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.

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.

shmexpired

I accidentally ate expired applesauce today, which I find especially hilarious considering the topic of my last post.

It was one of those little plastic cups, and I had only eaten about half of that when I noticed the old date. So it was basically two or three spoonfuls. But I went into a panic anyway, and I didn't handle it well at all. I was too fixated on the knowledge that an actual thing had happened to trigger this panic. That usually isn't the case. And it made me give way too much weight to it.

I kept thinking about how if something bad was going to happen because of this, there was nothing I could do about it now. I swallowed the food and it was gone, and I couldn't reach in and get it out again. That's a very obvious statement, but I was thinking "why? how is it possible that there isn't some way to take it back?" and it seemed bizarre and unfair that food would just disappear into me like I was a black hole but still be able to have whatever effect it was going to have on me.

I did some unhelpful googling (the people who post asking if it's okay that they just ate expired food never actually return to say what ended up happening) until I could get in touch with my wife at work. She gave me a long speech about how it was completely fine. I started crying from relief, which then turned into frustrated crying because seriously? I can't believe something so silly and small will be so disruptive to my day. This phobia makes me feel like an idiot. Or a child. In fact, I remember as a child freaking out on my family or baby-sitters and asking them to reassure me about food anxiety. And it's still happening.

I feel like I should know these things by now. I should have a better understanding of food in general. I think I have never bothered to learn the truth (or common sense) when it comes to some topics, food safety being one of them, because long ago I came to my own irrational conclusions and invented my own rules to keep myself safe. And these conclusions/rules aren't like normal facts that can change when confronted with contradictory evidence. If I didn't keep reminding myself, I feel pretty certain I would forget this ever happened within a couple years and it could happen again exactly the same as it did today. Because my mind wants to shove this out and go back to the simpler more ingrained rule of "any food past its expiration date will make you sick."

Not true, not true, not true. Must remember this.  

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.

"it's different this time"

This is usually how one of my emetophobic anxiety attacks plays out.

I notice something happening in my stomach. This leads me to think/say "I don't feel well."

I try to pinpoint the cause. In fact, I want to know the exact cause, which then leads to frustration, because that's almost always impossible. If I ate three different things an hour ago, I might spend way too much time and brainpower arguing with myself about which of the three things would be the most likely to make my stomach hurt.

I start assessing how bad the unpleasant feeling is. This is where things can quickly spin out of control. It doesn't really matter how bad the feeling is - what matters is how anxious I am. If I'm not careful, if I don't do something to try to calm down, I will soon arrive at the conclusion that this feeling is somehow different than any stomach-related feeling I have ever had before in my life. It's more severe, or it's in a different part of the stomach, or it feels like there's more _____ this time (churning, bubbling, flipping, whatever).

"It's different this time" - four words that I should never say, but I say them far too frequently. Other variations: "this feels different" or "what if this is something different?"

Sometimes it's not even the feeling itself that leads me to this "conclusion." Sometimes it's that I feel I was exposed to some illness a couple days ago, so this feeling MUST be related to that and therefore, it's different, where "different" really means "the moment I'm finally going to get sick."

From looking around at emetophobia blogs and forums, I can tell this thought is not unique to me. It seems like most, if not all, emetophobics get hung up on this idea of stomach pain being "different this time."

Maybe it's not only emetophobics, but all people with anxiety. One of the main cognitive distortions an anxious person will struggle with is catastrophizing, and if you are telling yourself "it's different this time" you are catastrophizing. Instantly you have changed something that is benign/harmless to something huge and scary. You have taken something you can handle, something you are familiar with (stomach pain for emetophobics, a panic attack for those with panic disorder, etc.) and made yourself believe it is unfamiliar and unmanageable.

You're basically saying "though every other time has been fine, this time I am clearly in great danger." Even if you don't fully believe that, that's the message you are reinforcing with your words, and it will only lead to more anxiety.

It seems like emetophobics have a kind of amnesia when it comes to their stomachs. With all the times in my life I have felt "sick," and all the times I have thought or said that what I was feeling was different than anything I had felt before, it's impossible that I could be right all those times. There isn't an unlimited number of unpleasant stomach sensations. If I am able to calm down some and then reassess, it's rare that I still believe it is a brand new feeling.

I think this irrational thought is one of the most harmful for me, so I have been putting a lot of effort into correcting myself whenever I catch myself thinking or saying it.

It is not different this time.
The truth is, I have been through this many, many times before.
I have had this same feeling at some point in the past and lived through it.
I know I can handle this. I'm practically an expert.
This feeling will pass.