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.
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