just opened door again

[June L]

Thanks Andy also for your own help and support.

[PanicAttackGurl]

Thank you to MynameisTerry for sharing the moodjuice panic self-help.

[jayb1]

Hi . I started my exposure therapy with walking to the paper shop, then the paper shop further away from home, my next step was to be the library accompanied but my therapist said I had to do it on my own.mi did it but with intense panic every day being physically sick when I came in. Now am back to square one going nowhere. My therapist admitted she had pushed me too far and has referred me for more intense therapy which I have to wait for. I feel so let down and dont feel I'm ever going to get better

[Davit]

There are two thoughts on exposure and they are very different.
The first and most popular and most likely to fail first time round is using it for a cure. This is based on the fact that everyone has a time that a panic attack can last before built in controls let it go. It is supposed to be 5 to 15 minutes. And probably is if you don't keep reopening it. So the theory is that if you make it through the first 15 minutes you will be okay. My Therapist never asked me to do this. She never would. We did the other thought on exposure and that is using exposure to test how well you have your coping skills in place.

This is based on the fact that "want to" is positive and "have to" is negative. So no matter how hard you push exposure because you "have to", and if you are successful you will have to do it for every situation.

Now suppose you were to decide to go to the library because you want to not because you are required to for exposure. And suppose you add that you don't have to if you don't want to. This gives you an out that you won't use unless you feel you have to. There can be no failure this way because there is no requirement. You are only going as far as your coping skills will let you. Remember it is your coping skills you are using this way, not exposure. Exposure is a marker this way, not a requirement. So the plan would be to go to the library if possible. By the way this way taking a friend is considered a coping skill and acceptable. After your exposure says my coping skills are working you can do it alone. So you start out small and work up. If you go ten steps and stop and go another ten steps it is an accomplishment not a failure because you didn't do fifty. Fifty might be the plan but it isn't a requirement.

I think that the problem here is that you want to, but feel you have to and have to is negative. With this it is changing how you see going some where and it covers everywhere not just the one situation you are exposing to. You should never do exposure unless you have coping skills firmly in place.

Just an option, but I feel forcing panic attacks to go away just doesn't work well. Getting tunnel vision and falling down and puking is not going to give you a positive feeling about exposure.

I can go any where I "want to" and now even "have to" situations get treated like "want to".

I only put this here so you know, off the deep end exposure is not the only way. But it is for some Therapists. Except they don't have to do it.

[jayb1]

Thank you for your response what you're saying makes total sense. My therapist saw being accompanied as a safety behaviour whereas I did see it as a coping behaviour. Iam going to try baby steps again first and be proud of what I have achieved. I was told that my exposure had to be done on a certain day at a certain time so the build up to it caused massive panic before I'd even started it. So if I decide on the spur of the moment I can go somewhere and cope is this ok?

[June L]

While since I have been on here. I am still opening the door. Still have high anxiety but I am getting more able to cope with it. I do the exposure on my own as I have no one to do it with me. But even with high anxiety I can now get over the road alone and into smaller shops. Ok I only buy one or two items when no else is waiting to be served but where as at first I could not buy anything and then only if I did not have to wait for change. Now I practise giving a note so I do have to wait for change. I am also still going in the library and round my garden both have become a lot easier. I have even started doing the garden itself. However, I have just changed the way I do the exposure as I was not going to one shop or place and telling myself I have down well. I was forcing myself to walk round the block where all my shops are up road to my doctors surgery. Back to shops go in several smaller shops and then walk round the block again sometimes twice all in one outing. Ok I was doing it but I was also seeing anxiety and depression getting worse in me in general. So I think I may have been trying to hard. Regards safety behaviour I feel use whatever it takes or helps you to start getting out. I have found in past my own safety behaviours start disappearing as I get more confident.

[MyNameIsTerry]

Thats all progress June. ERP is all about micro goals, anything big is counterproductive and its good that you have identified that you are not habituating to what could be too large right now.

So, break it into chunks by inserting goals inbetween what you can do and what you are struggling on right now or change it to a new goal that has less intensity and build it up gradually or come back to it later.

Safety behaviours are not great but it is possible to start with them and then reduce them back out.

[June L]

Here I am again with latest update. This past week I have spent hours at a time doing my garden and chatting to my neighbours with no anxiety. Where two months ago it was panic attacks just trying to walk round to my garden and the anxiety too high to even stand and talk to anyone. With the going out I am now able to not just shop in my small local shops alone:I am back in my Morrison's supermarket and by keep going back each day over the past two weeks I have got so I am now able to buy and pay for items in there.. Ok I cant do a full shop yet but it feels wonderful to be back in the store. Now I intend to just keep doing the gradual exposure as I can see although prior to going out anticipatory anxiety is still high as I stay out longer and longer the anxiety lessens and my confidence grows. But I also agree with others you do feel done in after exposure but the reward is well worth the freedom you gain from doing it. And now I treat it like a challenge what can I achieve today and it makes me want to go out and find out. Take today my cash point was out of order so I ended up in the bank but again I was so pleased as I could not have even done this a few weeks ago. But what has helped me the most is the support of others on this site and I hope by others reading my experiences it helps them too.

[Davit]

June Have you tried the CBT technique "want to" instead of "have to" it is in the thread Words I believe.

You will note the use of the words "want to" in your post, note the feeling it gives you compared to if You "have to" as in have to do exposure at the same time.

[June L]

Hi again to everyone. when I came on this site I could not even walk round to my garden. My agoraphobia was house bounding me. It had done for months. I had severe depression anxiety and panic attacks even indoors . I could not get to my doctors but I never wanted back on medication so felt it was not a bad thing. On top I had just lost my brother to cancer so grief was also not helping. Does C B T work? I can tell anyone reading this yes it does. Today thanks to others advice on this site along with the reading of C B T self help books and Drs Clair weeks books I am well on the road to recovery. The depression is no longer seen. The panic attacks indoors have gone. As for the agoraphobia its is getting better all the time. I am now able to shop in all the shops where I live alone even do my own shopping on Saturdays even in my large Morrison's supermarket without anxiety. I have now been back to my doctors surgery and just gone in it to show myself if I needed to see my doctor I now can. I am now practising walking further and further away from my home. I have had no help from anyone other than people on this site and the reading of c b t self help books. When I first started going out again it was with cue cards, band on wrist, Walkman anything to distract my mind from all the symptoms of extreme anxiety but by going out everyday no matter how I felt the anxiety symptoms lessened and today the wristband, Walkman and cue cards are not needed to go to the places I have now overcome. I now enjoy going out again. It may only be local at moment but I am walking further and further away from my home. Where once my home was in site today I am walking two blocks away from it. So anyone on this site who is reading C B T does not work please if you think it will help you give it a try - its what I have done and I am glad I have.