Therapy

Counseling, CBT, whatever. I can't tell you whether I was skeptical or anything before I went because I honestly didn't know what to expect. I thought that the stereotype of a couch and box of tissues on a side table was probably just a big cliche, but that's all the thought I'd put into it.

Apart from, that is, the intense worry, tears, stress induced diarrhea, sickness and panic that I brought upon myself the morning of my first session. I was terrified! Not of dealing with this life-long phobia either, but simply of feeling sick when I go there. I didn't care what horrible memories I had ready to be extracted from my defective mind or whether I would fail in being 'cured' but that simple little thing that maybe I'd be sick when I was there. All over the therapist's lovely floor (I had imagined everything to be brand new, pristine and perfect). Still, I went and dealt with it and became the cliche of a person who has therapy that I had imagined. Going into the room wracked with worry, tense and shaking, coming out smiling and almost skipping down the street.

On the way there was interesting, I saw my old friend's Dad walking down the high street and thought 'how ironic'. This is the friend that I mentioned in my post on Deceber 8th - the manipulative one. Little did I know that this would become the pivotal point of why I have emetophobia in the first place. I wouldn't find that out until the fifth session though.
As I left I walked towards the library to meet my Mum and on the path was a little pile of puke. I walked right past it and didn't give a shit. Something good had happened.

Each Monday I'd go back and start of telling her how I was feeling in that moment. She'd then ask me how my week had been and I'd tell her how it was in terms of anxiety. Usually if something had gone wrong she'd ask something like 'so why do you think you felt like that?' and it would all just come pouring out. Honestly, my first worry was '50 minutes a session is too long, I'll run out of things to say'. I couldn't have been more wrong.

Each week I'd go up to the room, sit down and she'd go and get a glass of water for us each. She showed me where the toilets were and put a door stop in the corridoor so I could run there if I felt sick. Everything was on my terms. The rooms weren't what I'd imagined at all...with stand alone heaters, unmatching furniture and very little decoration. We used a plastic bin to put the tiny alarm clock on and take note of how much time we had left. It might sound a little stark but quite honestly the bareness of the walls and the simplicity was perfect. Cosy even. I took a photo of the children's drawing on the wall when I left as a reminder of how comforting that room was.

Session Five
I'd been noticing how much better my life had been getting and how much more positive I was since I'd started therapy but I wasn't sure we were getting to the heart of anything. My therapist had said she wanted me to figure it out for myself by asking me questions and I was skeptical about that, but it worked.

I started asking myself when the first time I had a bout of sickness and starvation was. It was when I was around 8-9 when that friend had come to stay at my house for the weekend. I dreaded her coming round because she could say 'jump' and I'd say 'how high?'. This was an endless source of amusement to her and she'd make fun of me infront of our school friends, saying she liked something so I'd say 'yes I like it too' and then say 'oh actually I don't like it' so I'd then say 'no I don't either' so she wouldn't hate me. I had to like and dislike the same things as her or she'd turn the entire school against me (no joke, she was the most popular and powerful girl). I can remember days standing int he playground alone because I'd said or done something wrong and having to apologise to her so I'd have some friends again.

Anyway, that weekend she came to stay she wanted to play a game that I can only describe as 'let's make Lucy eat loads of gross stuff and laugh maniacally while she does it'. I can't remember everything that she told me to eat, apart from hamster food and whole peppercorns but by the end of it I felt really ill and totally humiliated. If I hadn't done it I'd have to suffer the consequences at school on Monday and at age 8, I'd no idea how to say 'no'.
Mum took me into town after dropping her off to run some errands and I can remember the sheer terrified panic I felt in the Post Office when I was positive I was going to be sick. For 3/4 days after I ate nothing but a walnut.

So there you are, the reason I have emetophobia and the reason why I feel nauseous every time I have a blow to my confidence. The combination of feeling so lowly and so nauseous somehow got them linked together in my brain. Nowadays if I don't go out and do something to boost my confidence I'll get into a cycle of feeling sick and not going out because of it.

The only difference is that now I know exactly what it is, I can take an adult perspective on it and tell myself that 'there's nothing to worry about anymore'. The days of being manipulated by friends are very much over and I know exactly when to recognise the warning signs of someone starting to control me. My therapist wanted me to remember not to let it happen again and her reasoning was 'you're very keen to please and usually don't mind what happens, letting other people make decisions and you'll go along with the consensus. This is fine until you DO have an opinion or a preference on something and it comes as a huge shock to them. They feel they're losing control of you and try to tighten their grip'. Her advice was then to be more decisive in everyday life, to voice my opinions and say when I do or don't want to do something. Possibly one of the most valuable things ever said to me...

Hello Again

Well it's been three months since I've written here and a lot has happened in terms of emetophobia. At the moment it seems like a little niggle, whereas then it was taking over my life so I'm feeling very positive.

Things like the 3 hour train journey are still hard, but having done it about 10 times now I know I can and I do, every time. The stress of it tires me out but that's a good excuse to have a bath run for me and an early night! That's just about the worst thing about it, if I'm honest.
The plane journey seems very insignificant now, even though it marked a huge step towards my recovery. There were tears in the departure lounge, gritted teeth, shaking hands etc. but in the end I found I was ok. I rather disliked the plan journey there as it was dark and I couldn't see whether we were on our side or going straight. That made me feel a little dizzy and quite sick but as soon as we landed that went away and I realised it was actually probably nerves. I LOVED the flight back, which was early in the morning but light enough to see the clouds whizzing by. I even ate the sandwich we were given and was relaxed enough to enjoy my podcast so that goes to show that once you just go and do something, it gets so much better.

Anyway, I'm rambling. I'll say now that I still have days where I wake up feeling anxious and the whole anxiety - nausea cycle begins. I still carry my bottles of ginger beer, andrews salts, heartburn tablets and little plastic bags everywhere I go but I no longer feel guilty about doing so. I need them to make me feel calm and that's just how I'm dealing with this at the moment. They will go when I feel comfortable without them.

I still have emetophobia and I think that maybe I always will, but it's starting to get more and more insignificant as time goes on. Why? 6 weeks of therapy. This calls for another post...

Fight or Flight

I've had a couple of days writing here because I've travelled to see my boyfriend. The 3 hour train journey went well until the very last 10 minutes when I just desperately wanted to get off and everyone was standing up around me. That was basically claustrophobia and having had 4 hours of stress catching up with me. Overall though, it went very well and I had nothing to worry about. I think another couple of those journeys and I'll be well on the way to getting over my fear of trains :)

That brings me to conquering my next fear. Two fears infact. Firstly next monday there is the doctor's appointment to have a flu jab. Going to the doctor's scares me because of all the people in the waiting room that could be sick, the smell and the intense attention you get from the doctor themselves. I hate that almost 'interview' like setting.

Secondly is the slightly more terrifying prospect of getting on a plane. My boyfriend announced he's taking me for a short Christmas holiday the other day and while I'm desperately excited and certainly not going to pass it up because 'I'm too nervous' I am, in all honesty, shitting a brick.
I've never been on a plane before and the idea of there being absolutely no stops, hundreds of miles up and stuck in a metal room for 90 minutes is just horrible. My boyfriend is going to bring some sleeping tablets for me, but I'm also worried the side effects will be nausea...just what I don't want.

I had a little taster of what I might feel like this morning. Bf and I have both got a bad cold which sometimes makes you feel a little nauseous. This was ok while I was sleepy but when I got up to go to the toilet and get water to relieve it I had a panic and was thinking 'if this is how I feel ont he day we have to fly I'll die of fright'.

I should mention that what I write in here isn't what I am LETTING myself think, but what I'm trying to STOP myself thinking. I try my best to practice positive thinking, telling myself that actually I'm just being silly, that the air hostesses and pilot do that journey several times every day and if they can do it then why can't I? Whether this will work I've no idea but it does ease the panic short-term.

How it's Perceived

Emetophobia is a little embarrassing. After all it is an irrational fear and nobody likes admitting they're being irrational.

What do you reply with when somebody says 'why are you scared of being sick? It's natural and very rarely happens'. Er, yes...I know! What do they think is going through my head when I'm in situations which make me nervous? The answer is this:

"Lucy stop being such a twat. You are not going to be sick, there's nothing you've done that could possibly make you sick, and even if you are then it'll be due to how much you're worrying. Pull yourself together, calm down and you'll feel fine again."

Of course this rarely works on its own.

Anyway I'm straying from the point which I intended...A couple of nights this week I haven't wanted to eat dinner at the same time as everyone else. This has been for a few reasons: firstly I ate lunch too late and simply wasn't hungry at the same time. The next time I felt extremely down, possibly stress, possibly SAD and feeling down usually means not feeling hungry, or even feeling sick. When I feel depressed I worry about where it will lead, which makes me anxious and therefore I feel sick. Also I get so tearful I'm worried I'll cry at the table.

The result of this is that (I think) my family thinks I have an eating disorder. This has happened before when I've gone through a severe bout of anxiety + emetophobia when I ate half a walnut in four days when I was about 8. That was a culmination of being quietly manipulated (bullied if you like) by my supposed best friend, and I blame most of my problems on her. I'm straying again.
The point is that I'm not sure how to convince them I don't have an eating disorder without explaining my emetophobia to them. It's not a matter of 'they won't understand' it's a matter of 'they WILL understand, but they'll worry too much'.

I have told my mum that the shorter days affect my mood and I could be suffering from SAD. Whether I am or not remains to be seen but it's the best explanation I can think of. I just hope she believes me and doesn't continue worrying I have anorexia or something.

Dipping

As is normal when dealing with I condition like this (I guess) I'm having an awful few days. I've felt constantly low, very tearful, lacking in energy and motivation, feeling run down and generally ill. I think I'm over analysing what I'm going to have to go through in dealing with my emetophobia and anxiety, without giving it a chance first. It's awfully difficult to get out of this way of thinking though.

I also haven't left the house in a week. It usually wouldn't bother someone like me, who likes to be inside but it's going a bit over the top to not even step outside in 5 days (or however long it's been, I can't even remember). I'm sure my family must know something is going wrong as I'm not leaving my room and my mum keeps asking why my appetite is so low (when it comes to eating dinner anyway...possibly emetophobia again and having to eat infront of people). She's also noticed how frequently I am ill, which is always something I've dealt with. I think another symptom of long term anxiety and always being run down.

I might try phoning the doctor's tomorrow morning very early and see if I can get an appointment for the same day. I'm fed up of feeling so low.

What I've Done

Now that I've documented what happens and what I intend to do about my incredibly common phobia, I thought I'd write down what I HAVE done, my little habits that I carry out to try and help myself and what I've done to try and get better.

About 14 months ago when I was at university I was in the swing of every other week getting on a train and then on a coach to see my boyfriend for the weekend. One week I'd eaten something that didn't agree with me and I was very nervous about getting on the train for fear of being sick. This went ok and I thought 'I'll get another train rather than the coach as train's have a toilet', yet when I got to the station there was no train, only a coach. This sent me off into a state of panic, along at a busy city train station on a busy platform. I was crying on the phone to my boyfriend, feeling very ill, shaking and not knowing what to do. In the end I just got on the coach and dealt with it but ever since then I've had problems getting on trains and buses, and I've only been on a coach once or twice.

This was when I decided I realised I had a problem and went to see a doctor. He prescribed my a cognitive behavioural therapy (CBT) CD and sent me on my way. It didn't work and because all my housemates had moved out for various reasons, living alone made me paranoid or just about everything and I was too scared to go back.

Since I failed my first year of University I've carried a bottle of ginger beer around with me everywhere (the ginger settles upset stomachs and is commonly used for motion and morning sickness). I usually only drink it when I feel sick or nervous so it's easy to tell when I'm quietly panicking and telling myself I'm fine. It's become a huge comfort and one I will find it extremely hard to live without my bottles of it lying around everywhere.
Also (I can't remember when I started doing this but it wasn't too long ago) I carry little nappy bags around everywhere when I leave the house. You know those scented bags the same size as sandwich ones? This, of course, is so that if I think I will be sick I have somewhere to do it that's contained and won't require anyone to clean it up. I try to not bring these with me sometimes but as soon as I have to do something particularly nervewracking I have to have them again. I understand this is standard practice for an emetophobe, but I'm keen to stop it as I know that it's not doing me any good at all.

I did, once, go into a Tesco without any bag at all (usually I have a huge slouch bag that I take everywhere). I simply had my purse and that was it, and actually I was completely fine! I felt very proud afterwards and I really want to do it again.

When I'm in restaurants I tend to try and sit nearest the door or the toilet. Having to sit in between people is a nightmare but I haven't actually been to a restaurant with anyone but my boyfriend in a long time. He takes me to restaurants to stop me avoiding them and I have actually got a lot better. Last week we went to one in town which was very cramped, I ate until I was very full and didn't go to the toilets once. Usually I'll order whatever I know definitely won't fill me up and have a toilet break halfway through to let it go down. Unlike a lot of emetophobes I will eat meat at restaurants. I don't have a fear of food poisoning and infact getting it would probably be a godsend as it would get me over my fear. My biggest fear is being sick in public, not being sick at home, although I'm sure I would be terrified if it happened.

I feel I've rambled incessantly throughout this post without much point to it. It's also much too lengthy, sorry! Anyway, I DON'T hope you can identify with anything I've said and I hope you don't share any habits with me. They don't help and need to be stopped...hopefully very soon!

I thought I'd try and capture the essence of a nausea/anxiety attack for an emetophobe. I've seen someone do this before and I identified with it quite closely, so perhaps anyone reading this might find comfort int he fact that someone else does the same thing!

Of course something will have to trigger off the attack. That could be anything from simply waking up feeling unwell, having to get up and go somewhere too early (it takes a long time for my stomach to be ready for activity in the morning), having eaten too much or even having eaten too little. The most common trigger for me is the anticipation of going somewhere where it would be very embarrassing to be sick, e.g. a restaurant, lecture, certain shops, a bank etc. and it will start that morning.

I'll try to eat something, otherwise I know I'll feel dizzy and faint later on (which also = nausea), but getting it down is a nightmare. Often I'll have heartburn as my stomach just doesn't want food and I'll have little appetite. Then nearer the time when I have to leave I'll have a feeling of impending doom wash over me. Often this makes my head feel heavy and I get one of those nausea headaches which ties in with neck tension. I'll feel shaky and light headed, yet very jittery and full of energy that I can't expel. That's the anxiety.

Often I'll have to go to the toilet anywhere up to around 6 times before I have to leave (depending on how anxious I am) and I always have diarrhea. This is less of a problem, I can cope with it fine, but it's the relentless nausea which is the problem. It's around now that I'll have the proper attack, usually I'll withdraw somewhere where I can be alone. That might be outside, in my bedroom or in a bathroom; somewhere I know it's ok to be sick. I'll feel myself go pale, usually noticing my pallored hands and nails. I'll sweat and shake, feel very cold but hot inside and take layers off rapidly. All the time feeling as though I am definitely going to be sick any second. I'll fan myself, stand up, sit down, stand up again, stand still waiting to puke, walk to the window for air, heart beating, trying to breathe slowly, etc.

I wonder how many times I've ever done this? It must be well over 20 in my lifetime. Out of all those times I can't think of one where I was actually sick which should prove in my head that wherever I go and whatever I do I will be fine. I know logically that people won't be angry if I'm sick, but my greatest fear is that I am sick infront of another emetophobe. I would feel endlessly guilty and I know I'd ruin their week or even month with worry.

So what happens after these attacks? Maybe I'll 'get out of' whatever was making me nervous by showing someone how ill I feel or that I'm panicking about it. If I go then I'll probably be nervous in the car, have a 2 second nausea attack and then just deal with it. That's when I feel wonderful and feel proud, but it's so much effort.
Once it's all over, or once I know I don't have to go I'll immediately feel very, very tired. After a panic attack like that I can fall asleep in about 2 minutes and even thinking about it is making me want a nap. It certainly requires energy.

People with other phobias besides emetophobia will probably also relate to the feelings I've described. It's all just a flight or fight response which, unfortunately, we still have built into us hundreds of years after it's necessary.