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.

marriage, emetophobia style

The other day I woke up to this note on our dry erase board:

"FYI - there's a baggie of carrots for you in the fridge, ready to eat. I removed any w/ spots or that were 'funny looking.' I love you!! <3"

I seriously have the best wife ever. I am so lucky to have someone who understands this phobia so well and is willing to offer constant support.
 

emetophobia and high school

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

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

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

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

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

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