My wife and I went to a restaurant for lunch today, which didn't go quite as well as dinner the other night. I had a lot of anxiety ("nausea") in the time between finishing my meal and leaving the restaurant. Of course, the moment we walked out the door, I felt better, an experience I'm all too familiar with. It's always kind of infuriating, because part of me is thinking "this isn't anxiety, it really is something else this time" but that never turns out to be true. Being wrong is not the infuriating part. I'm happy to find out that the horrible thing I thought was happening to me is not real. What's infuriating is knowing that once again, I let anxiety bring down my enjoyment of an experience.
I used the same techniques I've been using: affirmations, deep breathing, mindfulness. In a public place it's not always possible to be completely focused on telling yourself "I am breathing in, I am breathing out" or something like that. Mindfulness in a situation like this involves focusing on your environment (instead of on your thoughts/feelings/internal state). It helps to think of the five senses (although smell and taste might be too much for an anxiety attack that is presenting itself as "nausea"). I focused on the music playing on the overhead speakers, the tennis match on the TV above the bar, the conversation I was having with my wife, the cold/wet feeling of the glass of water sitting in front of me.
In discussing my anxiety with my wife, she made me realize that I have a habit of trying to finish my meal as close to the time of us leaving as possible. Of course, this never really works out, because no waiter/waitress is going to bring the check while you still have food in front of you. But still, this is exactly the type of behavior that I am trying to eradicate from my life. I'm making a new goal to stop doing this, to eat at the pace that is normal for me and finish whenever I finish. If I have to sit in the restaurant for half an hour after I'm done, oh well. Nothing bad will happen. Emetophobia shmemetophobia!
Sunday, September 4, 2011
Saturday, September 3, 2011
restaurants / thinking through anxiety
Since my second class was canceled, I wanted to come up with a suitable replacement challenge. A few nights ago, I was out with my wife, and we decided spur-of-the-moment to walk to a nearby restaurant for dinner. I generally don't handle restaurants well, and when we go to one, it's usually planned out at least a day in advance. It felt wrong and dangerous to go to one right then, without the planning, and since I know logically that no planning is necessary, I agreed that we should go and that I should handle it.
It was an extremely successful meal. I felt some anxiety when we first got there, because I had a strange feeling in my stomach, but I was almost positive it was a combination of hunger and my anxiety about going to the restaurant. It went away once I got my food and started eating. Most of the time, I feel the least anxiety while actually eating, because I am focused on the delicious food. The time between when I finish eating and when we leave is the problem. The check has to come, and then it has to get paid, and then the receipt has to come back, and I spend this time worrying about how full I am and the feelings of digestion in my stomach. Lately when we go to restaurants, I focus on making myself as calm as possible during this period, by saying affirmations to myself or doing breathing exercises. I think I am getting much better at sitting with the feelings and knowing that it's just my body doing the normal work it always has to do.
I tend to focus on the fact that "this uncomfortable feeling is happening to me again" rather than the fact that it has never resulted in anything bad happening in the past. I noticed this a few months ago in therapy when I was talking about events that were coming up that I was anxious about. I told my therapist that I thought I would feel sick during them and worry that I was going to throw up, and in the back of my head I was thinking "but why does that matter? You are saying you are afraid of fear, which is pointless. Don't you get it? That is all that will happen. You might feel anxious, and that's it. As it has every other time in the past, it will fade away without anything horrible happening. Then it will be gone as if it never existed, because it's barely anything, just an out of control emotion." It was such a strange epiphany, the first time I'd ever really gotten that concept in my entire life. It didn't fix everything, but it was exciting to me anyway, and it's something I've always tried to keep in mind since then.
Around the same time, I discovered another similar hole in my logic. Often when I "feel sick" in a public place, I don't think about the feeling itself. I think mostly about where I am or what I am doing and judge whether it's okay to feel the way I feel based on that. Like if I am out at the grocery store, I will be thinking without even realizing it something like "I could throw up because I am at the grocery store" instead of "I'm not going to throw up, I've had this feeling before, and being at a grocery store in no way increases the odds of anything bad happening."
Sleep is like this. I feel convinced (especially when I wake up in the middle of the night and am still half-asleep) that being asleep in itself will lead to me throwing up, because I am not awake to guard against it. I know it's best to calm down, no matter what, but I find it hard to move on to the next step after that, which would be to return to sleep. Even when I start feeling better, I tell myself to wait a few more minutes and make sure it sticks.
To help with this, I posted a set of affirmations next to my bed so that I see them if I wake up in the middle of the night: "This feeling isn't dangerous - it will pass." "I've survived this before and I'll survive this time too." "This isn't an emergency. It's okay to think slowly about what I need to do." "These are just thoughts - not reality." I'm so used to them by now that sometimes I'll just stare at them, too tired to really take in what they mean word by word, but knowing that they have a general meaning of 'I'm not going to throw up, I can go back to sleep.'
It's just comforting to have them there, not only as a means to reduce my anxiety in that moment, but as a reminder of the changes I've been making to my life in general. Positive self-talk is no longer foreign to me. My outlook on everything is changing, and it's exciting to think about where I am heading.
I tend to focus on the fact that "this uncomfortable feeling is happening to me again" rather than the fact that it has never resulted in anything bad happening in the past. I noticed this a few months ago in therapy when I was talking about events that were coming up that I was anxious about. I told my therapist that I thought I would feel sick during them and worry that I was going to throw up, and in the back of my head I was thinking "but why does that matter? You are saying you are afraid of fear, which is pointless. Don't you get it? That is all that will happen. You might feel anxious, and that's it. As it has every other time in the past, it will fade away without anything horrible happening. Then it will be gone as if it never existed, because it's barely anything, just an out of control emotion." It was such a strange epiphany, the first time I'd ever really gotten that concept in my entire life. It didn't fix everything, but it was exciting to me anyway, and it's something I've always tried to keep in mind since then.
Around the same time, I discovered another similar hole in my logic. Often when I "feel sick" in a public place, I don't think about the feeling itself. I think mostly about where I am or what I am doing and judge whether it's okay to feel the way I feel based on that. Like if I am out at the grocery store, I will be thinking without even realizing it something like "I could throw up because I am at the grocery store" instead of "I'm not going to throw up, I've had this feeling before, and being at a grocery store in no way increases the odds of anything bad happening."
Sleep is like this. I feel convinced (especially when I wake up in the middle of the night and am still half-asleep) that being asleep in itself will lead to me throwing up, because I am not awake to guard against it. I know it's best to calm down, no matter what, but I find it hard to move on to the next step after that, which would be to return to sleep. Even when I start feeling better, I tell myself to wait a few more minutes and make sure it sticks.
To help with this, I posted a set of affirmations next to my bed so that I see them if I wake up in the middle of the night: "This feeling isn't dangerous - it will pass." "I've survived this before and I'll survive this time too." "This isn't an emergency. It's okay to think slowly about what I need to do." "These are just thoughts - not reality." I'm so used to them by now that sometimes I'll just stare at them, too tired to really take in what they mean word by word, but knowing that they have a general meaning of 'I'm not going to throw up, I can go back to sleep.'
It's just comforting to have them there, not only as a means to reduce my anxiety in that moment, but as a reminder of the changes I've been making to my life in general. Positive self-talk is no longer foreign to me. My outlook on everything is changing, and it's exciting to think about where I am heading.
Thursday, September 1, 2011
mindfulness
It turns out the teacher for the class I'm taking is currently out of the country and unable to get a flight back because of the nasty hurricane weather that's been traveling up the coast. She didn't show up for our first class, and I got an email letting me know that the second class is canceled too. So much for my goals for the week!
But on some level, I'm grateful it turned out this way. I felt like this class was a huge step for me, and this turned it into a smaller baby step. I did not technically attend a class, but I sat in a room with about twenty other students I didn't know for the twenty minutes before we all decided to give up on the teacher and leave. That alone was a frightening situation for me, and I "felt sick" for probably the first fifteen of those twenty minutes.
I said my four-part affirmation to myself, and it did help somewhat. But in a sense it felt like the anxiety was flooding my brain and making it hard to even focus on the words, so I switched over to a mindfulness / breathing exercise from another book I read recently, The Miracle of Mindfulness by Thich Nhat Hanh. I took deep breaths, and each time I inhaled, I would say to myself "I am breathing in" and each time I exhaled, I would say to myself "I am breathing out." Or "I am breathing in a long breath" and "I am breathing out a long breath."
I guess because the words are combined with the concentrated act of controlling my breathing, they work in a way the affirmations don't, where I'm able to replace the "flood of anxiety" feeling in my head with just the breaths and the descriptions that go with them. At this point, it's hard to sustain, because I haven't been practicing mindfulness for very long. But having seen the way affirmations became more and more helpful the longer I worked with them, I'm optimistic that mindfulness techniques will end up being incredibly useful also.
Mindfulness teaches you to be only in the present moment, not in the future or the past. This may seem like a stupid idea to an emetophobic who is feeling nauseous - why would you want to remain in that present moment rather than thinking of something else?
-Because the more you practice being in the present moment, the more relaxed you will be, in general, overall. It's easy to handle what is happening right now in the present moment, not so easy to handle the vast expanse of possibilities in the future.
-Because when you are in a situation that causes a lot of anxiety, you may think that you won't be able to remain in that situation for the length of time you need to, but you can be pretty sure that you can get through the next minute or five minutes, at least. Kind of like AA's "one day at a time." Staying in the present moment in this way, you can get through whatever scary situation you are facing. And then, having survived it once, you'll know you can do so again.
-Because as an emetophobic, when you're leaving the present moment, it's usually not to go to some happy place in your mind where you don't feel sick. You're leaving the present moment to go into a fake or feared future ("I must be getting sick" "what if I am getting sick, and what if this causes me to throw up?"), and this is obviously not helpful.
But on some level, I'm grateful it turned out this way. I felt like this class was a huge step for me, and this turned it into a smaller baby step. I did not technically attend a class, but I sat in a room with about twenty other students I didn't know for the twenty minutes before we all decided to give up on the teacher and leave. That alone was a frightening situation for me, and I "felt sick" for probably the first fifteen of those twenty minutes.
I said my four-part affirmation to myself, and it did help somewhat. But in a sense it felt like the anxiety was flooding my brain and making it hard to even focus on the words, so I switched over to a mindfulness / breathing exercise from another book I read recently, The Miracle of Mindfulness by Thich Nhat Hanh. I took deep breaths, and each time I inhaled, I would say to myself "I am breathing in" and each time I exhaled, I would say to myself "I am breathing out." Or "I am breathing in a long breath" and "I am breathing out a long breath."
I guess because the words are combined with the concentrated act of controlling my breathing, they work in a way the affirmations don't, where I'm able to replace the "flood of anxiety" feeling in my head with just the breaths and the descriptions that go with them. At this point, it's hard to sustain, because I haven't been practicing mindfulness for very long. But having seen the way affirmations became more and more helpful the longer I worked with them, I'm optimistic that mindfulness techniques will end up being incredibly useful also.
Mindfulness teaches you to be only in the present moment, not in the future or the past. This may seem like a stupid idea to an emetophobic who is feeling nauseous - why would you want to remain in that present moment rather than thinking of something else?
-Because the more you practice being in the present moment, the more relaxed you will be, in general, overall. It's easy to handle what is happening right now in the present moment, not so easy to handle the vast expanse of possibilities in the future.
-Because when you are in a situation that causes a lot of anxiety, you may think that you won't be able to remain in that situation for the length of time you need to, but you can be pretty sure that you can get through the next minute or five minutes, at least. Kind of like AA's "one day at a time." Staying in the present moment in this way, you can get through whatever scary situation you are facing. And then, having survived it once, you'll know you can do so again.
-Because as an emetophobic, when you're leaving the present moment, it's usually not to go to some happy place in your mind where you don't feel sick. You're leaving the present moment to go into a fake or feared future ("I must be getting sick" "what if I am getting sick, and what if this causes me to throw up?"), and this is obviously not helpful.
Sunday, August 28, 2011
taking a class / affirmations
I am auditing a class at a nearby college, and it starts tomorrow. It will be Monday and Thursday evenings. It's been a really long time, at least a year, since I have pushed myself so far out of my comfort zone.
So my main goal for this week is to go to both of these classes. I'm betting that I will "feel sick" in the first class and that this will make me want to give up on it. And since I'm only auditing, it will be too easy to drop it.
My other goal, of course, is to bring down my anxiety if/when it occurs during the class. I have a four-part affirmation I've been using during the past year in situations where I don't feel well:
1. This feeling is temporary.
2. This feeling is not dangerous.
3. Calming down will always help.
4. Calming down is the only thing within my control.
Using affirmations in general is a pretty new concept for me. I used to dismiss them whenever I heard them as too simplistic or "lame" or something similar to that. When I first started repeating them to myself, it just felt like a useless chore. I didn't really believe any of them and would frequently come up with arguments against them. I still have trouble with this (trying to debate the affirmations, although now I'm more hoping to prove to myself that they are true), so I also have an affirmation about my affirmations that I use now: "Affirmations are meant to be repeated, not debated." This is a reminder to myself to just stop arguing with them. It took many months, but eventually they began to sink in, and now I find that they can be really helpful.
But I do want to elaborate on numbers 3 and 4 of my list, because these are the ones I had (sometimes still have) the most trouble accepting, and remembering the logic behind them is helpful to me.
Emetophobics want to believe they are in complete control of their bodies, and I have always believed that if I remain alert (aka anxious), I am better prepared to fight the possible sickness. This is not true. First of all, if someone is legitimately sick, being in a calm/relaxed state will not cloud their vision/judgment about what is happening to them. Calm is not the same thing as being unaware of reality. I tend to think things like "if I am calm, I may not notice I am about to vomit" which is completely ridiculous. Being calm will not ever make things worse.
Secondly, being calm will make things better, even for a person who is sick. Having a sickness, even a stomach virus, does not guarantee a person will vomit. The illness could cause other symptoms instead (in the case of a stomach virus, probably diarrhea). Anxiety is an emotion that easily causes an upset stomach all on its own, so having an illness and then adding loads of anxiety to it can't help matters. Of course, if a person is emetophobic, they will not be able to feel anxiety-free during illness, but there are always things they can do to feel less anxiety. It will be an extremely stressful time, and it will be difficult for them to lower their anxiety, but it is possible, and it is something that should be attempted. As a person living with a phobia, lowering anxiety is something that should always be attempted, no matter what the circumstance.
And in closing, I became familiar with affirmations (along with a bunch of other incredibly helpful anxiety-reducing techniques) through The Anxiety and Phobia Workbook by Edmund J. Bourne. I actually have the fourth edition, but I'm betting it's not that different from the newest version. The book has several pages of affirmations, and I have spent a lot of time reading and writing them over and over. I usually have one written or typed out on a sheet of paper and taped up on the wall over my computer. The one I have hanging there right now is one of my favorites:
"I'm learning to let go of worrying. I can replace worrying with constructive action."
So my main goal for this week is to go to both of these classes. I'm betting that I will "feel sick" in the first class and that this will make me want to give up on it. And since I'm only auditing, it will be too easy to drop it.
My other goal, of course, is to bring down my anxiety if/when it occurs during the class. I have a four-part affirmation I've been using during the past year in situations where I don't feel well:
1. This feeling is temporary.
2. This feeling is not dangerous.
3. Calming down will always help.
4. Calming down is the only thing within my control.
Using affirmations in general is a pretty new concept for me. I used to dismiss them whenever I heard them as too simplistic or "lame" or something similar to that. When I first started repeating them to myself, it just felt like a useless chore. I didn't really believe any of them and would frequently come up with arguments against them. I still have trouble with this (trying to debate the affirmations, although now I'm more hoping to prove to myself that they are true), so I also have an affirmation about my affirmations that I use now: "Affirmations are meant to be repeated, not debated." This is a reminder to myself to just stop arguing with them. It took many months, but eventually they began to sink in, and now I find that they can be really helpful.
But I do want to elaborate on numbers 3 and 4 of my list, because these are the ones I had (sometimes still have) the most trouble accepting, and remembering the logic behind them is helpful to me.
Emetophobics want to believe they are in complete control of their bodies, and I have always believed that if I remain alert (aka anxious), I am better prepared to fight the possible sickness. This is not true. First of all, if someone is legitimately sick, being in a calm/relaxed state will not cloud their vision/judgment about what is happening to them. Calm is not the same thing as being unaware of reality. I tend to think things like "if I am calm, I may not notice I am about to vomit" which is completely ridiculous. Being calm will not ever make things worse.
Secondly, being calm will make things better, even for a person who is sick. Having a sickness, even a stomach virus, does not guarantee a person will vomit. The illness could cause other symptoms instead (in the case of a stomach virus, probably diarrhea). Anxiety is an emotion that easily causes an upset stomach all on its own, so having an illness and then adding loads of anxiety to it can't help matters. Of course, if a person is emetophobic, they will not be able to feel anxiety-free during illness, but there are always things they can do to feel less anxiety. It will be an extremely stressful time, and it will be difficult for them to lower their anxiety, but it is possible, and it is something that should be attempted. As a person living with a phobia, lowering anxiety is something that should always be attempted, no matter what the circumstance.
And in closing, I became familiar with affirmations (along with a bunch of other incredibly helpful anxiety-reducing techniques) through The Anxiety and Phobia Workbook by Edmund J. Bourne. I actually have the fourth edition, but I'm betting it's not that different from the newest version. The book has several pages of affirmations, and I have spent a lot of time reading and writing them over and over. I usually have one written or typed out on a sheet of paper and taped up on the wall over my computer. The one I have hanging there right now is one of my favorites:
"I'm learning to let go of worrying. I can replace worrying with constructive action."
obligatory introduction post
It feels strange to give a background / explanation of something that has been with me my entire life. Chances are you already know something about emetophobia anyway, if you're here, and there are plenty of websites that explain it. Best of which, in my opinion, is this one. I'm not sure about the reliability of the rest of that website, but this FAQ was the first thing I ever stumbled across that made everything make sense to me.
I have no idea what caused my phobia. I have no memory of a traumatic experience involving me or someone else vomiting. I was 9 the last time I actually did throw up, but I must have already had the phobia at that point or was at least on my way to developing it, because I can remember times before that where I acted in weird ways. If my stomach hurt, I would crouch down on the floor if possible, because I thought that made me safer. I would try to hide from my teachers the fact that I felt sick, because I felt it was something shameful. If eventually my anxiety overwhelmed me, I would suddenly blurt out that I didn't feel well and needed to go to the nurse, and the teacher always looked taken aback. At some point in my childhood, I became scared to touch food at all, even after washing my hands, and went through a phase where I ate like a dog, holding my plate or bowl up to my mouth.
I was around 11 or 12 when I started researching online and found the FAQ website linked to above, but it took several more years before I really felt like I had any control over what was happening to me.
So moving on from history, this is business-as-usual nowadays.
-- I feel "nauseous" almost every day. This fake "nausea" is really anxiety, hunger, normal feelings of digestion, indigestion, heartburn, etc. It's hard for me to tell the difference between these and to identify my current feeling correctly. It's gotten easier over the years. But I still frequently get nervous that I am in danger of throwing up, especially if I "feel sick" in public. It's even hard for me to tolerate non-stomach pains, like a headache or general muscle soreness, since I will interpret these as signs of potential illness.
-- I think about the safety of my food a lot, the potential to get ill from food poisoning. This leads to avoiding certain restaurants or types of food that don't seem "safe" to me, throwing food away that is most likely still fine because I worry it has gone bad, or feeling anxious after consuming certain foods that seem high-risk to me. I also have a long list of foods I avoid eating before going out in public or while out in public (anything spicy, greasy, rich, too filling, too sweet - aka anything that could make my stomach hurt). This makes eating on long car trips and vacations difficult. Grocery shopping is also kind of a pain, because I inspect everything I am buying, and if anything looks weird or "off" to me (like an apple with a spot on it), I usually can't bring myself to get it.
-- Eating in restaurants in general doesn't work out that well. It's rare that I can get through an entire restaurant meal without "feeling nauseous" from anxiety.
-- I can remember times when I was young and threw up in the middle of the night, right after waking up. So I consider sleep to be a time where illness can sneak up on you and make you vomit before you have a chance to stop it from happening in some way. Because of this, it's hard for me to fall asleep if I don't feel well. I also frequently wake up in the middle of the night and "feel sick" - I'm guessing this is usually just hunger, since sleeping is also a long stretch of not eating.
-- I do not drink alcohol at all and avoid being in places/situations where other people are drinking (excessively to the point of drunkenness, I mean).
-- I avoid being around children, since they are much more likely to have some illness and/or be vomiting.
-- I keep a store of anti-emetics, Pepto Bismol, and Tums at home. This hasn't always been the case. I have always been extremely strict with myself about using these things, because I remembered reading that emetophobics could become dependent on them or abuse them to the point of unhealthiness, and I never wanted to allow myself to reach that point. But this past year has not been the best for me, and I have become (slightly) more lenient about it. I also just don't like putting anything out of the ordinary in my body, even something as harmless as Tums.
-- I avoid traveling in general and public transportation. I don't have a problem with motion sickness as far as I can tell, but my anxiety will lead to me feeling "sick" anyway if I am on a boat, plane, or bus. Trains and cars, not as much, depending on the situation and who I am with.
-- I am afraid that if I get a tickle in my throat or have a coughing fit, this could lead to throwing up, so I tend to carry a water bottle with me everywhere I go just in case this happens.
-- I ask my wife at least once a day if I am sick or if I have a fever. Or I will ask her while eating or directly after eating if she thinks the food is likely to make me throw up.
-- When my wife is sick, I don't take care of her. I keep my distance as much as possible. One time when she had a stomach virus, I went to stay with a friend and didn't come back until I was sure she was better and she had decontaminated all our belongings.
I think that's about it. I can't say I diligently stick to any of the behaviors in the above list, because I am always trying to challenge myself when it comes to this. Ever since I realized I had emetophobia, I have tried to keep the momentum of a normal life going, mostly by pushing myself to keep going out places. Keep going to movies, to restaurants, to school or work. My tendency is to want to be home all the time where I'm safer. I currently work from home, which I think has led to me losing some of that momentum. I don't go out enough anymore. But I'm determined to fix this.
Which is the main point of this blog, I suppose. To force myself to do the things I am afraid of doing and then write about how successful I am. There are so many ways I am successful already (some emetophobics can't even speak/write the word "vomit" or watch vomit scenes on TV), and I know I can do even better than I am doing now. Will I ever be completely cured? Most days I think absolutely not. But it's not just "cured" or "not cured," it's an entire spectrum of fear, and reaching the perfect positive end of the spectrum doesn't matter so much to me as long as I am able to function well enough in order to do all the things I want to do in life.
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