Brainstorming CBT Strategies

WARNING: This post contains conversation about, and descriptions of people vomiting. If you are uncomfortable with this please do not read any further.

During last week’s visit to the CBT guy we talked further about strategies that might be effective in treating my specific circumstances. I gave him the breakdown of clearly identified problems, but told him was really at a loss as how to proceed. He threw out some ideas and after spending a bit of time talking them over he suggested I go home and give it some more thought.

We first addressed my straight up fear of the actual act of vomiting. He made it clear that he considered it unethical to induce vomiting, though he did suggest he might not be disappointed if I should contract a stomach virus this winter. Because I cannot have the real experience we are left with things that are a step removed from reality. There is one obvious road to go down and that is watching people vomit. He did a quick youtube search and there is no shortage of videos along this vein. Who knew American societal decay could actually be useful? The very thought of watching these videos made me squirm in my seat. The fact that thinking about it made me so uncomfortable might be a clue that we are looking in the right direction. In the safety of my own home I did a similar search, and actually brought up one of the search results up. It was a 1:30 second clip of three people puking. It appeared they were using their fingers to induce the reaction, but the lighting was poor and I was a little overwhelmed by it all. I don’t know for sure, but I would guess I made through about 10 or 15 seconds of the video before shutting it down. I don’t know if it will eventually be helpful, but it sure does make me uncomfortable.

The second issue we addressed was my inability to read my body’s cues. He suggested setting up situations that would allow me to mentally isolate a sensation. If I could intentionally cause a sensation than maybe I could learn to recognize it down the road. The thought was to start with burping. Comsuming a larger than normal quantity of carbonated beverage would create gas looking for a way out. I would know it was gas because I put it there, which would in theory reduce my anxiety about being sick and allow me to burp. The idea makes sense to me, but there is a lot of daily stomach upset that would get in the way of this. When I told him about this concern we started a discussion about possible dietary changes.

If food is indeed the primary source of my constant stomach upset he suggested there were two likely culprits, dairy and grain. In the back of my mind I knew this was a possibility, but I don’t really want consider major dietary restrictions for the rest of my life. His idea for exploring this was to pick a time when a bathroom would be available and drink a large glass of milk. If it led to stomach discomfort he suggested getting Lactaid tablets and using them while I consumed the same size glass of milk to see if it helped. I have been less than eager to try this, and timing it would prove fairly difficult. In the week since my last appointment I have been experiencing greater than normal levels of stomach upset making any sort of experiment impossible anyway. I am not sure he actually expected me to do it this week as much as he wanted me to think it over. It is certainly been on my mind, but I am not sure I have had any sort of major breakthrough about it.

One thing that continues to become clear is that this is going to be a slow and uncomfortable process.

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3 thoughts on “Brainstorming CBT Strategies

  1. May it be an idea to start by looking at pictures rather than videos? There used to be a website online that was designed for emetophobic exposure therapy and was a graded list of pictures that you work through in your own time making sure you stay with each one until the anxiety drops. I had a bad year last year where I had a stomach bug, swine flu (included vomiting) and after years of not being sick cause of the fear it was absolutely horrifying. It did show me that I have nothing to fear, in reality, but unfortunately, the fear still clings to me. It’s got strong claws 😦 xx

  2. Oh, my friend, where do I start? I’m starting to feel guilty about my mega-comments. Hmmmm…I think I’d start with eliminating your daily stomach upset because you want to know what’s what, right? Are you experiencing stomach upset largely because of anxiety or because of your diet? I already pointed you in the direction of the “second brain” which is in your gut. So, let me expand on this. My daughter, as you know, was in the hospital recently, and the pediatrician on-call took me aside and told me that her eosinophils (white blood cells in charge of inflammation and allergy) were far too high. She was already gluten-free but she wanted me to remove dairy (casein) from her diet, too. Casein as well as gluten can cause extreme stomach upset but also mood swings–this is documented and well-known. Casein is the protein in dairy. When the body cannot tolerate it, it often launches an immune response. Lactose isn’t the only issue associated with dairy. All this is to say, go gluten-free for two weeks. If your stomach issues resolve, then you’ll know it’s gluten. Then try dairy. The deception about eating lactase with dairy is that adding the lactase enzyme only addresses the lactose issue. It does nothing to address the body’s tolerance or intolerance of casein. If your body does not tolerate casein, then lactase will not help you. Here’s my question: What if the entirety of your stomach issues was dietary? At their source, what if you have an intolerance? It’s a possibility. Would peace in your stomach and the removal of inflammation be worth it? Believe me, I get it. I’ve had to make major dietary changes, but I’ve watched certain “irreversible” health changes disappear. So…your therapist is right. Address the dietary issue. It’s something you have complete control over. And, any doctor would tell you to do it, too. Plus, there are links between anxiety and food intolerances. It’s a very worthwhile place to start. If you have more questions, you know where to find me. I’ve been GF for over two years, and my health is so much better.

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