Desensitization has been something that has really helped me. You can look it up on the web if you're not familiar with that term. It essentially involves taking more and more successive steps towards doing (or not doing) the thing you need to do-- to say something specific, for example. I think shrinks first developed it as a way of dealing with specific phobias. If you are afraid of biscuits, for example, but you want to make them for your son who loves them, you would start by thinking about the ingredients you would need to make them and/or by searching for recipes. Then you might print out and choose one recipe, or collect your ingredients in a box. Then you might measure the ingredients out into a bowl. Then you might mix the dry ingredients together, cut in the butter, add the buttermilk, mix the dough, all at separate times . . . I'm sure you get the idea by now. You can have as much time as you need between steps-- days, weeks, months, whatever, there are no rules. For some people, just listing out the steps between where you are now and what you want to be is a great place to begin. And you can break the steps down to be as small as you need to be, like measuring out one cup (out of 4) flour at a time.

So it has really helped me to to be able take one step at a time. I needed to do something for my physical therapy and I needed to purchase something. I talked about purchasing the thing one week in T, I had looked it up online, the next week T asked me if I wanted to buy it right now, so I got out my phone and ordered it off the web. Then I left the box, unopened, in his office for a couple of weeks. Then I opened the box one week and unwrapped the stuff in his office, left the box in his office. The next week I looked at the bag for a couple of minutes, then left it again. The following week I took it home, and left it in the back of one of my dresser drawers. For weeks. I couldn't touch it, so T suggested I bring it back. I did, and I put the different pieces that locked and unlocked together. Left it in his office. The next week, I took it out of the bag and just held it for awhile. Took it back home, and was able to use it several weeks later. I think it was about 6 months from start to finish. The last step, I realized that the only thing in between where I'd stopped (being able to hold the thing, but not use it) and where I wanted to be, was just that I had to do it. I had to take that last step and just do it, and that is always the last piece of facing the fear.

So it seems to me like figuring out the steps and then taking closer and closer steps to just doing it has a lot of practical value. I think when I get near the end, and this applies particularly to discussing things that feel really traumatic to me, the fact that I have already been able to say I wanted to talk about it, to have talked about talking about it in terms of why I want to talk about it, how I want to talk about it, what I need from T in order to talk about it, what I hope to get out of talking about it (usually at different times, they are different "steps"), there's a kind of momentum that comes from already having accomplished so many steps. Then taking the last one is more an evolution that feels natural and not nearly as scary.