Ok, before you do anything with exposure, lets look at some possible cognition aspects prior to the behaviour aspects, so you have some type of reinforcement to use as you practice the exposure itself.
- My father would take any opportunity to dominate me when I was in a vulnerable position.
- He would lean in over the back of the chair, place his head really close to mine and breathe deeply into my neck.
- I could not pull away as I was trapped between the desk and chair - it is this trapped feeling which causes the initial trigger.
- He would lean right over me placing his hands on the desk, either side of me, smell me with deep in-breaths and make groaning noises on the slow out-breath.
Ok, first cognitive points for use to reinforce your brain during and after each exposure attempt.
- You should talk during initial exposure to a trigger, because it helps keep you grounded to the reality of the present, with less chance of your brain wandering back into the past.
- Your brain will wander into the past at points, which is where you MUST NOT quit the process immediately, but instead adopt a firmer stance to your cognitive procedure.
- You should never let your SUDS level get above about an 8 out of 10, that is the time to step away from the exposure, yet still firmly using the cognitive aspects of reinforcement to lower your SUDS level.
What can you use for cognitive points? Please also help here with things you know work for you:
- Whoever the person is that will be behind you, use their name clearly, so your brain can distinctly interpret the difference to who is actually behind you vs. who your brain may say is behind you, referencing the past.
- Use the current date to reinforce present from past if required.
- Use jokes and humour that exist within the relationship to remain grounded as long as possible.
- DO NOT put intimate connotations into the exercise initially, ie. your partner kissing your neck or mimicking any type of past abuse behaviours.
- Please use anything you already know works for you.
Remember... this is desensitization training, it takes time, it will cause symptom spikes, and you must plan this carefully within your weekly routine to minimise fallout with important aspects.
You should plan and force an exercise routine immediately after initial exposures if symptoms sky rocket, even though every ounce of your brain will reject wanting to do it, you must commit prior to doing this... even if you have already gotten into your exercise clothing to walk, run, workout at gym, kick a football, anything aerobic pretty much to get you outdoors. The most basic thing, have a walking route outlined, and begin walking for around 30 minutes at the end of your exposure.
Exposure Itself
Sit on a chair, having your partner in sight. Have them then walk around the chair so you can see them, standing behind the chair for only a second or two, then moving back around to the side and front of you, so their within your sight. Process cognitive aspects of the reality of what occurred, ie. reinforce who is walking around you, your relationship to them, ask yourself the key questions that you need too, being:
- Was I sexually abused / assaulted / harrassed / provoked / etc?
- Was my life harmed from that event?
- Was my integrity harmed from that event?
- Was this the person that abused me?
- So... what do I have to fear then? Note any answers to yourself, then you must solve those answers.
Repeat process providing your remain under SUDS 8.
Progressively increase the time your partner stands behind you, pausing as they walk in a circle around you, pretty much. Remember cognitive points... keep talking.
Master that alone over days, weeks if required, before you add touching into the equation.
Repeat process when you feel capable, exactly the same, except this time when your partner pauses behind you, add them touching your shoulder, ie. putting their hands on your shoulder, again using all points mentioned, talking, etc... maintaining focus to now vs. past and that the fear is based on the past, not on the present.
The end outcome for your brain, is that the fear is no longer valid from anyone who has not abused you.
As you desensitize, get family to practice with you, then friends, slowly moving your exposure to people who are not as trusted within your brain. The ultimate goal and exposure therapy for you, is to be in a public place with your back to people... not touching you or even knowing them, but just exposed, knowing and reinforcing to yourself, nothing bad has happened, present is not the past.
Pretty much, use above, adjust to your liking, but implement. Never just give up or quit when it gets a little tough, but instead fight through it until at a good 8 out of 10 SUDS, then commit to the relaxation exercise you have planned immediately to reduce SUDS.
