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.

planning is good

I had a not-fun experience at the end of February / beginning of March. My wife came down with a stomach bug. That hadn’t happened since November 2006. Wow, almost a decade. Back then we were in college and living in a tiny dorm room together. I moved out for a week and stayed with a (wonderfully kind) friend who had a single dorm room.

After college ended, I was always wondering what I would do if it happened again, because I didn’t have any close friends who lived nearby anymore and would be willing to take me in. There were so many times I thought to myself, ‘I should have a plan. I should know exactly what I’m going to do and where I’m going to go. I should have an emergency bag packed and stashed somewhere.’ But of course, I never packed that bag or made that plan. That would have required facing up to the fact that this could actually happen.

So I was not prepared. But everything still worked out okay, better than last time even.

She warned me early in the day that she was not feeling well and didn’t know why, and she said I should feel free to go. I immediately left and spent several hours driving around in circles, sometimes stopping in a parking lot to text her and see what was happening. There were no developments for a while, and I finally drove back home and was thinking about going back inside. But then she texted me that she had just gotten sick and not to come in.

I had of course been really anxious this entire time, but there had been a part of me that thought maybe I was being irrational, overcautious. So it kind of surprised me to get that confirmation that this was really happening. My anxiety shot up to panic level; I suddenly got freezing cold and started shaking. And I didn’t know what to do.

It was a Sunday, meaning I had to work the next day. So I texted her that I was going to need to come in and grab some things before I left. She said she would stay in the bathroom while I was in there, but I was still incredibly nervous the entire time, thinking she might get sick again and I would hear it. Luckily, that didn’t happen. I grabbed my work computer/bag, wires and chargers, Kindle, and an extra book. I was trying to hold my breath the entire time.

I obviously couldn’t go in the bathroom, and I also felt like nothing in the kitchen or bedroom would be safe, so I had no other supplies. No clothes. No toothbrush or any other bathroom supplies. No food. See, this is why a bag packed in advance might have helped. At least with the clothing situation.

First thing I did was call a hotel nearby, and thankfully, they had an available room. They asked how long I’d be staying, and I didn’t know what to say. I said one night, but I might be extending it. They said that was okay, because they weren’t busy.

Next I had to go out and buy all the things I needed that I had not brought with me. Another fortunate coincidence; I happened to have a Walmart gift card in my wallet that had been sitting there for years (because I don’t usually shop at Walmart), and I had been on the verge of donating it. So I used that, and it helped cut down on the cost.

Once I was settled in the hotel, I was generally okay. I was worried in the back of my mind that I might be sick, and I was always thinking about contamination, so I’m sure that resulted in a lot of strange behavior. But emotionally, I was good. No more moments of panic. The hotel had good WiFi, and I was able to work normally; I didn’t have to take any time off.

I checked into the hotel Sunday night. I checked out and went back home Wednesday morning. Which, now that I think about it, seems like an amazingly short period of time. But it was mostly because of money. Even though I technically could have afforded staying in the hotel for a week, it would not have been a wise financial decision.

I was kind of a mess the first day back at home in terms of contamination worries. Not wanting to move, not wanting to touch anything. It was another work day, so at least I had that to distract me part of the day. And I avoided my wife for several more days. I think I slept on the couch for at least another week.

As ridiculous as all this sounds, it is much better than I handled it in 2006. Hopefully this won’t happen again for another decade. I mean, really, I hope it never happens, but I know better than to expect that.

I still haven’t put together an emergency bag. It feels like jinxing myself, which is obviously not true, and it’s a terrible response (or lack of response). Yes, things worked out pretty well this time, but that was largely due to lucky circumstances (including the fact that I’m lucky to have enough money to be able to make these terrible choices). Avoiding making plans changes nothing, except that I will probably (again) end up in a situation where I’m stuck and have to run around frantically and spend more money than I would have had to. So yeah. I need to stop living in denial and get this done. Be responsible and prepared.

reduce anxiety, save the planet!

One of my new year’s resolutions was to be more environmentally friendly. It is kind of a three-part resolution actually, but it all ties together: 1) I am systematically working my way through my apartment, donating or throwing out objects I never use or don’t need (generating trash is not environmentally friendly, but this stuff I never touch is essentially trash anyway – just sitting in my home instead of at the dump); 2) I am buying less new stuff, making sure to only buy what I need, and to buy digital if at all possible – with the double positive result of less junk filling up the apartment (which helps me) and less consumerism (which helps the environment); 3) I am taking whatever other steps I can to reduce my impact on the environment. For example, I finally bought reusable tote bags for shopping, and I have been attempting to reduce the amount of junk mail I get by contacting the places sending the junk mail and asking them to stop (I’m not convinced I’m succeeding yet, but I’m new to the process).

All this has led to me realizing how many of my environmentally harmful habits are related to my anxiety issues:

• Excessive water usage. I am fanatical about avoiding or killing germs, so I take longer showers than I need to. They are probably around 20 minutes, and I’d like to get them below 10 minutes at least. Even worse, I wash my hands way more frequently than is necessary. I got out of bed about 3 hours ago and have already washed them 7 times, and it’s not like I was doing dirty manual labor, intensive messy cooking, or anything apart from my ordinary Sunday morning routine of eating, hanging out, online browsing, writing. I honestly didn’t even bother adding “wash hands less” to my list of mini-goals, because I don’t think I’m ready for that one yet. I already think a lot about ways I can rearrange what I’m doing to cut out one or two of the hand-washes, but beyond that I don’t see how I can stop washing them when I feel it’s absolutely needed – which, due to emetophobia, is unfortunately pretty often. It is my intention to tackle shorter showers though.
  
• Excessive paper towel usage. This is related to the water usage, because once I’ve washed my hands for the purpose of preparing/touching food I’m going to eat, it feels like the only way they remain perfectly clean is if I dry them with a disposable paper towel (as opposed to a reusable dish towel).
  
• Drinking bottled water. Tap water scares me, even though I know that makes no sense – especially because I will have it if I go out to a restaurant, but I’m never willing to drink it at home. There was a brief period of time (a few months, maybe) I tried using a water filter, the kind that attaches directly to the faucet, but then it broke. Other than that, it’s been bottled water for about a decade straight. Which is so horrible for the environment, and that one is definitely on my list to change this year. I think I’m going to try one of those water filter pitchers instead of the faucet type.
  
• Using disposable bowls and silverware. I loathe doing dishes because I never feel like I am getting the dishes clean enough which leads to spending a frustrating amount of soap, water, paper towels, and time on each one – I will spend at least five minutes agonizing over a bowl that might take someone else a minute to wash. Plus sponges disturb me as much as reusable dish towels. And I am extremely neurotic about my skin coming in contact with ‘food residue’. I don’t know for sure if this is related to emetophobia, but I feel like it must be. This ‘food residue’ anxiety also leads to more hand-washing, because even if a food I ate is not particularly messy/crumby, I can’t stand the thought that the food is still on my hands. If I ate a sandwich and I can smell bread on my fingers, that drives me crazy. I don’t think other people even notice this. Anyway, that is another of my goals for this year – get back to using real cookware.
  
• Wasting food. I’ve talked about this one before. I have serious food anxiety and if my food looks weird to me, my impulse is to toss it. This mostly applies to fruits and vegetables, because they don’t have one consistent way they “should” look (as opposed to pre-packaged food that will tend to look exactly the same every time you eat it), but it can apply to anything – if I open a container of sour cream, and it’s especially watery, that might freak me out enough to throw it away. And I don’t have consistent rules about what is unacceptable; it depends on the day, on my anxiety levels at that particular time. So how quickly I give up on a food and what I consider to be unsafe can vary. When it comes to three different apples with basically the same blemish, on one day I might think ‘okay, that’s fine, I know it’s still edible’; on another, I’ll think ‘I’ll cut that part off, but the rest will be fine’; on another day, I will feel like I can’t deal with it at all and throw it away. Another way I waste food is by taking food offered to me in public – at work gatherings, family picnics, etc. – that I know I am not going to eat, just so I don’t call attention to myself, and then throwing most or all of it away. I think I’ve already improved in both of these areas and want to continue to do so. I try to force myself whenever possible to eat the ‘weird-looking’ food, and nothing bad has happened to me. And there have been social occasions in the past year where I’ve simply refused food; yes, it’s awkward, but not the end of the world.
  
• Wasting resources in general. There are some things I just replace on a regular basis rather than clean, because they seem so gross and germy to me – like bathroom mats and toilet seat covers. I also have (germ-related) anxiety about buying used objects, whether online or in thrift stores or at garage sales, or even accepting something a friend is getting rid of and wants to know if we need. Since I’m trying to consume fewer resources, both of these will have to change. It’s better to keep using something that already exists in the world than contribute to creating more demand for brand new items.

I always find it really interesting to see all the links that can exist between anxiety and something that at first seems completely unrelated to it. Working on my anxiety – in particular, trying to cut down on irrational anxiety-related behaviors – will not only impact my personal happiness and ability to function, but could actually help the world. And vice versa – trying to help the world can (hopefully) force me to become more comfortable with situations that currently make me anxious. That’s awesome and extremely motivating – for both goals!

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.

exposure / limits

Some thoughts I had in response to this post on tumblr:


Love this. Super relevant to emetophobia and anxiety in general. I know it seems like every time you push yourself it has to go really well or else what was the point, but that’s not true. These experiences are still helping you recover and figure things out. If you think you can handle something and it turns out to be too much and causes an anxiety reaction, you will still survive it, and then you will know you need to take a smaller step first. Exposure isn’t an exact science; you won’t always get it right.

Also, sometimes when you have been anxious so long and have avoided everything, you’re not even sure what you like to do and what you don’t like to do. You could end up at an event where you’re not anxious, but you’re also not having a great time, and that doesn’t mean you made a horrible mistake. You could end up going to the movies several times and then realize ‘hey, I haven’t only been avoiding movies because of anxiety. I also find them really boring.’ It makes sense that you wouldn’t have known this before, because with an anxiety disorder you have this extra layer of fear obscuring your feelings. You have to work through the fear, and sometimes that means doing the same thing a few times until you are less anxious and can experience your true reaction.

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.