work trip

It’s been a while since I posted. I’ve been spending a lot of time thinking about posting. I finally went on that trip for work, and of course the plan was/is to talk about that – what went well and what didn’t. But it’s now been six weeks since it ended, and I wrote (literally) close to fifty pages in my journal about the experience, and I still feel like I don’t have a firm grasp on what I should or want to take away from the whole thing. The sort of “life lesson” – not that everything in life has to result in a life lesson, but this was so big that it feels like it should have changed me or my life in some fundamental way. Maybe that’s just a fantasy of the chronically anxious – “I did something terrifying and I handled it – aren’t I going to get anything out of it?!”

But nothing is really different, other than the fact that I’m not constantly thinking and worrying about this trip anymore. Which is strange in itself, because it took over my brain for so long. It was all-consuming. Almost every night before I fell asleep, I was going over some aspect of it in my head: imagining what I might say to people, what they might say to me, things I might have to do that I didn’t think I could do, what I’d wear, what I’d eat, how I’d get around, everyone I would have to see, how the flights might go, what the airports would be like, all the many ways things could go wrong. I probably should have attempted to stop obsessing, but it was so comforting, even something I looked forward to on some level. Now that I don’t need to do that anymore, it’s like there’s this giant void in my mind.

And I was prepared for that. I knew that when I no longer had this to dread and/or look forward to, I wouldn’t know what to do with myself. Part of me had been excited about it. It felt meaningful, to be forced by outside circumstances to live and interact with the world to an extreme. To an extent I could never force myself to. Now everything is simple again – calm and quiet, which is nice, but also dull. Time passing and normal routine and no Huge Event looming on the horizon to test my limits. I think if they had suddenly told us at the last minute to forget the whole thing, we weren’t going to do it anymore, I would have been miserable. Incredibly relieved, but also miserable.

In other words, I’m never satisfied. How can you be when you feel two completely opposite things at the same time? It reminds me (again) of what I’ve talked about here before, the connection between anxiety and excitement, between fear and the desire for what you fear. It does seem like the two frequently coexist in me.

I think if the trip had never existed, had never been proposed in the first place, I would be fine. I think I’m happier when my life is calm and quiet and dull. But with the alternative fresh in my mind, it’s very hard for me to let go of the fantasy of having a life that is non-stop excitement, intensity, and stimulation and becoming the type of person who can thrive in a life like that. I’m better off not thinking about it.

Anyway, now I’m home again, and I have all this restless energy left over, and I’ve been trying to direct it towards 1) being more productive at my job 2) writing and submitting poetry.

As for how the trip went, I would say pretty well, overall.

• The closer I got to the trip, the more I felt like the only way I could get through it was to be upfront with people about my anxiety and my limitations. Which I think is a very good idea in theory. Unfortunately, it got a little out of control to the point where I was probably revealing too much (and too quickly, since I was interacting with people who were essentially strangers). Which possibly means that a lot of people I work with now have a skewed idea about just how extreme my anxiety is. And it doesn’t matter that now my mind has settled down again and I’m behaving more normally, because that was their first impression of me, and it’s nearly impossible to correct a first impression.
• Other than that, I felt like the social interaction went better than I had expected. I’m not sure why I feel that way, because I avoided people and I was quiet and when I had to speak, I was almost always panicking that any second I would say something that would somehow ruin my entire life. But I didn’t say anything that ruined my entire life, and other people told me I was coming across as normal (because – see bullet point above – I wouldn’t stop talking about how socially awkward I was), so I’ll count it as a success.
• I had a hard time eating before or during work, which led to me feeling shaky and nauseous most of the time. In the evenings I would eat in my hotel room and feel a little better, then wake up the next morning feeling like shit again.
• Even with feeling sick so much of the time, I did not have any extreme panic attacks and only a couple minor (and short-lived) anxiety attacks.
• I slept better than I thought I would. I woke up early every morning because I was so paranoid that I would sleep through the two different alarms I had set. But it still worked out okay, because I was going to bed early too and didn’t have any trouble falling asleep.
• I was able to concentrate on training. That was one of my biggest worries, that I just wouldn’t be able to focus or retain any of the new information I was supposed to learn, so I was happy that wasn’t the case.
• I work with some incredibly nice people who (many times) went out of their way to make things easier for me. So I’m glad I was more honest about what I wanted/needed than I usually am. I just need more practice navigating the line between ‘self advocacy’ and ‘presenting my entire identity as Anxious Person.’
• There were no major issues with the actual traveling part. I still don’t like flying, especially taking off and landing. But by the time I was flying home I had gotten to the point where I almost felt at ease when we were actually up in the air. 12 flights in about four months, and I finally got a little bit desensitized.
• I’m alive? And still employed? And to my knowledge, I didn’t make anyone hate me. I’m pleased with that outcome.

self-advocacy

So you have anxiety. And that means for every situation you come across that involves other people and triggers that anxiety, you have to choose between two options.

One is that you power through it and endure the anxiety. The other is that you ask to be excused from it or to reach some sort of compromise where you still do it but in a way that is more comfortable for you.

This is also complicated by the fact that you want to get over your anxiety, or improve as much as possible in your ability to live the life you want, which usually involves some level of exposure therapy and challenging yourself. You know you should power through. You know you tend to feel good about yourself when you’re able to.

But that doesn’t mean you should or can force yourself through any triggering experience that comes up. For one thing, exposure therapy is supposed to proceed by gradual steps. It works best that way. Taking a step you’re not ready for can do more harm than good. Also, it’s exhausting. It’s so unbelievably exhausting to confront intense anxiety on a regular basis. If that means an experience comes up that you probably could handle, but you would rather make some adjustments to make it easier on you – solely because you’re tired of having to handle things that are super overwhelming – you shouldn’t be put down for that. It’s not the same as being constantly avoidant. It’s making a choice to be kind to yourself, to let yourself have a break from having to work so hard – in ways that are often not visible to the people around you, so even though you have to hear a lot about the ways in which you’ve failed to live up to the behavior of a non-anxious person, you rarely get any praise for what you do manage to accomplish.

I have such a hard time with self-advocacy. Trying to figure out whether it’s a good idea. Whether it’s okay. How long to cling to my “demands” before letting it go and accepting I’m not going to get what I want.

I don’t trust myself at all. I don’t like advocating for myself. I hate debating. I hate sounding defensive. I hate the thought that I’m being seen as a burden, someone incomprehensible and exasperating that has to be dealt with. I hate acknowledging the minor things I’m trying to avoid, and even more so, I hate the tone of voice the other person almost always gets that makes me feel ridiculous, the tone of voice that says ‘what is wrong with you? how can this possibly be an issue for you?’ I hate having to repeat myself over and over because people don’t listen, don’t take in things that don’t make any sense to them.

I hate the fact that other people are so quick to belittle me in subtle ways that it doesn’t take long at all before I am completely mired in guilt and self-doubt. I start thinking there must be something wrong with me to have even started this conversation. I wonder if I’m doing it to get attention. But I’m not, because I would much rather the person have just agreed to what I wanted from the start without acting like it was a big deal at all. I wonder if I really need what I’m asking for. I usually conclude that I don’t, because I decide I will survive whatever the situation is, even if it’s ten times more miserable than it needs to be. I decide I need to put the other person first, because this is obviously a much bigger sacrifice for them, even though they usually don’t have a full understanding of what I’ll be dealing with, because I’m not forthcoming enough about it. I tend to feel like I talk about my anxiety constantly, too much, and I don’t even think that’s true. For how big a presence it is in my existence, I’m sure I talk about it way less than I would be inclined to if other people didn’t respond the way they did (getting all uncomfortable, implying that I really need to do something about it because it makes me wrong, it makes me not fit in, and it would be good if I could fit in, conform to society’s model of success, etc.).

The whole process is unpleasant and I think there have been times self-advocating has ended up causing me more anxiety and misery than if I had just done the anxiety-producing thing.

Looking back over my entire life, I don’t think I have ever asked for an accommodation that extreme. I have asked for things that should be simple and easy to say yes to. For example, when I refused to do presentations in school. I went to my teachers and I told them I couldn’t do it, and it was fine if that meant they had to give me a zero for the assignment. I didn’t say they had to give me an alternate assignment. Or even imply that they would be a horrible person for failing me (although I do kind of think they were). All I said is that I would prefer failure to giving the presentation, that I was choosing the zero grade. That was my choice to make. And most of the time they were absolutely horrid about it – rolling their eyes or scoffing at me, pretending they didn’t hear me and then calling my name to present anyway (forcing me to go back up to them and insist again that I wouldn’t do it, this time with more people witnessing it), saying over and over again ‘no, you have to’ every time I said I wouldn’t, acting really angry about it for no good reason I could see.

I had one teacher who actually got it. Instead of making me present, he met with me one-on-one and we had an informal conversation about the topic of my presentation. Did this lead to the ruination of my education? No. He gave me a chance to get the grade I deserved, the grade that reflected my understanding of the subject matter. That’s all that happened. He encountered someone with anxiety issues and treated them decently. Shockingly, life went on and tragedy did not ensue.

Anyway, I guess I just wanted to explore my thoughts and feelings on this topic, because I am attempting to ask for accommodations at work. So far, it has not been going well, and as usual, it’s making me feel crappy about myself. And I know I shouldn’t feel that way. I’m not doing anything wrong – even if they end up denying my requests. Even if they get huffy and act like I’m deliberately trying to make their lives harder. Even if there is a part of me that thinks I could manage without what I’m asking for. I’m not a terrible person for wanting to eliminate a tiny fraction of the stress this trip is going to cause.

exposure / limits

Some thoughts I had in response to this post on tumblr:


Love this. Super relevant to emetophobia and anxiety in general. I know it seems like every time you push yourself it has to go really well or else what was the point, but that’s not true. These experiences are still helping you recover and figure things out. If you think you can handle something and it turns out to be too much and causes an anxiety reaction, you will still survive it, and then you will know you need to take a smaller step first. Exposure isn’t an exact science; you won’t always get it right.

Also, sometimes when you have been anxious so long and have avoided everything, you’re not even sure what you like to do and what you don’t like to do. You could end up at an event where you’re not anxious, but you’re also not having a great time, and that doesn’t mean you made a horrible mistake. You could end up going to the movies several times and then realize ‘hey, I haven’t only been avoiding movies because of anxiety. I also find them really boring.’ It makes sense that you wouldn’t have known this before, because with an anxiety disorder you have this extra layer of fear obscuring your feelings. You have to work through the fear, and sometimes that means doing the same thing a few times until you are less anxious and can experience your true reaction.

traveling yet again / exposure

The sick relative that I went to visit at the end of May died earlier this month. It was of course sad but not at all unexpected. She had been sick for a very long time and was continuously getting worse, so at least she is not suffering anymore.

I kind of had this idea that I wouldn’t go back down to Virginia for the funeral, since I don’t share the consensus that funerals provide closure. I had gone to visit her one more time while she was alive, and that was what mattered. I dreaded the thought of having to go through the anxiety of the trip again. But I couldn’t stop thinking about my family, imagining them all going through this awful process without me, and the more I thought about it, the more I realized I didn’t actually find that version of the future believable. It was a weird feeling, knowing I just had to be there. Even though I was still going through my usual indecisive back-and-forth, part of me knew there was only one option and that no matter what ended up happening on the trip, I would be more miserable if I didn’t go. Because I would no longer be the person I want to be (or the person I am?).

So anyway, I went back down there for another long weekend. And this time, I went alone; my wife wasn’t able to go with me. I took a different flight route and went through two airports I had never been to before. I stayed with my family, both to offer support to them and to try to save money and avoid the hassle of a hotel (which was a terrible mistake, and I forgot being around my family for extended periods of time has a horrible effect on me, but whatever). I went to a wake/viewing and funeral, something I had not done since I was 13 (before my intense fear of death developed). I socialized with a ton of people, family and strangers (and family members I hadn’t seen in so long they were essentially strangers). I hung around my young nephews again. All of these things made me nervous and tense, but I didn’t have any panic/anxiety attacks.

When I think back over the past few months, I’m amazed. It doesn’t seem possible that all this has happened, especially in such a short period of time. I am always trying to motivate myself to create an exposure hierarchy and actually stick to it, and I don’t do it - more out of laziness than the fear of it not going well. But life stepped in and did it for me, even proceeding from an easy step (slow-paced planned trip to New York City by train with my wife) to a slightly harder one (fast-paced last minute trip by plane to Virginia with my wife, staying in a hotel) to the most difficult/stressful so far (fast-paced last minute trip by plane to Virginia alone, staying with my family). Throughout all this, the trip I have to take for work (which probably will be the most difficult of all) has been repeatedly postponed and is currently scheduled for mid-September. I definitely feel a lot more prepared for it and confident that I can handle at least some aspects of it, like the traveling.

And it’s not even just that I “handled” all this. Some parts of it gave me such a high. Particularly the last most challenging trip. I feel bad saying that, given the circumstances of why I had to make the trip, but getting on planes and rushing through airports alone trying to find my gate tapped into this part of me I don’t usually acknowledge. The part of me that wishes I was the complete opposite of who I am, someone who exudes confidence and has everything together. It’s really rare, but every once in a while I feel like I am that opposite-of-me person for a little while, and I always, always love it.

It reminds me of this post I wrote a long time ago (see here) about the idea that anxiety is actually a projection of, or in some way related to, the feeling of excitement. I want so much to be able to face any person, any situation, any challenge (and come away from each encounter with the certainty that I succeeded completely) that it makes everything more terrifying. It means so much to me, that fantasy - an unrealistic and probably unhealthy fantasy, I guess - of being perfect and extroverted and effortless and charming. I know I’m never going to be that person, at least not to the extent I want to be, because I can’t change my entire identity/personality. But it’s nice to have those brief moments where I feel like I am coming across that way to the people around me. And it’s also nice to view anxiety as, in some way, an indicator of my dreams and goals and not just as the sick/defective part of me.

CYEAT: Chapters 13 & 14

I finished the Cure Your Emetophobia and Thrive book. Chapter 14 is a short “that’s the book, thanks for reading, keep working, and tell your friends!” kind of chapter, so I decided to combine these last two into one post.

Chapter 13 is amazing, because it sums up everything the book has covered, it breaks it down into sections and easy to follow outlines, and it drives home the key points you want to remember. It’s almost like you could skip the rest, just read this chapter, and you’d still be getting most of what you need. I mean that in the best possible way and am not trying to belittle the rest of the book. I think it’s helpful with a book like this - to not have to reread the entire thing later on when you start to forget. To be able to go back to one chapter and have this great summary that allows you to quickly recall everything.

There were definitely things about this book that annoyed me - the way the writing style sounded like an infomercial at times, how some sections seemed to over-explain (like the chapter on the difference between stress and anxiety) while others didn’t get the attention I thought they needed (I would have liked to have seen much more on battling the social anxiety component of this phobia, but I suppose you can always supplement with a book specifically about social phobia), and the author’s overconfidence in the methods and emphasis on “cure.” I get the sense that you could never say ‘this program didn’t cure me’ without hearing in response that it was because you didn’t fully understand some part of it or didn’t work hard enough or didn’t do one of the exercises enough times. I guess that’s something that applies to most self-help books though. It’s not an attitude that appeals to me, but maybe other people feel differently and think the author lacks credibility if they don’t have that die-hard belief that their methods (and only their methods) will always work in the end (and if not, the fault lies with you).

I am not cured. Again, I am not convinced this phobia can be fully cured. On the other hand, I certainly haven’t put the effort into this program that the author recommends (which includes at least 6-8 weeks of continuing to follow the program once you have finished the book, and then starting all over if you still aren’t cured), so the author could still say I haven’t done enough, and there is no way for me to prove it will never cure me, just as there’s no way for him to prove it will.

But I’m going to stop being hung up on that word “cure” now, and putting that aside, the book contains a lot of incredibly helpful information. It’s certainly the best emetophobia-related book out there (we don’t have many options at this point in time, but still), and overall I would say it’s worth reading and having in your possession as a reference.

It has made me think a lot (most of those thoughts have been documented here) and given me ideas on what more I can do to make my life better. I’m sure I will keep going back to it, re-working exercises, trying to internalize the more rational thought processes I know I should have. Practice always helps. And revisiting always helps, because even if you have heard about or read the same ideas a hundred times (such as how important it is to counter negative thoughts with positive ones), there is something about encountering those ideas again that is inspiring and motivating. That reminds you, ‘oh yeah, I haven’t been using affirmations and I really wanted to try that’ or ‘I know working through an exposure hierarchy would help me so much; I should start again and not give up on it this time.’ It’s easy to lose sight of all the many options you have for improving or changing things when you’re busy living your day to day life and reacting to the world based on your current instincts or coping mechanisms.

improvement

The trip to Virginia was a complete success! I seriously can’t believe how well I handled it, especially with all the phobia “triggers” it included:

• Flying, which leads to worries about motion sickness (something I never have a problem with, but I always worry I will), other people getting motion sickness, and catching some illness from someone on the plane.
• Socializing frequently with people who may or may not be sick. I was only hanging out with my family, and they don’t know and/or understand and/or care about my phobia (we don’t really talk about anything emotional, so I am unsure who knows/understands what). So I could not rely on them to look out for me by warning me that they were sick or had been sick recently. It seemed like one of them might have a cold, so that was a little stressful, but nothing came of it. For all I know, it was allergies.
• Spending a lot of time in a hospital. I was mainly there to visit a relative who has cancer, so I was in the hospital with them for a few hours each day. I knew I couldn’t catch the diseases of the people around me, but I still felt “contaminated” by germs. Even hugging my sick relative felt unsafe, but I did it anyway. My parents tried to harass me into eating in the hospital cafeteria, but that was something I could not bring myself to do.
• Hanging out with my very young nephews, a one year old and a four year old. This probably stressed me out even more than the hospital. They were all over me, and the one year old even put his hand right on my lips as soon as I walked in the door. Plus they unpredictably cough on you, and every time they eat, I can’t stop thinking about how they don’t know the limits of what they can consume without being ill. On the other hand, they are so adorable and sweet, and I really had a great time with them. I hadn’t met the one year old yet, and I hadn’t seen the four year old since he was a baby, so he didn’t remember me and was excited to “meet” me and show me all his books.
• Spending long stretches of time away from my wife and my “safe space” (usually home, but in this case the hotel room). I would leave in the mornings and hang out with my family most of the day, not getting back to the hotel until the evening. I don’t spend that much time out in public by myself anymore (since I started working from home). Usually when I’m out somewhere for a whole day, my wife is with me.
• Eating while on vacation. This didn’t go quite as well as it did in New York City, because I avoided eating while around my family. But during the times it was just me and my wife, I was completely fine and able to eat normally. We bought a few safe snacks from a grocery store to keep in the hotel room just in case, but we didn’t even eat most of them. We mostly went out, and I got to have all the delicious food I have missed from my hometown that I hadn’t had in SIX YEARS, because when we went down there in 2011 I could barely eat anything.

I didn’t have any panic attacks or intense episodes of feeling “sick”. No feeling dizzy or crappy because I couldn’t eat. No having to cancel plans because of that. No inability to sleep. And not that much holding back from what I wanted/needed to do. I’m so glad that I went and was able to offer some support to my sick relative and the rest of my family.

Compare this to the way the trip went in 2011 (see post here), and I’m amazed at how much has changed in four years. And I wasn’t even aware of it! It’s so weird to have actual strong evidence that all the work I’ve put into getting better has actually gotten me somewhere. I have often felt like I’m not doing enough, but it has helped so much anyway. I think it helped just to make the commitment to learn to think a different way, because now, even when I lapse into old negative thought patterns, there is that sense that I am doing something wrong which leads to the motivation to get back on track.

It also helps that I take better care of myself physically now, specifically when it comes to eating habits. Trying to eat healthier, plus forcing myself as much as possible to eat regularly, on a normal schedule, has cut down on instances of feeling “sick” so much, and that of course means I don’t get anxious as frequently. Seriously. My stomach used to hurt all the time from going long periods of time without eating, and I just kept telling myself it was better and it was safer not to eat, that not eating had to lead to less stomach pain, or would ensure I was safe from getting sick even if I felt stomach pain. The reality is that it made me feel terrible, and then I wondered why I felt terrible all the time and experienced near constant anxiety because of it.

So I’m super pleased. If I can take trips without having some kind of meltdown, even when they are stressful or short or last-minute trips, that would be such an incredible improvement to my life. I want to be able to travel. My dream of eventually getting to Europe is seeming much more within my reach.

more traveling

The trip for work got pushed back again. Now they are saying maybe it will be a few weeks from now. It’s been at least a year since they first brought it up. The other day I was trying to say that this trip would be hanging over me the rest of my life, but I accidentally said “lives” instead. And you know, I think that’s more accurate. I’ll be reincarnated, some confused little kid thinking “I don’t even have a job! Why do I have to go on a business trip?”

But now another situation has come up where one of my family members is in very poor health, so I am having to go down to Virginia anyway, this weekend, to see them. I mean, I don’t have to in this case. It’s my choice. But it still doesn’t really feel like it is, because even though I want to see them, I don’t want to make this trip and am dreading it so much. I want to stay home and have things be normal.

I just have to keep reminding myself it’s important and I can’t be selfish all the time.

Plus there is another bright side to this. The trip is going to follow the exact route I’ll have to take when I go on the work trip (if that one ever actually happens), and since this one is a short trip over a weekend my wife can go with me. So it’ll be like a practice run, which I think will be really helpful.

All signs pointing to this being the right thing to do. And yet it still feels like a horrible decision made by someone who isn’t me, and I want to crawl into a cave where no one will ever expect or need me to do anything ever again.

As usually happens, my brain has already started assaulting me with extra irrational thoughts. “Your hands will only really be clean if you wash them in THIS sink. The other one’s no good.” “If you wear mismatching clothes to bed, you’ll get sick.” Things that make no sense, just little things that I guess make me feel like I am in control. Or could be in control, I should say, because I’m doing my best to ignore these thoughts. But it’s strange how they suddenly appear and feel absolutely true even though I can see how insane they are.

I’m hoping I’ll feel better once we leave and I have to start going through the motions of getting through this. The anticipation is always the worst part. I’m so used to my safe routine and it feels surreal to even imagine doing something else. But in reality, it probably won’t be that strange.

I mean, the NYC trip went so much better than I thought it would. Maybe this will be totally fine. Sometimes I think I am stuck in this mentality of thinking my anxiety is still as bad as it was a few years ago. That’s obviously not true. I think back to things I said or wrote during that time period and can barely remember what it was like to feel that way. I guess that’s part of the worry - that things got so terrible so fast, and it was so unexpected, and I am still not even sure why it happened. Part of me wonders if something will set it off again, as unlikely as that seems.

At least this trip will give me plenty more opportunities to try out the CYEAT book’s special technique for fighting negative thoughts.

CYEAT: Chapter 12

Throughout this book, the author keeps dropping hints of a special technique he developed that you’re going to learn later to help reduce anxiety and change your negative thoughts. Well, in this chapter, that special technique is finally revealed, and I’m not all that surprised it was a bit of a let-down.

It’s not even that it’s not a good technique. It is just very similar to the anxiety-reducing advice you would get anywhere else, kind of a melding together of a few different common techniques (noticing and countering negative thoughts, positive visualization, self-esteem building).

The technique, I’m sure, could be helpful. It’s the trademarking and the weirdly intense hype that lead me into the mindset of ‘that’s it?’ Before finally telling you the technique, the author builds it up for several pages. I honestly feel like I am watching an infomercial at times. This will make your life substantially easier! Quick and simple! Anyone can learn it! You don’t need to believe it, just do it! Stop living a life that isn’t really the life you want! This may seem like other techniques you have used, but it is actually very unique!

It is a pretty short chapter, especially if you disregard the lengthy sales pitch. The exercise at the end is to keep a log of every time you can use this technique to combat an anxious or negative thought over the next week. If I’m wrong about the amazingness of this technique and it works much better in practice than it sounds, I’ll report back here.

One part of the technique is focused on detailed visualization of a positive outcome, and that is something I’ve been thinking about a lot lately. Because I am great at envisioning everything that could go wrong, but I don’t put nearly enough effort into imagining something could go well. Or even adequately. And it has usually been the case that things don’t go quite as badly as I thought they would.

trip postponed

My work trip got postponed again! I shouldn’t be surprised, because they have been talking about this trip for about a year and keep pushing it back, but I was fairly certain it would actually be happening this time because the flights had already been booked.

At first I was incredibly annoyed, because I had gotten attached to the dates and had been planning non-stop and resigning myself to the fact that I would be doing this soon. I already went shopping and bought new professional clothes. I got my hair cut. I told my family I was coming. And then all of a sudden it was being called off. Now they are saying the trip might be in early June, but those sound like tentative dates, so basically I am back to knowing nothing. Which is frustrating.

At the same time, I’m now feeling so relieved I won’t be getting on a plane in a couple days. I was starting to have moments where I would be lying in bed in the morning, thinking “am I really going to be on my way to the airport one week from now?” and it didn’t feel real at all.

Anyway, it sounds like I have at least another month to prepare. Not that I can have any expectations, because hey, it’s much more fun for them to be unpredictable and wreak havoc with my stress levels. Maybe by Monday morning they’ll have decided it’s going to be next week.

But if nothing else changes, I’m sure I’ll be getting back to the CYEAT book in the meantime.

recap of NYC trip

I am home again - for the next week or so. First trip of the month completed, and it went really well. It went so well it was shocking and a little disorienting. Because one of the many downfalls of anxiety for me is that when I expect to have horrible anxiety during something and I don’t, it makes me feel strangely lost. I started feeling like I didn’t know myself, and then I started thinking really irrational things like “wait, do I even have anxiety problems? have I been exaggerating all this time? were all those terrible things I went through over the past few years lies?” And of course they weren’t - how could they have been? That doesn’t make any sense. I wish my mind didn’t only think in extremes.

The trip wasn’t perfect. I did experience some anxiety, but mostly in the realm of mentally obsessing over germs/contamination, which I see as better than intense emotional anxiety or physical symptoms like nausea. I was very aware all the time of the dirty things I was coming in contact with - cabs, public restrooms, train stations, etc. I’m used to feeling like my environment is very sanitized and I had to lower my standards and just try to get over the fact that I was not going to feel like things were clean enough for a week.

I had some trouble sleeping (thanks in large part to the hotel bed being incredibly uncomfortable). And there was one morning where I did feel really nauseous for a few hours and started to freak out. But I managed to calm myself down and decided I would relax in the hotel that morning instead of going out like I had planned. By the afternoon I felt fine again and we resumed our wandering through the city.

Not bad at all, considering what happened last time. I did not spend a night in the bathtub. I did not ever feel like I was going to legitimately lose my sanity.

But the biggest accomplishment is that I ate a normal amount for practically the entire trip. I don’t know if I have ever managed to do that before on a long trip like this. And that may be the main reason why the trip went so well, because when I don’t eat, it makes me feel terrible, and that makes my anxiety worse. Once that cycle starts, it’s hard to stop it.

All of this should probably make me feel more optimistic about the Virginia trip, but it doesn’t really. My stomach still feels like it’s dropping into my feet every time I think about it. I try to tell myself that since I was able to eat well in NYC, I should be able to do the same in Virginia, but then I think I can’t really compare the two. Virginia is going to be a lot more fast-paced and will involve tons of situations outside my comfort zone, and lots of social interaction, and I won’t feel as in control of any of it. I can’t exactly decide to take a morning off in the middle to regain my composure.

I talked to my boss about the social events, and she was really nice about it and said I could skip them if I felt like I couldn’t handle them, but she wanted me to be open to attempting to go to them, because it would be such a good opportunity to interact with everyone. So I guess I am going to try, at least for the first “welcome” event. I’m starting to wonder if it would just call more attention to me to skip them anyway. I don’t know. What’s more embarrassing, being noticeably absent from every social event, or going to them and being super nervous and maybe not being able to eat and having to come up with some excuse for why you’re not eating? I really can’t decide.

traveling

I keep trying to motivate myself to blog about the next chapter, but I think I’m going to have to accept the fact that CYEAT posts are going to be on hold until early to mid May. Because I can’t think about anything but the two week-long trips I am taking this month. So I’m going to write about that instead.

I mentioned in here a while back that my bosses want me to travel to Virginia for a week of training. It was originally supposed to be sometime last fall or winter, but it kept getting delayed. Now it’s finally happening, during the last week of this month.

Which is about the worst timing ever, because my wife and I also planned a week-long trip to NYC that starts at the end of this week and goes into next week. That trip alone was already stressing me out, and that’s going to be the easier one. The one where my wife is with me and we go at a slow pace and she makes sure I don’t get too overwhelmed.

No matter how carefully we navigate it, I know I will experience a lot of anxiety and it will really wear me out. And now I’m going to get back from that trip, have about a week and a half to relax and get back to homeostasis, and then have to leave for the training trip, which will be a thousand times harder. And I’m pretty sure I’ll be spending most of that in-between time obsessing over the second trip rather than relaxing. I already can’t stop obsessing about the second trip even though right now I should be preparing for the first one.

There are, I guess, three major concerns I keep going over:

- The actual traveling part. I hate flying. I hate all public transportation. We’re taking a train to NYC and that’s a little easier for me, but taking a train to Virginia could potentially take a full day (or night) and I don’t want that. So I figure I will suck it up and do the plane. But I have only flown alone once before, and it was in 2007. Pre-breakdown. I honestly have no memory of how I managed it. Everything seems so much harder now. So I will have to fly and navigate an airport, because of course there will be a layover, possibly more than one. Then once I get there, my boss has arranged that the hotel shuttle will take me back and forth to the work building. Screw that. I will probably rent my own car so I can have control over my coming and going. Oh, and also, as of right now, I can’t find a good flight connection, which may mean I will have to fly into an airport in a city a couple hours away and then figure out how to get to my destination from there. And I am not comfortable driving on the interstate. The only solution I can come up with so far is that my mother picks me up (and drops me off again at the end of the trip) because she lives nearby. But I’m not loving that idea either.

- Eating, drinking, sleeping. Any time I get really stressed out, I start doing all of these things less. This always happens to me on trips. I don’t feel well, so I don’t eat or drink as much. I get super dehydrated. My blood sugar is low all the time. I feel weak and shaky and sick and weird. Everything around me feels kind of surreal. But if I try to force myself to eat and drink more, that makes me feel nauseous, especially if I am trying to eat around other people or if I attempt to eat anything that isn’t completely bland. And it starts to feel almost physically impossible, since I have no appetite. After a day or so of that, I’m exhausted and it feels like an ordeal even to get out of bed. But I’ll have to get out of bed, go to work, focus on training, and socially interact with people. I’m thinking I will probably plan out every single thing I’m going to eat in advance and try to stick to that meal plan as much as possible, but I’m not sure how successful I will be.

- The social interaction. I’m not around people much anymore, and it’s honestly a huge relief most of the time, because I have a very strong desire to appear perfect to everyone around me combined with an inability to stop being horribly awkward. Which I think usually comes across as me being rude rather than scared (ignoring people, nervously laughing at things I shouldn’t laugh at, blank stares, sarcasm, and general stoicism). My boss has planned five socializing meals for us to attend. They all sound terrifying. It sounds like a few will involve large groups of people, including many people I have communicated with for several years but who have never met me face to face, so they will probably want to meet me face to face, and it’s too much to even think about. It is my goal to get out of every single one of those. Especially because three of them are lunches on training days, and if I go to those and am not able to eat, I don’t know how I will make it through the afternoons.

Also, I have no way of knowing how many panic attacks I’m going to have while I’m around my coworkers. It’s funny, because I used to work in the building with them, so it’s not like I haven’t dealt with that before. I have had anxiety attacks during one-on-one face-to-face meetings with my boss and been able to hide it. So it’s likely I’ll still be able to hide it pretty well. But part of me worries. I’m out of practice. And then of course there’s the fact that I don’t want to have anxiety attacks, whether I can hide them well or not, because they are miserable and further contribute to me feeling completely exhausted and out of it. But I don’t think I’m going to be able to avoid that. I’m guessing I will have them during the training sessions, when I feel most obligated to be composed and focused, when I know it would be bad for me to leave the room because that is after all what I’m there for. To try to learn something in the midst of all this insanity.

I probably should have fought harder to get out of this trip. I did try to get out of it, but it was a pathetic attempt, because I get too embarrassed to lay out exactly how bad it’s going to be. And I get scared thinking “am I really going to bail on something else? am I seriously going to be this person all my life?” I want to be able to do things. This particular thing feels way out of my reach, but I don’t know. Maybe it won’t be as bad as I’m imagining. I just have to do it. I have to do it, because it’s even harder to handle the thought of saying ‘no, absolutely not, you have no idea what this is going to do to me.’ And part of me worries I would end up getting fired.

I have internalized so much mental health stigma and it makes me feel guilty to even be saying some of this, because I believe people should push back more in these situations and advocate for themselves. I just feel like I can’t do it anymore. I have done it so many times and gotten so many horrible reactions. I had teachers in high school who literally made me cry because they were so mean to me for refusing to give class presentations, even though I told them I didn’t mind taking a zero for the assignment. Wouldn’t it be nice if the automatic reaction was to say ‘that’s fine, there are of course perfectly valid alternatives to presentations (or intense week-long out of state training sessions) and this doesn’t make you a lesser person at all‘? I think society is heading more in that direction, but it’s taking a long time.

CYEAT: Chapter 11

I found this chapter really interesting because it talks more about unhealthy belief systems and about various types of reinforcement you receive.

First, there is the reinforcement of your actual fears or symptoms. If you get really anxious about a situation, then it might not go as well as it could have. You might even have a panic attack or react in a way that is embarrassing to you. This would (wrongly) reinforce that you were right to be anxious all along.

Another way you can reinforce your fears is by constantly asking the people around you to reassure you. Asking if they think you are sick, if you will get sick based on this thing that happened to you, if it’s safe to go on a boat, if this medication you were prescribed causes nausea, if they have ever experienced this specific physical symptom, etc. Asking these questions reinforces the idea in your head that you need to ask the questions because there is a need to fear these things, because these things are dangerous. Also, since people are usually nice and want to make you feel better, they will offer this reassurance you want, probably forever, for as long as you keep asking. Their reassurances also reinforce the idea that you have something to fear, and that you can’t handle it or solve the problem on your own.

My wife and I have discussed this before, because I ask her for reassurance sometimes - still too frequently, I’m sure. But it used to be a lot worse, especially when my anxiety was really bad, and she started giving me different responses to my requests for reassurance. Instead of telling me ‘no, you’re not sick’ or ‘yes, everything will be fine’ she would say ‘what do you think?’ and make me come up with the answer myself. Or if I asked if she thought I was sick, she might say something like ‘I don’t know, we’ll see.’ I think it helped me because I realized I wasn’t going to get what I wanted from her, so I stopped asking the questions as much and just turned instead to relaxation techniques to stop myself from obsessing about these worries. Or I relied on my own logic, common sense, past experiences and realized I couldn’t be certain what would happen, but I could figure out what was likely to happen.

This kind of reinforcement is everywhere you look in online support groups for emetophobia, which is why I am so wary of them and have spent very little time hanging out on those sites. The author seems to agree with me on this; he says that when you are frequently interacting with other people who have the same worries you do, it normalizes those worries. It also keeps them fresh in your mind, easily accessible, like lyrics you hear over and over. So for example, next time you have to get in a car, you might automatically think of the eight posts you saw recently from people worrying about carsickness. Even though being in a car doesn’t usually worry you that much, now you feel more anxious about it.

Another kind of reinforcement is positive reinforcement for having the phobia. This would be anything you feel you gain from being emetophobic. For example, going back to online support groups, you might start feeling close to the other people with emetophobia you have “met” and consider many of them friends. This could be an especially positive gain if you are usually isolated because of your anxiety issues and don’t have many friends. You have gained a social network, and maybe you will start to think that if you get better and the phobia doesn’t affect your life as much, you will lose that.

Or it could be that you have had the phobia for so long, it feels like a big part of who you are. It’s one of the things that makes you you, and other people in your life (like your closest friends) know that. If someone in a movie gets sick, your friend might automatically look over and ask if you are okay, and that feels good, to be known that well.

Maybe in general, you love the attention you get for having anxiety. It feels nice when the people around you care about you and want to take care of you. The author points out this is especially true when you have low self-esteem. And having a lot of social anxiety or general anxiety doesn’t help either, because again, it’s isolating and that can lead to cravings for social contact.

I know that’s definitely a factor for me. I am a very quiet, reserved person. I don’t know what the biggest cause is (social anxiety, introversion, shyness, stoicism - I am pretty sure they all contribute), but I don’t talk much, especially in groups, and I’ve been that way for most of my life. I also don’t do much. I have tended to sit at home most of the time, by myself, where things feel safer and I feel more in control. So from my perspective, it has always seemed like most of the attention I get is for having problems - anxiety related problems, usually. I don’t know any other way, because it feels like I’m not going to be the person who is dramatic, or tells a captivating hilarious story, or does something risky that amazes everyone. And even those moments when I have done something amazing and people have given me attention, it gets overwhelming for me very quickly and I want it to stop. It feels easier to be sort of chronically pitied by reminding people of your anxiety and limitations every so often. I don’t know. It’s weird.

None of that means that the problems aren’t real. I have severe anxiety. It just so happens that I sometimes get something positive out of it (or at least something that appears to be positive from my warped perspective). The author is pointing it out because it’s good to keep it in mind, to be aware of any obstacles that might stand in the way of recovery. A small part of you wanting to stay anxious because you get attention from it (or because you have anxious friends, or you run a popular anxiety-related blog, or whatever) is another obstacle to reflect on in order to figure out how to move past it.

CYEAT: Chapter 10

I don’t have much to say on this chapter other than it seems weirdly out of place. It probably would have made a better Chapter 1 or even part of the Introduction.

It discusses what the terms “anxiety” and “stress” mean in detail and the differences between them. Basically this boils down to: anxiety relates more to mental worries (thoughts and emotions), stress relates more to your body’s physiological responses to a perceived threat. Either one can cause the other, and sometimes the words are used interchangeably. Anxiety can be about something in the present moment, or it can be “anticipatory anxiety” - worrying about something in the future (and building it up in your mind so that it does end up being scarier than if you hadn’t worried about it for weeks beforehand).

It’s all a giant feedback loop. If you worry about something and tell yourself it is (or will be) terrible, you become more anxious and stressed. As you become more anxious and stressed, you worry about it more. You may worry so much that you can’t sleep. Not sleeping causes even more stress build-up because your body is not as equipped to deal with it. Stress plus this lack of bodily care can lead to you getting physically sick, which leads to more anxiety and stress (especially for emetophobics). Etc.

If you can intervene in the cycle and try to minimize the effects, it will help in all the other areas too. Fighting your negative thoughts lowers your anxiety, makes it more likely you will get a good night’s sleep, meaning you will be more able to handle the next day’s stress and will stay healthier.

CYEAT: Chapter 9

I wrote a post a few years ago about how important it is to choose the right words for your self-talk. When I am telling myself "I feel sick" or "I feel nauseous" I am reinforcing the idea in my head that I am actually sick or nauseous, when really it's most likely anxiety. So it would be better to say "I don't feel well right now" (just because it doesn't have that word "sick" in it, which carries all the visuals and associations I have with the concept of sickness) or "I feel anxious."

That is basically what this chapter is about - the way the language we use affects our emotions, thoughts, behavior, and ability to handle situations well.

I have mixed feelings about this concept. For a while, I was uncomfortable with the idea of affirmations and positive thinking, because I couldn't help seeing it as self-brainwashing. But I was in such a bad place, I didn't much care. I still recited positive thoughts to myself constantly, obsessively, trying to get back to being a person who could also feel positive emotions on a regular basis. And they really helped me, and that was awesome, although still in the back of my mind I was worried about self-brainwashing, about turning myself into someone who was happier but somehow not authentically me.

Then something occurred to me. Two things, actually. One was the idea that I could just as easily say I was un-brainwashing myself, because I had already brainwashed myself throughout my life to think negatively. Which then led to the realization that it was useless to fear self-brainwashing, because we are all doing it all the time, every second of every day, and we have no control over the fact that it happens. It is just happening. We’re thinking our thoughts, and those thoughts are changing us. I’m still slightly uncomfortable with the idea of actively taking control of this process, making the conscious choice that I’m going to think a certain way so that I’ll feel a certain way. But I think that is just because of my external locus of control and the fact that I don’t want to make decisions in my life because I’m always worried I will make the wrong ones.

Which is also a useless fear, because I can't escape making decisions. Even if I think I am choosing not to decide, that's a decision. And I'm pretty sure my chronically deciding not to decide is having a more harmful effect on my life than anything else.

Back to the book - the author includes many examples of negative statements we might think ("I should be able to do this by now" or "I couldn't do that") and examples of how to counter these negative statements ("I'm getting better at this every day", "I can do anything that I put my mind to").

I can get on board with this. I do think it's best to pick apart your negative thoughts and try to make them as positive as possible.

My only issue is that I feel like this strategy belittles some people's problems, and the author doesn't say anything about this. For example, there is an example where the negative thought is "This cancer is killing me - I'm going to die" and the positive replacement (which was focusing not just on making it positive instead of negative, but also active instead of passive) is "I own this cancer, I'm going to fight this thing." Positive thinking does help in all situations and it's possible it could even help you get over cancer. But I don't like the idea of someone being really sick, dying even, and the people around them insisting it's because they are not thinking positively enough.

So I guess what I'm saying is I believe positive thinking is an enormous help in all situations, but it's not guaranteed to change reality. If you're thinking "I couldn't do that" about lifting a car, you can't just keep telling yourself you can do anything, you're strong enough to lift this car. I suppose in that sort of situation you can tell yourself other positive things, such as "I'm sure if I trained really hard physically, I would get much stronger, even if I was never strong enough to lift a car." Or "even though this cancer might kill me, I can still enjoy my life fully as long as I have it."

Another point the author makes is that we shouldn't be so quick to apply medical labels. For example, if you say you're depressed, it could be harder for you to get over that feeling than if you just said you were feeling sad at the moment. Calling our worries about vomiting a phobia could make it harder to get over it. Saying "I'm addicted to smoking" could make it harder to stop smoking than if you said "I smoke because I want to." A medical label gets us entrenched in the idea that it's huge and scary and more permanent, that it's a condition, it's the way we are, and either we can't change it or it would be extremely difficult to change it.

I'm still torn on this one. I can see the logic, and I think some people do use these sorts of labels too freely - such as saying they are depressed when they are really just having a bad day. I think that is something our society does in general, not just about illness/mental illness. Most of us tend to want to stand out, and we want all of our experiences to be big and important. So we might walk out of a movie theater saying "that was the worst movie I have ever seen in my entire life" when we know that's not true at all and we could think of 20 worse movies we have seen. Just because it sounds more fun and dramatic that way, better than just saying "that movie was not good."

But it sounds like the author is saying we should throw out all diagnoses, and I think that's an overreaction. Sometimes it feels really amazing to have a label for a problem you have had all your life, a problem that seems like this weird force acting on you that you can't understand until one day, you look around on the internet and find out it's called "emetophobia." And you read about it, and you say "this is me." I can still remember experiencing that moment (I was 11 years old), and in my memory it all seems magical, everything falling into place. Everything becoming understandable.

Yes, the downside to that might be that it reinforces it as a part of who you are. But honestly, before I found that word, it was already part of who I was. And I have seen other people with emetophobia leaving comments online along the lines of "Wow, I have had this problem for 40 years and now I finally know what it is, I am crying, I am so relieved, I always felt so weird and hid it from people" etc. Meaning they have lived most of their lives without that label, and it doesn't seem like it enabled them to get over the problem because they were downplaying it in their mind as just a quirk of theirs. Receiving that label can make you realize that it's an anxiety problem and that there are things you can do to get better.

So I pretty much don't agree with that particular part of the chapter. But I do think it's a good idea to refrain from labeling things inaccurately (referring to yourself as bipolar because of basic mood swings everyone has).

Basically, it all boils down to being careful with your language, analyzing it to determine if it is true, if it is too negative, what effect it could be having on you. I don't think there is a need to avoid saying you have a phobia at all costs. But if you are saying things on a regular basis that are having a negative effect on you (like "This phobia controls my whole life and I can't do anything about it") then it would be a really good idea to change that, because you will feel much happier and more in control of your life.

CYEAT: Chapter 8

This chapter looks at unhelpful thinking styles. I already knew most of them and have talked about some of them in other posts, but it is very useful information and I figure it’s always good to review and keep them fresh in my mind:

- Negative thinking (aka chronic pessimism)
- Obsessive thinking (you can’t stop brooding about things)
- Paranoid thinking (you think everything is about you - ties into social anxiety)
- Black and white thinking (extremist, not considering there could be a middle ground because you hate uncertainty and want things to be clear-cut)
- Catastrophic thinking (blowing up minor things into huge issues)
- Perfectionism (setting too high standards, being too hard on yourself)
- Hypervigilance (over-arousal, being too focused on what you consider to be dangerous signs in your body or surroundings)

Catastrophic thinking is one I know I’ve talked about before. The author claims all of these unhelpful thinking styles are common for people with emetophobia, and I would agree I have had trouble with all of them, but in my opinion catastrophizing is the one that seems to fit emetophobia most. It is usually the same thing we are blowing out of proportion every time - some harmless feeling in our bodies that we automatically think means we could be sick.

For me, that catastrophizing can then lead to all the other types: obsessing over the feeling and the worry that I am sick, being hypervigilant for signs of any changes to the feeling, being paranoid that if I did get sick everyone would notice and hate me, pushing myself to fight through the anxiety while maintaining my usual stoic appearance (perfectionism), and then, once the anxiety passes, thinking about how I can’t stand anxiety attacks and how much my life sucks because of anxiety (negative, black and white thinking).

The chapter includes tips on how to change these thinking styles, such as distracting yourself with some fun activity when you are obsessing, minimizing negative thoughts you have and focusing on what you can be grateful for instead, taking time to relax every day, and in general challenging your thinking Notice your negative thoughts, question whether they are true, revise them if they sound extreme (“That was the worst day ever. I will never be happy again” becomes “That was an unpleasant day, but I have no way of knowing what tomorrow will be like or how my feelings might change”).

It also discusses how we can gain things we feel we need from these unhelpful thinking styles. For example, if we continue to expect the worst, we know we won’t be disappointed or rejected, which is comforting in its own way. So I’m sure it’d be a good idea to think about why I might want or need to cling to certain bad thinking habits.

CYEAT: Chapter 7

I am not really sure what the point of this chapter is. It's supposed to be about personality types, but then only one personality typing system is discussed in-depth, and it's not clear why the author chose this particular one.

There are three basic personality types - the Carer, the Brooder, and the Dramatist. The chapter provides a detailed description of each type, and then there are exercises where you determine which type you are (primarily, because it says most people have aspects of all three), which type your best friend or significant other is, which type certain celebrities/characters are.

It felt like overkill, because the three personality types are easy to understand, and I had no problem choosing which one I most identify with (the Brooder, or the stoic worrying obsessive type). It seemed like choosing which one best describes your friend - or Steve Jobs - was just meant to help you drill all the characteristics into your head, so maybe that means the author will be coming back to them in future chapters and wants you to remember them clearly. Or maybe it was just pointless fun, like the Enneagram (I'm a 4).

Either way, I don't see what it has to do with emetophobia. The author's viewpoint seems to be that since these personality types are mainly sets of thinking styles and belief systems, it ties into the idea of changing your thinking, changing your beliefs, thus changing or influencing your personality for the better. If you know yourself well, then you will know what you need to change. Or something like that.

CYEAT: Chapter 6

This is a short chapter and seems kind of like a recap or intermission to me - reflecting on the last few chapters and hinting at what's to come.

You are reminded of the three underlying issues for emetophobia: external locus of control, low self-esteem, and social anxiety. The rest of the chapter explains how each one of these three negatively affects the other two (and gives examples).

If you have an external locus of control, it's going to lead to you having lower self-esteem and more social anxiety. If your self-esteem lowers, you're going to have more social anxiety and your locus of control will become more external. If your social anxiety increases, it will lower your self-esteem and again make your locus of control more external.

That's the bad news. The good news is that the same goes for moving in a positive direction. If you improve with any one of these three, it will lead to improvement with the other two. So you don't have to tackle fixing all three at once because even focusing on just one, you can't help but have an effect on the others at the same time.

Which is awesome and very hope-inspiring. I'm looking forward to the development of this idea and more specific tips on improving in the three areas.

CYEAT: Chapter 5

This chapter talks about the social anxiety component of emetophobia. It goes into what social anxiety is, how it manifests, why everyone has social anxiety to a degree, how the amount of social anxiety your parents have influences how much you will have, etc.

There is a quiz to measure how high your social anxiety is. I got an 85 out of 100, although I felt it was kind of unnecessary to take it. I already know I have terrible social anxiety. There are times I think my social anxiety has a worse effect on my life than my emetophobia. And I know they are connected, because as terrified as I am at the thought of getting sick in general, I am way more terrified by the thought of getting sick in front of other people. This includes my wife. I've never been able to decide how I would handle getting sick at home if she was around, because the emetophobic part of me would want her to stay, but the socially anxious part would want her to leave and go far, far away. I feel like the socially anxious part would probably win.

This is why I'm much more likely to have an emetophobia-related anxiety attack when I'm out in public. There is that added component of it feeling like the wrong / inappropriate place and fearing everyone will judge me or hate me.

So I agree, I definitely think the two issues are strongly linked. But this chapter was a let down for me. It's a lot of information I already knew, and the only advice given on how to deal with social anxiety is to notice when you are feeling it and challenge the thoughts - tell yourself you don't need to feel anxious and that you can handle the situation. I know it's good to challenge your thoughts and tell yourself positive things, but to me, this is presented way too simplistically in this case. It sounds like it boils down to "Feeling socially anxious? Well, don't. You don't need to, so tell yourself that and stop!" When I am out walking alone and feeling terrified at the thought of the cars driving by and the people inside them looking at me, I am well aware this is irrational and I can handle the situation. Reminding myself of this doesn't stop the pattern of feeling anxious, hating it, and avoiding walking alone.

The author hints you will get better at challenging negative thoughts by the end of the book, so I'm hoping there is more to come that will help in this area. In the meantime, there are a lot of helpful tips for coping with social anxiety online. Helpguide.org is one of my favorite sites. I feel like they always do a great job covering issues and various treatments - this is their page on social anxiety.

CYEAT: Chapter 4

One of the premises of this book is that there are three main issues underlying emetophobia (and most other mental health problems): an external locus of control, low self-esteem, and social anxiety. Chapter 3 focused on locus of control, and this chapter focuses on the self-esteem component.

The chapter starts with a quiz to determine your level of self-esteem (a list of statements for you to agree or disagree with), and I scored super low - 10%. I can't say I'm surprised based on the statements they provided. One of the statements is "I find it really hard to ask someone out on a date" and I find it hard to believe anyone would disagree with that. That's a difficult thing to do.

I have been conflicted about this topic for most of my life, because I think I am very arrogant in some areas of my life, or at certain moments. Some of the thoughts that pop into my head make me think I can't possibly have low self-esteem. But I've been giving it a lot of thought over the past year or so and have come to the conclusion that most of this "arrogance" is a defensive act. I have developed a habit of acting superior and putting other people down (thinking I have better taste in literature than anyone else, or I'm more intelligent, etc.) because I feel so ridiculously inadequate. Which is a despicable personality trait to have and something I want to change, because there's no excuse for thinking or acting like you're above other people. But yeah, that's what it is. It really started hitting me when I noticed that any time I am out in public and feel nervous, I'll start trying to look incredibly bored and over everything and everyone around me. I feel like if I can convince the world it's unimportant and beneath me, I'll be fine and it can't have any negative effect on me.

Also, a person's self-esteem can fluctuate, and this chapter does an amazing job of explaining that. First of all, people with an external locus of control are going to be strongly influenced by whatever situation they are in currently. If they are doing well on a project for work, high self-esteem. If a minute later, their boss comes in and criticizes them, self-esteem plummets just like that and they can't remember why they were ever feeling good about themselves.

Self-esteem can change very quickly. It just depends on what you are focusing on in your life. If you're focusing on all the things you don't think you have done well, it's going to be low. But if you make an effort to focus more on what you've done well lately, it will be high. The main exercise for the chapter is to list anything you've done lately that makes you feel good about yourself and carry that list around with you. Anything, even if it seems small (paying a bill or buying a present for a family member). Review it frequently. Add new things and bump old ones off the list. Focus more on what you are doing well than the mistakes you think you've made. It will make you think more highly of yourself, which leads to having more confidence, taking more chances, doing more things well.

For some reason, the author includes an Amazon website testimonial from someone helped by this self-esteem exercise at the end of the chapter. This was the only part that turned me off and made me feel (again) suspicious of the motives here. I feel sometimes like this book is trying harder to convince you it can help you than actually helping you. I already bought it, why does it seem like it's still being marketed to me?

But still, it's raised a lot of good points and included some really good advice so far. I'll keep trying to overlook the blatant posturing.

CYEAT: Chapter 3

Definitely the most interesting chapter so far. It talks about locus of control, how you can have an internal locus of control or an external locus of control.

People with an internal locus of control basically believe they have more control over their lives, the ability to influence events, a positive attitude. They think they have the skills to handle whatever comes. In the face of circumstances that can't be controlled (such as a loved one dying), they believe they are able to deal with the challenge or trauma and are more resilient as a result.

People with an external locus of control are the opposite. They are more negative and believe that what happens in their life depends on external factors (fate, luck, gods, or other "powerful"/authority figures controlling what happens to them) instead of what they themselves do. They tend to be more submissive and helpless. When something beyond their control happens, they don't believe they can handle it.

The author claims all people with emetophobia have an external locus of control. We also have a high desire for control, and when you combine the two, you end up with a ton of anxiety (because you are always feeling powerless and ill-equipped to deal with anything) and constant attempts to control everything you can, even the most insignificant things.

Which of course describes me perfectly. The quiz earlier in the book was to determine if you had an internal or external locus of control, and when I went back and reviewed my answers, I scored a 20 which apparently is an extreme external locus of control.

The main way I try to stay in control is by avoiding anything that I think might put me at risk - going on long trips or public transportation, taking medication, drinking alcohol, eating foods that seem risky, etc. - but there are other more active controlling behaviors too that I don't think about as much. I wash my hands excessively. I ask people questions constantly - ask them to reassure me about things I'm worried about, confirm I'm remembering facts correctly, make my decisions for me (from the insignificant to the huge and life-changing). I have certain numbers I feel are lucky or unlucky. I frequently use the website random.org to make my decisions for me.

In fact, this reminds me of a conversation I had the other day where I was saying that I would rather use a computer to generate an answer than flip a coin. Flipping a coin doesn't feel random enough to me, because I am holding/tossing the coin and thus it feels like I could somehow influence the outcome. And I want NO responsibility for the outcome, because I feel like I would make the wrong decision, whether consciously or subconsciously. (Of course I am still pushing the button to generate the computer's answer, and if I pushed the button a second earlier or later, I would get a different answer. Thinking about this drives me crazy.)

One of the exercises in the chapter was to go back to your quiz answers and identify your external beliefs, then choose 5 that seem the easiest to change, and work on changing them. For example, one of mine is that the number 23 is unlucky, and I could work on telling myself that's not true and making sure I don't avoid that number.

But as much as I agree with this concept and the idea of changing external beliefs and working on thinking in a more 'internal locus of control' way, I felt like some of the "external beliefs" from the quiz shouldn't be changed. So I was a little conflicted at this section. For example, one of the external beliefs was "I believe that you cannot make someone fall in love with you - if it is right it will happen." Do I really want to change that belief? What's the alternative - believing that you can convince people to fall in love with you? I suppose that may be true to an extent, but besides it being weird and manipulative, I don't see the point.

Still, in general it's good advice. Try to think of ways you tell yourself you don't or can't control something. Figure out what factors you think are controlling your life ("this day is ruined because of the rain" or "I can't change because my parents made me this way") and reframe your thoughts to put yourself in control again.

CYEAT: Chapter 2

Chapter 2 focuses on cognition and how the way you think affects your mood, your anxiety, your outlook on life (similar to chapter 1’s belief systems affecting your perception). It also goes into visualization, which I always find interesting.

The author talks about Coué's Law of Reversed Effort, which says (I'm paraphrasing) that when you want one thing to happen, but you are imagining or worrying about a different outcome, what you imagine will have a stronger effect than what you want. You can make it more likely something will happen by imagining/visualizing it.

Of course, that’s not always going to be true. If you want to have a safe flight and are worrying the plane will crash, you won’t make it crash. If you are worrying you will vomit, it’s very unlikely you will make yourself vomit. But you can make yourself feel “nauseous” and convinced you’re going to vomit by worrying you’re going to vomit, or even by worrying you’re going to feel nauseous.

Another example the author gives is losing a sports game because you’re imagining how awful it would be to lose, which then makes you anxious and causes you to lose your focus. Basically, your thoughts, your belief systems, your imagination, all of it, can influence your feelings and anxiety level, and that can have an effect on your behavior too.

To counteract this, it’s best to 1) tell yourself positive things and 2) visualize what you want to happen instead of what you fear might happen. Seems pretty common sense, right? Putting happy thoughts/images in your head can only have good results.

It’s difficult to do though. I spent months after my breakdown drilling affirmations into my head. I’ve gotten to the point where I can pull them out during an anxiety attack (and they are really helpful), but in general, I’m still usually thinking negative thoughts and putting myself down. It’s such a strong habit. And I hardly even know how to form a picture of what I want to happen when I’m so used to visualizing the worst outcome for every situation. The book recommends practicing these positive visualizations on a regular basis, sitting down for 5-10 minutes at a time and really fleshing out the visuals. I’m definitely going to start doing that.

CYEAT: Chapter 1

Ah, belief systems! The first chapter explores how your beliefs about the world influence the way you perceive the world, and how your perceptions then reinforce those beliefs.

For example, if you believe knocking on wood will bring you good luck, you're going to notice every single time you knock on wood and then something good happens. This will reinforce your belief. You're less likely to notice/remember the times you knock on wood and something bad happens.

Or (for a more negative emetophobia-related example) if you assume you're going to feel "sick" any time you go out somewhere, you will tend to notice the times you go out and don't feel well while overlooking the times you go out and feel fine. This is definitely one of my beliefs. I will complain to my wife that this always happens, that I can't ever go anywhere without feeling "sick" from anxiety, and she will remind me this isn't true and point out specific examples. She can see the whole picture, whereas I only see the bad because I'm invested in my belief - probably because 1) I get extremely frustrated and want to be able to express it in an extreme way ("this always happens" instead of "I hate that this ever happens") and 2) knowing there is potential to experience anxiety makes me want to stay home and if I can believe going out will always result in a struggle, it's that much easier to talk myself out of doing things.

Today was one of those good days that defies this belief. I went to see the new movie Into the Woods, which is pretty long (about 2 hours), and I didn't feel "sick" once.

At the end of the chapter there were a couple exercises about identifying what beliefs you have that may be limiting you (nothing about how to change them yet) and also a quiz, which excited me because I love taking quizzes. But at the end of the quiz there was no scoring or commentary. The author just said to set it aside and the book would come back to it later. Intriguing.

Nothing ground-breaking yet. I already know I have many flawed and harmful beliefs. But of course, it never hurts to remind yourself of these things. Even knowing I have these beliefs, I still don't always realize when I am reinforcing them and behaving as if they are true.

CYEAT: Introduction

In the introduction to Cure Your Emetophobia and Thrive, the author includes a first-person declaration that the reader is supposed to sign. The declaration says things like "I intend to overcome my emetophobia" and "I will complete all the exercises in this book with vigour", etc. Then a place to sign your name and date it.

On the page after the declaration, he asks anyone who didn't sign to think about why they didn't sign. He offers suggestions such as maybe you thought it was silly or wouldn't make any difference. But it got me thinking about why, in a broader sense, I sometimes feel wary about trying to cure this phobia.

First of all, I very much doubt it can be cured, at least not completely. I feel like at the very least you would still have moments in your life, moments where you had a stressful week or were really tired, where it would creep back out again.

But mere moments would be an improvement, obviously, and something to strive for. My next thought is that getting to that stage of 'mere moments' of anxiety would obviously be difficult and horribly unpleasant. The introduction talks about this too, how you have to put in a lot of time and work and complete all the exercises. Then I end up putting those two thoughts together and come up with: I could spend so much time doing these difficult unpleasant things and in the end, it's possible it still wouldn't make any difference.

The author mentions that he thinks exposure therapy (inducing vomiting) would help many people with this phobia, but they won't do it: "Their desire for control tends to be so strong that they would not let themselves undergo exposure therapy - even for just one day, if they were guaranteed a cure."

That's the problem though. No one can be guaranteed a cure. Honestly, if I was guaranteed a cure after one day, I would induce vomiting for sure. That's not reality. Reality is that you would probably have to do it several times to desensitize yourself, which would take more than one day, and there is no guarantee it would be successful. Without that guarantee, it's not worth it. In my mind anyway.

Another thing that makes me uneasy is thinking about how if I was cured, I would probably vomit more frequently than I do now. I get caught in that emetophobic feedback loop where I'm horrified thinking I would vomit, then remind myself that since I was cured I wouldn't care, but still feel freaked out by the thought. The present me feels sorry for the future me who would be cured and thus would not protect herself adequately by the standards of present me. It doesn't make sense. But I keep circling back around to what is essentially a fear of being cured.

Then there is the fact that I have had this phobia my entire life, as long as I can remember anyway, and it is such a huge part of me that it feels like part of my identity. Sometimes I can't imagine who I would be without it. And it's always scary to think about losing a huge part of who you are, even if it's a sick part that's holding you back in so many ways.

So those are my reservations. All that being said, if someone came up to me, handed me a pill, and told me that if I took it I would throw up once and then be cured forever, I'd do it in a heartbeat. I know that's not possible, but it's a nice fantasy.

I do want to commit to the experience of this book as much as possible and see if it can help any (even if it doesn't actually cure), so I will sign the declaration (well, write it out and then sign it, since I bought the ebook version). Since they say it's so important to do so. Full speed ahead!

thrive!

I bought the Cure Your Emetophobia and Thrive book a while ago, and I decided I'm finally going to start reading it. I'm certain it will not cure my phobia and can't say I'm too pleased they decided to give it that title, but I figure there has to be something helpful in there. Even the worst anxiety self-help books I've read have had at least a few good tips.

So here goes. Putting my skepticism/cynicism aside (as much as possible).

And I'm going to live-blog this potentially miraculous experience.

walking goals

Happy 2015 everyone!

Last year I made a resolution to walk 5000 steps a day. Since I work from home and don't like going out all that much, I was averaging barely 1000 steps. Definitely not healthy.

I never do well with exercise goals, but I found it really easy to stick with this one after I bought a pedometer. Those things are amazing. I don't know why, but being able to track by number of steps rather than time is so much more motivating. I bought this Omron one and love it. You probably know the Fitbit is the more popular brand because you can sync up to your computer to track your progress or to other people to form groups, challenge your friends, compete and such. (Also Fitbits are much smaller and more aesthetically appealing.) I got mine before the Fitbit craze and I'm not too interested in making my exercise social at this point in time, so I'm sticking with the Omron for now. It tracks total steps, aerobic steps, miles, calories burned. I rarely look at anything except the total steps - I clip it to my pants, wear it until I hit my step goal, then take it off.

I knew I wanted to work my way up to 10000 steps a day, and I thought it would be easier to do if I added 1000 steps to my goal every month. In September I bumped my goal up to 6000, in October to 7000, etc. and started out 2015 at 10000 steps a day. So that's my main resolution for this year, to stick with that goal.

I think all this walking and trying to eat healthier has decreased my anxiety. 2014 was an awesome year. I pushed my boundaries - going to concerts, festivals, etc. - and I still experienced some anxiety during most of these events, but I had a great time overall.

I did end up seeing The Nutcracker last month, and that was wonderful too. Even though I felt mildly "sick" during most of it. I just took deep breaths and tried to ignore it, which is usually easy for me to do these days. I keep telling myself it's not real illness, even if a part of me doubts it. Then intermission comes - the lights turn back on, everyone starts moving around, I know I could leave if I wanted, I'm able to talk and laugh with my wife for a few minutes, and all of this instantly makes me feel better. Because it is only anxiety.