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. 

personality changes from anxiety

Can a period of severe anxiety (or a nervous breakdown, emotional collapse, whatever you want to call it) change who you are forever?

This is a question that has plagued me over the past few years. After my anxiety spiraled out of control in 2010, I felt like I changed almost overnight into a very different person. Other people didn't seem to agree with that assessment, which was comforting, but I was obsessed with the idea that I was different, that it had destroyed/ruined me, that I would never recover, never be "the same" again. And I kept focusing on every change I noticed and claiming it was proof or at least cause for concern, from completely minor changes that didn't even matter to the really big ones.

I expected these alterations in my personality / behavior to go away almost immediately. I definitely expected them to go away after weeks and months of anxiety-fighting work. What's funny is that most of them have gone away by now, but it happened gradually over about 3 years, and during that time it seemed like I was throwing my hands up every month and saying "it's been six months! It's never going to happen!" or "I've done everything I'm supposed to do and I'm still not myself again!"

Some examples (I do so love to make lists):

•  My entire life (for as long as I can remember) I have slept curled up on my side. After my breakdown (and even in the weeks leading up to it), I couldn't anymore. I started feeling like I could only sleep on my back. Whenever I lay on my side, I felt convinced I was hurting myself in some way, crushing my organs, or squishing some part of my body to the point that I would end up cutting off circulation, and this would cause me to die in the middle of the night. Even lying on my back, I had trouble falling asleep because I didn't know what to do with my arms. I didn't want them lying next to my body because when they pressed against me, I felt that same 'being squished' sensation. It seemed at the time that I could even feel the pain of this imaginary crushing.
  
  This went on for a very long time. I think it's only been within the past few months that I've finally started to go back to my old sleeping position. Also, I think it was one of the changes that freaked me out the most, even though it had no real significance. Maybe because it had no real significance. I couldn't understand why it had happened and just saw it as evidence that I wasn't me anymore, not even in the most relaxed scenario possible.
  
  
• When I was younger, I had problems eating in restaurants and usually would refuse. When I went out to meals with my friends, they all knew this and didn't expect me to eat, and even some of their parents knew and didn't push the matter. But from around the last year of high school up until the breakdown, I had made serious progress in this area. For example in 2009 (1 year, 2 months before breakdown) I went out to lunch with my boss. Ate normally, small-talked, no panic. After the breakdown, I lost my ability to handle restaurants again and frequently complained about this and how I thought I would never be able to eat normally in one again. I know I've mentioned this issue in a lot of my posts. I would say I'm still not fully back to where I was, but I was absolutely wrong about it being a permanent setback. It's obvious to me by now that I'm continuously improving in this area.
  
  
• Same for long car rides and vacations. When I took that vacation to VA in 2011, I was a mess. I wrote about it here and tried to put a positive spin on it, as I always do, but I was barely functional for most of the trip. I haven't taken another trip to someplace that far away since then, but I feel certain it would go better if I did. I've taken smaller trips since then. Stayed in hotels. Went to Warped Tour. I got through all of that while still feeling like a sane human being - even, I would say, feeling like myself.
  
  
• I had terrifying intrusive thoughts. It was very OCD-like, but I didn't have any compulsions. It may have been something I read about called pure-O, or just my brain's total meltdown. At first I was afraid I was going to kill my cat, and I was afraid to go near him. That only lasted about a week or so. Then that switched to being afraid I was going to kill myself, which lasted much longer. Several months. I didn't want to kill myself, but I thought I would anyway, that my body would just go on auto-pilot and do it, out of my control. I think it was because I was so anxious / unhappy all the time, and I worried it would never get any better. That caused a nightmare chain reaction in my brain. "Not happy --> things will not get better --> you will kill yourself --> oh my god, but I don't want to --> too bad, you won't have any control over it - after all you didn't have any control over this happening in the first place --> no I can't let this happen! must tell someone and/or have them watch me to make sure I don't do anything" etc. I got so panicked over this one day I called my wife and made her come home from work to keep an eye on me.
  
  This has gone away completely. It went on for about a year. I think the last time I had that thought was the end of 2012.
  
  
• I couldn't handle sad/dark books or movies or shows. This was a big adjustment for me, and I was incredibly frustrated by it, because most of what I liked to read was dark in some way. I couldn't read anything that referenced death or suicide. I couldn't read anything that was gross or gory (including things that aren't even that bad, like accounts of childbirth) or surreal or that caused any intense emotion (so that was basically everything). I even remember freaking out while reading a young adult book because of a part where one of the characters fused with a chair. The simple (but surreal) idea of someone becoming half-chair was too much for me.
  
  This has been gradually going away over the past few years and I think I am finally at the point where I can read/watch anything without having an anxiety attack over it. Except maybe horror movies. I'm still being super cautious with those. I'll probably never go back to watching the extremely scary ones I used to. 

This is getting long, so I'll stop. My purpose in writing all this is just to point out that everything did seem to change drastically, and (especially because the breakdown itself was so traumatic) it was scary to feel like I had lost myself, and I convinced myself I was irreversibly damaged. And that wasn't true. Now I'm seeing that it was all temporary. Of course it was hard to be patient and rational at the time, because everything was so unpleasant, but looking back on it, I can see that it was unreasonable to keep telling myself that because x amount of time had passed, I was clearly going to be this different person forever. As much as I wanted to, I didn't get to dictate how much time it would take to recover.

Maybe it is partially true that the experience forever changed me, but if so, it's in a more positive way than I am used to thinking. Yes, it was intense and horrible, and I'll never forget it completely, and I learned a lot from it. By that I mean I learned how to ensure it never happens again. I learned to take care of myself, both physically and mentally, enough to keep myself from a complete mental collapse. There's still a lot of room for improvement, but I have reached the point where my day to day life is manageable, and I have reached the point where I feel like I have my identity back. Those are both things I used to think I would never be able to say again.

mastering restaurants and other things

It's been way too long since I posted here. Last month I was working on another writing project and this month I've been preoccupied with Christmas, trying to think of what to get everyone. Other than that, not much has been happening.

I can only think of two emetophobia-related incidents that happened recently. One good, one not so good.

The not so good one was a couple nights ago when I went out to eat with my wife. I've got to say, I think I've generally been doing really well with eating out at restaurants. I finally figured out how to deal with the situation, because two things happen to me when I eat at a restaurant. One is that I switch over to my "restaurant stomach" or in other words, my stomach appears to shrink in size. I know it must not actually be shrinking, but because of anxiety, I can never eat the amount in a restaurant that I could eat at home. But I always used to anyway. Out of habit, I would eat the same amount of food I typically eat at a meal, and then end up feeling awful. Now I have caught on to this and am forcing myself to eat way less. It usually means I don't even come close to finishing my meal, but oh well. Then I have tasty leftovers to eat later at home when I have my normal stomach back.

The other thing that happens because of anxiety: my throat becomes tight, feels more closed up, and this is mainly where I am still running into problems. I don't tend to notice this sensation in my throat, because it's very subtle, and it's a symptom I'm not that anxious about. But then sometimes when I swallow a bite of food, it feels stuck or like it's going down the wrong way or like I'm choking. That combined with the worries in the back of my mind about throwing up leads to a giant spike of panic. Which is what happened the other night. I'm talking to my wife, everything is good, and then suddenly I get this terrified look on my face as I panic that I'm choking or am going to throw up. The panic was over within a few seconds (aside from my heart continuing to pound for a while) and then I just felt silly and embarrassed. I'm pretty sure no one but my wife saw that look on my face, but the fact that I could not control it made me think about how awful it would have been if someone else had seen it. And made me flash back to all the many, many embarrassing incidents in my past where someone else did see a look like that on my face, including people who had no clue what was happening to me.

I guess I just need to keep this in mind when I go out to eat. Chew more, be conscious of swallowing and such. Sometimes I wonder if it's a good idea to work around these sensations because it feels like I am working with my anxiety instead of against it. But I don't seem to have much of a choice. I regularly go out to eat and that anxiety (so far) is not going away. The level of anxiety varies, of course, based on a million factors from my mood to the weather to whether I watched a movie/show earlier that day that showed someone vomiting. But there is always some level there, so if I want to be able to go out to eat at all, I need to adjust to these two symptoms. And like I said before, I think my adjustments are working out and making it so I can actually enjoy going out to eat, and that's nice. Not something I'm used to being able to enjoy, ever. Even with the brief panic the other night, I feel like the meal was a success.

Now for the good emetophobia-related incident. A friend came to stay with us at the end of November. He visits us pretty frequently, and over the last few years, I have been having a difficult time with these visits. Just like with going to restaurants, having someone stay with us makes my base level anxiety go up, and what tends to happen is I start getting a lot of stomach aches, almost constant stomach aches, especially if we go out anywhere. And when your friend comes to stay with you, they don't want to just sit around your house the entire time. And to make things even worse, I find it almost impossible to hide the fact that I feel sick and miserable or to keep quiet about it. So this friend has had to hear about how I don't feel well a ridiculous amount of the time, and it's a wonder he still comes to visit.

I'm sure you know where this is going. This last visit was practically PERFECT. It was the best time I've had hanging out with him in so long. I can't even say for sure why it went so well. Probably because I expected it to. I was feeling really great physically before he showed up, and I just felt confident that I would continue to feel great, that I could keep up the momentum of feeling good, if that makes sense. I was determined to. I've been feeling very guilty about what a terrible friend / hostess I've been.

As soon as he arrived, we went out to eat, and I ate more than I think I have in several years while at a restaurant with someone other than my wife. After that, we went somewhere else before going back home, which would normally make me very anxious (I always want to go straight home to digest and recover from the experience), and I was fine. We also went to see the movie Catching Fire (second in the Hunger Games series), and it was opening weekend, which meant the theater was completely packed. I was sure I would end up panicking at least a little during the movie, but nope, didn't happen, and I even had some popcorn. Also, he takes a bus when he comes to visit, and the bus station where we pick him up is a long drive from our house, about two hours one-way. I got through all eight hours of driving without any high anxiety periods (seriously, a miracle)!

It was like I was a normal person for a whole weekend. He's coming to visit again in about two weeks, and I'm excited. Because now I know it's possible, that I'm capable of handling it without any problems. Maybe it won't be absolutely perfect again, but I'm at least positive that I won't be the complete downer I've grown so accustomed to being.  

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.         

regressing

The person I was going to meet for dinner cancelled, as they ended up not having enough time during their vacation to make the long drive over to my area. I can't say I wasn't partially relieved. I had been stressing about it every day. But at the same time, it would have been nice to prove to myself that I could get through a situation like that.

Then last weekend a friend came to visit and stayed with us. I had so much fun hanging out with him, but my anxiety spiked. Which was both surprising (because I'm close to and comfortable with this friend) and annoying.

We went on nature walks, and because it was hot, I worried I would get heat stroke and throw up. Or I worried I was overexerting myself, and that would make me sick. We went out to eat twice. The first time (breakfast) was absolutely fine, but the second time (dinner) I wasn't hungry, probably due to anxiety, and I was anxious that this meant I was getting sick and would throw up. We did a bunch of other things too. By the end of the day I was exhausted - it was more activity than I am used to - and then I worried I was sick because I felt tired! I had to repeat affirmations in my head in order to fall asleep and then woke up in a half-asleep panic at around 2 in the morning, feeling "sick" and trying to figure out where I could go to be sick in private, if it was going to happen.

I hardly ever wake up feeling like this anymore.

I feel like I've hit some kind of wall. I don't experience much anxiety anymore, but I guess it's only because I feel safe, because I'm only hanging out on a "narrow strip" of my room, as Rilke would say. I don't expect these (pretty minor) challenges to throw me so much, because I'm feeling so great most of the time. I really need to find more things to do around here that put me in situations where I am uncomfortable. I hate to think this is as good as it gets. I want to be able to go into any situation without returning to the mess I used to be.

making plans

I've been noticing that I'm afraid of making plans. I've pretty much always been that way. I hate telling someone days or weeks in advance that I'll meet them at [insert time] at [insert place], preferring to either have more casual (non-)plans or to make plans at the last minute. I think this is a result of the anxiety I've always had and knowing that if I make set-in-stone decisions it's harder to undo them later when I become too anxious to follow through. This has happened several times, and it's difficult and embarrassing to get yourself out of something you've already committed to. At a certain point I just started thinking 'I'll probably end up chickening out anyway, why bother?' and I still have that mentality.

It's clearly not leading me anywhere good. For one thing, most of the time I immediately decline invitations, not even wanting to get into the whole back-and-forth 'should I, should I not, what if' cycle of thinking. Then I end up missing out on a lot of potentially fun and/or rewarding experiences, sometimes even beating myself up about it or feeling plagued with regret. It's not even usually regret about any one specific outing, more a cumulative regret at this point, a feeling that I am missing out on almost everything.

Also, not-making-the-decisions becomes a strong habit. When I do agree to hang out with someone, I hem and haw about the specifics, asking them what they want to do, where they want to go, etc. until they have made all the plans and I end up in a situation even more unpleasant. Until recently, it never even occurred to me that I could take matters into my own hands and suggest times/places that would be more comfortable for me. Just the idea of doing so still makes me feel guilty, like it's wrong for me to be allowed to make choices.

I've been trying to stay aware of all this, and today a situation presented itself that gave me the perfect opportunity to break my habit. Someone I know (although not that well) is taking a vacation next week and will be close to where I live. So they emailed me and asked if we could get together one evening.

My first thought was 'there's no way I could handle that, I've got to think of some way out of it.' After I talked myself past that, I wrote her back saying yes and asking what she wanted to do (the habit takes control yet again). Finally, I sent a second response with a specific restaurant where we could meet. It's a place I've been many times, so I know how to get there, what I could eat there, and that I'll feel more relaxed in general being in a familiar setting. Better able to handle any anxiety brought on by the food or socializing.

This seems like such an effective strategy, I don't know why it took me so long to realize it and start taking advantage of it. Now I won't have to spend the next week looking up directions, taking practice drives, or obsessing over an online menu, trying to find the perfect "safe" dish. Not that I should be doing any of those things anyway, but it's nice to be able to take something extremely stressful and overwhelming and turn it into something slightly more manageable, even if it will still be a challenge.     

accomplishments

I finally did it. I made a doctor's appointment for a check-up. It's at the end of August, and I'm already really worried about it. I can't even put my finger on why exactly, but I guess it's a fear that I'll find out I have some horrible health problem. Or that I have one, but it won't be identified, because I will forget to bring something up or describe something incorrectly. I feel like I should make some long list of all my concerns to take with me, so I don't forget anything. But that would probably be annoying, huh?

I also have been trying to take better care of myself physically - exercising and eating healthy. I wouldn't say I'm doing either enough, but I'm keeping it in mind as a constant goal, and I have been doing better than usual. Last Friday I took the day off work and dedicated the day to relaxation. I didn't speak all day (just thought it'd be nice to have an atmosphere of absolute quiet). I tried to eat all my meals mindfully. I took a long walk around town (it was a gorgeous sunny day) and then did about 45 minutes of yoga. I worked on some writing projects and then later that evening, I listened to my meditation CD. It was the perfect vacation day.

Then over the weekend, I went to see the new Pixar movie Brave. There were of course children in the theater, and as a general rule, I try to stay away from them. They scare me quite a bit, because I see them as being constantly sick. Seriously, it seems like my (almost 2 year old) nephew is sick with something different every single week, sometimes things I have never heard of. But I was able to handle the movie without feeling much extra anxiety. I tensed up slightly every time one of the children walked by me and kind of leaned away from them. That was about it. The movie was incredible, by the way. It was the best kids' movie I've seen in a long time.

After the movie, I went out to eat at a restaurant I've only been to once before. I was really hungry and ate a lot, including dessert. I only had a little anxiety, and it was in the car after leaving, when I realized how full I felt. But it (the anxiety) passed quickly.

I'm so happy with all of this. I feel like I'm doing really well, other than freaking out about the doctor's appointment. It's not for a while, which could either mean I have plenty of time to calm down about it or that I have plenty of time to get more and more anxious. Of course, that's up to me and what I choose to think, so... time for affirmations! 

blah

I haven't had that much emetophobic anxiety lately. I even went out to dinner recently and ate until I was overly full and didn't feel the slightest bit worried about it. I can't remember the last time that happened. So there's the good news.

But I've been having tons of anxiety about my health in general. I keep noticing little aches and pains and feeling like there is something wrong with me. Plus I feel low-energy. All of this could, of course, be caused by anxiety and anxiety alone. But how can I know for sure? I can't. I can't know anything for sure, and my refusal to accept this is basically the root of all my problems.

My only option really is to start up an anxiety-fighting regimen again to see if that makes me feel any better physically. I think the main area I need to focus on is exercise. But I also bought a CD player for the bedroom so that I can listen to guided meditation CDs in there, away from distractions (naughty cat, TV, noisy air conditioner).

And I'm trying to work up the courage to make a doctor's appointment. This was one of my New Year's resolutions, to get a check-up this summer, and now it's summer, but I've yet to make the appointment. It'd be nice to be officially told there is nothing wrong with me, and then I'll have that as ammunition against all these irrational thoughts.

positive self-talk / exposure hierarchy

I'm still working through the different steps of the emetophobia online study. Last night I was trying to come up with my own personal exposure hierarchy, and I started going back through the Cognitive Behavioural Therapy Workbook for Dummies, because I worked through a lot of the exercises back in 2010-2011 and knew I would get ideas there for what I tend to avoid the most. I also found a bunch of loose papers I had been keeping in there with helpful affirmations. I haven't looked at any of this stuff for a long time now, because I've been feeling so much better, so it was weird to go back and see how much trouble I was having. Some of the things I was thinking back then seem so foreign to me now, which I love, because they were awful things. But I thought I would post some of the positive information/statements that I collected or created to help during that horrible time.

I remember I looked online for new affirmations sometimes, but I usually couldn't find anything that resonated with me like the affirmations from the workbooks did. I did find this website with anxiety coping statements and information about thought stoppage, and I printed it off and had it tucked in the front cover of the book.

Then I had a list of negative statements I was constantly thinking back then and a positive rebuttal I had come up with to counter each one:

1. 

I should be able to just get over my anxiety, knowing that's all that it is and that it's in my head. What is wrong with me? 

It's not that simple. There is no quick fix. It will take time and work to overcome my anxiety, and I am working really hard at it. I should be proud of myself for what I am able to accomplish at this point, and for my ability to stay motivated at working hard on these issues.

2. 

There is no reason for me to feel anxiety in this situation. I'm getting worse (or not getting better). I'm not the same person I used to be. 

I keep thinking that my anxiety should "make sense" and should only pop up at the times that it makes sense that it would based on the past. But an anxiety disorder isn't like that - by definition, the amount of anxiety you feel with an anxiety disorder is extreme and does not make sense. I may still be going through a rough time, but that doesn't mean I haven't improved a lot in the past year, and it doesn't mean I should lose hope that I can one day be a relatively anxiety-free person.

3. 

I have a very hard time knowing what I feel or want, and that isn't normal. 

Again, I have an anxiety disorder. This causes me to feel insecure and doubtful and indecisive at all times. It doesn't mean that I am an abnormal person that has no real feelings or desires. It doesn't mean that I will never figure out what I want. There is always time to change things, and it is within my control to change them.

4. 

I never really do anything. I don't have a real life. 

I actually do many things, sometimes so many that I complain about how I am too busy. It is in my nature to want to stay home, and some people are like that. But also, some of that tendency might be coming from my anxiety problems (which, aside from this severe period, I have had to some degree all my life) and maybe once I get better at dealing with my anxiety, I will feel more like going out and doing more social/outside activities.

5. 

I know better than to expect this event to go well. I'm definitely going to have anxiety there, so I should just accept the fact that I'm going to be miserable and get through it as best I can. 

I can't predict the future. There is no way of knowing for sure how much anxiety I will have in any situation. I may not even have any. Expecting the worst will only make me more anxious, which won't help. If I tell myself I can handle this situation and go into it with confidence, I am more likely not to feel anxiety and to have a good time overall.

6. 

This feeling is unbearable. I can't stand feeling like this way anymore. 

This feeling may be unpleasant, but it is not unbearable. I have survived it many times before and can survive it again. If I tell myself I can handle the feeling, it will most likely go away faster and will not be as horrible. 

Thoughts on worrying 

Worry does not help you prepare for problems. Planning and taking constructive action in response to worries can help you solve a problem or prepare for a less than ideal situation. But worrying in itself will not help you prepare for what might come up in life. 

There is no point in practicing being unhappy. Most of the time, things turn out well, and in preparing all the time for bad things by worrying, you are just increasing the amount of time you spend feeling miserable.

---

This is the exposure hierarchy I came up with in the end (in order from least scary to most scary). I can do all these things, but I try to avoid them as much as possible, because they make me either really uncomfortable/uneasy (for the first few) or really anxious.

-- Watching vomit scenes on a cartoon
-- Watching vomit scenes in shows/movies (not animated)
-- Going to a pharmacy
-- Eating dessert (or something unhealthy) at a restaurant
-- Buying/eating something from the grocery store that I think is "high-risk" (for food poisoning)
-- Eating at a restaurant and getting something new/unfamiliar from the menu
-- Using public restroom
-- Eating a big meal before leaving the house to go somewhere
-- Eating at a restaurant, then going somewhere else (not straight back home)
-- Eating far away from home (at least a 3 hour drive back)
-- Eating at a restaurant at a busy time when it's crowded
-- Staying at a hotel overnight
-- Staying at a hotel overnight and eating out somewhere that night

a practically non-phobic lunch

I had a fantastic day. I went out to lunch again, and I did not feel "sick" before, during, or after eating. I did have an uncomfortable full feeling at one point, but I didn't get anxious about it, and it went away within five minutes. I also finished my meal when usually I have to take half of it home, because I get "full." (My wife jokes that I have an "at home full" and a "restaurant full" that are wildly different.) And I got dessert and almost managed to finish that too!

I have no idea why this meal went so well, and around the time I was waiting for my dessert, I actually started worrying about my lack of anxiety, thinking about how strange and uncharacteristic it was. But even that didn't lead to anything bad. I just tried to remind myself to be appreciative of it. I know it's weird that I needed to tell myself to enjoy this, but my mind usually starts racing just as much when I have oddly perfect experiences like this. It drives me a little crazy, because I want to know why. I want to know what I did this time that was so right, what led to me having the experience I wish I had every single time. But obviously it's one of those questions I'll never be able to answer. I can only make guesses, and quite possibly it was just luck, just a good-feeling day.

I have pretty bad social anxiety that competes with the emetophobic anxiety, and trying to work around both of them is really annoying. I try to only go to restaurants at off-times when I think there won't be a big crowd, 11am or 2-3pm. But it's really an off-time for me as well, and it leads to me badly planning my earlier meals / snacks so that I show up at the restaurant and am either not hungry or so hungry that I feel "sick." I didn't do that today. I went at a normal time, around 1pm, so I wondered if that had something to do with it.

Also, the decision to go out for lunch was a little spur-of-the-moment. I didn't have days to think about it and figure out exactly what was going to happen. Basically, I'm wondering if all the planning and preparing I'm trying to do to make sure these meals are successful is having the opposite effect. My therapist was saying something similar to me the other day, something along the lines of "if you are putting all this effort into planning events and still feeling sick during them, maybe it would be better to stop planning and just accept whatever happens." It's much easier to go along with that when "whatever happens" is amazing, like it was today. I need to get to the point where I can have a more challenging day and be accepting of that too.

In any case, people without this phobia don't do all this planning, so I'm sure it is something I should try to stop. It's not really getting me anywhere, and it takes so much mental energy.

reframing thoughts

I went to a restaurant to have lunch yesterday. It's been a while, and I was feeling nervous about it for days beforehand. In light of that, I think it went really well. I was able to keep pretty calm before and throughout the meal. After I finished eating, I felt (or imagined I felt) a little queasy, and then I was anxious for a while. This was during the drive home. I kept mentioning to my wife that I felt sick. Yes, repeatedly, because it's not enough to just mention it once, right? She kept telling me to rephrase what I was saying, telling me that it was better to say "I don't feel well" than to say "I feel sick." In the moment, with the anxiety and whatever the physical feeling was, I was exasperated by this. It seemed like it didn't matter what words I used, the situation was still horrible. The whole "just semantics" argument that doesn't make any sense because the words a person chooses do matter.

It reminds me of a quote from Cormac McCarthy's The Road: "Just remember that the things you put into your head are there forever, he said. You might want to think about that." You can change the way you think, and by doing so, you can change your entire perspective. You are always in control of that. The idea of this scares me, because right now I am not that skilled in using the control to my advantage. Telling myself and others that "I feel sick" is almost as bad as saying "I am sick" or "I must be sick" when I'm not (which I've done many times). With this phobia, I really need to keep a clear head when it comes to the word "sick."

Pretty much all of these statements should be avoided: "I feel sick," "I am sick," "I must be sick," "I feel like I'm going to throw up," "I feel nauseous," etc. They are all going to be inaccurate or exaggerations most of the time, and they will only heighten the anxiety. There are so many other statements to use in their place: "I feel anxious," "I feel full," "I feel digestion," "I feel hunger." Sometimes I don't want to use these more accurate statements just because it feels like it trivializes the very serious / intense worry I have in that moment. And it will trivialize it. But not in the sense of you having a huge problem and the rest of the world not noticing or caring. The worry itself will start to become trivial so that it doesn't affect you as much. Just from you making the effort to use the most accurate / truthful words possible. And if none of the "true statements" seem true to you, go with the most optimistic one that you can imagine being possible.

the comfort zone

Things have been going extremely well for me. I've been eating almost every meal without feeling really sick and/or anxious. I think I'm finally back to the point where my anxiety is pretty much non-existent as long as I am just hanging out at home. It's only an issue if I go out anywhere or if someone comes to visit us. That doesn't sound like much to celebrate, I guess, but I'm loving it. Pretty much all of last year (and some of 2010), for the first time in my life, I felt like there was nowhere that was safe. It was horrible, and I'm so happy to have a "refuge" again and to be feeling more in control of my anxiety.

On the other hand, I don't want to spend all my time at home, which is what I've been doing. Clearly it's time to get out more and see what happens, see if I can manage to feel anxiety-free other places. I think I am going to start trying restaurants again. Sometimes my experiences with them are fine, sometimes they are awful. I'm hoping with practice that the awful times lessen.

Unfortunately, there is some possible unidentified problem with my car right now, so I am sort of stranded until it gets checked out and fixed (or given a clean bill of health). Hopefully it gets resolved this week. Until then, I can't deny that I'm thoroughly enjoying my comfort zone. Right now I'm making my way through the Hunger Games trilogy.

practice trip

We took another practice road trip this past weekend. We went to the same restaurant, and this time, I got something that I considered to be "unsafe" to eat while out in public. After eating, we drove around the area. We were looking for a particular store, but we never found it. We just kept driving around and got kind of lost in a semi-busy area. Driving in an unfamiliar area and traffic and being lost are all things that make me stressed out, but I didn't start feeling really "sick" because of it, which is exciting to me. I think I am ready for the VA trip. I actually feel like I can handle it. There were many times during the past year when I felt like I might be stuck here forever because of my anxiety, so I am looking forward to getting far away. 

more on road trips

The test run drive went really well. I didn't even need to get out my written affirmations. It was a quiet, non-stressful drive. Most of the time we were surrounded by farmland. On the way there, I could feel the anxiety start in my stomach at times, and I just tried to bring my attention back to the external world - the music playing, the scenery. I read somewhere (no clue where, my brain is way overloaded with self-help books and websites) about playing a game with yourself to calm down where you look for something that starts with the letter "A", then the letter "B", etc. So I used that to distract myself too.

Sometimes when I start to "feel sick" I view it as a kind of black and white transition where I've left the realm of calmness / happiness, and that's it - now there's no going back. But on this drive I happened to be able to tap into logic (for once) and realize that only a few seconds had passed between feeling absolutely fine and feeling "off" in some way. Obviously I still was absolutely fine and was able to return to feeling that way with a little effort.

I felt a little "sick" after eating in the restaurant too, but it didn't last long, maybe about five to ten minutes of the drive back home. All in all, I'm super pleased with how it went, although I do keep thinking about how tame a challenge it was compared to the much longer trip coming up. My main areas of concern are:

-- the drive itself. We'll be on the road longer, there will definitely be more traffic and crazy drivers. Plus having to eat during the drive.

-- staying in a hotel. The last time I actually threw up, I was in a hotel, on vacation with my family. I know some emetophobes have bad associations with certain foods because they were sick after eating them. That didn't happen to me, but I guess I associate hotels in general (well, they do all look alike and smell alike) with the experience and feel slightly unsafe in them.

-- I'll be meeting my nephew for the first time. He's a little over a year old. I might have to hold him. Part of me really wants to. I've loved him since the day he was born and the first pictures went up on facebook. But part of me worries he will spit up on me. Or get sick on me? At what age does it stop being called spit-up? I have no clue, but really it makes no difference to me.

-- eating in general on the trip, eating away from home, eating around other people. I need more practice with this.

We are planning to have a couple more of these "test run" trips, if we have time to fit them in. The goal for the next one is to go eat somewhere and then go out shopping instead of coming straight back home.

road trip

In a month, we're going to be taking a trip to Virginia to visit family. We'll be driving, and the drive down there takes about 12-14 hours. I'm starting to get really nervous about it. The last time we took a road trip, it was to a city about three hours away. I had a horrible anxiety attack during the drive, and the stress of it not only ruined the trip, but it stayed with me for months even after getting back home.

As a test run, we are taking another smaller trip this weekend to upstate Vermont. This drive will only be one and a half to two hours, nowhere near the length of the VA drive, so maybe it isn't the most challenging test run possible, but that's probably a good thing. I think what I really need is some confidence-boosting, and hopefully this is small and easy enough that it will be a complete success. Plus we're going to be eating breakfast once we get there, in a diner that I've never been to before, so that will make the whole experience a little scarier. My goals are to eat a small snack before we leave, eat a normal-sized breakfast at the diner, and keep my anxiety down as much as possible.

It's already starting to get cold here, and we have had to turn our heat on a few times in the past week. Not being used to it, I got a mild sore throat for a couple days, and ever since then, I have been on edge about every tiny little thing happening in my body and have convinced myself several times that I am coming down with some illness. I'm seriously frustrated with myself. I don't think I have been working hard enough at fighting these irrational thoughts. I've been neglecting affirmations. I'm going to take a list of them with me on this car trip so that they will be easily accessible if/when I get anxious.

"I don't need these thoughts. I can choose to think differently."

food anxiety

While I was eating dinner tonight, I became convinced that "something was wrong" with my body, and everything in me told me to stop eating, because there was a good chance I would throw up soon. I ate anyway, trying to focus all my attention on the fact that I didn't have one bit of evidence to show that anything was wrong aside from my uneasy feeling. It's been a while (a week or two) since I've had this experience, and it's strange how easy it is to forget how to handle it. At first, I didn't do anything, just letting the thought "something is wrong something is wrong something is wrong" run through my head over and over again, which is a thought I frequently have at the start of emetophobic anxiety. It's nice and vague but still terrifying. The word "wrong" stands out to me when it would probably be better to zero in on the word "something" to remind myself that the "something" is only anxiety. Eating dinner did not cause anything bad to happen, as usual. The existence of anxiety in general baffles me sometimes. I'm a rational person, but it takes over and puts thoughts in my head that make no sense. How is it possible that it can do that?

I'm going out to breakfast early tomorrow morning before work. I've been thinking about this all day and how all I want is to be able to go and eat eggs and pancakes and enjoy them. Situations like this seem so conditional in my mind - I'll be able to enjoy my breakfast only if I get enough sleep tonight, only if the restaurant isn't crowded, etc. I stood in my kitchen for at least a full minute earlier, trying to decide if I would be more likely to feel okay tomorrow if I had a small snack before going to bed. Snack or no snack, snack or no snack. It feels like I have to make the right decision, and then suddenly I remember that no normal person would care, because they would be able to enjoy their breakfast whether they had a snack or not. This decision in no way actually affects that outcome. It felt really amazing to think about that. There is potential to have so much more freedom in my choices and to not have to analyze everything all the time. There is an annoying wall between what's going on in my mind and that kind of freedom, but sometimes I can break through it temporarily.

restaurants / new goal

My wife and I went to a restaurant for lunch today, which didn't go quite as well as dinner the other night. I had a lot of anxiety ("nausea") in the time between finishing my meal and leaving the restaurant. Of course, the moment we walked out the door, I felt better, an experience I'm all too familiar with. It's always kind of infuriating, because part of me is thinking "this isn't anxiety, it really is something else this time" but that never turns out to be true. Being wrong is not the infuriating part. I'm happy to find out that the horrible thing I thought was happening to me is not real. What's infuriating is knowing that once again, I let anxiety bring down my enjoyment of an experience.

I used the same techniques I've been using: affirmations, deep breathing, mindfulness. In a public place it's not always possible to be completely focused on telling yourself "I am breathing in, I am breathing out" or something like that. Mindfulness in a situation like this involves focusing on your environment (instead of on your thoughts/feelings/internal state). It helps to think of the five senses (although smell and taste might be too much for an anxiety attack that is presenting itself as "nausea"). I focused on the music playing on the overhead speakers, the tennis match on the TV above the bar, the conversation I was having with my wife, the cold/wet feeling of the glass of water sitting in front of me.

In discussing my anxiety with my wife, she made me realize that I have a habit of trying to finish my meal as close to the time of us leaving as possible. Of course, this never really works out, because no waiter/waitress is going to bring the check while you still have food in front of you. But still, this is exactly the type of behavior that I am trying to eradicate from my life. I'm making a new goal to stop doing this, to eat at the pace that is normal for me and finish whenever I finish. If I have to sit in the restaurant for half an hour after I'm done, oh well. Nothing bad will happen. Emetophobia shmemetophobia! 

restaurants / thinking through anxiety

Since my second class was canceled, I wanted to come up with a suitable replacement challenge. A few nights ago, I was out with my wife, and we decided spur-of-the-moment to walk to a nearby restaurant for dinner. I generally don't handle restaurants well, and when we go to one, it's usually planned out at least a day in advance. It felt wrong and dangerous to go to one right then, without the planning, and since I know logically that no planning is necessary, I agreed that we should go and that I should handle it.

It was an extremely successful meal. I felt some anxiety when we first got there, because I had a strange feeling in my stomach, but I was almost positive it was a combination of hunger and my anxiety about going to the restaurant. It went away once I got my food and started eating. Most of the time, I feel the least anxiety while actually eating, because I am focused on the delicious food. The time between when I finish eating and when we leave is the problem. The check has to come, and then it has to get paid, and then the receipt has to come back, and I spend this time worrying about how full I am and the feelings of digestion in my stomach. Lately when we go to restaurants, I focus on making myself as calm as possible during this period, by saying affirmations to myself or doing breathing exercises. I think I am getting much better at sitting with the feelings and knowing that it's just my body doing the normal work it always has to do.

I tend to focus on the fact that "this uncomfortable feeling is happening to me again" rather than the fact that it has never resulted in anything bad happening in the past. I noticed this a few months ago in therapy when I was talking about events that were coming up that I was anxious about. I told my therapist that I thought I would feel sick during them and worry that I was going to throw up, and in the back of my head I was thinking "but why does that matter? You are saying you are afraid of fear, which is pointless. Don't you get it? That is all that will happen. You might feel anxious, and that's it. As it has every other time in the past, it will fade away without anything horrible happening. Then it will be gone as if it never existed, because it's barely anything, just an out of control emotion." It was such a strange epiphany, the first time I'd ever really gotten that concept in my entire life. It didn't fix everything, but it was exciting to me anyway, and it's something I've always tried to keep in mind since then.

Around the same time, I discovered another similar hole in my logic. Often when I "feel sick" in a public place, I don't think about the feeling itself. I think mostly about where I am or what I am doing and judge whether it's okay to feel the way I feel based on that. Like if I am out at the grocery store, I will be thinking without even realizing it something like "I could throw up because I am at the grocery store" instead of "I'm not going to throw up, I've had this feeling before, and being at a grocery store in no way increases the odds of anything bad happening."

Sleep is like this. I feel convinced (especially when I wake up in the middle of the night and am still half-asleep) that being asleep in itself will lead to me throwing up, because I am not awake to guard against it. I know it's best to calm down, no matter what, but I find it hard to move on to the next step after that, which would be to return to sleep. Even when I start feeling better, I tell myself to wait a few more minutes and make sure it sticks.

To help with this, I posted a set of affirmations next to my bed so that I see them if I wake up in the middle of the night: "This feeling isn't dangerous - it will pass." "I've survived this before and I'll survive this time too." "This isn't an emergency. It's okay to think slowly about what I need to do." "These are just thoughts - not reality." I'm so used to them by now that sometimes I'll just stare at them, too tired to really take in what they mean word by word, but knowing that they have a general meaning of 'I'm not going to throw up, I can go back to sleep.'

It's just comforting to have them there, not only as a means to reduce my anxiety in that moment, but as a reminder of the changes I've been making to my life in general. Positive self-talk is no longer foreign to me. My outlook on everything is changing, and it's exciting to think about where I am heading.

obligatory introduction post

It feels strange to give a background / explanation of something that has been with me my entire life. Chances are you already know something about emetophobia anyway, if you're here, and there are plenty of websites that explain it. Best of which, in my opinion, is this one. I'm not sure about the reliability of the rest of that website, but this FAQ was the first thing I ever stumbled across that made everything make sense to me.

I have no idea what caused my phobia. I have no memory of a traumatic experience involving me or someone else vomiting. I was 9 the last time I actually did throw up, but I must have already had the phobia at that point or was at least on my way to developing it, because I can remember times before that where I acted in weird ways. If my stomach hurt, I would crouch down on the floor if possible, because I thought that made me safer. I would try to hide from my teachers the fact that I felt sick, because I felt it was something shameful. If eventually my anxiety overwhelmed me, I would suddenly blurt out that I didn't feel well and needed to go to the nurse, and the teacher always looked taken aback. At some point in my childhood, I became scared to touch food at all, even after washing my hands, and went through a phase where I ate like a dog, holding my plate or bowl up to my mouth.

I was around 11 or 12 when I started researching online and found the FAQ website linked to above, but it took several more years before I really felt like I had any control over what was happening to me.

So moving on from history, this is business-as-usual nowadays.

-- I feel "nauseous" almost every day. This fake "nausea" is really anxiety, hunger, normal feelings of digestion, indigestion, heartburn, etc. It's hard for me to tell the difference between these and to identify my current feeling correctly. It's gotten easier over the years. But I still frequently get nervous that I am in danger of throwing up, especially if I "feel sick" in public. It's even hard for me to tolerate non-stomach pains, like a headache or general muscle soreness, since I will interpret these as signs of potential illness.

-- I think about the safety of my food a lot, the potential to get ill from food poisoning. This leads to avoiding certain restaurants or types of food that don't seem "safe" to me, throwing food away that is most likely still fine because I worry it has gone bad, or feeling anxious after consuming certain foods that seem high-risk to me. I also have a long list of foods I avoid eating before going out in public or while out in public (anything spicy, greasy, rich, too filling, too sweet - aka anything that could make my stomach hurt). This makes eating on long car trips and vacations difficult. Grocery shopping is also kind of a pain, because I inspect everything I am buying, and if anything looks weird or "off" to me (like an apple with a spot on it), I usually can't bring myself to get it.

-- Eating in restaurants in general doesn't work out that well. It's rare that I can get through an entire restaurant meal without "feeling nauseous" from anxiety.

-- I can remember times when I was young and threw up in the middle of the night, right after waking up. So I consider sleep to be a time where illness can sneak up on you and make you vomit before you have a chance to stop it from happening in some way. Because of this, it's hard for me to fall asleep if I don't feel well. I also frequently wake up in the middle of the night and "feel sick" - I'm guessing this is usually just hunger, since sleeping is also a long stretch of not eating.

-- I do not drink alcohol at all and avoid being in places/situations where other people are drinking (excessively to the point of drunkenness, I mean).

-- I avoid being around children, since they are much more likely to have some illness and/or be vomiting.

-- I keep a store of anti-emetics, Pepto Bismol, and Tums at home. This hasn't always been the case. I have always been extremely strict with myself about using these things, because I remembered reading that emetophobics could become dependent on them or abuse them to the point of unhealthiness, and I never wanted to allow myself to reach that point. But this past year has not been the best for me, and I have become (slightly) more lenient about it. I also just don't like putting anything out of the ordinary in my body, even something as harmless as Tums.

-- I avoid traveling in general and public transportation. I don't have a problem with motion sickness as far as I can tell, but my anxiety will lead to me feeling "sick" anyway if I am on a boat, plane, or bus. Trains and cars, not as much, depending on the situation and who I am with.

-- I am afraid that if I get a tickle in my throat or have a coughing fit, this could lead to throwing up, so I tend to carry a water bottle with me everywhere I go just in case this happens.

-- I ask my wife at least once a day if I am sick or if I have a fever. Or I will ask her while eating or directly after eating if she thinks the food is likely to make me throw up.

-- When my wife is sick, I don't take care of her. I keep my distance as much as possible. One time when she had a stomach virus, I went to stay with a friend and didn't come back until I was sure she was better and she had decontaminated all our belongings.

I think that's about it. I can't say I diligently stick to any of the behaviors in the above list, because I am always trying to challenge myself when it comes to this. Ever since I realized I had emetophobia, I have tried to keep the momentum of a normal life going, mostly by pushing myself to keep going out places. Keep going to movies, to restaurants, to school or work. My tendency is to want to be home all the time where I'm safer. I currently work from home, which I think has led to me losing some of that momentum. I don't go out enough anymore. But I'm determined to fix this.

Which is the main point of this blog, I suppose. To force myself to do the things I am afraid of doing and then write about how successful I am. There are so many ways I am successful already (some emetophobics can't even speak/write the word "vomit" or watch vomit scenes on TV), and I know I can do even better than I am doing now. Will I ever be completely cured? Most days I think absolutely not. But it's not just "cured" or "not cured," it's an entire spectrum of fear, and reaching the perfect positive end of the spectrum doesn't matter so much to me as long as I am able to function well enough in order to do all the things I want to do in life.