Okay, this is what I've learned from therapy thus far. 100% of my anxiety about vomiting(and many other situations)comes from my fear of vomiting. When I do get anxious, 80% of the time, it is caused by my thoughts, i.e., what if I get sick, I'm going to vomit, is today the day, and 20% is caused by external stimuli, like hearing about others vomit, etc. So one of the things I need to work on is the thoughts. I've learned two techniques, and am wondering if these are both appropriate.


1. Challenging the thoughts....asking where is the evidence for this, has it happened before, what would I do if the worst happened. I've noticed this seems to work well when the thoughts are just starting, and I'm not very anxious. Then, when I ask myself, "Well, what if the worst happened?" I say to myself, "Who cares? I would just vomit and get it over with."


2. The stop technique. When my anxiety is high, challenging the thoughts and saying "what if the worst happens?" just increases my anxiety. When I'm more anxious, I say "Stop! I am choosing not to participate in these thoughts! I am safe, and I am not in danger." Is this way as effective as challenging the thoughts? Hopefully it at least has some benefit, because when I'm more anxious, I can't challenge the thoughts.


How long will it take for this stuff to start working? I've been doing it consistently for about a week, and have noticed the "Stop" response start up automatically once or twice.


I'm doing a little better than I had been the last couple of weeks. I was actually able to drive to Chicago to meet my new hypnotherapist (supplement to CBT) yesterday with only moderate anxiety (even with being stuck in traffic for two hours). Of course, I had a huge panic when I got home, but I really liked the hypnotherapist, he seemed to have a lot of insight into my issues. Exposure therapy is currently on hold, due to the fact that I am barely holding it together anxiety wise. We will probably start up again this week or the following week, using Sage's hierarchy.


The anxiety is still very rough, but I'm having more good hours in a day than bad hours on most days, so that's an improvement. The possibility of an SSRI is still there, but we're kind of taking it on a wait and see basis. I think maybe things are finally calming down because my stress levels are decreasing.


Sage, when you did your first round of CBT which cured the fear of yourself vomiting, what exposure hierarchy did you use? Was is the same as the one posted on the "treatment info sheet"? If not, could you post it here for us? I'd like to have as many ideas as possible for exposure.