general health anxiety

It's been an intense week. It seems pretty clear that as this VA trip gets closer, I am going to be dealing with every anxiety thought in my big fat collection. I was in near panic mode two nights in a row, thinking I had cancer or some other life-threatening disease, because of an irritated throat and all my muscles being incredibly sore. Actual causes? I'm thinking the throat thing is (...still...) our heater (hoping this will possibly maybe sink in sometime soon), and the muscle soreness was from lack of sleep and anxiety. I'm feeling fine now and don't know how I managed to leap from those incredibly benign symptoms to "I'm probably dying."

I think I'm going to start doing some serious CBT work again to keep myself from getting stuck in this negativity. A while ago I bought and read Overcoming Health Anxiety by Rob Willson and David Veale. There are a ton of CBT exercises in it to combat health anxiety, but I haven't done any of them yet. I just read the book straight through first. Now I am revisiting it, so I figured I would share my general thoughts about the book here.

I specifically bought it, because I heard there was a chapter devoted to emetophobia (a whole chapter!). But that chapter was a huge disappointment to me. It was late in the book, and emetophobia was basically laid out as an example of a type of health anxiety. So the book up until that point had already covered health anxiety in general and had provided several different techniques to help cope with or overcome it. At the end of the emetophobia chapter, they listed ways to cope with or overcome emetophobia, but they were the same techniques given in the earlier chapters (just reworded to show how they related to emetophobia). There was nothing new. There isn't anything wrong with that really, but it bothered me, because the rest of the chapter was only a description of our usual neurotic thoughts and behaviors. So at the end of the chapter, I was left feeling more anxious than I was before reading it.

The authors even included a list of conditions or situations that can cause vomiting that emetophobes don't usually worry about, as a way of pointing out how irrational we are by selecting certain risks to focus on and ignoring others. In what scenario did they imagine that information would be helpful? For some emetophobes, their current goal is only to become the safest / healthiest emetophobe they can possibly be, no matter what abnormal behaviors that goal leads to. This would be almost a challenge to them! For those that are trying to cut down on abnormal behaviors, they are just left with more information in their heads to try to ignore.

I consider myself to be in the second group, which is why I'm never going to post an entry here talking about 1) what foods have been reported to cause the most food poisoning, 2) which anti-emetic is the best to take before going on a long car ride, 3) "full-proof" ways to make sure you never get a stomach virus, etc. I don't consider any of that helpful and try to avoid reading anything of that nature on other emetophobia blogs or forums. It's my hope that this blog will not make other emetophobes worse.

But back to the book. That chapter aside, most of it was really amazing, and I would recommend it, because any of the CBT exercises can be used with emetophobia. One of the exercises is to write down the symptom (or physical sensation) that you are worrying about, write down your "catastrophic misinterpretation" of the symptom, and then write down all possible alternative explanations for the symptom. My experience a few days ago probably would have been better if I had used this exercise to remind myself how many possible alternative explanations there are for muscle soreness.

When I read these self-help books, I sometimes don't take the time to actually work through the exercises, by writing down responses or repeating ideas to myself on a regular basis. I have tended to think that just reading through them is good enough - especially because most of it is very logical or common sense. The rational part of my brain tells me "that's obvious and easy, and I'll remember it." It's funny, because a bunch of the books even include a warning NOT to think this way and stress how important it is to do the work. When the anxiety disorder takes over, there is no logic or common sense anymore. Reading through all those exercises did not stop me from feeling terrified that I had cancer. It doesn't stop me from worrying that I am going to throw up. I need new thoughts to compete with the negative thoughts I've been rehearsing my entire life, and they won't be there if I don't practice them and drill them into my brain. Sometimes it's as dull and tedious as studying for school, but it's worth it.