415- CBT4Emeto - 21-26

My exposure tasks for the last few CBT4Emeto sessions have usually been the same ones, so I had decided to avoid a repetitious posting on individual sessions. , 

Today I'm working on catching up, and shall discuss sessions 21 to 26.  Their dates were 1, 16 and 30 July, 27 August, 17 September and 5 October. 

Henceforth, my habitual trigger warnings are reiterated. 


I'll reference again 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. 

My exposure tasks have been the same over the last few sessions, because my CBtherapist wishes me to become more accustomed to them and that they become a normal aspect of my routine, instead of difficult tasks. They are, for the time being, to apply as much and as often as possible. 

We came to number these tasks, to save time in referring to them - having each a copy of the list. For sessions 21-26, my main exposure tasks have been and remain 2, 5, 6 and 7. Here's the list, with, when applicable, updates about my progress : 

2 - further reducing my avoidance of garbage in the streets, by walking no more than a meter away. After consistent difficulties, this exposure became somewhat "easier" for me. I no longer avoid nor cross the street, unless I pas in front of reaking garbage, just after a meal. 

3- sorting laundry : My wife had caught up with most of it, but whenever I'm not running for errands, I sort the laundry a tad bit and asked my wife to leave it to me more often, when possible. 

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. My usual coping mechansim is through listening to music, and sometimes singing along. When triggered, I still have to take a break, breath fresh air at the window, and sometimes, especially at evenings, I  have to skip part or whole dishwashing sessions.

5- to take my glasses off and to squint for bloody scenes on TV. Before session 20, this was a very small success, but, as we finished rewatching Star Trek Voyager, I managed to implement this exposure by rewatching NYPD Blue, a cop show from 1993 onwards, which is more graphic and contains more blood than Star Trek, simply due to its nature and period. We watched the first season, with only a few discreetly bloody scenes ; and a few of the second, where this task is even more useful, due to augmented graphic content. Thus far, I avoided only a couple scenes and excercized my exposure properly on all the others. 

6- fewer layers of paper towel when cleaning the sink. Before implementing this, I had used several layers, multiple times. Since CBT4Emeto session 18, I have been limited to 2 layers at a time, with more or less difficulties and had managed a bit up to session 20.
On session 25, I have been limited to 1.5 instead of 2. During the weeks leading to session 26, the last to date, I managed to implement this every single time and realized that it's because I've been more regular in cleaning, thus avoiding buildup of filth, thus allowing 1.5 layers and this exposure. 

7- Constricting the neck : depending on the season, and during daytime, I have to avoid using my wide collared tshirts, shirts, and wear narrower collared ones instead ; or, I have to use a scarf, for the same purpose of creating the sensation of constricion, for as long as I can. 

At night, I'm still allowed to use my wide collars - as I explained on session 26, I still find it impossible for me to implement this task at night, because my other struggles (especially CPTSD nightmares) are so frequently triggered, that I have no energy to try this, just yet.

Session 26 for Emeto was also our overall 50th CBT since I had started with this therapist, back in May 2016. She had first helped me with my social phobia, and on overall session 25, we swapped to my complex emeto, because I became autonomous in my social exposures and had met my goals in reduced anxiety and avoidance. I didn't expect the series for emeto to be as fast, and indeed, at equal numbers of sessions, I still have a lot of work ahead. My progress have been mostly for the hemophobia portion - the phobia of blood. The other components are still difficult, and I haven't even begun working on some of them! 

But, I'll tell you one thing : I'm not in a race, I have a constructive exchange with my CBtherapist and I trust our work together. The reduction in anxieties based on the 4 phobias comprised in this 'complex-emeto' (my own term to describe the 3 other phobias that are intertwined and share similar symptoms and triggers into my emetophobia) is perceptible, though bound to be reprented by a small %. These phobias have been with me even longer and far more ingrained than my social phobia, hence the need for more work - on which I embarked on 27 November 2018. 

For my next CBT4Emeto session (27) on 14 November, I have to continue tasks 5, 6 and 7. The others are of secondary importance at the moment, but I still have to do them when opportunities are offered. However, in just over 2 weeks, we'll be travelling to London, where tasks 7 and 2 will be most present, whilst 5 won't be feasible at all - I won't be normally watching any TV over there. On the other hand, this trip will offer many social opportunities, and since I have some updates about my progress in that aspect, I'll post a seprate entry to discuss both progress, and exposures to come - thus ending this current entry rather abruptly.


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