Tag Archive | exposure therapy

Timeline

Last week’s homework for therapy was to create a timeline of my entire life including anything major, stressful, traumatic, or highly memorable.

Umm yeah this was not fun. I went back through forty years, year by year and filled in the events. It left me feeling drained. And sad. So much pain there.

We started going through the events together, and my counselor asks questions or for more details about certain events. So far we made it to age 5. I was already tired going into the session. This format is particularly troubling. I feel like I can’t hide anything. Like every secret is coming, and that timeline is the roadmap of doom.

We spent some time discussing the molestation by my brother when I was 5, he was 12. Counselors have never focused much on this, because of my dad’s abuse taking center stage. But it seems I have considerable amounts of shame and guilt surrounding what happened with my brother. I think I have not been able to shift blame onto him like I did for my dad, so I still feel responsible or accountable. We were both kids, more equals than with dad. It is not simple. I want to forgive us both. But I don’t. It makes me feel like a bad person.

So yay, we uncovered the next topic for cpt retelling exposure. I am not sure if I should post that story once I write it. I feel much more protective of my brother than my dad. Or is it my own shame that makes this feel wrong? Have to think about it. 

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Doing the impossible

Fear, anxiety, panic, triggers…these can make certain things seem impossible because you feel like you are dying or battling lions or jumping out of airplanes. We can’t do it because we have the stress chemicals in our bodies as if we are in a life or death situation. We can try reasoning, you will be fine, and it helps, but is not always enough to overcome how we feel. If you feel like your head is in the mouth of the lion already, you are sweating, heart racing, choking, about to scream, vomit or pass out…saying to yourself, or hearing someone else say “you are safe, you will be fine” seems like a lie. In that moment I have to trust my feelings, it is how our bodies are designed to keep us safe.

So I can wait out this response though, and try not to trigger it to level 10. If I approach something that causes this response in me very slowly, breathe through it, wait until I am calm again, I can keep moving forward.

I have successfully tackled a few items on my avoidance list using this method. I prefer to do it all in one day, but very slowly, rather than repeated exposures on multiple days as my counselor suggested. I use my ability to hyperfocus. 

There was an entire city I was avoiding. I completed an art commission there with an intimidating man. He fooled me and my name got involved with a lawsuit from another artist. I had huge amounts of guilt, shame, and overall feelings of failure. I have avoided the city to avoid seeing my art, avoid running into this man, and avoid confronting my feelings.

Last week I decided it was time to stop avoiding this. I headed to that city and got to my safe zone, about 5 miles away, and pulled over at a park. I stayed there about 20-30 minutes until I felt restless and bored instead of anxious. I drove a little closer until I felt like choking and pulled over at a Walmart. I went in and bought some cookies. I ate a few until I was calm and drove a bit closer. Next I stopped at McDonalds and got some coffee to go with my cookies. This stop took a little longer. I did some writing on my phone to distract me. I drove a little closer and stopped at a movie theater. I looked up the movies and considered seeing one, but nothing sounded interesting or worth the back pain of seats not meant for me. I drove closer and realized I was on the same street now as my art. I was feeling dizzy, so pulled over again and did some breathing exercises and texted my sis in law. I drove again and parked across and down the the street from my art. I could just see it now. I cried. I cried a lot.

I sat there for about 2 hours, looking at my art, crying, feeling hurt, angry, guilty, sad, whatever came up I allowed myself to feel it. I listened to the radio and wrote to online friends. Then another wave would hit and I cried again. Once it was dark and the place had closed, and I was sure I would not run into the owner that hired me, I drove across the street and into the drive next to it to really see my art close up. I have not been here for years. It was in bad shape. Many spots were damaged by weather and many were repaired by less skilled artists. Oddly, this made me happy. It brought me comfort that it no longer resembles my work and I can get some distance from it now.

I drove past it again yesterday with no anxiety, no hesitation, just a bit of sadness, no crying.

So I am learning how to process these huge emotions, stop avoiding so much of my life, and keep moving forward as I heal.

The White Coats are Coming

lab_coats

I mean Doctors, not mad scientists, because I’m much less distressed about scientists in general. But Doctors? Doctors offices, hospitals, Eeek, gulp.

OK, I sound like I’m kidding, because I do that to lessen the intensity for myself. But seriously this is the next stage of my homework for individual counseling. If you recall I had created a list of situations that cause me distress, and then rated the situations using the 0-100 SUDS, subjective units of distress scale. We noticed that I had some doctor related situations on my list with different ratings. I told my therapist I wanted to start with doctors because I view that as more of a necessity than some of the other social situations. I can’t ask Hubby to go to the dentist or gynecologist for me – I kinda have to do that myself, and it would be great if I could do it with less distress. I’ve always managed to go…eventually…if I have to…and then my heart is racing, I sweat through my clothes or the paper gown, I shake in fear, I can’t sleep for days, I can’t eat or binge eat…I don’t manage the distress well. And because these are not daily situations, I can build up loads of anxiety for the next time, never getting exposure and practice like I do for say the grocery store. Certain situations have never become easier – I simply (ha, simply, she says) grit my teeth and get through it without passing out somehow.

So I’m supposed to break down all of the situations related to doctors and make a new list with SUDS ratings, getting as specific as possible. I have a few ways I can think of to organize this list or it would already be done. I’m not sure if it is more helpful to group by type of symptoms and SUDS rating, type of doctor/situation, or by my fears. Let’s see what happens.

 

Before the appointment is made:

  • Deciding it is an important issue (50) – I get annoyed with the hassle, feel fear what if I ignore a really bad problem, don’t trust my judgment what if this isn’t a problem at all, what if no one believes me or understands me, probably no one can help me anyway
  • Calling receptionist to make an appointment for myself or my family (40) – What if I commit to a date and something else comes up or I forgot about something else or we don’t have the money that day or I don’t feel well and can’t drive that day
  • talking to Hubby about money/schedule (80) – How do I explain my concerns without blaming him or over worrying him but get his input and support, and I might need him to drive me and get a day off of work and I hate asking too much I feel like such a burden and a pain in the butt, why can’t I do this stuff myself, I should be working and not depending on him so much right now
  • Can’t sleep several nights before appointment as I start to imagine and prepare (80) – The nights are really long and I try to relax but it gets worse, and I have nightmares when I do fall asleep
  • Get ready very early and slowly, trick myself one step at a time to stay calm (80) – I can’t rush at all or the anxiety will overwhelm me. I learned to give myselm time to move slowly, dress slowly, check and recheck my pockets and purse so I don’t forget anything, check my map, do calming breathing, drive slowly, and arrive early

 

Stressors at the appointment

  • Driving to unknown location for first time (80)
  • Driving to known location (10)
  • Arriving Late to appointment (90)
  • Forgetting something (wallet, insurance card, phone, etc) (90)
  • germs in the office, signing in touch the shared pen, people coughing near you in waiting room (80)
  • public weighing (60)
  • confusing or triggering forms to fill out with history – how much to share? (80)
  • nurse/doctor might not understand my problem (60)
  • I might be asked to undress (80)
  • I might be touched without warning (100)
  • some touching can be triggering – dentist hovering over me, ob/gyn exam (100)
  • if they hurt me i lose even more trust, hard to speak up (100)
  • new doctor – I don’t trust them yet or know what they will ask me to do (80)
  • I have to share private details about myself (80)
  • I ask for certain tests/labs and feel frustrated doctor didn’t think of it – are they idiots? (70)

 

Types of appointments

  • family doctor in town (20) – 5 min drive, been there many times, low confidence in doctor abilities for anything complex but trust to monitor vitamin D and cholesterol
  • pediatrician (50) – 30 min drive, high confidence in doctors, rarely go unless kids aren’t getting better or I know they need vaccines or other issues discussed, high fear of other germs in the office
  • my dentist (80) – 30 min drive, high confidence in ability but feel they overcharge and attempt to oversell and I hate saying no, I hate laying down in the chair while they surround me, it always hurts no matter how much novocaine is used, I feel ashamed for having bad teeth and eating candy, one hygienist knows my neighbor so there is lack of privacy too
  • back doctor (40) – 2 hour drive, hubby always goes with me and usually drives so I don’t get too tired/overwhelmed, high confidence in doctor, they don’t hardly touch me, I undress in private for xrays, everyone is kind and professional
  • neurologist for migraines (30) – 2 hour drive, hubby drives me, no touching at all, no undressing
  • botox for migraines (80) – 2 hour drive, hubby drives me, triggering position as I lay down and doctor hovers over me, procedure is fairly quick but fairly painful with 50 injections in my face, neck, head, shoulders like many beestings
  • dentists for kids (20) – 1 minute drive, no one touches me, low stress
  • optometrist (20) – 30 minute drive, no touching, once every year or two as needed, ask for dilation instead of air puff
  • urgent care center (60) – do I really need to go? it is super expensive so I don’t trust my own judgment vs fear, can it wait. minimal touching depends on what is being examined.

 

Stressors after the appointment

  • I don’t trust diagnosis and do my own research before filling Rx or doing next steps (80)
  • I don’t schedule followup if I feel fine – waste money (30)
  • I feel guilty for not following doctors orders (30)
  • waiting for lab results creates anxiety and then I feel like a failure if something is wrong, like a bad grade (60)
  • feel guilty spending money on Rx (50)
  • pick up candy with meds at pharmacy (40)
  • might get frustrated with pharmacy if meds aren’t ready on time (40)

 

(photo credit: By Pi. from Leiden, Holland (Lab 15 – Lab Coats) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons)