Last Friday when I went to my appointment I expressed my concerns about the depression versus anxiety diagnosis and laid out the degree to which this fear of vomiting has impacted my life. I was surprisingly nervous going into the appointment and wasn’t realty sure I was going to do it until I started talking. I find it a little strange that after six plus years of seeing this guy I still have trouble expressing myself, but talking about this is still something I have some trouble with particularly with male doctors. For some reason I am more comfortable verbalizing my fears and insecurities to a woman. He listened politely to the entire story; I laid it out from the beginning and asked that he be patient with it as I explained seemingly unrelated parts of the puzzle and brought everything together in the end. I had had the conversation in my head a number of times in the days leading up to the appointment so once I got talking the ideas flowed pretty easily despite my apprehension.
When it was all said and done he agreed that the fear of vomiting thing was a significant issue that needed further exploration. He strongly suggested I seek out psychotherapy and suggested a guy he knew he has a special interest in dealing with phobias. I was not thrilled at first for a couple reasons. First this guy’s office is in a very busy area in the center of one of my work routes. I drive a company vehicle that may as well be a billboard on wheels. I take my privacy concerning this stuff very seriously and I was concerned that I would be too conspicuous. Second as I mentioned in the first paragraph I am not thrilled about talking with men, and this was going to be some difficult work. I just didn’t know. I was further discouraged when the office ladies indicated that there was a waiting list to see the guy and the wait would probably be several weeks. In the end I decided that the wait would give me time to decide if I really wanted to peel back the cover these issues at the moment. One could imagine my surprise when later that afternoon the office called me back to arrange and appointment for the following Wednesday. I am off this week so traveling to the appointment in a company vehicle wasn’t an obstacle so I decided to give it a go.
As I write this I am several hours removed from that first appointment and have had some time to reflect on the conversation. My first thought is why the hell these doctors don’t talk to each other. I spilled my guts about this just a few days ago. It was hard, and I didn’t relish doing it again, but I figured these guys are in the same practice so the talking doc should have at least seen the notes from the visit that led up to this. Nope. We started from scratch. The guys first question was “what are you looking to accomplish by being here?”. This is certainly a fair questions and even a good starting point unless the patient, me, thought you were already going to have the answer to that. Shit. He followed up with “Why don’t you tell me about what has been happening”. I am out of practice with this stuff. I didn’t have the first clue where to start. It’s not like I am talking about some bump or bruise that just happened the other day. This guy is looking for a what? A summary of thirty years of anxiety? Does he really want me to sum up something that has affected every part of my life for this amount of time in a sound bite? It has become such a large complex issue that I am not sure it is even possible. This isn’t MSNBC or Fox News it’s the actual truth that matters here not just the words.
After something of a shaky start I was able to get out the general idea of how these fears have impacted my life and how the overriding sense of general anxiety sits on top of it all like a dark cloud. He asked interesting questions, though I could tell by some of them that his understanding of my turmoil is far from complete. It is going to take more than one 55 minute appointment to get all that across I suppose. I did like that he seemed goal oriented. My first several experiences with talk therapy were all open ended affairs. One of these therapists was fantastic and I really felt like I gained something with each visit, but even she didn’t really have a goal for our work that she articulated to me. These therapists created a safe place for me to work through some difficult times, but I came to rely on them as sounding boards which made it difficult to move on. This guy and a woman I spoke with a couple years back have both taken more of a no nonsense approach to what we are trying to accomplish. There are already actual outcomes’ being discussed which is refreshing.
There wasn’t much time today for anything more than outlining the problem and discussing a couple rough ideas for approaching them which all boil down to systematic desensitization. I am cautiously optimistic at this point. He was easy to talk to and once we got going I felt as comfortable as I have in any other therapy office. There is a lot going on here, and I am not sure we can just tease one piece out and make it go away. This one fear has been part of my life for so long that it has imbedded itself throughout my psyche. It’s like a tumor with tentacles weaving its way into places I am probably not even aware of. Is it possible to untangle this? I guess were going to find out.