irrationality, exhibit A

This morning while I was still sleeping (about twenty minutes before my alarm was set to go off), one of the neighbor's kids started coughing right outside the window, and it woke me up. I wasn't alarmed at first, but it kept going on and then started sounding more like choking and gagging. I pulled the covers up over my head, covered my ears, and started humming really loud. I could still sort of hear it in the background, so I hummed until I wasn't catching snatches of it anymore. I have no idea if anything even happened or if the kid just coughed for a while, but I've still had about a thousand worries today related to this 15-20 second event, starting with the ridiculous idea that the germs might come through the wall or window. Almost every real or far-fetched way illness could reach me is running through my mind. I've been doing so well this winter, not obsessing over contamination, and I'm finding it really annoying. I guess I always hope the thoughts are gone, but really it more seems like they just settle down temporarily. Like the thoughts are leaves and anxiety is a wind. The wind's picked up again, so the leaves are flying around all over the place. It's such a pain. Even if the kid did actually get sick, I know I have no more reason to think and worry about this than I do on any other day, days when other kids in other places might be getting sick without me there to see or hear it. It's just been a while since any of my senses have been exposed to it. If it even happened!

And the tune I hummed to myself was pitiful. In my fear, I couldn't think of one specific song to commit to, so what I came up with barely qualified as musical at all. It got me thinking about how maybe I should pick a song now to use if this ever happens again, which then got me thinking about the movie My Girl. Remember Vada and her "do wah diddy" meltdowns? Maybe I'll just steal hers, it's a pretty good one.

Joking, by the way. Believing I'll be able to handle the next situation is probably a better idea than picking a "panic song."

reframing thoughts

I went to a restaurant to have lunch yesterday. It's been a while, and I was feeling nervous about it for days beforehand. In light of that, I think it went really well. I was able to keep pretty calm before and throughout the meal. After I finished eating, I felt (or imagined I felt) a little queasy, and then I was anxious for a while. This was during the drive home. I kept mentioning to my wife that I felt sick. Yes, repeatedly, because it's not enough to just mention it once, right? She kept telling me to rephrase what I was saying, telling me that it was better to say "I don't feel well" than to say "I feel sick." In the moment, with the anxiety and whatever the physical feeling was, I was exasperated by this. It seemed like it didn't matter what words I used, the situation was still horrible. The whole "just semantics" argument that doesn't make any sense because the words a person chooses do matter.

It reminds me of a quote from Cormac McCarthy's The Road: "Just remember that the things you put into your head are there forever, he said. You might want to think about that." You can change the way you think, and by doing so, you can change your entire perspective. You are always in control of that. The idea of this scares me, because right now I am not that skilled in using the control to my advantage. Telling myself and others that "I feel sick" is almost as bad as saying "I am sick" or "I must be sick" when I'm not (which I've done many times). With this phobia, I really need to keep a clear head when it comes to the word "sick."

Pretty much all of these statements should be avoided: "I feel sick," "I am sick," "I must be sick," "I feel like I'm going to throw up," "I feel nauseous," etc. They are all going to be inaccurate or exaggerations most of the time, and they will only heighten the anxiety. There are so many other statements to use in their place: "I feel anxious," "I feel full," "I feel digestion," "I feel hunger." Sometimes I don't want to use these more accurate statements just because it feels like it trivializes the very serious / intense worry I have in that moment. And it will trivialize it. But not in the sense of you having a huge problem and the rest of the world not noticing or caring. The worry itself will start to become trivial so that it doesn't affect you as much. Just from you making the effort to use the most accurate / truthful words possible. And if none of the "true statements" seem true to you, go with the most optimistic one that you can imagine being possible.

internal weather

At times, this phobia has made me feel hopeless. Only when it is at its worst, thankfully - those periods where I am feeling sick and anxious all day every day. It doesn't take much of that before I feel like I am living in a state of despair and that there may not be anything that exists outside of that state. Then feeling and thinking that way starts to scare me in itself. I spent a lot of time online during these moods, searching for anything that could make me feel a tiny bit more hopeful. I came across this letter one day, which had a huge impact on me, and now I always think of it when I'm having a hard time.

I just love the metaphor of the weather and the idea that the best course of action is to wait it out rather than fighting it. You don't stop living your life when it's raining, but you also don't run out and yell at the rain to stop or try to come up with some crazy involved plan to control it. You don't ever say to yourself, "well, that's it. I'll never see the sun again."

In my mind, I was absolutely convinced that my personal "sun" was gone forever, but it came back, because it will always come back.

the comfort zone

Things have been going extremely well for me. I've been eating almost every meal without feeling really sick and/or anxious. I think I'm finally back to the point where my anxiety is pretty much non-existent as long as I am just hanging out at home. It's only an issue if I go out anywhere or if someone comes to visit us. That doesn't sound like much to celebrate, I guess, but I'm loving it. Pretty much all of last year (and some of 2010), for the first time in my life, I felt like there was nowhere that was safe. It was horrible, and I'm so happy to have a "refuge" again and to be feeling more in control of my anxiety.

On the other hand, I don't want to spend all my time at home, which is what I've been doing. Clearly it's time to get out more and see what happens, see if I can manage to feel anxiety-free other places. I think I am going to start trying restaurants again. Sometimes my experiences with them are fine, sometimes they are awful. I'm hoping with practice that the awful times lessen.

Unfortunately, there is some possible unidentified problem with my car right now, so I am sort of stranded until it gets checked out and fixed (or given a clean bill of health). Hopefully it gets resolved this week. Until then, I can't deny that I'm thoroughly enjoying my comfort zone. Right now I'm making my way through the Hunger Games trilogy.

eat!

A friend from college is visiting for the weekend, and we're having an amazing time. I've been looking forward to his visit for weeks, and I've also been having pretty low anxiety overall, so I was expecting only a mild increase. But my anxiety kicked into high gear over-drive craziness yesterday before he even arrived. Because I had been so sure this wouldn't happen, I was even more convinced than usual that it must not be anxiety, which meant I could be actually sick with something. Big surprise, that assumption was incorrect. And thinking that way led to me eating much less than I should have yesterday.

For years, I was fanatic about avoiding eating whenever anything stressful was going on. I always thought that was the safest course of action, not just "in case I am sick" but also "in case I get anxious about being sick." I could just tell myself it wasn't possible for me to get sick, because I hadn't eaten (which is not even true, I know, but it's still an idea I cling to even today). My wife started to break me of that habit from the moment we started dating. At that point my usual pattern was to eat one big meal a day (a lunch/dinner after getting home from school) and to avoid eating around any anxiety-producing situation, including going out anywhere. I was also so picky that bagels were an unfamiliar food to me that I wouldn't eat. I'm not sure I had ever even tried one.

It took a while, but eventually she got me into the mindset that it was important to eat (at least) three meals a day, and it's amazing how much better I started to feel. I'm betting most of the stomachaches I got back then were caused by my horrible irregular eating patterns. It probably also contributed to me feeling anxious / depressed / moody in general. When I eat too little now, it makes my anxiety get out of control. It's strange, because I still have that instinct to avoid food, but at the same time I am always trying to remind myself now 'no, avoid eating too little. It will lead to you feeling like everything around you is surreal.'

I see all the time on blogs / forums that people with emetophobia are not eating and feel like they can't. But you really can, and you should force yourself to do so. Not eating is a really big deal, even if you are not technically in the danger zone of "starving yourself" yet, because it will keep you feeling a lot more balanced. It makes a huge difference there. And it also will definitely lead to your stomach feeling overall better after a while if you continue eating regularly / well.   

affirmations

Affirmations really work. They help so much in reducing anxiety. For anyone who has tried them without seeing any improvement, I'd say chances are you only need to give it more time. It took months for me. I'm not sure how many months exactly, but it was at least half a year before I noticed them having even the slightest effect, which felt like an eternity given how high my anxiety was during that entire time period.

I could not sleep through the night. I would wake up at some point every night feeling "sick" and have to get out of bed. Sometimes I would watch TV or do word searches, but I also had a little notebook where I would write affirmations. At first, I found them pretty useless as just thoughts in my head or even words spoken out loud. I needed to see them written, and I would write them ten times in a row, pausing each time to really think about the message and let it sink in. Even before they actually began to resonate with me, writing them out was a calming, repetitive, hope-filled activity that would make me feel a little better and help me get back to bed.

After a while, I started keeping four of the most calming ones right next to my bed. My initial goal was to stay in bed, even if I did wake up feeling "sick" and anxious, and having those affirmations right there to look at sometimes allowed me to do this (rarely at first, but more and more as time went on).

I also now have a set I carry with me in my purse, affirmations written out on index cards. I pulled them out pretty frequently on our long road trip and during the high anxiety times in the hotel.

When I first started using them, I worried it was just a form of brainwashing, but it's pretty much the exact opposite. I already am brainwashed with anxiety, and these are correcting that. When you come up with your own affirmations, or if you are choosing them out of a book, you just have to make sure that logically you can see the truth in them, even if they don't feel true (it helps if you create/choose them at a time when you are not extremely anxious).

Probably my go-to affirmation for times when I feel "sick" is: "This feeling isn't dangerous - it will pass." It is true whether you are sick or not. Of course, I always try to tell myself I'm not, and that the "feeling" I'm referring to is anxiety. Since I started using the affirmation a little over a year ago, I have been right about that 100% of the time. That just proves to me even more that it is undeniably the thought my mind should be having when I don't feel well.   

happy new year

Happy New Year! I hope 2012 is a great year for everyone. I feel optimistic that it's going to be a better year for me. 2010 was a crazy hurricane / whirlwind of anxiety. 2011 had its intensely bad moments too, but it was better than 2010, so I seem to be heading in the right direction. Also, I am determined to get it together this year and actually do the work I need to do (like eating healthier, doing CBT, etc.). I had to go back to my long list of New Year's resolutions and revise it into a plan that I think is realistically achievable. This is something I've never done before. For some reason, letting go of the idea of "perfection all at once" tends to fill me with a squirmy reluctance to try anything at all. But that reluctant feeling wasn't as strong this year. More evidence of progress!

So the last book I ended up reading in 2011 was Living with Emetophobia by Nicolette Heaton-Harris. I bought it months ago, maybe around September, but I have been putting off reading it, because I had heard that it was mostly a long description of emetophobia, and I had a feeling it would only end up upsetting me or triggering me in some way. I figured it would not be helpful at all but might add more irrational thoughts or behaviors to my list. A few times, reflecting on that, I thought about never reading it. But since it is pretty much the only book on emetophobia out there, and I am writing about the same topic on a regular basis, I had to check it out.

All the reviews I heard were correct. The book mostly explained emetophobia in depth, all the different thoughts or behaviors an emetophobic person might have. I could relate to most of it. Some of it made no sense to me. (Am I the only emetophobe that doesn't feel compelled to look at someone who may be getting sick? When I see a car parked on the side of the road, I shut my eyes or look away and feel no urge to witness what I fear might be happening.) In addition to the explanations and personal stories, there were about four pages of advice on how to cope, including nothing more advanced than deep breathing, distracting yourself, and taking small risks whenever possible to try to expand your comfort zone.

But as bad as I felt it was objectively, I am hesitant to really criticize it, because it exists, at least. It's something that takes emetophobia out of just the Internet world, and I have to think it has had some positive impact in giving the problem more weight / attention. Also, if what an emetophobic is looking for is validation of their issue and the knowledge that they are not alone, the book does provide that.

Unfortunately, I'm way past that. Thanks to the Internet, I've known for years what the name of my issue was, and I've read stories from and talked to many people who are also dealing with it, and I'm betting that's the case for most of the emetophobes of my generation. It's not enough anymore. I'm not looking for someone to swap horror stories with. In fact, I generally feel like it might not be a good idea for me to ever meet another emetophobe in person. The idea of emetophobia support groups all over the country raises some doubts in my mind. Would we not just feed off each other? If half of us in the meeting felt nauseous from anxiety at being at the meeting, and the other half found out about it, wouldn't we all just be scared one of us might be legitimately sick? I don't know.

My real issue with the book is that I felt a little damaged and hopeless after reading it, and that feeling stayed with me all night. I rang in the New Year with a vague feeling of sadness at knowing that this phobia touches every part of my life and that there is no cure for it. I don't think the author meant to leave the reader with that impression, at all. But I feel like she spent 95% of the book talking about all the ways emetophobia manifests in a person's life and then ended the book with the message that it could be contained but not cured. It's hard not to focus on the bad parts of that instead of on the ray of hope that is "containment."

This morning, though, post-sleep, I felt better and able to see it all in a more positive light. Containment may be settling, but that doesn't mean it dooms me to a life of unhappiness. Everyone is settling for something in their life. Like someone might have a bad ankle because of an injury when they were young. Of course it would be better if they didn't have to deal with that, but they do, and they work around it. I know from experience exactly how contained emetophobia can be. In college, it was there, but I rarely felt upset about it. I wasn't doing anything special to contain it. It was just out of luck, I guess, or maybe because I had so much going on (schoolwork, friends, events) to distract me from it.

So that's my hope for 2012, that I can get my phobia as contained as possible. With the knowledge about managing anxiety that I have now, I should be able to reach a level of containment even better than the one from college.

And if I want to be wildly optimistic, I have heard of some emetophobes who have been able to cure themselves. Plus with more research into it, maybe a cure that works for everyone will be discovered / developed. It's possible.