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.

forums / support groups

I'm reading Leslie Jamison's The Empathy Exams, and it is a really amazing book. She's such a good writer. There is a part where she is talking about a conference being held for people with a specific disease/condition, and it reminded me so much of how I feel about emetophobia forums:

When does empathy actually reinforce the pain it wants to console? Does giving people a space to talk about their disease - probe it, gaze at it, share it - help them move through it, or simply deepen its hold? Does a gathering like this offer solace or simply confirm the cloister and prerogative of suffering? Maybe it just pushes on the pain until it gets even worse, until it requires more comforting than it did before. The conference seems to confirm, in those who attend, the sense that they will only ever get what they need here. It sharpens the isolation it wants to heal.

She says it much better than I did. It's why I sometimes feel like I am walking a fine line with this blog (because let's face it, a blog focusing on a phobia is not all that different from an online forum focusing on it). Am I actually helping, or am I making things worse for people? By sharing my perspective and what it's like for me to be living with this, am I encouraging others with the same problem (maybe even a milder version of it) to fear situations/objects they wouldn't fear on their own? Am I setting a bad example by avoiding so much? It's why I try to always show my bravest and most positive face when I write here and leave out details of some of my more irrational (harmful) anxiety thoughts. I don't like to post anything that doesn't include some bit of hope or advice.

I guess I'm over-thinking this and that it's up to each individual to know their limits and what they can or can't handle reading. I'm somewhat inclined to avoid reading what anyone else has to say about their experience of emetophobia, which seems like a silly philosophy for someone who blogs about the same topic. Sharing symptoms is just a strange practice, but especially so when it's a mental illness. It's already "all in your head" and that makes it easy to pick up a new aspect, to think "oh, that person's right, I should be afraid of that, why haven't I been avoiding that too?" The line between body and mind, or health and illness, gets very blurred with this phobia.

But I can't say that we should absolutely never be communicating with each other about our issues either. Especially when there is still so little awareness of this phobia (and such a stigma around mental health issues in general).

I don't know what conclusion I am drawing here, just musing about this. I guess I want to say that if any blog or forum is giving you new worries, it's probably best to take a break from it. And that you won't only ever get what you need from other people with emetophobia. Yes, it's nice to know they're out there, but sometimes it's better to seek out someone who can be a good example of how to live as if you don't have this fear. Maybe that won't be someone who can completely understand what you're going through, and maybe that's a good thing. We don't want to get so wrapped up in our reality that we forget there's another better reality we're supposed to be trying to reach.  

forums

I haven't had another panic attack since that one at the grocery store last month, but my anxiety levels have still been all over the place. Some days have been perfectly fine, others not so good. I have been meditating and doing deep-breathing exercises more. I have been looking through my affirmation flashcards. Hopefully this is helping me even out, but I haven't noticed a significant change yet. That might be because I am still not doing these relaxation exercises consistently enough. I should be doing them every night, but right now it's more like twice a week.

Another change I made that I do think is really helping me is that I stopped going to emetophobia forums. Up until maybe a year or two ago, I never went to these forums. I mean, I can remember popping into them a handful of times during my teen years, but they bored me. I really had no interest in putting more effort into handling my phobia then. I felt like I did well enough. But when things got worse, I started visiting them, thinking they might be helpful.

It's been just the opposite for me. I feel like they have made me worse. And they were somewhat addicting too. I couldn't stop logging in for a while, reading everything, leaving comments with advice occasionally. I tried to avoid threads that looked like they might contain information I didn't want to have in my head. For example, I try not to read anything anyone posts anywhere ever about norovirus. I don't care if it's facts about it, helpful tips on avoiding it, how it's spread, good news about it, whatever. I know I have the potential to get so unbelievably obsessive about it. The information gets stuck in my head, and I find myself changing my behavior.

But it wasn't always easy to tell what might be in a thread, and I still kept coming across this negative information. I remember one night I had just eaten Pizza Hut for dinner. Then I logged into one of the forums, and the very first thing I saw was a thread titled something like "Pizza Hut food poisoning" or something like that. So I didn't even have to click on that one for it to make me anxious!

That is what annoys me so much about groups of people with emetophobia getting together. Inevitably, 90% of what is discussed will be things like that. People asking which foods or restaurants are best to avoid. People posting in a panic asking for someone to give them a safe/benign reason why they feel sick. I wish there was more discussion of how to deal with the anxiety/phobia itself. But I notice that when people bring up this point on the forums, they usually end up getting attacked by people who are "anti-recovery" I guess, that stress they would rather it be a "support" group than a "recovery" group. I find it odd. I think the best support is encouraging someone to recover. If someone had encouraged me to work on recovery when I was younger, I'm sure I would have ignored them, so yes, I agree that no one can/will recover before they're ready. But at the same time, during those years that I was technically "anti-recovery" I wasn't "pro-support" or at least not that kind of support that seems like a merry-go-round of scaring each other. I don't see how that helps anyone.

I have become very afraid of eating out at restaurants during the winter, and I know that is a direct consequence of hanging out on these forums and seeing other people constantly post about being worried about this. It's something I never thought about before. I have eaten out at restaurants year round my entire life, and I have never gotten sick from doing so. My method of eating out whenever I wanted to did no damage, and there was no need for anything to change. But I have changed and am now extremely reluctant to eat out anywhere until it's spring/summer again.

I feel frustrated with myself for letting myself be influenced like this. It seems I can't read the fears of other emetophobics on a regular basis without being affected by them. So I have stopped going to these forums, and now I'm hoping that as time passes these extra thoughts/fears I've acquired will drift out of my head again.

It's a little disappointing, because, first of all, it is exhilarating to be in contact with so many people who understand the way you think. And also, every so often, I would come across something that was uplifting or helpful. But it was so rare, and it's just not worth digging through all that negativity for those few positive gems. 

I think I'm much better off sticking with blogs. I've always found they tend to be more recovery-focused and positive, since they are more about sharing information than getting support. I've never seen a blogger post while having a panic attack and expect someone to immediately show up to talk them through it (maybe because bloggers know they're addressing a smaller audience). I really like that. I'm looking for less agitation in my life and more understanding of the fact that anxiety is really something you have to handle on your own. Not that I don't sometimes rely on my wife to calm me down, but I like to see those times as times where I have failed myself. Any time I can fix a situation on my own, I know I've just done something that is so much better for me in the long run.