Cbt4Panic Gradual Exposure for dp/dr

So yesterday I started to read CBT4 panic properly, had a really positive day thinking wow I can do this, today my head has plummeted when I tried to start the Gradual exposure exercise.

Doing an activity for 8 days and write down how the panic was before, during and afterwards.... So I thought I would share my journey on her too.

The morning didn't start off too great, I woke up and we had men fixing the boiler in the house so I sort of hid until they left!! (yep I know I shouldn't have done!!)

Got up and the sun started to shine.... brilliant my brain much prefers the sun (doesn't everyones??)

Dusk is the crappiest time of day for me I can almost guarantee my dp/dr comes on worse at that time...... t the minute from about 3pm to 6pm! and sods law that is when my work is!! I haven't managed to work for about 5 weeks now.... but I completely love my jobs and miss them like crazy.

anywayback to the Gradual exposure.... driving is a big problem for me.... I suffer from DP/DR badly when my head is being a ****, so driving can feel unsafe to me.... If I don't feel real then how am I meant to drive safely?? but I guess deep down I will be concentrating more so theoretically I would be safer (my head doesn't really see that) My mum says that she never feels unsafe when I drive however my head is so I guess that is good.

The plan...
Drive to the nearest town, (5 miles away) maybe drop something off at one of the charity shops and go to Tesco to get some cat litter.

what actually happened...

Before I went I was quite calm to start with, My DP/DR about a 4/10

then as I went to get dressed my dp/dr increased 6/10

Put my shoes on and it shot up to but still determined to go ahead with it I need to be free of this again!! 8/10

Got to the car and started driving.... the DR decreased a bit, maybe because I was concentrating on other things 6/10

further in the journey I passed the local primary school.... the children were just walking to church for the end of term service 8/10

Decision made onto the charity shop, DP/DR has subsided a little and there is a supermarket next to it 5/10

,Charity shop, only in there a couple of minutes 5/10

Small Supermarket DR increases as I have to talk to a shop worker that I don't know they don't have the cat litter I want 7/10

Need to go to another supermarket so head to 'Big Tesco's' (we have a Tesco Express and a super market so one is known as Big tescos)
but we are passing my nephews house and I need to talk to him so call in there to talk about Christmas as he is coming to ours 7/10

To Big Tesco walk round get a few things very busy (what am I thinking trying this just before xmas?????) maybe it is a good thing?!?! DP and DR fluctuate while walking round each time it upped itself I tried to let it be and tell myself that it was just a feeling and wasn't going to hurt me and i just my fight or flight reaction making a mistake, It worked about once the rest of the time it just kind of laughed at me 4/10 - 8/10

Still no bloody cat litter (cats know what you lot are getting for christmas lol) Now we have to go to another shop!! so on to Lidls. bought some cooked meat from the reduced section in Tesco so nibble on that... it wasn't the nicest beef as my mum said "you can mend your shoes with that beef!!" Since my head has been bad I hardly ever eat while I am out, anx makes me feel sick 7/10

On to Lidls, we may as well stock up the tin cupboard while we are here .... right?? 8/10

Walk around Lidls DP increases and I tell it 'whatever do your worst'... so it did!! I carried on round the shop, didn't walk out and go hide (result!! so I thought!!)..... Just getting over a cold so have a tickly cough.... have a coughing fit and end up being sick... right in the middle of Lidls!!!!! managed to catch it in my hand so that was good (ish) ewwww....... are people looking at me it is so busy in here, a few were looking at me at the time they were string at me thinking ewww how disgusting, now I am home my head thinks that only a few were looking at me and that was because they were checking I was ok and not choking lol 10/10

Ffs, still no cat litter, I really need this cat litter.... on to sainsburys!!! To sainsbury's still really bad DP but I have to go there I need the cat litter so drive there 9/10

Into Sainsburys, don't really want to get out of the car, my mum offers to pop in for me and check as she sees I am struggling BUT i decide in for a penny in for a pound... We both went in..... seriously DP/DR you can go now I am fed up with you 9/10

Struggled round, why does the pet section have to be the far side of the shop??? so many people anyone would think it was Christmas soon!! 10/10

Got it the holy grail.... cat litter!!! :D paid for it got back the car ready to explode..... but managed to keep it in and drive homeIt has now been so long that it is getting dark ffs my worst time! 9/10

pulled in to my street.... ffs I needed to post those xmas cards.... turn round go out of my road and down to the post box in the village!! I almost got back home!! 8/10

finally get back home and my brain is so tired and panicky that it revolted on me for half an hour, I still managed to put the shopping away while really panicking and then sat on the settee in a panicky mess 8/10 - 10/10

Now 2 hours later my brain is now settling down into my 'safeplace' again 6/10

hopefully it will settle even more later as I chill more..... going to try not to have a bath tonight... I have had one daily for the last couple of weeks, kind of like a safety measure, no idea why, maybe something to do to take my mind off things but in the last.

So I think my 'Gradual' exposure turned into something not so gradual and my head is telling me that I completely failed as yesterday I felt so positive about it all and today I came crashing down!.......but at least I have the bloody cat litter!!!


Tomorrow...... the same trip to town but to a different shop in the middle of town..... watch this space :)

and if you have read this far.... are you bored yet???

Interesting read and adventure VBJ... I don't see that as a failure at all. You did it didn't you? :D Tracking it like that enables you to see your progress as well as triggers so you can address them. The very fact that you're actually taking control and doing this is a win/win. Keep up the good work!

Positive thoughts

Hi
First of all - well done for actually taking this on and for having the courage to face it this way :-)

but I'm wondering if it might be an idea to alter your plan a bit

First of all you need to make a list of situations that cause the dr or dp and order it from least anxiety producing to most - then you start with the LEAST anxiety provoking on the list and build your way up to the most

Sounds like you are starting with a high anxiety situation - imagine if someone had a fear of dogs and decided to overcome it by first stroking a Pit Bull - they would be much better starting off with a small cute puppy

I know you have only recently been reading the books in earnest so you also may need to read through book 2 for some time longer to really understand the 'acceptance behaviour strategies' that will help you face the anxiety in a new way rather than just bravely facing it

And finally - since the problem is dr and dp (which feels worse when you drive) you can start by doing gradual exposure to the physical and mental symptoms without leaving the house. If you read over the 'Interoceptive Exposure' section in book 3

Or if you are determined to use the driving situation you can break THAT down into smaller chunks

day 1 - drive down the road for 1 mile
day 2 - 2 miles
etc
day.. - drive to Tescos and sit in car - and drive back
day.. - drive to Tescos walk in to store - wait for 2 minutes then go home
etc

I know this sounds tedious - but the repetition and gradual nature of doing it this way allows you to experience the anxiety and your subtle reactions and behaviours that maintain it

the way you are doing it is brave but it seems like you are doing SO much at one time that the 'experimental' side of exposure is being overshadowed by too many anxiety triggers - so it's up and down

I'm not saying that can't work - but taking it more gradually works better in my experience

But - again - well done :-)

I loved reading your post Venus, and related to it muchly...I think alot of anx sufferers here would too, and as the others said it's great that you got out there and did it despite the crazy christmas crowds, so well done you!

Cath S ☺

Hiya Robin... Thank you for replying,

The problem I have is that I am the only driver in the house and we live 4/5 miles from any sort of shop and have no buss service..... last time I had a relapse I had a neighbour who could drive me places and my brother in law lived near too..they could get things for us or take my mum to the shop.. we don't have this this time.

I also need to get back to work which is 15 miles away ..... I work for an after school club and also an after school Nanny sometimes till midnight.... I have already been off for about 5 weeks and my boss is struggling with the child care, she is a single mum.

I LOVE my jobs, missing them so much, I don't want to lose either of them but if I am not back soon then my boss will wave to find someone else and I completely understand that (She hasn't said that, I have) BUT i would hate to lose it and my other job.

So to be honest, not sure how to take it more gradually to get to where I need to be.... maybe my expectations are unrealistic but need my jobs.... haven't had any money coming in for 5 weeks now at all :/ my contract at the school is zero hours so no sick pay from there and the family I look after I do as Self employed.Don't think I can apply for any sort of government help :/
I had to give my fit notes to the school, so I don't have them to claim for it anyway.... Difficult when you aren't getting any money in to test yourself driving as petrol is so expensive. So have to make my journeys count when I do drive :/ :/

Maybe I should start a crowd funding page "Lets get Emma fit again" they seem to use them for so much crap nowadays "please pay for my dog to get plastic surgery" and such like...... ps I am joking and under no circumstances get your dog plastic surgery, it is not big and it isn't clever"
https://images-na.ssl-images-amazon....LL._SY300_.jpg


Anyway today The plan was to drive to town and go into Heron Foods to fill the freezer and then put petrol in the car then maybe deliver an xmas present to one of my friends.

What actually happened....

Woke up feeling relatively 'normal' 3/10

DP/DR upped a bit when I went to get dressed 4/10

Drove to town, brain was not too bad really, my DP upped because of the cloudy dull weather, it always does 6/10-8/10


Parked in the centre of town, typically the shop we need to go to is in the middle of town (it is only a small town).... Lots of people around 7/10

walked through town to the shop 7/10

walked round the shop DP/DR peaked at 9/10 but I continued and did it.

Got back to the car and a person had blocked me and another 4 cars in and just left her car! I just wanted to come home. 9/10

Woman finally came back to her after 10 minutes.... moaning that she couldn't park elsewhere as she was picking up something heavy from the market. (there are plenty of parking spaces, it is a big car park. she didn't have to block anyone in!! she could have even parked closer to the market!!) she even got one of the men at the market to carry the stone ornament for her so it didn't bloody matter where she parked!!! She told us we were in the wrong as we were impatient!! and to "don't get on me, where else was I meant to bloody park?!?!?!?"
I resisted the urge to shout at her, but it was close. feeling festive an all that.... NOT!!! but hey at least I got pictures of how she had parked so her car will star on "Bourne Bungle Drivers" this evening .....I never do that but this deserve it lol 8/10 - 9/10

Can finally go get some petrol put some in the car while my mum goes and pays 7/10

Drive home and remember I have to go pick up a repeat prescription before xmas.... bugger!! 7/10

Drive to the drs surgery..... My mum goes in and pays and picks up my prescription.

While I am out I may aswell go an drop off this present to one of my best friends..... I could do with a hug and she only lives 15 minutes off the drs surgery...a bit of a crappy drive but I got there and got a hug and swapped christmas presents. I was only there for 5 minutes.... she suffers too so it was good to see her and get a hug. 7/10 - 9/10


Drive home and my DR increases as it starts raining 9/10

Now I am home and my head is suffering, I am sat here with my DR at about 7 or 8/10 trying to get it to do its worst determined not to let this beat me

fingers crossed that by doing this it settles down this evening.~

Thank you for reading again and thank you for all of your replies..... I am not sure how to do the gradual bit really.... all my simple days seem to turn into really complicated ones.

I mean, I have a big estate car, a bollard and kerb by the side of me and another car the other side of, so no chance I can get out..... bloody woman!!!

http://i68.tinypic.com/2chw4ko.jpg

Ps, not the woman in the picture, that is my mum trying to guide another car out a parking spot the other side

Hi Venus

I do applaud your bravery - however I'm a bit worried that people reading this might get the wrong idea about how exposure works - and what the process is.

So I would urge anyone wanting to practice exposure to read the 3rd book of my course at cbt4panic.org

With exposure you really HAVE to stay in a trigger situation (the specific one you have chosen to practice with) until your SUDS (subjective Units of Distress) levels have come down by half

What you are doing is just going into a variety of trigger situations and rating the SUDS but without waiting until they come down - which means you leave the place with the memory of the SUDS being high - which means you will still have a solid fear of that particular situation

I'm honestly not sure that that will do much to really help you overcome DR or DP - of course you are bravely going into these situations and I know just how much courage that takes - and you are doing so because it is a necessity

But if you really want to be FREE of DR or DP you would need to approach this in another way

Can I suggest that you spend some more time reading over the 3 main books and really study book 3 in great detail

You also need some strategies to help you have a different response to the DR or DP - facing it is one thing but if you alter your inner responses (thoughts and behaviour) you can really start to lessen the anxiety

I really hope you don't mind me writing all this but I just feel it is very important for others who may be getting the wrong ideas

If it would be possible for you to attend a CBT therapist and learn about exposure that would be really helpful

Robin

Right.... so starting again...

My head is still determined to do this even though my DP/DR is got 10 x worse in the last 2 days.... logically that is because my routine has changes and I have been busy over the last couple of days. but of course in my mind I am back to square one!!

So today, decision made.... my mum is my safe person... I am having to go out with her as a necessity... but this is still having one of my safety measures in place..... I may have to go to work, with my mum in the car yet as I need to get back to it!!

Today I did pop to town with my mum, we needed a few things. and while we were there we went to look at the Christmas reduced things. my DR was being an arse all the way round today.... I had a few moments when it reduced.... didn't think I would be able to drive home but I did because I had to!

BUT when I got back home my mum got out the car and went to drive for a mile up the road.... no where to turn mile up the road so it was more like one and a half....My DP/DR was at a 9/10 leading up to it and through out.... I am now back on the settee and it is still really high.... but I didn't give into it, I was looking round me trying to ground myself .... It didn't work but maybe it will start to tomorrow. when my head is being less 'needy' today then I will read more :)

Tomorrow is another day :)

Quote:

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Originally Posted by robinhall

If it would be possible for you to attend a CBT therapist and learn about exposure that would be really helpful

Robin

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The waiting list is about 4 months here unfortunately so won't be doing that for a while unless I pay for it :/

So today, my brain is a mess, whatever I do my dp is bad, I am sitting here not being able to go out at all because of it and the weather combined. just taken a propranolol to see if it will help.

I am trying to just let the DR/DP be and tell it to do its worst..... but then it does it worst and my head really can't cope with the feeling.

Today I am back to not seeing a way out of this feeling and not sure I will get out and drive today at all!!

So just sent a message I really didn't want to send

I sent a message telling my boss that maybe she needed to find someone else to look after her children.

Everyone tells me I have to look after my brain and put others 2nd... but my brain just can't do that

Everytime I put pressure on my head to go back to work then my head then rebels and today I just got in the car sat i it and cried and panicked.

,any people tell me I have to force myself to do things so my head needs to realise things aren't scary and others like cbt4panic tell me I have to do it really gradually..... I am confused as to what to do.

All I know is that my boss deserves some stability and so do her children.... so me saying I am almost ready to come back (which my brain believes at the time) and then not being able to do it is letting her down and she doesn't deserve that.

She is ringing me n her way home from work......
I am completely heartbroken, it tore my heart in two sending the message but it had to be sent.

so my boss has now called and told me not to be so stupid.... and that she isn't allowing e to quit

she says she will work round me however long it takes but obviously the sooner the better for both of us....

My head is still crying and basically not sure if they re happy tears of just that my brain is overloaded...... I could do with a good nights sleep.... fingers crossed

I think anticipatory anxiety plays a big part in this, Venus. The JFDI approach is fine when there is no build up to an anxiety-inducing "event" but when you've got time to think about doing something challenging it's all the harder to do.

How kind and understanding your boss sounds. You'll get there but maybe you need to do it your own way and not follow a set programme? Find what works for you without putting pressure on yourself?