250 - CBT2017-20, June exposures & more

This morning marked the 20th CBT session (with my second CBtherapist) and was very positive! 

Indeed, during the 19th session from May 2nd, we had set a series of additional exposures, with the aim of avoiding the fewest possible social situations, and to increase not only level of difficulty, but also the frequency of these exposures. 

In May, I had quite a few exposures, with also a few avoided situations - the biggest of which had been the march against Monsanto. 

As my therapist had an unforeseen impediment when we were supposed to meet again, she had called to reschedule this 20th CBT from June 6 to today, the 15. 

In the interim, I therefore continued my exposures, expanding on the ones from May :

• I routinely went to the mall and supermarkets for shopping during rush hour, to face my biggest anxieties of longer queues and possibly stressful situation if other customers would confront one another or cashiers (as it does happen from time to time). 

Thus, every few days, I would go one or several stores, such as on May 11, 13, 16 & 26, already discussed in the hyperlinked blog entry above, and again in June. 

Among these shopping excursions, I noted that my coping mechanisms kick-in much faster, and that the level of anxiety has reduced, even during rush hour.

• On June 13, I went to 5 stores, and asked for help from 3 vendors in 2 of those stores; followed by small talk with cashiers from the other 3 stores – and all those, with no anxiety whatsoever. From this outing, I also got some needed sun, and physical exercise as I had to walk between each shopping area, and ended carrying a few kgs of groceries from the last one.

Once back home, I made a phone call to another store, to inquire about a product that I couldn’t find during this outing, and after this call, I went to this store as well as another on June 14 (yesterday), asking questions and help from a total of 3 vendors. Again, no anxiety!

I had left one store to go to the second when I saw that there were too many people ahead of me. But the concern here wasn’t anxiety, just efficiency as I lacked the time to run these errands each in turn.

After both, I read in the park for an hour, before I headed back home. Unfortunately, the park was too empty to get a proper exposure.

• In the meantime, in early June, I was asked to host mhchathour on twitter, and enjoyed this first experience behind the questions and hosting – receiving compliments and support from the attendees.

In turn, I can start imagining host more chats, and possibly group direct messaging based chats, to circumvent twitter’s 140 character limit, have a dialogue in a small committee and a deeper conversation that a twitter chat can offer – being thus a good addition but not meant to replace anything.

• Yesterday, June 14, also marked a huge accomplishment: I made 2 calls to inquire about tram constructions this summer, and squeak at the company for the difficulties they put me in through some of their choices and lacks of accessibility during this period, as they’ll replace the tram by shuttles, which will run different paths, lengthening not only my journeys in the buses but also the walk from each of the stores/mall and having to divide my shopping weight because they won’t raise the sidewalks – which is bad when you have 20+ LBS (9+ kgs) in a shopping cart.

The person I had reached on the phone for these questions didn’t have all answers, and she called me back just a few hours after that to inform me about each element. I congratulated her diligence and told her to take note that I wasn’t happy with these issues, so she can pass the word along to her superiors and other “thinking heads”, for future reference.

I don’t tend to squeak so often, but felt it was important to tell them so they can make better choices in other occasions, because if no one tells them, nothing would ever change nor get improved.

• Another massive accomplishment occurred earlier this month, on the 7^th. I went to the park to read and to meet Sophie again, where each of us read from our current book, but we also had really constructive and long talks. Not only our friendship has grown a lot over the past few months, but also got to practice my exposures with her, because she has been very aware of my social phobia and all my anxieties in social situations, observing my body language and always ready to help.

This time, I also had made a quick phone call to a repair/spare parts shop where my aunt & I have left my airbed back in March ; what’s important in this is that I don’t tend to make such phone calls in public places.

That day, I stayed in the park for a whole 3 and half hours, which is an absolute record for the entire CBT period, but also in the past 15 years. Yes, read that again: I hadn’t remained in any park for 3+ hours in 15 years!

These past 6 weeks, I have had many exposures. They have been a lot more frequent – about 4-5 days each week, in much higher difficulty levels and frequency.

I love these achievements so much and today, my BCtherapist not only congratulated me for them, but also told me that I am in the consolidation phase, that in 2-3 additional monthly sessions we should be done with CBT for social phobia and then, we’ll start working on other phobias (I think to start with emetophobia or coprophobia at first) and thus help my progress.

Until then, from session to session, I have to continue all my exposures, making them not only regular but to  automate my coping strategies, so I can reach a much more manageable anxiety level and to recover enough so I can function without her further help in social situations.

Thus far, my exposures have been tasks, and in the coming 3 or so months, as I work on automating my coping skills, the goal is to make them a second nature and not a task to go through.

• I quickly discussed with her my current research into a possible Asperger’s diagnosis. She gave me an address and a name of a specialist who could help confirm – after I discuss it with my psychotherapist on June 19.

She told me that even if I don’t have Asperger’s, she and my him are both aware that I exhibit some symptoms, which are shared in the phobia diagnosis and that they have taken them into account in their advice and therapies.

She then asked what it’d mean to me to have such a confirmed Asperger’s diagnosis, if I indeed to have it and I answered that since it wouldn’t change my need for therapy, it’d be for

• Self-knowledge as this has been an important part all my life, to know myself better and to be able to
• Tell people and friends what and why I function the way I do, and how to help me cope if I need any help.
• Also, as a mental health blogger and activist, it’s important to me to be able to discuss all my experiences, raising awareness and remaining truthful and honest sharing in all my aspects, to build dialogue bridges and bring stigma down.(Knowing that Asperger is not a mental illness but a developmental disorder, it would represent one aspect of how I am "assembled") 

This 20^th CBT session has been one of the most positive for me and confirmed its benefits and usefulness. Each person is different and so is each therapist. In any case, find the one that best suits your needs, and know that recovery is possible! I’m 41 and I’m proof that even after a lifetime of avoidance and difficulties, I am now far more able to attend many social situations and events that I couldn’t before!