Walter created his 'baby steps' to face his phobia with his Fear Ladder. Now with Counsellor Bob, Walter will face his fear by going through the same steps in his mind's eye, in his imagination. He will practice facing his fear of the well water being contaminated right there in Robert Jenkin's office.
Walter’s Well Water Part 2
Robert Davies © 2019
Bob Jenkins, counselling therapist trained in TEAM CBT Therapy, explained once again to Walter that he had to face his fears to get rid of his phobia. Together they had looked at his negative thoughts about the contaminated water, which helped Walter to understand that what he was telling himself was not true at all. Then Walter came up with realistic, positive thoughts that were 100% or close to a 100% true. This put the lie to the thoughts that Walter had been telling himself.
“Okay, Walter, let’s go over your defeated negative thoughts. You wrote “I can die,” in thinking about drinking the water. What is your new thought?”
“It is – It was a bump in the road not a cliff to fall over and die.”
“Good. Remember that. Repeat it to yourself during the day – It’s a bump, not a cliff.”
“The next defeated thought was – I am fighting this alone. What did you write that was true, positive and realistic?”
Walter looked at his mood log again, “I have a support team.”
“You are dang right. Excuse my language. You have your beloved wife, children, the people at the hospital. There are good people dedicated to helping you. I am helping you. Dr. Burns, who trained me, is helping you albeit indirectly. You have several people on your team. We could even include your parents who only want the best for you. We could tag on your friends, who may not know about your phobias, but nevertheless, want the best for you. You ARE NOT ALONE, Walter. What was another thought that you beat up?”
“Well, that – I will be unable to cope with life.”
“Yes, you figured the phobias would leave you an emotional cripple. You figured that would be the case also after your surgery to remove that growth? What did you write down for that one?”
“I wrote – I can learn to cope appropriately.”
“Exactly,” said Robert Jenkins. That anxiety is on a long continuum. Everybody has anxiety. It is good to have. Concern makes us look both ways when we cross the street. Worry stops us from taking dangerous chances. Sometimes worry gets out of hand, and we end up with a phobia. But we all can learn to control anxiety. It is a tool that works for us.”
“Thank you, Bob.”
“Listen, you were the brave one. I stood behind you. Remember?”
Walter smiled.
“Okay, Walter, let’s do a cognitive exposure right here in the office.”
“Cognitive?”
“Yeah, you have your fear ladder to practice at home. Now we will prep you by practicing it in your head.”
“In my head? Why not the real thing?”
“You have the Fear Ladder. Remember. You will do 'the real thing', at home. Right now, it is good to do it using your imagination. Trust me. I do this all the time.”
“Now, close your eyes if that doesn’t bother you; otherwise, keep them open. Let’s go to your house in your mind’s eye.
“Okay. I’m closing my eyes.”
“Thanks, Walter. Okay. You are at home now. You have just put your clothes, under-wear, too, in the washing machine using that well water. You have dried the clothes and now you take them to your bedroom and you get dressed. First, underwear, then in whatever order suits you: socks, pants, t-shirt, shirt or sweater – whatever you want to wear. Okay, as you get dressed let your anxiety rise. Is it rising?”
“A little.”
“How much?”
“Oh, only about 20%.”
“In your imagination, just stand their with all your well-washed clothes on, getting your anxiety to rise, knowing that these clothes have just been washed in that contaminated water.”
“Is it rising?”
“How high?”
“It is up to 60%.”
“Okay, we just waited 30 seconds. Any higher?”
“No.”
“Okay, just hold it at 60%. Feel that uncomfortable anxiety. Let it burn itself away. It will start to go down. … Okay, I have just counted to 30 Mississippi’s. Has it dropped?”
“Yes, to 40%.”
“Let me know when it gets to 20%.”
“It’s at 20%.”
“Stay with it. It will burn to nothing.”
“Bob, it’s down to 0%.
“Okay. Step Two! Washing the dishes with the well water. You just filled up the sink with the well water. The soap is in and so are the dishes. You put your hands in the water. Okay, hold it. Keep your hands there. Let me know when your anxiety starts to climb.”
“It’s climbing.”
“Good, Walter.”
“How high is it now?”
“It is at a 100%.”
“Good work. Keep it there. Start washing the dishes, but keep putting your hands in and out of the water. Feel the anxiety. It is so very uncomfortable, but you are facing it and burning it away, Walter. How high is it now?”
“Still 100%.”
“Stay there. Burn it. Burn it away. Let it burn as hot as you can.”
“It’s going down now.”
“Good. Hold onto it. Don’t let go of the anxiety. Keep letting it burn. Burn. Burn.”
“It’s going down to 60% now. Oh, it’s at 40% already.”
“Let me know when it gets to 0%.”
“It is there now, Bob.”
“Okay, Walter. Let’s keep on going.
Bob and Walter imagined each step.
Classical Exposure – Technique of Using Gradual Exposure Fear Hierarchy
Describe your fear: The water from my well will contaminate my family and me.
List the least frightening activity as Level 1 and the most frightening as Level 10. Try to make the anxiety as bad as you can for as long as you can at each step on your Fear Hierarchy. In most cases, the anxiety will eventually diminish and disappear.
1.
⇓
Least Frightening
Wear well-washed clothes.
2.
⇓
Splash water on face.
3.
⇓
Wash the dishes.
4.
⇓
Take a shower.
5.
⇓
Brush teeth.
6.
⇓
Eat food cooked in the well water.
7.
⇓
Sip green tea.
8.
⇓
Drink a glass of water.
9.
⇓
Drink three glasses of water.
10.
Now see yourself doing all those steps everyday.
Most Frightening
With the shower, Walter kept his mouth and eyes closed.
“Feel the water come down over your head. Feel it running down your back and down your front and legs. You are sort of ‘underwater’ in well water. Feel the anxiety. Get the anxiety as high as you can.”
In that instance, the anxiety went to 100% and then bit by bit, it dropped to 0%.
With the food, Walter was encouraged to keep eating while his anxiety soared all the way to 100% and then dropped down slowly but surely.
“Keep slowly chewing that food and swallowing. Feel that food cooked in the well water go down your throat into your stomach. Feel the digestive system start to work at it in preparation to send its nutrients all over the body to every cell.”
Together Bob and Walter walked through the steps: letting the anxiety rise, then letting it burn and burn, then holding on until it burned to nothing.
“Well, Walter. You did it. Now go home and repeat it. How do you feel?”
“Amazed! Who would have thought?”
“Ready to go home and do the same thing all over again?”
Walter’s smile said it all.
The following week Walter returned triumphant.
“Walter, I am glad you are feeling better. But that anxiety or phobia will come back again, maybe with the water or maybe eating in the cafeteria at work. Who knows? We will do an inoculation next week to prevent that.”
“What’s that?”
Bob explained it.
"So, we will do the inoculation next week to stop any re-occurrences."
Walter left to return the next week.
Join Counsellor Bob and Walter in Part 3, Walter’s Phobia: Well Water Part 3
About the Stories
Most people like stories, and therapy is all about stories. Telling stories about powerful techniques used in TEAM CBT therapy demystify this therapy one story at a time.
Yet, confidentiality is a cornerstone of all counselling. Without confidentiality, clients wouldn’t feel safe going to therapy to divulge the most painful areas of their lives. To safeguard clients while illustrating TEAM CBT techniques, confidentiality is kept by either having the client’s consent and/or by distorting the facts, making the client unrecognizable .
Robert Davies
Counselling Therapist