Emetophobia shmemetophobia

I'm back. I have something very important to share. Here it is!

Nobody wants to have bad things happen to them, especially if those bad things involve harm to their body.

Which you know, of course. That's obvious. But there are related implications that I find very reassuring and that really didn't occur to me for years. Once I realized what this truly meant, it became much easier to calm myself down in a variety of triggering situations.

You want to avoid catastrophes, and so does everyone else. So does our society in general. This is why so much of our world is designed to be easy to use for, let's say, those who don't have a lot of common sense or don't think things through. This is why you'll encounter warnings like don't drink this chemical, don't let your child play with this plastic bag, don't stop the chainsaw with your hands, etc.

Not only do we get these warning labels for almost any imaginable danger, we also have more common warnings drilled into our head by the people around us, pretty much from childhood. Don't go swimming during a storm. Don't get in a stranger's car. Everyone learns the general scenarios that could lead to danger, and, depending on their personality, respond with varying levels of caution.

Which brings me to you, unfortunate person with severe anxiety. I am guessing you're extra cautious when confronted with any of those scenarios or warning labels. I am guessing you also have a wide range of scenarios you have decided are dangerous all on your own, without anyone else telling you so (or agreeing with you) and are constantly doing your best to avoid those scenarios or take (most likely unnecessary) steps to make yourself safer.

But remember, nobody wants to have bad things happen to them. Especially if those bad things involve harm to their body. And with regards to whatever you fear, ask yourself: if there was an actual danger of this behavior or situation causing harm to my body, wouldn't I have heard about it before? Wouldn't I have heard or read something, somewhere, about it potentially causing harm?

If eating parts of the apple too close to the stem could cause me to get sick, wouldn't I have heard about that?

If this dental procedure I'm about to go through was likely to make me vomit, wouldn't I have been told that was a possibility?

If watery sour cream or watery yogurt was a sign that it was likely to be bad in some way and give me food poisoning, wouldn't that be one of those things that I was warned about all my life?

Those are just a few of my own personal examples.

I don't know how to stop these little worrying thoughts from popping into my head, as they still do, regularly. But I have found this line of thinking to be an effective countermeasure, a way that I'm often able to dismiss the worry.

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 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.

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.

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.

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.

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.