because exposure in a lot of cases , would be unethical. We can't work on this particular avoidance behaviour because I'm not going to put myself at risk of catching a bug and to be honest, I think if anyone was asked to expose themselves to someone with a stomach bug with the risk that they'd catch it, they'd be pretty unhappy about it.

Secondly, I usually eat vegetarian when I'm out to lower the risk of food poisoning. Again, this behaviour is difficult to work with because I could eat a shop-bought chicken sandwich today and not get sick, I could eat one tomorrow and not get sick, I could eat one every day for the next 30 days and be fine. But the one I eat on the 31st day could be the one. I've tried it before and it doesn't lower my anxiety.

Thirdly, I avoid places if there is a stomach bug going around. I take my daughter to a couple of little playgroups. If I heard that a lot of the kids were going down with a bug, I'd avoid it for a week or so. Again, I feel this is normal behaviour - who's gonna expose their kid to a bug when it can be avoided? Or do I just think that because I'm an emet?

So I think the therapist had a hard time trying to work out how we'd move forward. She's a trainee psychologist so obviously only has limited experience and she pointed out that she may not be the best person to work with me going forward and was going to discuss this with her supervisor.

I must admit I feel a little deflated as I came away feeling like this is it and this is the way things are going to be for the rest of my life but I can't let myself think like that or I may as well just resign myself to a lifetime of misery, obsessing about when it's going to happen. I emailed her some advice written for therapists on how to work with emetophobia so perhaps this will give her some ideas.

Next appointment is Tuesday, so I'll be back to update!