View Full Version : Psychologist suggested something weird. What are your thoughts?
One of my worst fears is fainting. It's never happened to me before and the prospect terrifies me and controls my life. I only leave the house when I absolutely have to because I'm afraid of fainting. Even feeling tired makes me panic because I start having obsessive thoughts that I will faint. This all started when I first experienced lightheadedness for the first time in my life during my first panic attack. I don't go anywhere in case I faint and this is has been my thought for 5 years. 5 years of rarely going shopping or anywhere alone in case I faint. At this point I am agoraphobic most days. I feel either lightheaded or tired just thinking of leaving the house and entering a shop, so you can imagine what happens when I'm there. Those thoughts only intensify.
The psychologist suggested, in the safety of the room with her there, that I do an exercise that would induce a faint. Because I am so tortured by the unknown of fainting but have an extreme vision of it in my head, and obsessively google how it feels to faint, she thinks it's best I experience it. I said no but I'm back home now thinking about it and was wondering what everyone else thinks of this idea? I've heard of therapists getting patients to blow into straws and spinning around in circles because it feels like a panic attack and it helps them see the symptoms are harmless, but it's the first I've heard of fainting.
Would you do it?
Have you fainted?
Any other thoughts?
Thanks :)
It looks like exposure therapy. Go and do it, you are safe.
Thanks sharkster :) my therapist even went so far as to say fainting is relaxing! She believes all my fear and panic about it is irrational in light of what it actually is. I'm just scared it'll be an awful experience and make my fear worse!
One of my worst fears is fainting. It's never happened to me before and the prospect terrifies me and controls my life. I only leave the house when I absolutely have to because I'm afraid of fainting. Even feeling tired makes me panic because I start having obsessive thoughts that I will faint. This all started when I first experienced lightheadedness for the first time in my life during my first panic attack. I don't go anywhere in case I faint and this is has been my thought for 5 years. 5 years of rarely going shopping or anywhere alone in case I faint. At this point I am agoraphobic most days. I feel either lightheaded or tired just thinking of leaving the house and entering a shop, so you can imagine what happens when I'm there. Those thoughts only intensify.
The psychologist suggested, in the safety of the room with her there, that I do an exercise that would induce a faint. Because I am so tortured by the unknown of fainting but have an extreme vision of it in my head, and obsessively google how it feels to faint, she thinks it's best I experience it. I said no but I'm back home now thinking about it and was wondering what everyone else thinks of this idea? I've heard of therapists getting patients to blow into straws and spinning around in circles because it feels like a panic attack and it helps them see the symptoms are harmless, but it's the first I've heard of fainting.
Would you do it?
Have you fainted?
Any other thoughts?
Thanks :)
I have done that exercise as a kid and don't recommend it.
There was something on TV not long ago about kids doing it and it was stated that it's dangerous.
It may be safe with a therapist but I personally wouldn't do it.
Yeah, I know what you're talking about. But her idea was set the timer and hyperventilate for 60 seconds. I got to 30 and really didn't want to go through with it. I'm not even sure it would have even worked. I would've thought it would be hold your breath for 60 seconds. I thought hyperventilation CANT make you pass out?
I think the therapist meant a less dangerous way than what the kids are doing. But I might be wrong...
MyNameIsTerry
07-01-16, 05:17
Thanks sharkster :) my therapist even went so far as to say fainting is relaxing! She believes all my fear and panic about it is irrational in light of what it actually is. I'm just scared it'll be an awful experience and make my fear worse!
As sharkster said, it's an exposure exercise or a Behavioural Experiment. Both are used in many therapies including CBT.
I think in your case it's a control issue to break. It's like one I had ages ago about not wanting to fall asleep and the normal sensations of doing so made me question how weird it was and made me anxious.
The point of a Behavioural Experiment is to test the validity of your fear and prove to you that it is irrational. We all know it's not that simple and takes a lot more work but it's a first step they can use for you to build on.
Your therapist should be licenced in some way or trained. If they are within a trusted framework, like our IAPT one which is governed by our NHS, then you have security in knowing they are acting within their expected guidelines.
I did one where I had to do sprints. I was so concerned about being out of breath that I wouldn't exercise and found even walking hard. To challenge my beliefs she set me a homework exercise to do some sprints to raise my HR. This was safe with my health but in the case of yours it does need someone there to monitor you, at least because you could injure yourself in the faint itself.
I think the therapist meant a less dangerous way than what the kids are doing. But I might be wrong...[/QUOTE]
You're probably right but only you can decide if it's right for you.
If it was me I'd change therapists.
I've met some psych that are crazier than me.
Fear of X is almost always worse than X
Dear Ditapage,
since I feel lightheaded very often (also feeling of fainting), I can really relate to what you are going through. I was staying a lot at home because of it, I actually wasnīt living anymore. I was unable to go anywhere. If you wanna talk about it, I would love to tell all about my story, what helps me, maybe this could help you somehow or comfort you.
About the "experiment" with your psychologist I would say so. I would not do it, as this could be a new potential trauma for you. I fainted in a past a couple of times (not because of anxiety), and this really is a bad and unpleasand experience. If I would do this now with my psychologist, it would be surely for me a big trauma. Maybe it would be better if you take it slower/easier. Donīt go to extreemes. Maybe you could try (instead of this experiment) going to shop everyday with the person you trust, alway so, that you have an option to go/run out of it, if it would be so bad. Just take it easy, step by step. Eventually you will see, that you wonīt pass out. That those physical symptoms that you feel are just our mind playing horrible triks on us, because of bad past experiences and so on.. I can actually promise you, that you will never faint in those situations, even if it feels exactly so. I experienced that a lot/still do (for 6 years), but never happened.
Take care dear, wish you all the best.:bighug1:
Hi,
hmmm this is a tricky one. I have to agree with Barb that it has the potential to become a negative situation something that you may look back on and think 'I don't want that to happen again' because fainting feels different for everyone I think.
I have fainted before and for me it wasn't unpleasant it was just like falling asleep I guess. I had a tummy bug and hadn't eaten in a long time so when I tried to go to the toilet I just got the feeling I need to lie down now but didn't make it back to the bed before my brain just went 'ok you need to rest' so I fell asleep for about a second then woke up on my knees.
Do you know what it is about fainting that scares you? is it the actual sensation? or the fear of hurting yourself on furniture etc?
A common trait I see on the boards with situations like this is a negative response in reaction to one's own personal fears or experiences, especially concerning the medical/mental health profession.
Another common trait I see are sufferers gravitating to the negative. Ten people could say something positive and the one negative response is the one the sufferer grabs onto.
One would have to believe that this therapist didn't just suggest this out of the blue or willy nilly. A therapist's job is to assess the patient, the situation and recommend an effective way to treat and overcome it.
Yes, for someone who's been essentially been held captive by their anxiety or for those that have had an unpleasant experience, it may appear to be somewhat extreme but again, the therapist must have a good reason for suggesting it. Sometimes it takes a real life slap upside the head to break the bonds that hold them.
I would go for it. The worst that can happen is nothing and you're in the same boat you're in now. On the other hand, this could be a huge breakthrough that could help free you from the jaws of the dragon. In the big picture, what do you have to lose?
Positive thoughts
A common trait I see on the boards with situations like this is a negative response in reaction to one's own personal fears or experiences, especially concerning the medical/mental health profession.
Another common trait I see are sufferers gravitating to the negative. Ten people could say something positive and the one negative response is the one the sufferer grabs onto.
One would have to believe that this therapist didn't just suggest this out of the blue or willy nilly. A therapist's job is to assess the patient, the situation and recommend an effective way to treat and overcome it.
Yes, for someone who's been essentially been held captive by their anxiety or for those that have had an unpleasant experience, it may appear to be somewhat extreme but again, the therapist must have a good reason for suggesting it. Sometimes it takes a real life slap upside the head to break the bonds that hold them.
I would go for it. The worst that can happen is nothing and you're in the same boat you're in now. On the other hand, this could be a huge breakthrough that could help free you from the jaws of the dragon. In the big picture, what do you have to lose?
Positive thoughts
I usually agree with your advice Fish but in this case I think the opposite
I usually agree with your advice Fish but in this case I think the opposite
Much respect. I guess we'll see what happens.
Positive thoughts
Ok so let me start by giving a bit of background on this type of intervention/suggestion by the therapist.
It sounds like a combination of exposure and a strategic intervention where you encourage a person to do the action they are trying to avoid. Typically therapists will suggest something like this hoping for 1 of 2 possible outcomes: 1. you do it and realize it wasn't that bad, you survived, your fear subsides or 2. you try repeatedly to do it over and over and realize that it is quite difficult to make yourself faint. As a result, you are less afraid of it actually happening.
Does that make sense?
My point is this is a real intervention that therapists use HOWEVER not every intervention is appropriate for every person. Being that I am not your therapist, I can't really tell you whether or not it is appropriate for you personally or what your therapist's intention was. I suggest you go back to your therapist and discuss your feelings and thoughts about it after you let the idea digest a little. Therapists work best if they receive honest feedback from their clients. It is more helpful to your therapist to tell them that you didn't feel comfortable doing it than to just walk away and find a new therapist. They can only be better able to help you with more information you provide them about your experiences and feelings.
MyNameIsTerry
09-01-16, 05:14
An explanation of the types of Exposure Therapy off Wiki:
Exposure therapy is based on the principle of respondent conditioning often termed Pavlovian extinction.[8] The exposure therapist identifies the cognitions, emotions and physiological arousal that accompany a fear-inducing stimulus and then tries to break the pattern of escape that maintains the fear. This is done by exposing the patient to progressively stronger fear-inducing stimuli. [9] Fear is minimized at each of a series of steadily escalating steps or challenges (a hierarchy), which can be explicit ("static") or implicit ("dynamic" — see Method of Factors) until the fear is finally gone.[10] The patient is able to terminate the procedure at any time.
There are three types of exposure procedures. The first is in vivo or “real life.” This type exposes the patient to actual fear-inducing situations. For example, if someone fears public speaking, the person may be asked to give a speech to a small group of people. The second type of exposure is imaginal, where patients are asked to imagine a situation that they are afraid of. This procedure is helpful for people who need to confront feared thoughts and memories. The third type of exposure is interoceptive, which may be used for more specific disorders such as panic or post-traumatic stress disorder. Patients confront feared bodily symptoms such as increased heart rate and shortness of breath. All types of exposure may be used together or separately.[11]
While evidence clearly supports the effectiveness of exposure therapy, some clinicians are uncomfortable using imaginal exposure therapy, especially in cases of PTSD. They may not understand it, are not confident in their own ability to use it, or more commonly, they see significant contraindications for their client.[12][13]
Flooding therapy also exposes the patient to feared stimuli, but it is quite distinct in that flooding starts at the most feared item in a fear hierarchy, while exposure starts at the least fear-inducing.[14][15]
They are not only exposure exercises, they can also be Behavioural Experiments.
http://psychology.tools/behavioral-experiment.html
http://self-help.tools/obsessive-compulsive-disorder/
In those you will be asked to perform something that is intended to test your fear, this will mean anxiety/panic at some level. They can also be used to oppose beliefs by testing the opposite which will mean less anxiety/fear (possibly).
BE's are part of the Cognitive Restructuring module of CBT, something that seems to be missed a lot in the UK.
Exposure has various forms and some include even using substances to provoke bodily sensations e.g. caffeine. For me, the issue is the therapist, less so the exposure. I don't personally believe that Dita's is an exposure since it would be akin to "flooding" which isn't a very successful form when compared to the more successful ERP model. But the question is also a) is the therapist aware of the clients physical health and skilled in determining whether their health is sufficient for the exercise and b) is the therapist sufficiently trained (and insured) to conduct it. I have seen other versions of a BE that pertains to inducing hyperventilation in a NHS doc mine gave me and it made the point that you should ONLY do it if you have no adverse physical health conditions. The therapist may not be aware of our medical records so they should really enquire but to be honest I don't recall mine doing so. I have asthma so a sprinting BE could have been a bad thing but my asthma is well controlled and not severe so I made the decision myself, as we all should.
If you are unsure about your health, a doctor is a good place to go, usually your GP. They will assess both the exercise's content along with your known health and question you about any further health issues or concerns. You could also ask them about this form of exposure, although they may not be very familiar with the techniques inside the models.
Talking to your therapist is the first thing though. Let them explain it all. Therapy is a two way process, you have to commit to doing things and your therapist won't force you to do anything you feel uncomfortable with BUT part of their role is to entice you to TRY to challenge your fears through exercises otherwise overcoming may not happen. Ask them if this is a BE, in which case it fits to swgrl's option 1 BUT it won't be the end because it will form the starting point of tackling it, I suspect with a more structured approach like used in ERP or a more cognitive approach to challenge beliefs or a combination of the two. If it's an exposure exercise then ask what comes next. Flooding isn't great and not everyone can do it anyway and it doesn't work for many of us as it relies on you having a big epiphany and your fear going. (hence why it's not used much as we are constantly exposed but still suffering!)
PTSD does similar things in EMDR in exposing the client to the memories which can mean trauma BUT it is under controlled conditions and there is strategy involved to reduce this.
The simple fact is that, yes, you may come out of it feeling even worse BUT the therapist is there to bring you down again. Simulating fainting means a health & safety aspect because of the potential for physical trauma too. The therapist will then continue to work with you, they won't dump you and leave you worse off.
Now the last concern for me. Is this therapist a good one? For instance, in the UK anyone could spend 100 hours studying for an online diploma, obtain insurance, set up a company and see clients without ever having seen one or having been supervised. The industry is completely unregulated, other than 2 professional titles which are, so we could do this exercise with someone not really qualified to do it. Sure, their insurance covers them from day one, but that doesn't mean they should do it. So, is the therapy a national health one, a trained psychologist/psychiatrist, a member of a REAL association (we have many fake ones in the UK), etc to provide you with confidence in their ability/training? For instance, a psychiatrist by definition is also a MD able to practice. A psychologist is also a specialist and along with psychiatrists, work with the most challenging mental health issues far beyond anxiety.
Dita, those are from an Australian site some people use on here as they have online workbooks, but I use the downloads and recommend them a lot.
It is interesting how unregulated it can be. For us in the USA, you have to complete a master's degree which includes over 1000 hours of interning on the job, pass an exam, and then you can only work under the supervision of a licensed clinician and not alone. Once you complete 1500-3000 (depends on the discipline) hours you can be licensed and practice independently/collect insurance. But it is strongly encouraged that fully-licensed clinicians have supervision too. That's for masters-level therapists at least.
Here in Aus it's a quick course and off you go.
Therapists here can't prescribe drugs etc and are not supposed to give advice.
They're only supposed to help you work out your own solutions.
Any more and you have to be a psych.
I've fainted a few times at the dr's. I have a pretty bad needle phobia so I now warn whoever draws my blood that I might keel over. I find the most unpleasant thing is it's a bit disorienting, though I have hit my head and got bruises as well. It's also really embarrassing (for me) which is why I don't like it.
Could you maybe start with a smaller exposure first? Like an activity where you feel faint but are unlikely to pass out? Maybe if you do that first, you'll feel less anxious.
MyNameIsTerry
11-01-16, 05:56
I've fainted a few times at the dr's. I have a pretty bad needle phobia so I now warn whoever draws my blood that I might keel over. I find the most unpleasant thing is it's a bit disorienting, though I have hit my head and got bruises as well. It's also really embarrassing (for me) which is why I don't like it.
Could you maybe start with a smaller exposure first? Like an activity where you feel faint but are unlikely to pass out? Maybe if you do that first, you'll feel less anxious.
That's how ERP works so the therapist may change to that, if it is appropriate, and it is the direction of the therapy as a whole. So, it's a good suggestion to put to the therapist.
If it is a BE then they could just design a less provocative one to lead up to this or just give Dita an incite into what this larger one was going to show.
The therapist knows that changing thought patterns that are ingrained takes time so they won't be expecting a "cure", more an incite and realisation to work on.
I had a phobia of fainting for years and it was BECAUSE I fainted once. The feeling of blacking out and losing control scared me so much whilst it was happening and I personally feel that incident is a big reason as to why I have anxiety to this day - even though I'm not directly anxious about fainting any more per say. But I'm just worried that if you're anything like me the feeling of fainting could scare you and make things worse.
But then it could be different in a controlled environment. And it also sounds like your phobia is so bad that it's unlikely to get worse at this point as you're experiencing all those bad feelings already. If there's a possibility it could work and you're in a dyer situation already it may be worth trying it
It's gotten to the point where I get a strange debilitating tiredness and think I'm going to faint. Unless I have to go to work, I don't leave my house. I feel completely unsafe going out by myself. I am consumed by this fear of fainting . This awful overwhelming tiredness comes over me, eyes feel like closing, body feels like it's about to shut down. Arms feel heavy and weak.
I don't want to do what the therapist suggested, in case the feeling is awful. But this is ruling my life now. I expect that I'm going to faint everywhere I go. I don't know if it's just obsessive thinking due to the agoraphobia. I take diazepam and I still won't go out. The diazepam didn't cause the fatigue, I had it long before I started taking it. The Diaz actually helps the anxiety attached to this weak feeling. I don't know what to do anymore. I'm depressed which is probably also contributing to the tiredness. Except it's not a nice tired feeling. It's a horrible weak feeling. Then I start obsessing about fainting but people keep telling me I will just faint if it's gonna happen, I won't have time to think about it. And I don't have any condition that causes fainting- bloods were fine, no diabetes, the doctor is frustrated with me because he put it down to intrusive obsessive thinking and nothing more. I think it's fair to say now that I won't go anywhere because fear of fainting rules my life. Just the thought of going out brings on this horrible fatigue.
I don't even know if agoraphobia is causing the faint/tired feeling or if the faint/tired feeling is causing agoraphobia. Doesn't help that it's very hot at the moment where I live.
I appreciate everyone's comments and suggestions thus far.
Shazamataz
31-01-16, 08:34
I have a similar fear that's developed quite recently and it really is debilitating.
I have also been told, though, that you can't faint from anxiety.
it sounds like the sleepy feeling may be an anxiety symptom for you and then you associate it with thinking you are going to faint.
Try to remind yourself that you never actually have fainted so it's not likely to happen. I'm doing this myself at the moment and it's HARD because it really does feel like I'm going to faint. That said I never have fainted in my life, so how would I know what it feels like?
So, if things are so bad and it's really ruining your life I would take the chance. If you are caused/allowed to faint, really faint, in a safe environment then nothing bad can happen and maybe you will be able to seperate the feeling of real fainting with the way you feel and realise you aren't going to faint at the shops etc.
What have you got to lose?
I've done the induced feinting many times as a youngster. There was nothing unpleasant about the actual feinting for me. But I think even if you were ok with knowing feinting didn't feel unpleasant (by doing it with your psychologist) I don't think that would remove your fear of going out in case you feint. It still wouldn't be particularly pleasant feinting when out.
I think what you need to do is face the reality of whether you DO feint when out or not. What you feel may just be symptoms of anxiety in anticipation of going out as in an adrenalin dump or something similar. But once you face reality and actually go out and see that you don't feint you should no longer experience an adrenalin dump in anticipation of going out because you know when you go out you don't feint. So, for me, the exposure would be to go out and face the reality of what happens with someone you trust. If you don't feint, you're going to make pretty fast progress.
Right now it looks like you're deciding to not face any of the fearful situations and, for me, that's the last option. You want change and improvement ? Face stuff, face everything and SEE the reality, don't let fear stop you doing anything. It just guarantees you stay in the unhappy situation you find yourself in.
I agree with "x is almost always less scary than fear of x" (sorry if I mauled that Ursiainaa )
And I agree with swgrl to give your therapist really good feedback. Be completely open and honest about how you feel and what you're thinking.
Feinting with your therapist gets you familiar with the feeling of feinting but it doesn't really tell you if your fear that you'll feint outside is true or not. Only going outside does that. Dont let symptoms of anxiety or fear stop you. Feel the fear and do it anyway. I think the change that brings will not only reduce your anxiety in anticipation of these things but act as a huge antidepressant too.
Thanks everyone, excellent replies and a lot of good stuff I can remember and take on board when I'm wanting to go out and having all these pre-thoughts of what could happen but never does.
Shaz... Like you I try to keep in mind how many times what i thought would happen, didn't. But in the middle of a bad feeling/panic the thought occurs to me "maybe it will happen this time." Most unhelpful thought ever :( and being tired makes me think I'm about to faint. It's not a nice relaxed tired...it's like fatigue with adrenaline. I wish I could be absolutely certain what causes it. Wondering and anticipating and fearing it is really preventing me from making progress.
Besides the few days a week I go to work, I don't go anywhere else. I wake up thinking today's the day I will go and conquer a fear but the thought of being in the situation makes me weak and I don't go anywhere. I wake up tired.
Oosh thanks for the reply. I know all this stuff in my rational mind. I've conquered these feelings before but when I go out I don't enjoy being out, I tolerate being out and my mind is still stuck in "gotta get home before anything bad happens" mode. You're right; fainting while out will never be a pleasant experience. I doubt fainting itself is my fear. It's all the thoughts of having no control and fighting all the panic feelings.
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