in remission

Hello friends. How have the last two years been for you?

I definitely did not intend to stop posting here in such an out of the blue way. Life got very busy, or maybe I should say it's been one giant change after another. I feel like if I put the me who wrote the last post and the current me next to each other, in terms of anxiety, in terms of perspective on life, they would not be recognizable as the same person.

I moved to a new place. I started a new job. I met new people. I had to travel a bit for the job. I had to do public speaking for the job. I had to do a lot of things for the job that forced me to power through intense anxiety, which, as you might expect, has led to me being somewhat desensitized to a lot of situations that used to make me panic (or that I would constantly avoid).

My emetophobia is essentially dormant right now. It's still there, it will always be there, but it's the quietest it's ever been. It basically tells me to avoid sick people and make sure I have clean hands before I eat, and that's about it.

I'm summarizing, because this is a blog, and the actual details could fill a book. At least if I allowed myself to go on as long as I'm naturally inclined to.

But I don't want to give the impression that this muting of my emetophobia happened quickly or easily (or even that healthily). I pushed myself way too hard the past couple years. I powered through way more than I should have, for way too long, and the stress broke me down. I am still experiencing a lot of anxiety (it has just shifted and is currently attached to other things more so than vomit) and depression.

So, as much as I wish I could say this is a perfect success story, that I conquered emetophobia completely and am a role model for anyone still struggling, that is laughably untrue. I'll probably never be free of mental illness; it likes to morph into different forms year to year, but it sticks around.

That being said, emetophobia has been one of those forms for about two decades, and I never thought it would (or could) get to the point of having this little effect on my life.

I remain a walking encyclopedia of tips for coping with emetophobia (this will always be the case, I'm sure), and ... that's all. I'm around. I'm here if anyone needs anything, or if there is something in particular someone wants me to blog about. Email (lilandbody@gmail.com). Or leave a comment. Or contact me through tumblr. Hope everyone is well. Love to you all.

work trip

It’s been a while since I posted. I’ve been spending a lot of time thinking about posting. I finally went on that trip for work, and of course the plan was/is to talk about that – what went well and what didn’t. But it’s now been six weeks since it ended, and I wrote (literally) close to fifty pages in my journal about the experience, and I still feel like I don’t have a firm grasp on what I should or want to take away from the whole thing. The sort of “life lesson” – not that everything in life has to result in a life lesson, but this was so big that it feels like it should have changed me or my life in some fundamental way. Maybe that’s just a fantasy of the chronically anxious – “I did something terrifying and I handled it – aren’t I going to get anything out of it?!”

But nothing is really different, other than the fact that I’m not constantly thinking and worrying about this trip anymore. Which is strange in itself, because it took over my brain for so long. It was all-consuming. Almost every night before I fell asleep, I was going over some aspect of it in my head: imagining what I might say to people, what they might say to me, things I might have to do that I didn’t think I could do, what I’d wear, what I’d eat, how I’d get around, everyone I would have to see, how the flights might go, what the airports would be like, all the many ways things could go wrong. I probably should have attempted to stop obsessing, but it was so comforting, even something I looked forward to on some level. Now that I don’t need to do that anymore, it’s like there’s this giant void in my mind.

And I was prepared for that. I knew that when I no longer had this to dread and/or look forward to, I wouldn’t know what to do with myself. Part of me had been excited about it. It felt meaningful, to be forced by outside circumstances to live and interact with the world to an extreme. To an extent I could never force myself to. Now everything is simple again – calm and quiet, which is nice, but also dull. Time passing and normal routine and no Huge Event looming on the horizon to test my limits. I think if they had suddenly told us at the last minute to forget the whole thing, we weren’t going to do it anymore, I would have been miserable. Incredibly relieved, but also miserable.

In other words, I’m never satisfied. How can you be when you feel two completely opposite things at the same time? It reminds me (again) of what I’ve talked about here before, the connection between anxiety and excitement, between fear and the desire for what you fear. It does seem like the two frequently coexist in me.

I think if the trip had never existed, had never been proposed in the first place, I would be fine. I think I’m happier when my life is calm and quiet and dull. But with the alternative fresh in my mind, it’s very hard for me to let go of the fantasy of having a life that is non-stop excitement, intensity, and stimulation and becoming the type of person who can thrive in a life like that. I’m better off not thinking about it.

Anyway, now I’m home again, and I have all this restless energy left over, and I’ve been trying to direct it towards 1) being more productive at my job 2) writing and submitting poetry.

As for how the trip went, I would say pretty well, overall.

• The closer I got to the trip, the more I felt like the only way I could get through it was to be upfront with people about my anxiety and my limitations. Which I think is a very good idea in theory. Unfortunately, it got a little out of control to the point where I was probably revealing too much (and too quickly, since I was interacting with people who were essentially strangers). Which possibly means that a lot of people I work with now have a skewed idea about just how extreme my anxiety is. And it doesn’t matter that now my mind has settled down again and I’m behaving more normally, because that was their first impression of me, and it’s nearly impossible to correct a first impression.
• Other than that, I felt like the social interaction went better than I had expected. I’m not sure why I feel that way, because I avoided people and I was quiet and when I had to speak, I was almost always panicking that any second I would say something that would somehow ruin my entire life. But I didn’t say anything that ruined my entire life, and other people told me I was coming across as normal (because – see bullet point above – I wouldn’t stop talking about how socially awkward I was), so I’ll count it as a success.
• I had a hard time eating before or during work, which led to me feeling shaky and nauseous most of the time. In the evenings I would eat in my hotel room and feel a little better, then wake up the next morning feeling like shit again.
• Even with feeling sick so much of the time, I did not have any extreme panic attacks and only a couple minor (and short-lived) anxiety attacks.
• I slept better than I thought I would. I woke up early every morning because I was so paranoid that I would sleep through the two different alarms I had set. But it still worked out okay, because I was going to bed early too and didn’t have any trouble falling asleep.
• I was able to concentrate on training. That was one of my biggest worries, that I just wouldn’t be able to focus or retain any of the new information I was supposed to learn, so I was happy that wasn’t the case.
• I work with some incredibly nice people who (many times) went out of their way to make things easier for me. So I’m glad I was more honest about what I wanted/needed than I usually am. I just need more practice navigating the line between ‘self advocacy’ and ‘presenting my entire identity as Anxious Person.’
• There were no major issues with the actual traveling part. I still don’t like flying, especially taking off and landing. But by the time I was flying home I had gotten to the point where I almost felt at ease when we were actually up in the air. 12 flights in about four months, and I finally got a little bit desensitized.
• I’m alive? And still employed? And to my knowledge, I didn’t make anyone hate me. I’m pleased with that outcome.

self-advocacy

So you have anxiety. And that means for every situation you come across that involves other people and triggers that anxiety, you have to choose between two options.

One is that you power through it and endure the anxiety. The other is that you ask to be excused from it or to reach some sort of compromise where you still do it but in a way that is more comfortable for you.

This is also complicated by the fact that you want to get over your anxiety, or improve as much as possible in your ability to live the life you want, which usually involves some level of exposure therapy and challenging yourself. You know you should power through. You know you tend to feel good about yourself when you’re able to.

But that doesn’t mean you should or can force yourself through any triggering experience that comes up. For one thing, exposure therapy is supposed to proceed by gradual steps. It works best that way. Taking a step you’re not ready for can do more harm than good. Also, it’s exhausting. It’s so unbelievably exhausting to confront intense anxiety on a regular basis. If that means an experience comes up that you probably could handle, but you would rather make some adjustments to make it easier on you – solely because you’re tired of having to handle things that are super overwhelming – you shouldn’t be put down for that. It’s not the same as being constantly avoidant. It’s making a choice to be kind to yourself, to let yourself have a break from having to work so hard – in ways that are often not visible to the people around you, so even though you have to hear a lot about the ways in which you’ve failed to live up to the behavior of a non-anxious person, you rarely get any praise for what you do manage to accomplish.

I have such a hard time with self-advocacy. Trying to figure out whether it’s a good idea. Whether it’s okay. How long to cling to my “demands” before letting it go and accepting I’m not going to get what I want.

I don’t trust myself at all. I don’t like advocating for myself. I hate debating. I hate sounding defensive. I hate the thought that I’m being seen as a burden, someone incomprehensible and exasperating that has to be dealt with. I hate acknowledging the minor things I’m trying to avoid, and even more so, I hate the tone of voice the other person almost always gets that makes me feel ridiculous, the tone of voice that says ‘what is wrong with you? how can this possibly be an issue for you?’ I hate having to repeat myself over and over because people don’t listen, don’t take in things that don’t make any sense to them.

I hate the fact that other people are so quick to belittle me in subtle ways that it doesn’t take long at all before I am completely mired in guilt and self-doubt. I start thinking there must be something wrong with me to have even started this conversation. I wonder if I’m doing it to get attention. But I’m not, because I would much rather the person have just agreed to what I wanted from the start without acting like it was a big deal at all. I wonder if I really need what I’m asking for. I usually conclude that I don’t, because I decide I will survive whatever the situation is, even if it’s ten times more miserable than it needs to be. I decide I need to put the other person first, because this is obviously a much bigger sacrifice for them, even though they usually don’t have a full understanding of what I’ll be dealing with, because I’m not forthcoming enough about it. I tend to feel like I talk about my anxiety constantly, too much, and I don’t even think that’s true. For how big a presence it is in my existence, I’m sure I talk about it way less than I would be inclined to if other people didn’t respond the way they did (getting all uncomfortable, implying that I really need to do something about it because it makes me wrong, it makes me not fit in, and it would be good if I could fit in, conform to society’s model of success, etc.).

The whole process is unpleasant and I think there have been times self-advocating has ended up causing me more anxiety and misery than if I had just done the anxiety-producing thing.

Looking back over my entire life, I don’t think I have ever asked for an accommodation that extreme. I have asked for things that should be simple and easy to say yes to. For example, when I refused to do presentations in school. I went to my teachers and I told them I couldn’t do it, and it was fine if that meant they had to give me a zero for the assignment. I didn’t say they had to give me an alternate assignment. Or even imply that they would be a horrible person for failing me (although I do kind of think they were). All I said is that I would prefer failure to giving the presentation, that I was choosing the zero grade. That was my choice to make. And most of the time they were absolutely horrid about it – rolling their eyes or scoffing at me, pretending they didn’t hear me and then calling my name to present anyway (forcing me to go back up to them and insist again that I wouldn’t do it, this time with more people witnessing it), saying over and over again ‘no, you have to’ every time I said I wouldn’t, acting really angry about it for no good reason I could see.

I had one teacher who actually got it. Instead of making me present, he met with me one-on-one and we had an informal conversation about the topic of my presentation. Did this lead to the ruination of my education? No. He gave me a chance to get the grade I deserved, the grade that reflected my understanding of the subject matter. That’s all that happened. He encountered someone with anxiety issues and treated them decently. Shockingly, life went on and tragedy did not ensue.

Anyway, I guess I just wanted to explore my thoughts and feelings on this topic, because I am attempting to ask for accommodations at work. So far, it has not been going well, and as usual, it’s making me feel crappy about myself. And I know I shouldn’t feel that way. I’m not doing anything wrong – even if they end up denying my requests. Even if they get huffy and act like I’m deliberately trying to make their lives harder. Even if there is a part of me that thinks I could manage without what I’m asking for. I’m not a terrible person for wanting to eliminate a tiny fraction of the stress this trip is going to cause.

traveling yet again / exposure

The sick relative that I went to visit at the end of May died earlier this month. It was of course sad but not at all unexpected. She had been sick for a very long time and was continuously getting worse, so at least she is not suffering anymore.

I kind of had this idea that I wouldn’t go back down to Virginia for the funeral, since I don’t share the consensus that funerals provide closure. I had gone to visit her one more time while she was alive, and that was what mattered. I dreaded the thought of having to go through the anxiety of the trip again. But I couldn’t stop thinking about my family, imagining them all going through this awful process without me, and the more I thought about it, the more I realized I didn’t actually find that version of the future believable. It was a weird feeling, knowing I just had to be there. Even though I was still going through my usual indecisive back-and-forth, part of me knew there was only one option and that no matter what ended up happening on the trip, I would be more miserable if I didn’t go. Because I would no longer be the person I want to be (or the person I am?).

So anyway, I went back down there for another long weekend. And this time, I went alone; my wife wasn’t able to go with me. I took a different flight route and went through two airports I had never been to before. I stayed with my family, both to offer support to them and to try to save money and avoid the hassle of a hotel (which was a terrible mistake, and I forgot being around my family for extended periods of time has a horrible effect on me, but whatever). I went to a wake/viewing and funeral, something I had not done since I was 13 (before my intense fear of death developed). I socialized with a ton of people, family and strangers (and family members I hadn’t seen in so long they were essentially strangers). I hung around my young nephews again. All of these things made me nervous and tense, but I didn’t have any panic/anxiety attacks.

When I think back over the past few months, I’m amazed. It doesn’t seem possible that all this has happened, especially in such a short period of time. I am always trying to motivate myself to create an exposure hierarchy and actually stick to it, and I don’t do it - more out of laziness than the fear of it not going well. But life stepped in and did it for me, even proceeding from an easy step (slow-paced planned trip to New York City by train with my wife) to a slightly harder one (fast-paced last minute trip by plane to Virginia with my wife, staying in a hotel) to the most difficult/stressful so far (fast-paced last minute trip by plane to Virginia alone, staying with my family). Throughout all this, the trip I have to take for work (which probably will be the most difficult of all) has been repeatedly postponed and is currently scheduled for mid-September. I definitely feel a lot more prepared for it and confident that I can handle at least some aspects of it, like the traveling.

And it’s not even just that I “handled” all this. Some parts of it gave me such a high. Particularly the last most challenging trip. I feel bad saying that, given the circumstances of why I had to make the trip, but getting on planes and rushing through airports alone trying to find my gate tapped into this part of me I don’t usually acknowledge. The part of me that wishes I was the complete opposite of who I am, someone who exudes confidence and has everything together. It’s really rare, but every once in a while I feel like I am that opposite-of-me person for a little while, and I always, always love it.

It reminds me of this post I wrote a long time ago (see here) about the idea that anxiety is actually a projection of, or in some way related to, the feeling of excitement. I want so much to be able to face any person, any situation, any challenge (and come away from each encounter with the certainty that I succeeded completely) that it makes everything more terrifying. It means so much to me, that fantasy - an unrealistic and probably unhealthy fantasy, I guess - of being perfect and extroverted and effortless and charming. I know I’m never going to be that person, at least not to the extent I want to be, because I can’t change my entire identity/personality. But it’s nice to have those brief moments where I feel like I am coming across that way to the people around me. And it’s also nice to view anxiety as, in some way, an indicator of my dreams and goals and not just as the sick/defective part of me.

improvement

The trip to Virginia was a complete success! I seriously can’t believe how well I handled it, especially with all the phobia “triggers” it included:

• Flying, which leads to worries about motion sickness (something I never have a problem with, but I always worry I will), other people getting motion sickness, and catching some illness from someone on the plane.
• Socializing frequently with people who may or may not be sick. I was only hanging out with my family, and they don’t know and/or understand and/or care about my phobia (we don’t really talk about anything emotional, so I am unsure who knows/understands what). So I could not rely on them to look out for me by warning me that they were sick or had been sick recently. It seemed like one of them might have a cold, so that was a little stressful, but nothing came of it. For all I know, it was allergies.
• Spending a lot of time in a hospital. I was mainly there to visit a relative who has cancer, so I was in the hospital with them for a few hours each day. I knew I couldn’t catch the diseases of the people around me, but I still felt “contaminated” by germs. Even hugging my sick relative felt unsafe, but I did it anyway. My parents tried to harass me into eating in the hospital cafeteria, but that was something I could not bring myself to do.
• Hanging out with my very young nephews, a one year old and a four year old. This probably stressed me out even more than the hospital. They were all over me, and the one year old even put his hand right on my lips as soon as I walked in the door. Plus they unpredictably cough on you, and every time they eat, I can’t stop thinking about how they don’t know the limits of what they can consume without being ill. On the other hand, they are so adorable and sweet, and I really had a great time with them. I hadn’t met the one year old yet, and I hadn’t seen the four year old since he was a baby, so he didn’t remember me and was excited to “meet” me and show me all his books.
• Spending long stretches of time away from my wife and my “safe space” (usually home, but in this case the hotel room). I would leave in the mornings and hang out with my family most of the day, not getting back to the hotel until the evening. I don’t spend that much time out in public by myself anymore (since I started working from home). Usually when I’m out somewhere for a whole day, my wife is with me.
• Eating while on vacation. This didn’t go quite as well as it did in New York City, because I avoided eating while around my family. But during the times it was just me and my wife, I was completely fine and able to eat normally. We bought a few safe snacks from a grocery store to keep in the hotel room just in case, but we didn’t even eat most of them. We mostly went out, and I got to have all the delicious food I have missed from my hometown that I hadn’t had in SIX YEARS, because when we went down there in 2011 I could barely eat anything.

I didn’t have any panic attacks or intense episodes of feeling “sick”. No feeling dizzy or crappy because I couldn’t eat. No having to cancel plans because of that. No inability to sleep. And not that much holding back from what I wanted/needed to do. I’m so glad that I went and was able to offer some support to my sick relative and the rest of my family.

Compare this to the way the trip went in 2011 (see post here), and I’m amazed at how much has changed in four years. And I wasn’t even aware of it! It’s so weird to have actual strong evidence that all the work I’ve put into getting better has actually gotten me somewhere. I have often felt like I’m not doing enough, but it has helped so much anyway. I think it helped just to make the commitment to learn to think a different way, because now, even when I lapse into old negative thought patterns, there is that sense that I am doing something wrong which leads to the motivation to get back on track.

It also helps that I take better care of myself physically now, specifically when it comes to eating habits. Trying to eat healthier, plus forcing myself as much as possible to eat regularly, on a normal schedule, has cut down on instances of feeling “sick” so much, and that of course means I don’t get anxious as frequently. Seriously. My stomach used to hurt all the time from going long periods of time without eating, and I just kept telling myself it was better and it was safer not to eat, that not eating had to lead to less stomach pain, or would ensure I was safe from getting sick even if I felt stomach pain. The reality is that it made me feel terrible, and then I wondered why I felt terrible all the time and experienced near constant anxiety because of it.

So I’m super pleased. If I can take trips without having some kind of meltdown, even when they are stressful or short or last-minute trips, that would be such an incredible improvement to my life. I want to be able to travel. My dream of eventually getting to Europe is seeming much more within my reach.

recap of NYC trip

I am home again - for the next week or so. First trip of the month completed, and it went really well. It went so well it was shocking and a little disorienting. Because one of the many downfalls of anxiety for me is that when I expect to have horrible anxiety during something and I don’t, it makes me feel strangely lost. I started feeling like I didn’t know myself, and then I started thinking really irrational things like “wait, do I even have anxiety problems? have I been exaggerating all this time? were all those terrible things I went through over the past few years lies?” And of course they weren’t - how could they have been? That doesn’t make any sense. I wish my mind didn’t only think in extremes.

The trip wasn’t perfect. I did experience some anxiety, but mostly in the realm of mentally obsessing over germs/contamination, which I see as better than intense emotional anxiety or physical symptoms like nausea. I was very aware all the time of the dirty things I was coming in contact with - cabs, public restrooms, train stations, etc. I’m used to feeling like my environment is very sanitized and I had to lower my standards and just try to get over the fact that I was not going to feel like things were clean enough for a week.

I had some trouble sleeping (thanks in large part to the hotel bed being incredibly uncomfortable). And there was one morning where I did feel really nauseous for a few hours and started to freak out. But I managed to calm myself down and decided I would relax in the hotel that morning instead of going out like I had planned. By the afternoon I felt fine again and we resumed our wandering through the city.

Not bad at all, considering what happened last time. I did not spend a night in the bathtub. I did not ever feel like I was going to legitimately lose my sanity.

But the biggest accomplishment is that I ate a normal amount for practically the entire trip. I don’t know if I have ever managed to do that before on a long trip like this. And that may be the main reason why the trip went so well, because when I don’t eat, it makes me feel terrible, and that makes my anxiety worse. Once that cycle starts, it’s hard to stop it.

All of this should probably make me feel more optimistic about the Virginia trip, but it doesn’t really. My stomach still feels like it’s dropping into my feet every time I think about it. I try to tell myself that since I was able to eat well in NYC, I should be able to do the same in Virginia, but then I think I can’t really compare the two. Virginia is going to be a lot more fast-paced and will involve tons of situations outside my comfort zone, and lots of social interaction, and I won’t feel as in control of any of it. I can’t exactly decide to take a morning off in the middle to regain my composure.

I talked to my boss about the social events, and she was really nice about it and said I could skip them if I felt like I couldn’t handle them, but she wanted me to be open to attempting to go to them, because it would be such a good opportunity to interact with everyone. So I guess I am going to try, at least for the first “welcome” event. I’m starting to wonder if it would just call more attention to me to skip them anyway. I don’t know. What’s more embarrassing, being noticeably absent from every social event, or going to them and being super nervous and maybe not being able to eat and having to come up with some excuse for why you’re not eating? I really can’t decide.

traveling

I keep trying to motivate myself to blog about the next chapter, but I think I’m going to have to accept the fact that CYEAT posts are going to be on hold until early to mid May. Because I can’t think about anything but the two week-long trips I am taking this month. So I’m going to write about that instead.

I mentioned in here a while back that my bosses want me to travel to Virginia for a week of training. It was originally supposed to be sometime last fall or winter, but it kept getting delayed. Now it’s finally happening, during the last week of this month.

Which is about the worst timing ever, because my wife and I also planned a week-long trip to NYC that starts at the end of this week and goes into next week. That trip alone was already stressing me out, and that’s going to be the easier one. The one where my wife is with me and we go at a slow pace and she makes sure I don’t get too overwhelmed.

No matter how carefully we navigate it, I know I will experience a lot of anxiety and it will really wear me out. And now I’m going to get back from that trip, have about a week and a half to relax and get back to homeostasis, and then have to leave for the training trip, which will be a thousand times harder. And I’m pretty sure I’ll be spending most of that in-between time obsessing over the second trip rather than relaxing. I already can’t stop obsessing about the second trip even though right now I should be preparing for the first one.

There are, I guess, three major concerns I keep going over:

- The actual traveling part. I hate flying. I hate all public transportation. We’re taking a train to NYC and that’s a little easier for me, but taking a train to Virginia could potentially take a full day (or night) and I don’t want that. So I figure I will suck it up and do the plane. But I have only flown alone once before, and it was in 2007. Pre-breakdown. I honestly have no memory of how I managed it. Everything seems so much harder now. So I will have to fly and navigate an airport, because of course there will be a layover, possibly more than one. Then once I get there, my boss has arranged that the hotel shuttle will take me back and forth to the work building. Screw that. I will probably rent my own car so I can have control over my coming and going. Oh, and also, as of right now, I can’t find a good flight connection, which may mean I will have to fly into an airport in a city a couple hours away and then figure out how to get to my destination from there. And I am not comfortable driving on the interstate. The only solution I can come up with so far is that my mother picks me up (and drops me off again at the end of the trip) because she lives nearby. But I’m not loving that idea either.

- Eating, drinking, sleeping. Any time I get really stressed out, I start doing all of these things less. This always happens to me on trips. I don’t feel well, so I don’t eat or drink as much. I get super dehydrated. My blood sugar is low all the time. I feel weak and shaky and sick and weird. Everything around me feels kind of surreal. But if I try to force myself to eat and drink more, that makes me feel nauseous, especially if I am trying to eat around other people or if I attempt to eat anything that isn’t completely bland. And it starts to feel almost physically impossible, since I have no appetite. After a day or so of that, I’m exhausted and it feels like an ordeal even to get out of bed. But I’ll have to get out of bed, go to work, focus on training, and socially interact with people. I’m thinking I will probably plan out every single thing I’m going to eat in advance and try to stick to that meal plan as much as possible, but I’m not sure how successful I will be.

- The social interaction. I’m not around people much anymore, and it’s honestly a huge relief most of the time, because I have a very strong desire to appear perfect to everyone around me combined with an inability to stop being horribly awkward. Which I think usually comes across as me being rude rather than scared (ignoring people, nervously laughing at things I shouldn’t laugh at, blank stares, sarcasm, and general stoicism). My boss has planned five socializing meals for us to attend. They all sound terrifying. It sounds like a few will involve large groups of people, including many people I have communicated with for several years but who have never met me face to face, so they will probably want to meet me face to face, and it’s too much to even think about. It is my goal to get out of every single one of those. Especially because three of them are lunches on training days, and if I go to those and am not able to eat, I don’t know how I will make it through the afternoons.

Also, I have no way of knowing how many panic attacks I’m going to have while I’m around my coworkers. It’s funny, because I used to work in the building with them, so it’s not like I haven’t dealt with that before. I have had anxiety attacks during one-on-one face-to-face meetings with my boss and been able to hide it. So it’s likely I’ll still be able to hide it pretty well. But part of me worries. I’m out of practice. And then of course there’s the fact that I don’t want to have anxiety attacks, whether I can hide them well or not, because they are miserable and further contribute to me feeling completely exhausted and out of it. But I don’t think I’m going to be able to avoid that. I’m guessing I will have them during the training sessions, when I feel most obligated to be composed and focused, when I know it would be bad for me to leave the room because that is after all what I’m there for. To try to learn something in the midst of all this insanity.

I probably should have fought harder to get out of this trip. I did try to get out of it, but it was a pathetic attempt, because I get too embarrassed to lay out exactly how bad it’s going to be. And I get scared thinking “am I really going to bail on something else? am I seriously going to be this person all my life?” I want to be able to do things. This particular thing feels way out of my reach, but I don’t know. Maybe it won’t be as bad as I’m imagining. I just have to do it. I have to do it, because it’s even harder to handle the thought of saying ‘no, absolutely not, you have no idea what this is going to do to me.’ And part of me worries I would end up getting fired.

I have internalized so much mental health stigma and it makes me feel guilty to even be saying some of this, because I believe people should push back more in these situations and advocate for themselves. I just feel like I can’t do it anymore. I have done it so many times and gotten so many horrible reactions. I had teachers in high school who literally made me cry because they were so mean to me for refusing to give class presentations, even though I told them I didn’t mind taking a zero for the assignment. Wouldn’t it be nice if the automatic reaction was to say ‘that’s fine, there are of course perfectly valid alternatives to presentations (or intense week-long out of state training sessions) and this doesn’t make you a lesser person at all‘? I think society is heading more in that direction, but it’s taking a long time.

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.

CYEAT: Chapter 6

This is a short chapter and seems kind of like a recap or intermission to me - reflecting on the last few chapters and hinting at what's to come.

You are reminded of the three underlying issues for emetophobia: external locus of control, low self-esteem, and social anxiety. The rest of the chapter explains how each one of these three negatively affects the other two (and gives examples).

If you have an external locus of control, it's going to lead to you having lower self-esteem and more social anxiety. If your self-esteem lowers, you're going to have more social anxiety and your locus of control will become more external. If your social anxiety increases, it will lower your self-esteem and again make your locus of control more external.

That's the bad news. The good news is that the same goes for moving in a positive direction. If you improve with any one of these three, it will lead to improvement with the other two. So you don't have to tackle fixing all three at once because even focusing on just one, you can't help but have an effect on the others at the same time.

Which is awesome and very hope-inspiring. I'm looking forward to the development of this idea and more specific tips on improving in the three areas.

CYEAT: Chapter 5

This chapter talks about the social anxiety component of emetophobia. It goes into what social anxiety is, how it manifests, why everyone has social anxiety to a degree, how the amount of social anxiety your parents have influences how much you will have, etc.

There is a quiz to measure how high your social anxiety is. I got an 85 out of 100, although I felt it was kind of unnecessary to take it. I already know I have terrible social anxiety. There are times I think my social anxiety has a worse effect on my life than my emetophobia. And I know they are connected, because as terrified as I am at the thought of getting sick in general, I am way more terrified by the thought of getting sick in front of other people. This includes my wife. I've never been able to decide how I would handle getting sick at home if she was around, because the emetophobic part of me would want her to stay, but the socially anxious part would want her to leave and go far, far away. I feel like the socially anxious part would probably win.

This is why I'm much more likely to have an emetophobia-related anxiety attack when I'm out in public. There is that added component of it feeling like the wrong / inappropriate place and fearing everyone will judge me or hate me.

So I agree, I definitely think the two issues are strongly linked. But this chapter was a let down for me. It's a lot of information I already knew, and the only advice given on how to deal with social anxiety is to notice when you are feeling it and challenge the thoughts - tell yourself you don't need to feel anxious and that you can handle the situation. I know it's good to challenge your thoughts and tell yourself positive things, but to me, this is presented way too simplistically in this case. It sounds like it boils down to "Feeling socially anxious? Well, don't. You don't need to, so tell yourself that and stop!" When I am out walking alone and feeling terrified at the thought of the cars driving by and the people inside them looking at me, I am well aware this is irrational and I can handle the situation. Reminding myself of this doesn't stop the pattern of feeling anxious, hating it, and avoiding walking alone.

The author hints you will get better at challenging negative thoughts by the end of the book, so I'm hoping there is more to come that will help in this area. In the meantime, there are a lot of helpful tips for coping with social anxiety online. Helpguide.org is one of my favorite sites. I feel like they always do a great job covering issues and various treatments - this is their page on social anxiety.

catching up

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

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

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

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

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

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

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. 

some analysis

**Just a quick warning. I went into some detail about the act of vomiting in the post below (not in the sense of a personal anecdote, just in the sense of dissecting the act).**

It's still really cold and snowy/icy where I live, and I haven't been leaving the house much, so things have been calm. I did see the movie Frozen (it was amazing) and had my usual movie theater experience of feeling "sick" and anxious for about half the film. I was enjoying the movie so much that I kept ignoring my strong impulses to leave because I didn't want to miss a single second. What's funny is that I was incredibly distracted by my worrying and didn't even realize it at the time. I got the gist of what was happening, but when I re-watched the movie later at home, there were so many lines of dialogue and song lyrics I hadn't fully heard the first time - little details that made me love the movie even more.

Other than that incident, I've been doing really well. I'm pretty sure that's the only time in the past month my phobia has been an issue.

I've been thinking about how weird this fear is. Here's what I think is the strangest thing about it: it seems (to me at least) that vomiting would be less terrifying to me if you were to take away any of the individual components that make up the act.

I don't think I'm alone in this. I've seen other people online say things like "if there was no nausea, I could handle it" or "if it didn't taste bad, I wouldn't care that much." We could all be wrong, since there is no way to test these theories, but it's fascinating to me thinking about all the ways the act of vomiting could be slightly different and how any one of those alternatives seems better than what we have in reality.

What if it came out of a different part of our body than our mouths? That seems like it'd be fine. How bad could that be, if it came out of the foot or the elbow? In fact, that scenario would rid us of other components too - the taste and the feeling or fear of choking.

What if it all happened exactly the same except that there was no unpleasant feeling of nausea right before? That doesn't sound so bad either. None of that awful sensation of the sick feeling building up, getting worse and worse.

What if it was completely controllable? If you knew without a doubt you could decide when and where it happened? This is the one I would vote for. I think most of all I hate the idea of the suddenness or surprise of it, and how little control I have over it.

Somewhat related - what if you couldn't have complete control over it, but you did get a clear unambiguous warning sign at least a few hours in advance? Something like the tips of your fingers turning blue, where then you would know there was no going back. A little scary, but at least then you could start planning your next steps. None of that back and forth "will I, won't I, is this in my head?" crap.

What if it always tasted really delicious, like chocolate? I'm unsure of how I feel about this one. I'm not convinced it would lessen my fear that much, but I've seen other people say they think this would work for them.

What if it was all the same, but there was absolutely no social embarrassment that came along with it? I am always afraid of it happening, even when I am alone at home, but I am much more afraid of the idea of doing it in front of other people. If there was no social stigma, no reaction of disgust, or if people reacted to it as calmly as they react when someone sneezes, I think I would be much less bothered in general. Along the same lines, what if it wasn't indicative of something bad happening inside your body? Obviously this is why the social disgust exists, because people know you could have some illness and instinctively want to protect themselves. If it was just something that happened occasionally (like a cat's hairballs?) and wasn't a warning sign that you were sick, extremely drunk, or had some kind of food poisoning, I don't think it could be as big a deal to anyone, either the person experiencing it or the onlookers.

In a way, I find it comforting to take it apart like this and see that it's something that is made up of many horrible things, and it's the combination of all of those parts that makes it so overwhelming and scary. I don't know why. I feel like there is some bit of hope or wisdom to be found in this thought process, but I'm not sure what it is yet.

warped tour!

Last weekend I went to the Warped Tour music festival for the first time ever. It's a pretty intense event and I imagine it'd be intimidating for anyone with anxiety issues. With my blend of emetophobia and social anxiety, I considered it a major accomplishment that I even made it inside the festival. Before it opens, a line forms outside that is not really a line at all, but more a gigantic chaotic blob of people moving every which way. It was the biggest crowd I'd been part of in a long time. I was lucky to have two feet of personal space in any direction. As it got closer to the opening time, it was more like half a foot as everyone started pushing forward and compressing.

Also during this wait, lesser-known bands were walking through the crowd asking people in line to listen to their music and buy their CD/mp3. Which meant having to talk to people I didn't know and use headphones that tons of other people had been wearing before me. 

Aside from the stress of interacting with the people, it was insanely hot, which was my main worry emetophobia-wise. I was very concerned that the heat would make me sick. I rarely spend that much time in the sun, and it was 80-90 degrees. I only had one bottle of water that I was trying to conserve while waiting in the line, but then the event workers made me pour it out on the way inside (only one water bottle is allowed, but it must be sealed if you want to take it in). Basically, they want you to buy the drinks and food they are selling inside that is mega-expensive. But at least their drinks are packed in ice, so I was happy when I bought my new water bottle. I could hold it against my neck and get some relief from the heat.

Even though there was a lot more space inside the festival, it was still super crowded with people everywhere. Bands were playing all over the place, so loudly that I could feel the beat in my stomach, which made me worry for a moment that this would cause me to feel sick or panic. But with all this going on, I managed to keep it together and felt really calm the entire time I was there.

I only stayed about two or three hours, because it was just too hot and after a while I felt like I couldn't stand it anymore. I was all sweaty and sunburned (I wore sunscreen but didn't put enough on my face/neck) and started to feel dizzy, probably from hunger and dehydration. They don't let you leave and then come back, so I knew that if I stayed for most of the event, I would have to eat and drink while there. But still I let the habits of my anxiety take over and avoided anything but water, partially because I was afraid of getting or feeling sick and partially because I didn't want to use the public restrooms that were constantly packed with people. I'm sure this contributed to the dizziness/exhaustion I felt after a while that prompted me to leave much sooner than I would have wanted.

Still, I'm thrilled that I went and was able to have a good time for the most part. I can hardly believe how chill I was, especially considering how nervous I had been in the hours, days, weeks before I went. I had been obsessing about this for so long and feeling like I probably couldn't handle it at all.

But as I said in my post last month, I am trying to say yes to whatever comes along and to try things, even if I think they won't go well. There were many times I desperately wanted to back out of going. I was able to get through this because I kept saying to myself "maybe I won't be able to handle the whole event, but I can at least do this next small step." When I thought about calling it off in the days before I left, I told myself there was no need to make that decision yet. When I thought about turning the car around and driving back home while heading to the event (which was about three hours away), I told myself I would at least make the drive, and I could always turn around once I got there. When I thought about walking away when I saw that giant crowd of people standing in line, fanning themselves, I told myself I could at least try joining them and see how long I could deal with that. On and on, until I was inside actually enjoying myself.

Plus, now that it's over and I have a clearer idea of what it's like, I imagine I'll be able to handle it even better if I go again next year. I will definitely make sure to eat and drink more so that I have more energy and can stay longer, enjoy more bands.

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.     

dentist anxiety

I had to go to the dentist today to get some filling work done. They gave me a tiny partial filling in one tooth, and they also removed a filling I got when I was a child (one of those old mercury ones) and replaced it with the upgraded version.

I'm surprised at how anxious I was. This procedure was nothing compared to the wisdom teeth extraction, but for some reason I had lower anxiety during that one. Maybe just because I had lower anxiety in general back then.

I wish I was more comfortable talking to people (like dentists, doctors) about my phobia. I always think to myself that maybe I should give some brief explanation before they do whatever they're going to do, but I usually chicken out. They see I'm anxious, but they assume it's because of the pain, so that's what they reassure me about. I don't worry about the pain that much. I worry about all the objects and substances being shoved in my mouth, especially the substances. I worry about my mouth being numb. I also don't like being horizontal while they're doing all this, and I really hate it when they adjust the chair to the point where my head is lower than the rest of my body. It's awful to feel like you're upside down when you're anxious.

There were all these nasty tastes in my mouth after a while, and I could feel myself getting very scared. I was starting to feel "sick" and could feel my heart pounding in my stomach. Sometimes (here being a good example) I'm almost grateful for my social anxiety, because I fear that without it I would be much more likely to escape situations, to sit up right in the middle of my filling and say "okay, I'm done here." But I don't want to embarrass myself, so I search around desperately for things to tell myself to make myself stay, like:

• They do this procedure all the time. They can't possibly expect that whatever they are putting in my mouth would cause nausea/vomiting. If they did, they would have something ready in case of that happening. They would have warned me.
• My heart is pounding. This is clearly anxiety. Don't forget to keep breathing, slowly and calmly.
• Even if I did vomit, it's not as though this is a normal public place, like a mall. It's like a doctor's office. I wouldn't have to feel as humiliated about it here.

If I can visualize my mouth as disconnected from the rest of my body, it's easier. All the numbness and drilling and other stuff is going on there, not anywhere else. I can use my nose for breathing. I don't have to swallow. I just pretend it's not a part of me, or at least not a part that I need for the moment.

The procedure only took about fifteen minutes. When I sat up at the end, I discovered I was really shaky, so walking out to the car felt weird. Also, once I started driving, I started feeling even more "sick" and had to pull into a parking lot and sit for ten minutes to calm down. I had a bottle of water and probably would have felt better if I had rinsed out my mouth, but there's the downside of the social anxiety. I couldn't talk myself into doing that where other people could possibly see me. So I just took sips of the water instead, which helped a lot. Every time I swallowed a little water, the sick feeling went away temporarily, so I started driving again and kept taking sips all the way home. By the time I got there, I was feeling better.

I know I should be proud of myself for getting through it. I won't have to worry about it anymore, and it's nice to know I no longer have mercury in my mouth. But man. Right now I just feel wiped out. Anxiety is exhausting.

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.