thoughts on being overcautious

I'm back. I have something very important to share. Here it is!

Nobody wants to have bad things happen to them, especially if those bad things involve harm to their body.

Which you know, of course. That's obvious. But there are related implications that I find very reassuring and that really didn't occur to me for years. Once I realized what this truly meant, it became much easier to calm myself down in a variety of triggering situations.

You want to avoid catastrophes, and so does everyone else. So does our society in general. This is why so much of our world is designed to be easy to use for, let's say, those who don't have a lot of common sense or don't think things through. This is why you'll encounter warnings like don't drink this chemical, don't let your child play with this plastic bag, don't stop the chainsaw with your hands, etc.

Not only do we get these warning labels for almost any imaginable danger, we also have more common warnings drilled into our head by the people around us, pretty much from childhood. Don't go swimming during a storm. Don't get in a stranger's car. Everyone learns the general scenarios that could lead to danger, and, depending on their personality, respond with varying levels of caution.

Which brings me to you, unfortunate person with severe anxiety. I am guessing you're extra cautious when confronted with any of those scenarios or warning labels. I am guessing you also have a wide range of scenarios you have decided are dangerous all on your own, without anyone else telling you so (or agreeing with you) and are constantly doing your best to avoid those scenarios or take (most likely unnecessary) steps to make yourself safer.

But remember, nobody wants to have bad things happen to them. Especially if those bad things involve harm to their body. And with regards to whatever you fear, ask yourself: if there was an actual danger of this behavior or situation causing harm to my body, wouldn't I have heard about it before? Wouldn't I have heard or read something, somewhere, about it potentially causing harm?

If eating parts of the apple too close to the stem could cause me to get sick, wouldn't I have heard about that?

If this dental procedure I'm about to go through was likely to make me vomit, wouldn't I have been told that was a possibility?

If watery sour cream or watery yogurt was a sign that it was likely to be bad in some way and give me food poisoning, wouldn't that be one of those things that I was warned about all my life?

Those are just a few of my own personal examples.

I don't know how to stop these little worrying thoughts from popping into my head, as they still do, regularly. But I have found this line of thinking to be an effective countermeasure, a way that I'm often able to dismiss the worry.

If anything has a good chance of making you get sick, it's incredibly unlikely you wouldn't 1) already know about it or 2) be warned beforehand.

planning is good

I had a not-fun experience at the end of February / beginning of March. My wife came down with a stomach bug. That hadn’t happened since November 2006. Wow, almost a decade. Back then we were in college and living in a tiny dorm room together. I moved out for a week and stayed with a (wonderfully kind) friend who had a single dorm room.

After college ended, I was always wondering what I would do if it happened again, because I didn’t have any close friends who lived nearby anymore and would be willing to take me in. There were so many times I thought to myself, ‘I should have a plan. I should know exactly what I’m going to do and where I’m going to go. I should have an emergency bag packed and stashed somewhere.’ But of course, I never packed that bag or made that plan. That would have required facing up to the fact that this could actually happen.

So I was not prepared. But everything still worked out okay, better than last time even.

She warned me early in the day that she was not feeling well and didn’t know why, and she said I should feel free to go. I immediately left and spent several hours driving around in circles, sometimes stopping in a parking lot to text her and see what was happening. There were no developments for a while, and I finally drove back home and was thinking about going back inside. But then she texted me that she had just gotten sick and not to come in.

I had of course been really anxious this entire time, but there had been a part of me that thought maybe I was being irrational, overcautious. So it kind of surprised me to get that confirmation that this was really happening. My anxiety shot up to panic level; I suddenly got freezing cold and started shaking. And I didn’t know what to do.

It was a Sunday, meaning I had to work the next day. So I texted her that I was going to need to come in and grab some things before I left. She said she would stay in the bathroom while I was in there, but I was still incredibly nervous the entire time, thinking she might get sick again and I would hear it. Luckily, that didn’t happen. I grabbed my work computer/bag, wires and chargers, Kindle, and an extra book. I was trying to hold my breath the entire time.

I obviously couldn’t go in the bathroom, and I also felt like nothing in the kitchen or bedroom would be safe, so I had no other supplies. No clothes. No toothbrush or any other bathroom supplies. No food. See, this is why a bag packed in advance might have helped. At least with the clothing situation.

First thing I did was call a hotel nearby, and thankfully, they had an available room. They asked how long I’d be staying, and I didn’t know what to say. I said one night, but I might be extending it. They said that was okay, because they weren’t busy.

Next I had to go out and buy all the things I needed that I had not brought with me. Another fortunate coincidence; I happened to have a Walmart gift card in my wallet that had been sitting there for years (because I don’t usually shop at Walmart), and I had been on the verge of donating it. So I used that, and it helped cut down on the cost.

Once I was settled in the hotel, I was generally okay. I was worried in the back of my mind that I might be sick, and I was always thinking about contamination, so I’m sure that resulted in a lot of strange behavior. But emotionally, I was good. No more moments of panic. The hotel had good WiFi, and I was able to work normally; I didn’t have to take any time off.

I checked into the hotel Sunday night. I checked out and went back home Wednesday morning. Which, now that I think about it, seems like an amazingly short period of time. But it was mostly because of money. Even though I technically could have afforded staying in the hotel for a week, it would not have been a wise financial decision.

I was kind of a mess the first day back at home in terms of contamination worries. Not wanting to move, not wanting to touch anything. It was another work day, so at least I had that to distract me part of the day. And I avoided my wife for several more days. I think I slept on the couch for at least another week.

As ridiculous as all this sounds, it is much better than I handled it in 2006. Hopefully this won’t happen again for another decade. I mean, really, I hope it never happens, but I know better than to expect that.

I still haven’t put together an emergency bag. It feels like jinxing myself, which is obviously not true, and it’s a terrible response (or lack of response). Yes, things worked out pretty well this time, but that was largely due to lucky circumstances (including the fact that I’m lucky to have enough money to be able to make these terrible choices). Avoiding making plans changes nothing, except that I will probably (again) end up in a situation where I’m stuck and have to run around frantically and spend more money than I would have had to. So yeah. I need to stop living in denial and get this done. Be responsible and prepared.

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 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.

catching up

Usually I try to space out any high anxiety / social events in my life. I might have something planned one weekend and because of that make sure nothing else is planned for the days or even weeks around it so I won't get overwhelmed, so I'll have time to prepare before, to recover after. Which makes sense, but it's also something I want to change, because the end result is that I don't do all that much. Or miss out on something I really want to do because I'm already doing something else around that time, and I worry doing both will be too much to handle.

In the past couple months, I scheduled a whole bunch of things close together. Mostly because a bunch of things came up all at once that I really wanted to do. I could have skipped some of them and almost did, but I decided I wanted to see if I could get through it all (while still having a good time).

• 9/11-9/12: An author I love gave two different lectures in a nearby town. I attended both and even got up the nerve to introduce myself and small-talk with the author a little bit.
• 9/14: I went to a pride parade/festival in a city that is about a 2 hour drive away.
• 9/20: I checked out a smaller festival in my town (fall-themed).
• 9/27: I helped out with registration for an event at my old college.
• 10/4: One of my favorite musicians was performing in the same city where the pride parade was, so I couldn't miss that. I got to meet them too! They were hanging around before the show, talking to fans.
• 10/18: I went to see a dance performance in a nearby city.

It was a complete success! I did all of the above without any serious anxiety attacks. There were of course moments of panic, but they were brief. For the most part, it was just excitement and happiness and fun. So much fun. They were all amazing experiences, and I am glad I didn't miss a single one of them.

Now it's starting to get colder (I think it may have even snowed a bit already), so I'm not feeling like going out as much. Although the dance performance was so amazing, I am thinking about seeing The Nutcracker ballet in December.

I've been considering moving this blog over to tumblr. I finally got into that website this year and have been spending a lot of time over there. It seems like it has more of an emetophobia community. Also, the formatting on this site has always driven me crazy. But I'm not entirely sure what I'm going to do yet. I might just post my updates both places.   

examining food

I've been sick this whole month. I got some horrible cold or maybe even a (non-stomach) flu, I'm not sure. For the first two-ish weeks, I was utterly miserable. Now I just have a few mild symptoms left, but even they are annoying me to probably an irrational level. I'm just tired of this illness dragging on. I guess my immune system is not what it used to be, since 1) I'm getting older 2) I hardly ever get sick because I stay inside all the time - I think the last time was early 2012 and 3) I still haven't cemented the habits of eating healthy or exercising enough. I'm going to have to try harder, and the thought of that makes me want to groan the mother of all groans.

I basically don't do anything good for my body but then have these high expectations I hold it to, that it can't be sick or in pain or feel heavy or unpleasant in any way. I don't like my body or particularly want to be in touch with it, even though it would help me so much to be more in touch with it and break down some of that dislike.

Due to the lack of positivity I've got going on right now, I've been putting off writing here. But there. I'm done with my sickness-complaining. Moving on. To something I've been thinking about that is one of the main reasons I have such trouble with healthy eating.

I seem to constantly be finding flaws with my food. I suppose I can't say it's a bad habit to look at your food before you eat it. Because yes, there could actually be something wrong with it. That just makes sense to check it out first, make sure it looks okay.

But it probably should be a quick glance-over, and my technique is more in-depth extreme fearful scrutiny. No surprise that I usually end up finding something wrong, some detail that leads me to think maybe I shouldn't eat this thing. These frozen waffles don't feel frozen enough (I also decide they're too frozen sometimes). This soup can has weird residue in the crevices of the top. These hamburger buns have too much white on the bottoms - which yes, I know is flour and I will still pick it off just in case it's dangerous in some way. These pudding cups have a tiny bit of glue on the packaging (tiny bits of glue frequently prevent me from buying something). One corner of this box of cereal is a bit crumpled. This container of hummus has too much condensation on the inside of the lid.

I mean, there are a million examples, and for almost every single one of them, I logically know it's fine, but I either won't buy the food or won't eat it. Sometimes when I am preparing something to eat, I will get frustrated to the point of wanting to cry because I will find five or six different things "wrong" with it and have to keep making the decision to proceed, and it starts to feel exhausting.

And of course it's ten times worse when it comes to fruits/vegetables, because they will not look the same every time you eat them. I still expect them to, because I so desperately want them to. I want to be able to look at a fruit or vegetable and know yes, that is exactly the way it's supposed to look. This is a possibility when you're dealing with super processed homogeneous junk food, but it will pretty much never be the case for healthy food.

I buy a lot of raw fruits/vegetables. Every week. And every week I probably end up eating a third or less of what I bought. I ask my wife to pick everything out for me at the store, because I know if I looked at them, I wouldn't think any of them looked edible. But this doesn't really help, because later at home, when I go to eat one, I get to inspect it for myself. Almost every time, I get scared and end up throwing it away. Apples, peaches, nectarines, grapes, etc. will have spots/dents or soft spots or discolorations or be oddly shaped or the first bite won't taste the way I remember it tasting last time. Carrots will have parts that are slightly green or gray or black. Bananas will have black spots. Clementines will have some green on the peels. Berries will be a little smushed and wet because of that. Etc.

Every single one of these examples is, again, something perfectly normal and not indicative of danger. I know that, but part of me is still terrified that if I stop being overly cautious, one of these "strange" fruits/vegetables will make me sick.

So I don't know what to do about this. I think I'm just going to have to suck it up and start eating them anyway to prove to myself nothing bad will happen. I have done this occasionally already, and then I will worry for a few hours, and nothing will come of it. But that doesn't seem to result in less fear next time.

Maybe it would help if I kept an actual log of these instances, so I could refer back to it and see that on such and such date, I ate a clementine with some green on its peel, and all was well. It would also be a good reminder of various "flaws" I might run into, because I will stop eating a certain fruit for a while and then buy it again and tell my wife something like "this clementine is green. I have NEVER seen this before" and she will laugh at me.

Anxiety amnesia confuses me.

work invades my comfort zone

It's been too long since I've written an actual post here. Sometimes I get intimidated by blogging and think I shouldn't bother unless I have something Really Important to say. Which just figures - feeling anxious about blogging about anxiety.

Things have been going pretty well lately. Today I spent hours hanging out in a nearby city (about a two hour drive from home) - walking, shopping, eating, shopping more - without any major anxiety incidents. I started feeling a little unwell towards the end, as I was heading back to the parking garage. But I knew it was dehydration. I am still having a problem with drinking enough when I am out places, especially when I am walking around outside, which unfortunately is when it is most important to do so. I guess it's a combination of 1) not wanting to have to use the restroom in case there isn't one around and 2) not wanting to use the ones that are around, because they are public and thus diseased in my mind. My same lifelong pattern of thinking it's better if I just "shut down" my body until I can be home and safe again.

Despite that, I feel today's outing was a success. And I've also been doing well with the more routine stuff - going out to restaurants, grocery shopping, going to the mall or other stores. I haven't been experiencing anything beyond the mild worry that I might have some kind of anxiety attack.

Since I'm getting more comfortable with these situations, I know it's time to push myself to do even more challenging things, but for the most part, I've been lazy about it. My wife and I want to take another trip to VA to see our families. It's something that has been on the back burner for a while. The last time we went was 2011, and it was difficult for me to handle the trip at the time. I know I would do better now. The only problem is that driving all that way is exhausting, so we are considering taking a train this time.

I don't believe I have been on public transportation since 2008, so pre-breakdown. I probably shouldn't think this way, dividing my life into "pre" and "post" breakdown, but every time something challenging comes up that I haven't done since before that period, I get scared I can't handle it as the "new" person I am now. It feels like that person from 2008 that was able to survive the anxiety of a long train ride was not actually me.

So my wife and I have been discussing taking a practice train ride somewhere closer to where we live (maybe 3 hours away) just to see how I do. Just to prove to myself nothing catastrophic will happen.

Which brings me to this past week, when I suddenly get an email from my boss saying the company wants me to travel to the office for a week for training on a new system (I work from home, but the actual office is in VA). They haven't decided exactly when they want me to come, but possibly as early as the last week of September.

So much for one step at a time! Plus this trip would be much more overwhelming than what I have been imagining. My wife probably won't be able to go with me. Since the company is paying, they will probably want me to fly. I will have to deal with rental cars and a hotel and seeing my family all on my own. I will have to go to work and socially interact with lots and lots of people, something I'm very rusty at. Basically, it's a terrifying scenario that I'm not at all convinced I have the strength to manage.

My current coping mechanism is to pretend it's not happening. And maybe it won't. They have wanted me to travel before and either changed their minds or asked someone else to go instead. So I suppose I shouldn't get all worked up over it until it's finalized.

This is what sucks about having anxiety issues but still being able to fly under the normal radar most of the time. I'm sure no one expected this to be a big deal for me. I mean, yes, my anxiety is always an issue at work because sometimes I'm afraid to make phone calls or to speak up in meetings, but that kind of stuff is manageable. I can be doing badly in those areas and still overall be doing a good job. But I can't flat out refuse to do something they ask me to do because of anxiety. It's not like I've requested any mental health accommodations at work (although this has made me wonder if I should have). Not to mention I just don't want to formally brand myself the problem employee, especially when I have a job that so rarely forces me into large-scale scary situations like this.

On top of potentially having to do this trip, I hate being reminded that this is who I am. I feel like my life is set up in such a way that I can pass for being mentally stable most of the time. Then something like this happens, and it's like 'oh, right.' Other people can casually hop on a plane and go somewhere for a week - or casually tell someone else to do it - and think nothing of it. Whereas my first thought is 'maybe I should quit right now so I don't have to do this.' In general, most people can deal with so much more than I can deal with. I pass for mentally stable because I live in a tiny box where going shopping without getting panicky is a great accomplishment.

I know this shouldn't actually make me think any less of how well I've been doing. I'm just frustrated because I was planning on working my way up to this trip, and I should have been working faster. Whether this ends up happening or not, I should be working faster and harder than I am. I don't know why I expect that life will always proceed according to my super-gradual exposure hierarchy. 

logotherapy

I recently read Viktor Frankl's book Man's Search for Meaning, which is both a memoir about his experiences in concentration camps during the Holocaust and an explanation of his therapeutic method/theory called logotherapy.

It was an amazing book, as I knew it would be. I had wanted to read it for probably two years and kept putting it off because I was afraid. For the past two or three years I have been trying to avoid books, movies, news articles, etc. that I thought would make me have any kind of strong emotional reaction. My anxiety issues had gotten so bad that whenever I felt extreme sadness or fear or disgust I would feel "sick" or worry that the emotion would make me lose control or go crazy in some way.

Over the past few months I've been testing this boundary. I've watched a couple horror movies I had never seen before. I read a few books that were really sad or had disgusting parts. Nothing bad has happened. I enjoyed the movies and books and didn't freak out. Probably the ultimate test was going to see the movie August: Osage County last weekend. This one took me by surprise, as I actually thought it was going to be more light-hearted than it was. The previews showed a lot of Julia Roberts / Meryl Streep banter that reminded me of the interactions between Lorelai Gilmore and Emily Gilmore. But the movie was not like that at all. It was dark, dark, dark. From the very first scene, I became tense and felt kind of queasy and upset through the entire thing. I even thought about walking out at some points. But I stayed, and I felt like that was the final proof that I can handle pretty much any form of entertainment again.

Back to Man's Search for Meaning. I loved it and was extremely interested in the concept of logotherapy. I didn't know much about it. Basically it focuses on searching for the meaning in your life rather than trying to solve the problem of suffering (because there will always be suffering of some sort). From the wikipedia page:

"Frankl’s concept is based on the premise that the primary motivational force of an individual is to find a meaning in life. The following list of tenets represents basic principles of logotherapy:

• Life has meaning under all circumstances, even the most miserable ones.
• Our main motivation for living is our will to find meaning in life.
• We have freedom to find meaning in what we do, and what we experience, or at least in the stand we take when faced with a situation of unchangeable suffering."

The concept is appealing to me. I feel like what started to make me feel happier about my life was trying to ignore/minimize my anxiety and focus on the rest of my life instead ("Goals" from my list of coping techniques). Realizing that I would probably never get rid of this phobia (or anxiety in general) completely, and even if that was true, it didn't have to be my entire existence or identity.

It's as if a person wants to cook breakfast, but there is a giant box taking up most of the space in their kitchen. They are still able to make the meal. It's just a little more difficult because they have to work around the box, make sure not to trip over it and spill food, make sure not to stub their toe or bang their knee on it. I'm trying to think of anxiety as being like that annoying box. What's my objective? What do I want to do? Once I know that, I can figure out the exact ways that my anxiety will present itself as an obstacle. Then I can figure out (using various other coping techniques) how I can deal with that anxiety and do what I want to do anyway.

It's worth working around the box to get the delicious meal in the end. And even if the worst happens, like you trip over the box and spill all your ingredients, then you would just have to start over. Go to the store. Get new ingredients. Try again. Because you can't just not eat. And living your life and going after your goals, finding your purpose/meaning, should be as vital as eating.

One of my favorite quotes from the book:

"What man actually needs is not a tensionless state but rather the striving and struggling for a worthwhile goal, a freely chosen task. What he needs is not the discharge of tension at any cost but the call of a potential meaning waiting to be fulfilled by him."

emetophobia and high school

I hate having emetophobia, obviously. It impacts every area of my life and generally makes everything a little more difficult. But I’ve been thinking lately about what it was like to have this phobia during high school, and I have to say that was probably one of the biggest challenges I’ve ever faced – getting through every single day of those four years while having to deal with this fear. I’m so glad to have that behind me and have the utmost respect for anyone still in that situation, because it is incredibly difficult.

You are pretty much trapped in one building for the entire day, going straight from one class to another. You have all the usual stress of schoolwork, interacting with your classmates (some of them nice, some of them psychotic), interacting with teachers and counselors and administrators and security guards and bus drivers (some of them nice, some of them psychotic), and then when you add anxiety issues and panic attacks to all of that, things start to get incredibly messed up.

I definitely made the situation worse, because I didn’t take care of myself physically in any way. I thought it was fine to get four to six hours of sleep a night. I usually skipped breakfast and sometimes lunch too. Many days I just ate one giant meal after I got home from school and that was it. Plus my diet consisted mostly of things like frozen pizza and soda (yes, tons and tons of caffeine), which I guess is pretty normal for adolescents, but definitely not healthy. I wasn’t even really aware at the time of how unhealthy all this was, but I’m certain it’s the reason I had horrible stomach aches so frequently.

I’ve been remembering some of the ways I used to cope with these stomach aches and the anxiety that came along with them. For the most part, my coping skills back then were pretty unhealthy and I would not recommend them, but I’m going to list everything.

***
1) Probably my main coping mechanism was to dig my nails into my skin (usually the backs of my thumbs or other fingers) as a distraction from my stomach hurting. Not the worst form of self-harm, but it did sometimes leave marks that were embarrassing.

2) I skipped school a lot more than I should have because of feeling “sick” when I woke up in the morning.

3) Along the same lines, I went to the nurse’s office an abnormal amount of times and sometimes went home early from school. This fluctuated. I went through periods where I was in the nurse’s office almost every day, and other times it would be more like once a month.

4) I guess you could say skipping breakfast/lunch was a coping skill I used, although a really bad and counterproductive one. I was even afraid to drink anything at times and would end up dehydrating myself.

5) I would leave class to go to the bathroom just to calm myself down. Getting myself out of the classroom where I felt trapped would usually make me feel a lot better, and then I could convince myself that whatever was happening was mostly in my head. But obviously I could only do this one time per class, so I had to try to save it for when I really needed it. Sometimes I would break down early and then regret it later in the class.

6) In my notes for class, I would draw lines, each one representing a minute, for however many minutes were left in the class. I would watch the clock and keep telling myself “I can get through this next minute. I can get through this next minute” and then scribble through each minute line as the minutes passed.

7) I had a bunch of questions I asked myself to try to determine if I was actually ill, like "if I was home right now, would I still be feeling this way?"

8) I heavily relied on my friends. I was open with almost all of them about my phobia. Most of them understood, even if some didn’t grasp the full extent of the problem. My closest friends knew almost everything about it and were an amazing support system. It was so great to be able to talk to them and have them reassure me. They had mental health issues of their own, and we actually had a simple hand code to communicate with each other about how we were feeling (for when we were around a lot of other people, or when we were in class but sitting across the room from each other). Holding up a hand meant “are you okay?” or “what’s going on?” Then two fingers meant the person was sad, three fingers meant the person was fine, four fingers meant the person was anxious. One finger was the response that only I used. It meant “I feel sick” and everything implied along with that.

After a while we started using these numbers in our notes/emails and when speaking to each other too. I can remember many times answering the question “what’s wrong?” with “I feel one” or “oneness.” Even though “oneness” is basically a philosophy of unity/harmony to everyone else in the world, it will always make me think of feeling anxiety-related sickness.

Anyway, having that code and knowing that I usually had someone around who would understand how I was feeling was a big comfort to me.

***

I would say numbers 5-8 are the only good responses, and #5 is iffy since it’s better to wait out your anxiety than flee the situation you’re in.

I so wish I had been aware of all the anxiety-reducing techniques I know now during those years. I know just making the changes to my diet and sleep schedule would have had such a huge impact on how I felt, and using affirmations, mindfulness, and breathing techniques would have helped with the rest.

But I would recommend telling friends if at all possible. Unless your friends are jerks and you know they would only use the information to make fun of you or torment you (in which case it might be a good idea to get some new friends), having them know takes so much pressure off. Before I started telling people, it felt like this huge weight/burden and this shameful secret I had to keep, and that tended to make the anxiety attacks even worse, feeling like I was not just trapped in the situation and in the feeling of anxiety but also trapped inside my mind, alone, with the secret of what was happening to me.

I still find that in any situation where I feel anxious, if I can say it out loud to the person I’m with, it helps diffuse a lot of the anxiety. And most people are understanding about it, many more than I would have imagined back when I tried to hide it.

In general, I was embarrassed by the way I acted a lot of the time in high school. I’m still embarrassed thinking back on some of these things. So I just want to say that if anyone reading this is in high school and feels this way, cut yourself some slack. Emetophobia and high school don’t mix well. You’re basically a superhero for every day you deal with both. Whatever you can do to get through it (aside from hurting yourself/others), it won’t be that big a deal in the long run. And college (where you have a little more freedom to design your schedule and can include breaks between your classes) is not nearly as terrible.

obsessive thoughts

I can't decide if I'm doing a particularly good job lately of living by the "emetophobia shmemetophobia" motto. I guess in some ways. But I've been noticing many areas where I need serious improvement.

I volunteered to help out at an event at my old college this weekend. I was at a registration table for some of Friday and most of Saturday, which meant having to socialize with a lot of people (and reflect on how terrible my social skills are, but that's a whole other issue).

It was early afternoon on Friday when I first got there, and one of the very first things that happened - I mean, probably within fifteen minutes of me showing up - was that a janitor walked by and stopped to inform me that I should be glad I hadn't been around this morning, because someone had thrown up in that room. She of course didn't know about my phobia and was just following that weird custom of gossiping about any vomit one has seen or heard about recently. I don't quite understand why people love to do this - maybe they feel compelled to because of their own disgust over the situation. I've encountered it many times in my life, but this was probably the first time in several years. It gave me déjà vu, because it's always so similar with the person lowering their voice and giving you this sly and almost gleeful smile. I've got something good, it's really really good, it's going to make me super popular with everyone, because it's about vomit! It's stuff like this that makes me want to stay home and never interact with anyone again.

She didn't give too much detail except to say it was "gross" and that it had all been cleaned up, but after she left I could not stop thinking about it. Wondering where it had been. Was I sitting right on top of it. Wondering, of course, if it had been from sickness or drunkenness or something else. I couldn't let it go, and it tainted the whole weekend for me.

My one success is that I still ate, and I ate pretty normal amounts. I'm proud of myself for that, because having heard this story, I didn't particularly want to anymore. I also only had one brief period (about five to ten seconds) of feeling on the verge of panic because of imaginary "sick" feelings. The rest of the time I felt fine.

But I couldn't bring myself to eat in the campus dining hall (the closest available food) and walked to a restaurant in town instead. The dining hall is buffet style, and I kept thinking the most likely way to catch any sickness going around would be to share food with all the students.

What really bums me out about this is that when I was a student there, I ate in that dining hall almost every single day and usually didn't worry about it that much. Now it seems like a terrible and dangerous idea. I've been thinking about this and realizing that my germophobic tendencies have gotten much worse since college. I guess that makes sense, because these days I am usually at home, which means I feel like I'm rarely in contact with other people's germs. That's not true at all. I still go out places, and even if I didn't, my wife does, and other people come to visit here occasionally. I'm not at all isolated, I just have the illusion of being isolated. It makes me feel safer, and then on the other hand it makes me much more anxious about certain situations and places that I used to be able to handle.

Logically I know that someone has probably thrown up in every single room on that campus, and that it was even happening when I was living there. I lived there for four years and encountered plenty of illnesses. I caught a lot of colds but managed to avoid the stomach bugs. Possibly that was just luck. Either way, it makes much more sense that I would have gotten sick then, while living there, than now, when I was just working there for the weekend. But it didn't feel that way to me. I felt like I left the safety of my apartment and walked into a hotbed of various illnesses.

On both days, the first thing I did when I got home was put my clothes in the hamper and jump in the shower. Then I thought about how that behavior has been gradually developing over the past few years, where I feel the need to get rid of all contact with the outside world when I come home from certain places that I feel were particularly dirty or germ-filled. In some of the books on OCD I've read, they talked about how people with extreme germ-focused OCD will have "outside clothes" and then have to change into their inside/home clothes as soon as they get home. This reminds me of that, and while the thought of me getting to that point seems ridiculous right now, I probably shouldn't dismiss the possibility. Which is unsettling.

All that extra anxiety just because I happened to hear about an instance of vomit that happened that day, even though it's likely happening all the time without me hearing about it. It's so difficult to get something like that out of your head once it's in there. It makes me think about how I watched the original short for the horror movie Mama on Youtube a few weeks ago and ever since then, I can't stop myself from imagining her standing behind me at night when I turn off the lights to go to bed. I normally don't let myself watch anything in the horror genre anymore. It was a tiny act of defiance (against my own limitations) that was clearly oh so stupid.

Sometimes I stop right before I flip the light switch and wait until I can think of something that is not scary that will hold my attention long enough for me to get to the bed. Sometimes that works. I wish that technique was as effective in the emetophobia situations, but there is no destination point (like the bed) where it feels like the obsessive thoughts can be let go, so instead I just have to keep reminding myself to replace them with positive thoughts, over and over and over.  

when in doubt, say yes

There hasn't been much change with my phobia lately. I still feel "sick" at least once a day, usually when I know I have to go somewhere soon or I'm already out somewhere. Or when it's early morning and I've woken up for some reason and want to get back to sleep.

For the most part, I don't feel a lot of anxiety, and I've also gotten way better at ignoring the fake sick feelings and moving on. But it feels like I've hit a plateau and can't get to the next level. I never want to do anything but sit around at home. I have to be talked into going anywhere. I'm even anxious at the thought of going on a walk around the neighborhood, because what if I start feeling ill and I'm several blocks away from home?

I have to keep reminding myself that this isn't new at all. I have been reluctant to leave the house almost my entire life. My friends in middle and high school usually had to talk me into going to the movies with them. I would always worry about it, especially if there were going to be people there who didn't know me that well and didn't know about my anxiety issues. What would they think if I started panicking? In other words, it's an ingrained habit to want to say no, one that may take a long time to change.

I guess I'm lucky in that I've always been aware that if I didn't keep forcing myself to do these things, day after day, year after year, it would quickly lead to very bad consequences (as in being unable to even walk out my front door). I've always told myself things like "you have to do this. You didn't do the last three things. Now do this one because none of them are ever going to be safe enough."

I do feel like I've gotten worse with regards to my tendency to want to be home. I lost the momentum I had in school, having a larger circle of friends, people who always wanted to hang out, events to go to, classes to attend. I started working from home, and now it sometimes feels like I don't even know how to be in public anymore.

But I also think I've gotten better in the past couple years at forcing myself to go out when the opportunity arises. It's definitely been my mantra this year - "when in doubt, say yes." If I'm unsure about doing something, if I'm thinking things like "I'm anxious about the idea of going to hang out with people" or "what if I get sick on this car ride?" or "what if this other bad thing happens?" then I take that as a clear sign that I have to go. That it would be bad for my mental health if I didn't. I don't want to let any of those thoughts dictate what I do, especially when it means I'm going to end up sitting at home watching TV some more. Even though I feel like that is what I'd rather do, and forcing myself to go somewhere else feels like self-punishment, I usually end up having a good time and am happy I went.

It's hard to work up the courage, and I've been forcing myself to think things like "so what if I go on this walk and end up getting sick three blocks away from home?" and trying to convince myself that I believe what I'm telling myself. I know I don't actually feel nonchalant about the possibility of that happening, but it works well enough for me to take the small risk of walking out the door. It works well enough for me to focus on the fact that I don't feel sick at that moment, and if I feel sick a few minutes later, after I've already left, oh well. I'll deal with those moments when I get to them.

It works for other situations too. Like sleeping. Sometimes I will be afraid to go to sleep because I don't feel well. It used to be that I would take that as a sign that I should stay up and wait until the "sick" feeling passed and I could be sure it was safe to sleep. Now I will go to bed anyway, and I tell myself that this doesn't necessarily mean I have to go to sleep. I'm not going to sleep, I'm just going to go lie in bed and see what happens. But once I'm lying in bed, in the dark, tired, I can't stop myself from drifting off even if I'm still half-worrying in the back of my mind.

And eating. I used to refuse to eat if I didn't feel well, even after I realized that lack of eating (low blood sugar) can also make you feel sick. Now I'm training myself to go get food when I don't feel well and haven't eaten in a while. It could be low blood sugar. Maybe not, but I'll eat at least a few bites of something and see what happens. Usually it starts to make me feel better and I eat the whole thing.

So basically, whatever my phobia is telling me I shouldn't do, I am doing. I think it's working out pretty well. I went on a weekend trip recently to a place that was a 3-hour drive away. I went to game night at a friend's house. I've been taking walks regularly. I've been saying yes to whatever comes up. I still wish I could get to the point where I actually wanted to say yes, but I may be far away from that point, and in the meantime, I'm happy to report that most of my yes-es are turning out to be fun enjoyable experiences.    

avoidance behavior

I've been avoiding leaving the house a little more than usual because I keep hearing about people I know having stomach viruses. I hate that I'm doing this. I know it's bad for my anxiety, and it's not protecting me the way I imagine or hope it is.

First of all, most of these people live in other states. They are posting about being sick on Facebook, and even though they are hundreds of miles away, I'm still worried. So of course I know logically that makes no sense.

Second, I don't live alone. Any excessive germ-avoidance behavior I engage in doesn't really matter, because my wife is normal and still behaving in her normal way. One of my most important rules, if not the most important, is that I don't allow myself to control her behavior or suggest that she do things the irrational way that I do them. Because it's just wrong. Wrong to try to control someone in general, wrong also to try to encourage someone to engage in unhealthy behavior. But I can't even say I've been doing a good job with this rule lately, because I asked her the other day if she was being careful at work about avoiding sick people.

Third, even though it appears to me that stomach viruses are everywhere right now and then magically will go away with the warm weather, that's not true. They are always around, year-round. They are always around whether I hear about them or not, whether people I know have them or not. There is no reason to take any extra precautions right now.

One of the things I think emetophobics forget a lot of the time is that we have immune systems. We rarely factor that in when we're trying to figure out how "at risk" we think we are. In all likelihood, we're exposed to stomach viruses and other illnesses much more than even we could imagine, and our bodies fight them off. That's what is supposed to happen, and it happens most when we're taking care of ourselves. Eating healthy, getting enough sleep, exercising are all important, of course, but aside from those, it's important to lower stress as much as possible. Stress affects the immune system. In other words, working to fight anxiety related to this phobia, working to stay as calm as possible, is protection itself from physical illness.

So that is my thought for the week. Trust the immune system! It knows what it's doing. It's working hard for me, and that takes some of the pressure off. I don't have to work as hard or worry as much as I do.

I did have a very successful day yesterday. I was supposed to go somewhere in the morning. I woke up feeling "sick" and almost backed out of it. I wasn't even feeling as "sick" as I have on other days when I've still gone places. I have just been overreacting because of the references to stomach viruses I have seen. Anyway, I made myself go, and I started to feel better and ended up having a great time. I am sure if I had backed out of it, I would have ended the day feeling moody, knowing I had missed out on something fun because of anxiety, and instead I got to end the day feeling happy and reflecting on the memories of the fun I had.

Emetophobia shmemetophobia!