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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Dinah on October 17, 2008, at 18:48:41
My therapist seems quite excited by the idea of working with me on desensitization. He actually referred to thinking about it outside our sessions in a way that sounded as if he really had.
He was pointing out all the things that I have described as arising from the phobia/obsession. I pointed out that they might have arisen from that, but that didn't mean that working through the phobia would reverse the rest of it, but he seemed undaunted. He gave me one of those answers he gives me when he doesn't want to argue but he's not giving up his idea either.
One of the things that he didn't quite say was *integration*. Which I don't even see as a beneficial outcome.
I see landmines everywhere. If he's the therapist who does this with me, I might lose my safe base. If I start associating him with vomit, will he be safe anymore? He says that when I've worked through my vomit phobia he won't be unsafe just because he's associated with vomit. But on the other hand, if he's unsafe because he's then associated with vomit, would he be able to help me through the desensitization at all? Plus, we're talking years. This isn't a phobia that can be ended in ten easy sessions.
If I go to a second therapist for this, I would have to cut down one session a week with my therapist. Again, we're talking years here. Plus I just don't like many people. It took me five years to trust him. The chance that I'll find someone else to work with, and find safe enough, and wish to work with for years, seem infinitesimal to me.
Then there's the fact that I'm not sure he can do it. There have been exactly two sessions in the thirteen years I've seen him where I really felt he's understood how big this is. How fundamental to who I am as a human being. Not only how scary it is, but just how BIG it is. And even then by the next session he started talking about it in hmmm.... not quite sure how to say it. Like it was a simple phobia. Making casual comments about things that just shouldn't be discussed casually, and that fill me with trepidation at the idea of his working through this with me.
He shares my concerns to some extent. But his eyes hold the fervor of a new convert. I think he sees this as a chance to *do* something with me.
I do know that therapy can't always be safe or feel good. But this seems like treacherous waters that might rob me of a leg in my support stool, and to no good purpose.
I *should* do this, I guess. A good girl would absolutely do this. But how? With him? With someone else?
Posted by muffled on October 17, 2008, at 20:25:55
In reply to I'm not sure what to do, posted by Dinah on October 17, 2008, at 18:48:41
I don't know much about desensitization, whats it involve?
Have you been able to find the core root of this fear? and maybe associated rootlets?
You seem to undertsand it all very 'rationally'.
But emotionally...ack! basketcase!
How does this get balanced?
What safeguards are in place to calm you?
My inclanation would be to do it with a T I know.....
but I don't really know enuf about it.I just can't help but think there is alot more to this than meets the eye.
Fear of fear itself, loaded on top of fear.
And from whence did it come?
Why are you blocking it?
IS the memory there?
Is it only showing emotionally/somatically/non verbally?
How can we tone down the power of it with less disruption?I dunno.
If it were me I'd want lots of background info FIRST B4 I start down this road.
Take care Dinah.
Muffled
Posted by lemonaide on October 17, 2008, at 21:41:44
In reply to I'm not sure what to do, posted by Dinah on October 17, 2008, at 18:48:41
Did he say what technique he was planing on using or being used? I can't remember if you have tried EMDR? I know that is the least painful and the quickest, and yes I said quickest. It works very quick compared to traditional desensitization. It is used in extreme situations like child abuse, war trauma, rape, so I suppose it would work for your phobia.
I think knowing you, I wouldn't recommend the traditional type, I just think it would be too hard to deal with specially given your reservations about it. It takes a great deal of motivation and trust to do it that way. DOing it this way does take a lot of time and commitment.
I am afraid of bringing up with how on this thread, because of your reaction to the phobia. But I do know somewhat how they do this and it would be hard. I don't have a huge phobia of it, and it would be hard for me.But with EMDR, I feel you could handle the short spans of uncomfortableness, because the symptoms of your stress react quickly to calm down. Plus you could get rid of this in as little as one session. Maybe your T could go with you for support? I feel it would be worth a try. You would just have to think of the past instances of it while receiving bi lateral brain stimulation. Then you think reasonable reactions to the phobia while doing the simulations.
Now if this is related to some other trauma, than it might take more sessions of EMDR for relief.
Posted by Midnightblue on October 17, 2008, at 21:53:48
In reply to I'm not sure what to do, posted by Dinah on October 17, 2008, at 18:48:41
Dinah,
Maybe you should show him your post where you talk about your concerns about his addressing this topic?
MB
Posted by Dinah on October 17, 2008, at 21:55:20
In reply to Re: I'm not sure what to do » Dinah, posted by lemonaide on October 17, 2008, at 21:41:44
Unfortunately EMDR just didn't work for me. The therapist got pretty fed up with me the last session and pretty much told me we were wasting both our time. She then switched to EFT, I think, but neither had the slightest effect on me.
I'm not entirely sure why something that works well on others should be so ineffective with me. My therapist thinks my observing self is just too strong and keeps me from fully committing to the process or allowing anyone else to have influence over me. That may be true.
What he is proposing is what was suggested at the emetophobia website.
http://www.emetophobia.org/forum/forum_posts.asp?TID=1925&PN=1
Systematic exposure. Not at all pleasant, no. And I question the premise, to some extent. I can watch an episode of House without running screaming from the room. It's not pleasant, but it's nothing like having someone in the house ready to throw up any second.
Sigh. I think that the key would be to keep me present with him. Keeping from using my dissociative skills. Those skills keep the fear very strong and healthy even as they provide some short term protection for me from the fear.
I know he could do that, if anyone could.
But it would take a very long time. It's not really amenable to flooding, because flooding just retraumatizes.
Posted by Dinah on October 17, 2008, at 22:06:03
In reply to Re: I'm not sure what to do » Dinah, posted by Midnightblue on October 17, 2008, at 21:53:48
I did talk to him a lot about it today. It's funny. When I first brought it up, I thought I should do it and he wasn't that gung ho about it. Now he seems really enthusiastic, and I'm retreating into reluctance.
I think he does understand the problems. He is giving it serious consideration, and I suspect he's going to maybe consult about it himself. But he's an optimist by nature. I always refer to it as his near delusional optimism. :) It's something I need in a therapist, but there are times when it makes me want to lean back a bit and make sure I'm not being swept along.
I think we thoroughly addressed the concern about whether he'd remain safe. He does share my concern about that. He doesn't want me to feel unsafe around him any more than I do.
Maybe I didn't as thoroughly discuss my fears that he's got too high expectations for this. If at the end we're wildly successful, all that will mean is that I won't be afraid of vomit. Not that I'll reverse years of what arose from my self help attempts at managing my phobia.
Posted by Dinah on October 17, 2008, at 22:14:57
In reply to Re: I'm not sure what to do, posted by muffled on October 17, 2008, at 20:25:55
I think the reason he's so excited is that I brought in these two posts.
http://www.dr-bob.org/babble/psycho/20081005/msgs/857540.html
http://www.dr-bob.org/babble/psycho/20081005/msgs/857545.html
He said that for the first time, he had an ah-hah experience about my fear. It all made sense to him, which it hadn't really before. It had never made sense to him that this all could have stemmed from something that happened past my tenth birthday. I'm not sure why. Is there some literature that says that serious effects can only come from trauma before age ten?The person I very briefly consulted about my dissociation said that it seemed totally reasonable to her that the thorazine they gave me for my terror over the whole vomiting thing (though they didn't actually believe me at the time) coupled with the actual trauma could have accounted for the dissociation. Apparently it was a reasonably heavy dose. Although I managed to function well at school... I don't know. I only have bits and pieces of my pediatric record. But I think I was on 50-100 mg of thorazine each night for that time.
I have to admit I'm a bit hurt that he would apparently think that integration would be a good outcome. Not that he said so. He said something vague about not knowing where it would go. But he looked too happy. :(
I thought he liked me just as I am.
Posted by lemonaide on October 17, 2008, at 22:17:15
In reply to Re: I'm not sure what to do » lemonaide, posted by Dinah on October 17, 2008, at 21:55:20
GOod link. I think I suffer from this,to maybe a lesser degree, and I won't go into why, but it is similar to your prior experiences.
I remember being in the 6th grade and there was this retarded girl who was belching a lot and it made me sick, and I started to cry because it made me so uncomfortable.
Then once when my FIL was in the hospital, he had a roonmate who started, and I had to flee the room. I was in tears.
Then my pets, my kids, and one time my husband. It is very distressing for me, gives me the gag reflex too.
But like all therapists, EMDR T's can vary just as much. What about the EMDR didn't work? It isn't will power or power of suggestion it works. You think of the troubling thought and watch her fingers go back and forth in most cases. They also have paddles that you can hold, that makes the bilateral movement. There is also a sound procedure. All you have to do is think of the bad thing, you don't even have to tell the T what the bad thing is for it to work. I know not everything works for everything. When you used EMDR what was it for?
Posted by lemonaide on October 17, 2008, at 22:24:22
In reply to Re: I'm not sure what to do » muffled, posted by Dinah on October 17, 2008, at 22:14:57
Dang, I just read your posts and I know I am not a T, but I know a lot about PTSD, and a huge flag with a red PTSD is waving at me.
Dreams
Dissociation
Panic attacks
irrational fears
Posted by Dinah on October 17, 2008, at 22:34:25
In reply to Re: I'm not sure what to do » Dinah, posted by lemonaide on October 17, 2008, at 22:17:15
It's apparently a pretty common phobia. I remember that when my brother used to throw up, sometimes it caused others to throw up.
It never affected me that way. I just panicked. I didn't get sick myself.
I do hate hospitals. Back before I learned to act somewhat normal, I remember sinking to the floor at the hospital, and no one had even been sick! Brilliant that, getting so scared of vomit that I sink to the *hospital* floor. Yech. Why do they all have carpeting? What brilliant person decides to put *carpeting* in a hospital?
I would say that maybe it was the EMDR therapist. She was a level something or another specialist, since dissociation was an issue. But since I have similar results for everything that's supposed to work for others but doesn't for me, I'm thinking it's more likely me. She was pleasant enough.
I'm thinking she thought it wasn't working because I didn't show the proper response. Let's see if I remember. It's been a while and it was before Katrina. I think that there are questions involved? How distressed are you? The problem was that I wasn't particularly distressed to begin with and my distressed level didn't change appreciably. I very rarely *feel* distressed. Certainly not in an office. The feelings aren't all that available to me. And EMDR didn't help them become more available to me. Or less. It really had absolutely no effect. Other than that I was mildly curious.
She used the sound, the fingers, everything. Zip, nada, nothing.
Posted by Kath on October 17, 2008, at 23:16:58
In reply to Re: I'm not sure what to do » lemonaide, posted by Dinah on October 17, 2008, at 22:34:25
Hi Dinah,
I don't like the idea of you going through something that you might not need to & that might be somewhat traumatic or at LEAST stressful.
I believe that EMDR & EFT did nothing for you.
Until you've tried TAT, I'd say, don't go forward with anything where you have to 'forge through the mudpuddle to get to the dry side'.
I used TAT to work on my Mom's getting cancer & dying of it. I used it for childhood abuse issues.
I hope I'm not being too pushy. It's just that it's such a powerful & gentle thing (plus it's free).
(((((((((((((((((((((((you)))))))))))))))))))))))
I wish I could help you.
much love Kath
PS - in my opinion, witnessing someone being ill like that, or experiencing it oneself can be terrifying for a child - or for anyone for that matter. It's such an "completely out of control" thing to either watch OR feel. I think the only other time I've felt my body be so strongly held in such a powerful uncontrolled experience was when my son was born. I remember comparing it to being sick to my stomach only at the other end.
Let's face it - it is SCAREY. At least in my opinion it is.
The thing I like about TAT is that one doesn't need to be re-traumatized.
xoxoxoxoxoxo Kath
Posted by Nadezda on October 18, 2008, at 10:14:49
In reply to I'm not sure what to do, posted by Dinah on October 17, 2008, at 18:48:41
Hi, Dinah.
I'm sorry I haven't been following along in this discussion as carefully as I'd like, so forgive me if I"m butting in, or saying something that's already been said to a faretheewell.
But really, the answer to this question boils down to one thing: Is this something that You want to do? Do you want to do it enough to move into the phase where you try it out? where you give this method (desensitization, or whatever your T, or another T, has as a technique) a real effort, and put yourself wholeheartedly into the work? All you need to know that.
You don't need to know if it will work. You can't know the fall-out. I do believe that you can stop short of contaminating your T, or ruining your life by trying. But all the provisos, the what ifs, the hesitations, are part of saying, I 'm not ready yet. If that's what you truly feel-- that in your heart, you don't want this now, the answer simply is No.
There's no shame in saying No. Because if it's an honest, No, then why or how could you possibly undertake this?. This takes a deep commitment-- not a wish that you could, or that you could please everyone, or live up to some idea in your own mind-- but just a real commitment to try-- a sense that you're scared, but, damn the torpedos, full speed ahead-- because you just need to, for yourself.
Remember also, that if you improve the situation, you've accomplished a lot. This isn't an all or nothing effort-- it's about becoming able to tolerate more. Steps, a partial inroad into the phobia, limiting its scope or power, would be very meaningful.
But forget about being a "good girl"-- that truly has nothing to do with where you really are.. I just don't think there's a should here though-- not one that matters.
You can make your peace with having this limitation. Or you can decide that you can't make peace with it, that you need and want to take this new step. Or you can decide that you can't make peace with it, but you aren't ready for this particular step. Deciding not to now is not giving up. It's saying, you're not ready. You may be ready in the future. You're made great progress recently. But there's no shame in not rushing forward too fast, if you aren't really ready for it.
If you look into what the DBT people call your own "wise mind," you'll find that you do have your own answers. We can give you all the support in the world for your decision. I certainly will. But only you can know what your decision is.
I sense that you may not be ready. In that case, it's not right to force yourself. It's not a failure not to do this-- it really is okay. Give yourself the right to make your own decision, though. It is your right.
hugs,
Nadezda
Posted by Dinah on October 18, 2008, at 10:27:37
In reply to Something to try first perhaps » Dinah, posted by Kath on October 17, 2008, at 23:16:58
It wouldn't do any harm to try. Maybe since it's something you do yourself, it might be more helpful than something coming from a strange therapist. My self defense responses might not come into play.
Posted by Dinah on October 18, 2008, at 10:34:50
In reply to Re: I'm not sure what to do » Dinah, posted by Nadezda on October 18, 2008, at 10:14:49
> I sense that you may not be ready. In that case, it's not right to force yourself. It's not a failure not to do this-- it really is okay. Give yourself the right to make your own decision, though. It is your right.
You're right, of course.
The traumatic (to me it *was* traumatic) experience I just had might have been enough to make me want to commit, for the first time in my life, to work on this.
But that's *all* I'm ready for right now. And for me it's a pretty big step on its own. I'm just too upset by what just happened to be ready for more than that right now. In the future, yes. But not right now. I need to rest.
Right now, I'm feeling a bit pressured by my therapist's enthusiasm. I don't want to let him down. I guess that's a good thing in general in therapy, but maybe not so much at the moment.
Thank you for seeing that, and making me see it in myself.
Posted by muffled on October 18, 2008, at 11:30:35
In reply to Re: I'm not sure what to do » muffled, posted by Dinah on October 17, 2008, at 22:14:57
Thanks for links Dinah, I not got alotta time these days so I missed them.
I am currently in a debate w/my T about how supersentive kids can learn to dissociate more readily than those who are not. They then use dissociation more readily and ongoingly as well, due to the fact that their sensitivity makes even seemingly non traumatic stuff, be responded to as if it WERE trauma, jsut because they are so sensitive.
LOL, we are in the midst of this battle at the moment!
Its is always been said, that trauma is subjective. So what traumatizes one, another may sail thru.
I'm not sure what I am trying to get at, other than the fact that maybe you don't seem to give Dinah enuf credit that she was in fact traumatized, whatever the form the trauma took, we may never actually know. But due to the signs....she was. Its just a fact. There are REASONS for her behavioral responses, the didn't come out of thin air. I am talking to myself as much as you as this is what my T has been telling me.
And of course....my response is 'I don't remember being a kid, MOST people DON'T'.
Ain't T fun?
Take good care Dinah,
I think your T likes you just as you are :-)
As far as the "I" wird, I have decided that it doesn't mean making other parts go away or be buried. For me it is about having the parts all work better together, To know of each other and to help each other and to develop trust in one another. It is NOT to destroy them or make them gone at all.
Gotta go pick squash.
Muffled
Posted by rskontos on October 18, 2008, at 16:37:31
In reply to Re: I'm not sure what to do » Dinah, posted by muffled on October 18, 2008, at 11:30:35
Dinah,
I understand I think about all this. I might have missed part of it. I wrote earlier a long post and then decided not to send it. First I wanted to say that I am one of those that do vomit when someone else vomits. My children, anyone for that matter. But I also faint at the sight of blood.
You know that I too dissociate. Lately for some reason it is beginning again. I only mention this because I am not entirely convinced that it can be totally eradicated from our brains unless we get to a point where we recognize we are truly safe. Like Muffled said you do sometimes perceive trauma when someone else might not. I agree about being too sensitive. The other day I left my chiropractor's office for a time while I was having a treatment and when I came back you know what I mean about leaving only mentally, everything seemed so far away and strange. Now I can't tell you what felt so weird about being there that my mind thought it needed to escape.
That is why I am not sure it can work but maybe it can for your sake. I hope I made some sense because I know what I am trying to say but I can't make the right words come out.
In fact at my chiro's I was practicing new deep breathing techniques. Then wham I was gone, and came back not to long after so it wasn't a long time but still felt weird.
I guess I would if I were you try it and see. I wish you luck and sorry for my rambling.
rsk
Posted by lucie lu on October 18, 2008, at 16:52:19
In reply to I'm not sure what to do, posted by Dinah on October 17, 2008, at 18:48:41
Dinah,
I don't have much experience with phobias other than school, claustrophobia and agorophobia, which all somehow to me seem different than what is under discussion here. I do have a colleague whose young daughter, when she was in kindergarten, had an unfortunate experience with a sick classmate on a school bus. This traumatized her so much that she ate NOTHING but white bread for an entire YEAR! Her parents were frantic. Eventually she got over it, I don't remember whether it was with therapeutic assistance or not. So obviously this phobia is no joke.
So I don't have any personal experience with phobia treatment apart from what I've read. But I do know something of your long history with your T and know how important it is to you. Given that, my suggestion is that you both (individually) seek consultation with other professionals, to minimize the risk of anything happening to your relationship during the process of treating your phobia. It may seem like overkill, but since you expect such treatment would last for a long time, it seems worthwhile to try to foresee things as clearly as possible. I think consultation can be really helpful under such circumstances, help to eliminate or at least identify potentially problematic biases, expectations, or misapprehensions. Basically, just bouncing ideas off a different wall.
Sorry I can't be of more help, but you are in my thoughts (where I'm giving you a big hug of encouragement).
Lucie
Posted by Kath on October 18, 2008, at 20:35:52
In reply to Re: Something to try first perhaps » Kath, posted by Dinah on October 18, 2008, at 10:27:37
Let me know if you need any help at all, okay?
luv, Kath
Posted by Dinah on October 20, 2008, at 8:59:45
In reply to Re: Something to try first perhaps » Dinah, posted by Kath on October 18, 2008, at 20:35:52
Thanks Kath. I'll look into it after I've had a bit of a rest. I suppose right afterward would be the time I was most motivated, but I notice I've gone into full distraction mode so I think my body's telling me I need to give it a break.
Posted by Kath on October 20, 2008, at 11:00:27
In reply to Re: Something to try first perhaps » Kath, posted by Dinah on October 20, 2008, at 8:59:45
Hi Dinah - I wish we lived close!
I'm not doing great today & it sure would be nice to share a cuppa tea or hug or both.
luv, Kath
Posted by Dinah on October 20, 2008, at 16:22:07
In reply to Re: Something to try first perhaps » Dinah, posted by Kath on October 20, 2008, at 11:00:27
That'd be so nice. The weather is so nice now, I'd love a chance to sit outside for a while.
(I did take advantage of the beautiful weather over the weekend and scraped old paint off my house.)
Posted by Kath on October 21, 2008, at 20:23:08
In reply to Re: Something to try first perhaps » Kath, posted by Dinah on October 20, 2008, at 16:22:07
The weekend was lovely indeed.
Today we got 2 inchse of - you guessed it? SNOW
It's even staying!!
DH assures me it will melt & this is not REALLY the beginning of winter.
hugs, Kath
This is the end of the thread.
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