I am really really struggling after leaving an intensive PHP/IOP program. I was there for 8 weeks and finished last Thursday. When I first left I felt like I made a lot of progress but now I’m doubting myself. I had my session with my outpatient therapist and she told me she wants me to do the top things on my hierarchy (my biggest fears are vomiting and needles/blood/fainting, so making myself vomit and getting a flu shot or blood work). I really don’t feel ready for either of those things. Talking about actually doing them brings my anxiety up to a 5. I don’t want to regress but I feel like this is pushing me too far. I can’t tell if I’m avoiding or if this genuinely is too fast for me. I just feel like I’ve had OCD for 20 years and I’m not ready to confront those major steps yet. I feel like I would rather die than do either of them. The whole thing is making me doubt that I made any progress at all.

WorriedDriver

Date posted: 5y

I think that’s a really aggressive approach and I would make a hierarchy with some more moderate exposures such as going to a clinic where they take blood, watching films depicting these topics, perhaps finding stage blood/vomit to handle

sosilay

Date posted: 5y

I agree with this. These things are all scary but I can see myself doing them. I guess I just wanted confirmation that I wasn’t being avoidant.

sara235

Date posted: 5y

I’m very curious that your therapist suggested you make yourself vomit? I do NOT want to undermine your protocols, but my therapist always emphasized that he would never ask me to do something unhealthy or that he himself wouldn’t do. WorriedDriver has some good advice; maybe ramp it down, and try some exposures that challenge you but don’t throw you in the deep end quite so much.

sosilay

Date posted: 5y

Exactly. For me, vomiting is my ultimate worst fear. I haven’t thrown up in over twenty years. When I first started treatment about eight weeks ago I couldn’t even write that sentence or acknowledge it out loud because I felt like I was “jinxing” something. It’s a very deeply set fear for me and it’s really not that I’m avoiding confronting it, I want to get past it, but I really don’t feel like that is something I’m ready for. I’m going to try and come up with some smaller steps for a hierarchy. It’s just hard adjusting from a partial hospitalization program where I was being coached for several hours a day on what exposures to do, to being on my own essentially with my outpatient therapist telling me I’m ready for this extremely difficult exposure.

sara235

Date posted: 5y

Ahhh, the “jinxing” —- that is one of my compulsions, too. My biggest trigger is stomach bugs, and I listened to a podcast from New York Times about a little girl who has OCD and is terrified of vomiting. She went through ERP camp, and they successfully mimicked the “vomiting experience” for her, but in such a way that it caused no physical harm to her. Listening to that episode is triggering but it also gave me hope.

sosilay

Date posted: 5y

That’s what we talked about working towards in my PHP program. I didn’t want to off the bat discount what my therapist was saying and be avoidant but I feel like making myself actually vomit will end up making my phobia worse.

sara235

Date posted: 5y

@sosilay It’s also just not a healthy thing to do to your body!

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