Presenting problem: Phobia of Vomit
Treatment modality: BWRT®
Number of sessions: 2
D has a small lump in his abdomen and is scheduled to undergo a biopsy at his local hospital.
He is unafraid of dying, understanding that death is inevitable, and is grateful to have enjoyed good health all his life. He explains that the only time he has stepped inside the hospital is when visiting his father, who spent a long period there before his death from cancer. D can vividly recall the busy ward, the bleeping of the machines and the obnoxious smells.
Some years after his father’s death, D’s mother fell ill and an ambulance rushed her to the Accident and Emergency department. On hearing that she was unlikely to survive, D found himself, momentarily, rooted to the spot in the car park outside. Then, he says, an overwhelming panic propelled him to rush back to his car, where he sat for several hours, missing the chance to say a final goodbye to his mother.
The thought of his upcoming tests has brought back this same sense of panic. D tells me that the fear of being hospitalised, like his father, is growing exponentially each day. Such is his terror that D has, this very morning, completed an application to a euthanasia clinic. He bluntly states that he would rather end his life than be forced to stay in a hospital ward.
I ask D what would be so bad about it and he screws up his face.
“Sick!” He says. “People being sick everywhere! The sound of it, the look of it, the very smell of it!”
We talk about his aversion to vomit and D remembers a bout of childhood food poisoning which caused him to be violently sick. His mother was wholly unsympathetic, he adds, and chastised him for the mess. Since then, he has spent his entire life being obsessive about hygiene in his determination never to be sick again.
Sitting in front of me now, D reveals the most distressing thought about the tests he is facing is the possibility that he might need chemotherapy, should the lump be cancerous. He knows that this type of treatment often induces nausea and vomiting.
Once we understand what he is most afraid of, we set to work on changing D’s automatic, emotional responses to the memory of the past, and his fears about the future.
A week or two later, D drops a note through my clinic door. It says that the hospital visits passed without issue, and the exploratory tests revealed nothing other than a little wear-and-tear. Signing off with thanks, he finishes with the news that he is retracting his application to the euthanasia clinic.
“After all,” he writes, “I have everything to live for”.
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