This past Friday I had the second appointment with the CBT guy who is supposed to help me work through this emetophobia. The appointment included a required background questionnaire that frustrated us both as we plowed through a bunch of extraneous crap that wasted a lot of what could have been otherwise useful time. Eventually the conversation did turn to the topic at hand, and I was able to fill in some cracks in his understanding of my circumstances that became apparent to me after I had time to process our last appointment. I also detailed a somewhat new realization that pretty much every time I have found something that gives me some joy in life it is eventually sabotaged by these fears.
In the short time we actually had to address the important issues he laid out a couple successful treatments he had used for other phobias. The conversation centered around what he called the extinction curve. This is basically the idea that repeated exposure to a phobic stimulus will eventually retrain the brain to react to the actual circumstances rather than some perceived threat. Though I never really knew it had a name the premise is something I am familiar with and actually used in aviation training as both a student and instructor. He also pointed out that while constant exposure can decrease anxiety avoidance will increase anxiety over time, as the mind will allow fears to grow unchecked by any doses of reality.
The two examples he used to explain what he was thinking of doing related to spiders and needles. In the case of needles to ensure the lack of exposure didn’t undermine the patients work the final phase was the repeated donation of blood at the minimum recommended interval. Having actually seen both sides of this, exposure and avoidance, work in airplanes I was buying into everything he had to say. I was having a little trouble trying to figure out exactly how it was going to be applied to my circumstances. The obvious challenge is that I am not afraid of anything that can be isolated in such a way. My problems stems from a fear of my own body’s reactions to scenarios I have no control over. I am essentially afraid of myself because I don’t trust my own body. I was eager for him to explain how he planned to apply the theory to this circumstance when he told me he had some homework for me. He wanted me to consider ways in which my fear could be addressed using this technique. I was a little taken aback by this. I had so hoped that he had dealt with the specific issue in the past, and had some basic framework for a strategy we could apply to me. Apparently he does not. Now I assume he is going to put his own work in considering the question, but initially I was not impressed with this turn of events.
At this point a few days have passed since our conversation and I am coming to look at the problem from a new perspective. He and I have talked about the specifics of this issue for a little over an hour. I have lived with it for thirty years. How could I expect him to come up with a plan to fix something as complex as this with such little information work with? The reality is that when you live with a phobia for this long it finds its way into spaces of your mind that you would never expect. Nobody knows about those spaces but me, and it would take months of weekly one hour conversations for him to even begin to wrap his arms around it. I find this truth somewhat discouraging. I appreciate there is a great deal of value in being part of your own solution, but I really hoped he would bring more to the table initially. Upon reflection I can see that he cannot provide the whole solution on his own, but I am not sure it is in me either. I have some thinking to do.