It's coming up to the end of June and just like everything else, whether we have kids in school or not, we tend to think of this time as an "ending" time. The good news is that many of my clients have now come to the end of their therapy and are headed out to experience the world with new skills and tools for coping with their anxiety. Of course they are still on wobbly legs, which is as true of a re-birth as a birth. It's scary to end your therapy and strike out on your own to see what you can see and let those anxious times come upon you. Some people feel confident, but most are unsure they have what it takes. They do!
So with the end of this time for a few and others dropping off the wait-list I now have some openings again. Of course, the times are rather select and it depends on your time zone and your availability. While I still encourage people to find a therapist "in the flesh" and offer to speak with them if they wish, many have had bad experiences with therapists who just don't understand the phobia and they really want to work with me. That being said (and I get it), I promise you that there are thousands of therapists who can help you get through this. They may have never heard of emetophobia, but if they really listen to you they will come to understand it.
I hope for many of you July 1st will be a beginning time. Time to address this before next winter!
It's June, or in emetophobic language, officially "not-winter!" The sun is shining, the outdoor patio furniture is being used, kids are outside playing and most emetophobics take a sigh of relief. Because if winter is over then "winter vomiting virus" aka "norovirus" season is over for another year.
First of all, that's not really true. It's winter in Australia and the Australian emetophobics are scared as hell right now. They're also traveling to the northern hemisphere by the plane load, and will bring the virus with them (sorry Aussies, I don't mean to blame - lol). Secondly, even if it is true that there are less "stomach bugs" about, that very fact is making your phobia worse.
It's true. The one thing that causes phobias for sure is avoidance. The more you avoid what you fear, the more afraid of it you'll become. I believe this is why emetophobia is so severe in most people who have it. Adults naturally "avoid" vomiting because they just don't vomit very often. Once every few years if you don't like it; once every 20 or so if you downright hate it; and if you're emetophobic you can go for a lot longer. But this "natural avoidance" as I like to call it is doing more harm than good. If adults were sick every few weeks, before long you'd probably not be afraid of it.
So how do I not avoid it when I'm so afraid of it, you ask? Good question. The best way is to start a program of gradual exposure which gets you talking about, and looking at, vomiting every week somehow. My program, as you can see from the "Resource" page, is very VERY gradual. It starts with just looking at the word "vomit" and goes on to drawings of cartoon people just not looking well, etc. But it's exposure nonetheless. And it gets you away from that dreaded avoidance which is only making you worse.
My best advice to northerners is to GET HELP NOW when the season is calming you down some. Don't wait until September when you send the kids back to school and freak out! It's much better and easier to get a good "run at it" in the summer so that by the time fall rolls around you will have some skills and tools to use to ease your anxiety.
Good luck everyone!
I get dozens of emails from families who are concerned about their emetophobic children. (I include teenagers when I say "children.") I can certainly understand their worry. Their child does not eat, does not want to go out, washes hands incessantly, etc. I am also impressed by the concern that parents have by reaching out for help. Unfortunately my practice is full right now and my wait-list, depending on your time zone, can be up to a year long. So here are some tips for those worried parents.
Even though my practice is full, I'm still willing to talk with your local therapist about how to approach treating your family/child. So if you find someone you really like to work with they can check out my resource website for therapists at www.emetophobiaresource.org. It's completely free
- Anxious children are responding to family stress. This doesn't mean that you're abusing your child or she's being sexually molested by someone, although if that were true, it could certainly lead to a phobia. In my work with families I have found that the stressor is often something as simple as moving away from friends or family, or mother being preoccupied with caring for an aging parent. Children around the age of 9 seem to be particularly at risk for responding to this type of stress by developing a phobia.
- Anxious parents make for anxious children. This is no way to suggest that it is the family's fault that the child has developed a phobia. But children "act out" family stress one way or another. It's probably easier to treat a phobia than a drug addiction, so perhaps there's a way to be thankful. And while I can certainly understand a parent worrying about a child with a phobia, don't forget that your worry is one more thing the child has to deal with. Try to remain calm, hopeful and optimistic while still taking it seriously and seeking help.
- Seek family counselling. Instead of assuming the child is the one with "the problem" set the microscope to examine a wider area. What's happening at home? What is the family stressor? If you as parents can get some family counselling and you can talk through the current situation with someone it will probably go a long way in helping your child.
- Don't allow avoidance. Avoiding what a child is afraid of will lead to a full-blown phobia or make an already existing phobia worse. Be kind, gentle and supportive but calmly let your child know that s/he must still go to school, to grandma's, etc.
- If your child isn't eating seek medical help. Let your child know first, again, calmly and firmly, that if they don't eat they will end up in hospital where they won't be able to come home until they start eating. This isn't a threat, it's just a fact and they need to know that they must do something to help themselves.
- Reassure your child that vomiting isn't dangerous or harmful. It can't hurt them in any way, so they don't need to fear it. This is more helpful than constantly reassuring them that they won't vomit. Kids can "sense" that you're b.s.-ing them on this one (how do you know if/when they will vomit?) so they will keep asking you over and over until you're about to throttle them.
Emetophobia Awareness Day is officially May 1st, 2012. I say "official" rather tongue-in-cheek. It's only official because I thought it up and said so! But the point is, we emetophobes need to come out of the closet for the good of all.
Emetophobia is so common yet most doctors, therapists and researchers have never heard of it. It's been featured on the TV show "My Strange Phobia" as though the woman featured was some kind of fluke of nature. As a result people suffer in isolation, are looked down upon by their partners and families and cannot find any help or hope from the medical community. This is wrong. Part of it is our fault.
For some reason emetophobic people (myself included, in the past) are horribly ashamed and embarrassed to admit that they are afraid of vomiting. Sometimes we try it, tentatively. "I'm deathly afraid of vomiting" we say. To which they reply "Well nobody likes it." As if we would then go, "Oh ok" and we'd get our lives back. But the problem is, these sorts of belittling comments silence us. This can go on no longer.
What I've noticed by listening to literally thousands of emetophobics online and after spending the past two years treating exclusively emetophobics is that we are not specific enough when we talk about our phobia. Some people use the word "phobia" loosely, meaning they squeal and jump up on a chair when they see a spider. This is not a phobia, it's just a fear. A true phobia of spiders would mean your life is completely ruined and you are debilitated by the fear. You can never sleep at night in case there's a spider in the house. You spend every waking hour vacuuming and cleaning and spraying with Raid. You can't work, socialize or even go out of your house because other places are not as "safe" from spiders. That's a phobia.
So we need to not only come out of the closet, but we need to say more. Explain more. I find in consulting with other therapists that most of them have no idea how scared an emetophobic is of vomiting. Some therapists have tried ludicrous ways of treatment such as suggesting that the emetophobic vomit in order to "see how it can't hurt you." Imagine having a fear of spiders and being forced to be covered with them for an afternoon. Now imagine having a phobia and doing the same thing. This is not "treatment" it's cruelty.
We have to speak out, and we have to be more explicit. We can't back down when our families or our doctor or therapist tries to brush the phobia off as not very significant and believes it can be overcome by just "getting over it."
Stay tuned to this blog (or subscribe) for ideas, press releases, tips and more as we get closer to May 1st. Meanwhile, think about what media outlets you might have access to or what PR/marketing folks you could approach for some help.
Living with emetophobia is not really about the fear of vomiting. In one sense, vomiting has nothing to do with your fear or phobia. I tell all my clients: your problem isn't vomiting. Your problem is anxiety.
It's just that things to do with vomit trigger the anxiety or panic attack. So getting over emetophobia is more simple than you think. Because it doesn't matter who is vomiting, who has norovirus, whether you feel nauseous or sick, how often you've washed your hands or anything else "out there in the world." None of those things matter. All that matters is your ability to control your anxiety. Because right now, your anxiety probably controls you.
Therapists measure anxiety on an 11-point scale called an "SUD" scale which stands for Subjective Units of Distress (or Disturbance). There are 11 points because zero is one of the numbers: 0-10. Zero represents no distress (anxiety) at all. 10 is the worst possible panic you could ever imagine.
As I am working through gradual exposure with clients I am constantly asking them for an SUD number. (It probably annoys the hell out of them!) But the numbers are important because they're your numbers. Hence the term "subjective." 7 is 7/10 for you. Perhaps that's when you start to feel your heart racing, but for someone else it's when they have sweaty palms and tingling feet. Everyone's numbers are different, but the numbers help us to get an idea of whether your anxiety is rising, lowering or staying the same.
But the numbers also serve another important purpose. They let you know how scared you are. Often phobics think of themselves as either "freaked out" or calm, but there are a lot of numbers in between those two and learning to recognize each one of them is key to overcoming your anxiety.
Let's say that you are feeling 1/10 for a baseline. A little stressed perhaps, but no noticeable symptoms. If your anxiety rises to 3 or 4/10 you can probably lower it again just by taking a deep, cleansing breath and then concentrating on slowing your breathing right down and dropping your shoulders to a more relaxed position.
If your anxiety rises above 6/10 being able to control it is more difficult. Up at 8 or 9 you're not even able to think straight. But often it is those numbers between 4 and 7 that give phobics the most trouble. It's there that you can feel a lot of body symptoms such as increased heart rate and breathing, tingly hands or feet, dizziness, nausea, etc. So if you notice your anxiety that high, it's time to try to relax. Breathe slowly. More slowly! Don't hold your breath at the top or bottom of the air - keep it moving. Relax shoulders, stomach, face and jaw. Then take a numerical reading again. Are you at 3 or 4 now? Great. Because it's much easier to lower it from there. More concentrated breaths, more relaxed muscles.
Just the act of "taking a number" can help calm you down. Whatever the number is, you can lower it! Just practice, practice, practice. If you need some help click on the "Resources" section and then "Relaxation Recordings." Good luck! Before you know it your fear of vomiting (or fear of norovirus) will be much better.
One of the reasons I have information on this site about norovirus is so that people with emetophobia can find it, and find the help they need to overcome their fear of vomiting. And this time of year I get more emails asking for help than all the other seasons combined. All because it's winter (at least in the northern hemisphere) and norovirus seems to be running rampant through the schools and nursing homes.So why the title of this post? Because researching norovirus is not going to help you with your emetophobia. In fact, it may only make it worse. If you are emetophobic you probably think your biggest problem is avoiding or preventing vomiting. But that's not true. In fact, vomiting isn't any problem at all. It's not dangerous. It's not harmful. It can't hurt you in any way. Your biggest problem is anxiety or the fact that you fear something that can't hurt you. Focusing on norovirus and ways to avoid or prevent vomiting is what will make your phobia even worse. It will trick you into believing that vomiting is some sort of big scary monster to be avoided
at all costs. But norovirus isn't Ebola
or AIDS - it's a harmless virus that makes you feel quite lousy for 24 hours and then you're fine. I understand how scared emetophobics are of norovirus - I used to be that scared. Luckily for me, I was emetophobic before there was an internet. I really think that if I had researched all this stuff and gone online talking to other emetophobics my life would have been completely destroyed.Spend your energy researching ways to get over anxiety disorders. There's lots of that on the internet! There are relaxation recordings, tips for panic attacks, and of course lists of therapists in your area that deal with anxiety disorders and phobias. If they've never heard of emetophobia just get them to email or call me!
I had to apologize to three of my emetophobia clients this past week for a photo I posted on my Resource Page
of some vomit (no people in the picture). I had found a photo which I thought would be good to put between another photo of vomit and the final photo on Level 8 of two people in a parking garage. Long story short: I posted the phot in HUGE format without realizing it! I had printed it out for my binder in the thumbnail version, and didn't realize the clients were looking at this ginormous zoomed-in view! Anyway, the clients all did extremely well in looking at it and I was very proud of them. But I have indeed made that photo smaller now!The photo, as well as many others I show clients to have them gradually desensitize to vomit, brings up an interesting topic which is the title of this week's blog. How much of our inability to cope with vomit is anxiety and how much is disgust? With anxiety, therapists use a standard "SUD" scale of 0-10 which stands for "Subjective Units of Distress." We ask clients (constantly, to the point we're annoying) to "give us a number." But the emotion of disgust is one of those interesting emotions that, at least at higher levels, is tied to anxiety. It's why some people faint if they see somebody with horrible injuries: the anxiety goes too high and all the blood drains from their head. The way I like to describe it is this: "When disgust goes too high, it pulls anxiety up with it." What does this mean for emetophobics? Well, is the glass half-full or half-empty for you? If you're the half-empty kind of person it means that you will have to learn how to cope with some pretty disgusting stuff in order to get better. Sorry. If you're the half-full sort of person
you can look at it this way: the perk of desensitizing your anxiety to vomit is that you also desensitize to disgusting things! So like...you could become a nurse in the end or one of those TV CSI people who examines bones and severed heads and such. (Can you tell which sort of person I am? haha)If you think you're the kind of person who gets disgusted easily or gets squeamish then it will be an important part of your
recovery to desensitize to disgusting things in general. The more you can handle looking at awful things, the less your phobia will be triggered in your everyday life.
Finally all my schoolwork is completed, resume updated, forms filled out, supervised hours all done, references and transcripts arranged for and criminal records check sent in and back. The whole package has been sent off to the registering body for consideration this October, and God-willing and the creeks don't rise I'll be a registered clinical counsellor before 2012. It takes such a long time! But I have a friend who's about to be licensed as a psychologist in California and she needed to complete 1000 hours of supervision first so I can't complain.This summer I've been taking it easy with a fair bit of time off to relax and enjoy my garden, Vancouver and the little fishing village I live in called Steveston.
I also bought a used bicycle and have taken up riding for exercise. Other than a nasty spill on Thursday and a skinned knee, it's proved to be very beneficial.One of the things I've been working on in my time off is an update and minor re-organization of the Resources page. Instead of just 8 categories of gradual exposure I now have 10 plus four more in the "miscellaneous"
sections. After working with over 30 clients the past year I noticed what was in the wrong order and what was missing. I now have a level called "sentences" which comes in after "words" and before "drawings." I also added a level of pictures of people around toilets - something that many emetophobes have a problem with. In the miscellaneous section is a page about animals, hospitals, a simple picture of a water fountain and a "is it soup" quiz that demonstrates how we assign
the property "disgusting" to some things which look exactly like other things that we don't deem disgusting at all. I haven't finished the "sentences" section yet, and I also hope to add another level soon called "in vivo" which means "in reality" - things that people can gradually begin to do in real life such as not washing hands so much, not disinfecting everything, not throwing out food, etc.I really hope that the new resource page helps a lot of therapists in treating emetophobia and also understanding it so that as many people as possible can overcome this phobia! Stay tuned for my fall newsletter!
Emetophobia doesn't get a lot of press. In fact, most doctors and therapists don't even know what it is. So I'm doing my best to spread the word and you can help. If you're on Facebook go to www.facebook.com/emetophobiahelp
and click "like." Then, when the wall posts go through your news stream click "share" on those so that the word gets out to your whole network. This way the word will grow exponentially. I've also posted an "Event" for April 1, 2011 that I'm calling "Fools for Emetophobia." It will be an international emetophobia day. Emetophobics everywhere will be encouraged to "get some press" on that day. The more people know the more therapists will inquire about how to treat it and then millions of sufferers will finally get the help they deserve. Yes, I dream big! Thanks to the beautiful template I used for this website, I've chosen the sunflower as a "brand" symbol. Keep your eyes peeled for it everywhere!