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!