408- CBT4Emeto - 16

It took me 5 days to get around to blog my 16th CBT session for emetophobia. It dates March 15th, but this entry is from the 20th.

It took me this long, because I've been both busy with other things, and postponning this entry due to the extreme difficulties in its composition. 

Henceforth, my habitual trigger warnings are reiterated and I must insist about them : the session was acutely painful. 


In reference to session 15 ,  I'd mentionned to my therapist that I'd been struggling increasingly over the past year with that nasty symptom of constrictions in my throat, often feeling as If I'm choking and this, in turn, triggering nausea, and my emet. 

To quote:

She asked that I bring my light scarf and that we'll work on this choking business, and until then, I am to avoid further widening all those slits I mentioned... 

I'd assumed the session would be difficult, and it was actually worse than I'd imagined. Indeed, after a quick survey of my limited progress with each task from the previous sessions, she asked me to wear the scarf and tie around my neck. After a few minutes, I started feeling that chocking sensation and had to loosen. We discussed these effects and my fears of chocking and that this nausea would cause me to be sick (that V-word I won't type) and she asked me to evaluate my anxiety level at that moment. It was 9/10, so she said to take the scarf off and wait a bit. 

After discussing a non-related topic, and enquiring at my anxiety which had subsided to its usual 5/10, she asked me to tie it again,  and after a few additional minutes, the effect was so bad, that I felt about to be sick. 10/10, I had to untie it, took it off, and had to press on my stomach so it wouldn't come out. It was that severe, that I thought I wouldn't make it.

For a few minutes, she asked me to look at some point in her office, or to close my eyes, which I did, and she spoke very gently to sooth me, which took a good 5 minutes of this meditional guided mediation to calm me down enough and to resume funcitonality.

As a task #7, adding to my other ones, I have to use this scarf at home, tying it over my neck for a few minutes at a time, whenever possible, and when I feel my anxiety reaching 8, to take it off, cool to 4 or 5, put it back on, till 8, and so on. I haven't been able to do it just yet, as we've been either receiving friends, or I've been out and about for errands. The only moments I would have had the time were too soon after mealtimes, which are absolute no-no's for this. 

I have another 12 days till  next session to manage it, and the other tasks as numbered from previous sessions, thus

(1 was only in January)
2 - further reducing my avoidance of garbage in the streets
3- sorting laundry 
4- washing dishes and concentrating, when I can, on the way the dishes are made, not about their dirt (thus far, I did only sporadically since this task was implemented)
5- to take my glasses off and to squint for bloody scenes on TV (more or less successful but not automatic yet)
6- fewer layers of paper towel when cleaning the sink

Thus far, each of these tasks have been only a partial success and either stagnating or a limited, small progress was won through them. 

For me, CBT for emeto is far more difficult than that for social phobias, I can tell you that. The levels of anxiety in the latter had reduced by 35% over the course of my sessions, but for emeto, it hasn't had a proper reduction as of yet. It's a daily struggle that I am trying my hardest to beat, with so few moments of respit that it reduces my overall quality of life. 

Since this phobia is so ingrained and so insidious, and have been with me for over 3+ decades, it won't go away in 15 sessions of CBT, no matter what duration and intensity. I'm tyring, but for the moment, it's beyond my capacity, and thus, I struggle on a daily basis with various triggers, and have to retreat, breathing fresh air outside or at the window, taking my time for tasks such as dishwashing, and still having to avoid many tasks that you'd judge routinely easy for you. 

Next session April 1st, and it won't be a fool's joke. 

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