Exposure Therapy

[anthony]

This is a continuance from another thread, as this is off-topic to the linked thread about dissociation: [DLMURL]http://www.ptsdforum.org/c/threads/dissociation-explained.13879/page-3#post-207248[/DLMURL]

Yes, the explanation of exposure therapy was very helpful. The trick is not to associate when engaging in it.

Exposure therapy.... no, the trick is actually just to go with what occurs when you do it. Exposure therapy has always been about facing present fears, however; present fears are obviously linked to past memories. The entire point of exposure therapy is that distinction and to get your brain to recognise that exact distinction. Past memories vs. are present fears realistic?

A past realistic fear could be as a child, who is being abused... you are a child, you are being abused by an adult, so your fears are realistic at that time and under those circumstances.

Now, you are an adult. Are fears that are either associated to past memories relevant now, or those that you have created yourself through behaviours due to past fears in the first instance?

The answer is typically no.

If you still lived in an abusive relationship, then those specific fears are quite realistic in the present. If you aren't living with realistic fears, then exposure therapy is about the act of getting you to recognise the distinction, past memories / behaviours were appropriate then, but are not now, and are a hindrance on your ability to live life today.

 

[Reclusive]

Man, I hate exposure therapy. I thought I was on the right trail - I do all the errand running and what not between my fiance and I because I'm the only one who can drive. But my t said that going to these 'safe places' doesn't really count and that I need to go out of my own volition and learn to be comfortable in places where I'm not. So I'm slowly exploring my back yard and a little bit of my front yard. I take my camera with me because I love photography, because I figured it couldn't hurt associating going out with good stuff, right? I'm hoping to make it down to the little park about 2 blocks from here soon. The palo verde are blooming and they're just beautiful.

I think part of the frustration for me is that all my symptoms came on at once, so I think that there should be a way to turn them all off at once. Just flip the switch back and off I go.

 

[anthony]

Well done...

The biggest thing you have to do is the confirmation afterwards, ie. what did you fear that stopped you doing x, and was that fear realistic after completing the task as you had first thought! The confirmation is the essential cognitive reprogramming aspect that must always follow each exposure.

 

[Reclusive]

I'm going to have to practice that last bit because the 'what did you fear' part is pretty lengthy. Dang, and I thought I had it down. Hrm... the hard one is going to be dealing with people. I don't know why, but dealing with them drains my energy completely, so I'm always scared that when I go out OMG someone will want to chat. And they frequently do. Suggestions?

 

[anthony]

Dealing with people is a lot of learning prior, ie. anger management, stress management, communication skills, etc. They are the areas you work on for exposure with people... not exposure therapy itself. In that one instance, you learn those skills first, then you put them into action. Different issue than what exposure therapy itself is designed for, even though it is everything we do, so to speak.

 

[Reclusive]

Stress management for sure. I always worry I'll fall off script or become too involved. I really do want to save the world. That would prolly explain why I get so tired being out and around people. Even close friends exhaust me when they visit. The internet is good, though, this isn't stressful. I think there's something in there.....

 

[Srain]

Would being exposed to lying, since that is probably a HUGE trigger or stressor (this one I'm confused about because it sometimes comes from one of the original sources of my childhood abuse), be considered exposure? I get so upset and go into a spin over this especially when it's someone close to me and I'm not prepared for it. I seriously over-react and can go downhill in a hurry.

Rain

 

[Cthulhu]

I've exposure-therapied myself since I was about 14. Didn't know the name for it but just did it because I didn't want to be so full of fears anymore, I more or less consisted just of fears.

Today all the 'simple' ones are long gone, some are still there, right now I am again trying to work on them. They are socially-relationship-related. The problem is that I really have absolutely no sense for all the signals other people give in conversations, so I can never divide between a fear that has become baseless and a reasonable one that still has its purpose. The latter one will totally look like the first one on the outside for 'normal-functioning' people, that's the problem.
A problem for me, too because I like to see myself as almost-normal. But I'm not, I will never be. So it's just trial and error and never let the errors come too close to my core.

 

[Sabrina71]

Rain, I had not had a panic attack in weeks until last Friday. It happened because I found out lies that people I trusted are telling. The lies were not even about me, but the anger, rage, and betrayal threw me into a full blown attack at work.

 

[The Albatross]

I can relate Cthulhu, I heard myself saying to my T this morning that even if I could find a way to be okay 75% of the time, I'd settle. I like what you said about never letting the errors come to close to your core. I'm still wrapping my head around my core and my sense of personal responsibility.

 

[anthony]

I've exposure-therapied myself since I was about 14.

Actually, every single person has done so just living life. Its like watching a child go play for the first time, going to school for the first day, etc etc. We all fear doing things for the first time, some more than others, yet life itself is a constant exposure therapy exercise. Just changing jobs, it invokes fear within us of starting a new job, meeting new people, etc. Getting sacked, same deal. So many unknowns suddenly popup and create fear based symptoms and responses.

Would being exposed to lying, since that is probably a HUGE trigger or stressor (this one I'm confused about because it sometimes comes from one of the original sources of my childhood abuse), be considered exposure?

The problem with something like that, is its more cognitive, and it affects everyone, with or without PTSD, and you don't know someone is lying to you unless you also know the truth. This would be more cognitive therapy based, not exposure based.

Not many people really like being lied too.

 

[Srain]

The part

Actually, every single person has done so just living life. Its like watching a child go play for the first time, going to school for the first day, etc etc. We all fear doing things for the first time, some more than others, yet life itself is a constant exposure therapy exercise. Just changing jobs, it invokes fear within us of starting a new job, meeting new people, etc. Getting sacked, same deal. So many unknowns suddenly popup and create fear based symptoms and responses.

The problem with something like that, is its more cognitive, and it affects everyone, with or without PTSD, and you don't know someone is lying to you unless you also know the truth. This would be more cognitive therapy based, not exposure based.

Not many people really like being lied too.

This helps out and I understand about the CBT. The part I guess I didn't make clear or maybe I didn't understand was the person lying to me doesn't do it all the time but I am just now guessing writing this that it doesn't much matter how many times. I wouldn't put up with it from anyone else this ongoing, blech. I know better than this.

Thanks.