Psychē Nashville
DBT and CBT in Nashville for Adults and Adolescents. Treating Depression, Anxiety, and Personality Disorders.
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Therapists are rarely short on opinions...so we decided to put them all here...

PSYCHe Says

What Doesn't Kill You Makes You Stronger RIGHT??

 By Sarah Kmita, LPC/MHSP

By Sarah Kmita, LPC/MHSP

Patients sometimes ask personal questions about my past experiences during their therapy sessions. Instead of doing the whole “sneaky therapist” trick of responding to their questions
with my own questions, or deflecting in some way, I will usually just answer them. Although I don’t believe that therapists must experience all situations/issues/events/diagnoses in order to
effectively treat their clients – just like surgeons can successfully remove an appendix without ever having their own removed – having some personal understanding to draw from can be quite handy.

I recently had the opportunity to “gain a new experience” and get perspective on Something I encourage my patients to do on the reg, yet had not done myself – until now.

Exposure therapy is the treatment of choice for overcoming anxiety. It involves deliberately exposing oneself to anxiety-provoking situations while simultaneously working to increase anxious feelings. Sounds counter-intuitive, I know. The idea of exposure therapy is that over time, the more we “lean into” the anxiety instead of trying to avoid it or calm ourselves down, habituation occurs (habituation is just a fancy word meaning to get used to something). Eventually, the level of anxiety originally experienced will decrease and likely disappear.

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Don’t get the wrong idea; exposure therapy is HARD, SCARY and UNCOMFORTABLE. Who in their right mind would want to make anxious feelings more intense than they already are? Exposure therapy is a treatment that requires a deliberate and conscious decision to do it. Sticking “just a toe into the water” during exposure therapy will not be enough to make a difference. It requires 100% commitment.

Now on to my personal experience with exposure therapy: my family and friends (and now you) all know that I have a huge and irrational fear of needles. I’ve never had a particularly traumatic experience while getting an injection or giving blood, but nonetheless I’ve been afraid of it for as long as I can remember.

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As I’m not a child anymore, it is no longer up to my parents to decide when I get an injection. It is up to me and me alone to choose to subject myself to a flu shot, donate blood, or get that long-overdue Tetanus shot that my doctor wears me out about every year…I’m obviously working up to this…Well, a couple of weeks ago I decided that enough was enough. Injections are, unfortunately, a part of life and are not going to get any easier for me unless I do something. I also could not help but feel a bit like a hypocrite after preaching to my clients the benefits of exposure therapy but acting like a scaredy-cat when it came to my own fear. As a clinician, I know I should not ask a patient to do anything that I am not willing to do myself.

So, the long-anticipated day finally came. I was headed to the doctor’s office to voluntarily get an injection (well, several injections actually). Thankfully, I had the support of my friend and colleague (who is also conveniently a Psychologist) to coach me through the exposure exercise. I climbed up into the exam chair as if I was headed to my execution, closed my eyes, went to my “happy place” and focused on breathing slowly and deeply. That was a mistake!

After the first injection, I became nauseous, light-headed, pale as a ghost (per my friend’s report), super hot and sweaty, and felt my hands fall asleep. It took the nurse, my friend, and the physician putting ice packs on my face and neck, bringing me water to drink and chocolate to eat for me to feel somewhat normal again. It was QUITE the scene – I freaked the doctor out and was completely mortified. Turns out, the reason I experienced all of these not-so-pleasant side effects was because my body was actually calming itself down too well! I was able to decrease my blood pressure so fast that it bottomed out, causing those fun bodily sensations.

After some coaching and encouragement from my friend, I was ready to go back into the ring for round two. This time I kept my eyes opened, increased the rate of my breathing, and stayed mindful that I was getting an injection. I made the decision to “lean into” the anxiety (as we therapists say). It was scary and uncomfortable to stay present, and I had to keep turning my mind toward the anxiety when it would automatically try to distract.

After the second injection, I experienced some of the same side effects as before, but the intensity lessened dramatically.

After the third shot, no nausea, sweating, or light-headedness at all! So THAT’s habituation!

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Now don't misunderstand. I still don’t like needles and will need to do more exposures over time to continue decreasing the anxiety that is paired with them, but I’m definitely off to a good start. Now, I have a much deeper appreciation of my patient’s fears and can speak from experience when they voice hesitation to complete exposure activities. I’ve been there—and I know first (numb) hand what it means!