This is the part 2 of my mini series about emetophobia. In this part, I want to put together some tips, tricks and ideas that work for me or that I know of for people who also struggle with this phobia. For the sake of people who have a strong fear around the associated words, unlike in the first part, I will be replacing any trigger words with only their first letters. The section dealing with exposure may be more or less triggering for some.
Mindset
One thing, perhaps not the healthiest out there, that has helped me a lot ever since I’ve become aware of this mechanism is the understanding that, seriously, people with emetophobia are less likely, at least on average, to v* than people who don’t have this fear. Part of this may be all sorts of things we do to prevent it, and that many of us simply aren’t all that prone to it, but what I think plays a greater role is that we’re often too stressed and blocked for v* to occur. I think this is a good thing to keep in mind, and very comforting, even though there’s always some chance of it happening. On a similar note, there are people, emetophobic and not, who only v* once in their lifetime, or maybe never at all. Now, imagine you’re one of these people, that you never v*ed for your entire life since the last time you actually did, and imagine that you’re nearing the end of your life, and you’ve been given some crystal ball or a mind superpower, thanks to which you can, reflecting back on your life, see it from different angles, what would happen if you did X or didn’t do Y. And one thing you learn about your life is that, with or without all your efforts, you weren’t meant to v* anymore in your life anyway. Wouldn’t you feel pity for missing out on all the yummy foods you never ate, all the journeys you didn’t take etc. despite deep down you really wanted to, just to avoid something that would never happen regardless of your actions, and that your efforts were essentially meaningless? Of course, we know that most people do v*, so looking at things this way won’t make anyone with emetophobia stop avoiding v*, but I think it’s an interesting perspective to put it in.
Coping with crisis
Evaluating how you’re feeling
Something that helps me not to panic right away when something triggers my emetophobia is to focus on how exactly I am actually feeling, to determine whether what I’m feeling is truly physical, or is it just my anxiety. N* is my primary anxiety symptom so sometimes it’s difficult, but I’m getting better at it every time. Basically, when I start feeling n*, or anything else that I think could potentially lead to v* and feel distressed about it, I try to establish how bad it is. You can try asking yourself questions like the ones below and see if you can answer them at all, which I guess won’t necessarily be easy at every severity stage of emetophobia, and if you can answer them, perhaps the answers will help to reassure you. For me, that’s most often the case.
- Are you able to function normally the way you’re feeling now, or would you rather just lay in bed?
- How about things that you normally enjoy, are you able to do them now with the way you’re feeling or are you feeling too s*? I think it’s important to differentiate here between feeling too * and not being focused on anything else than the way you’re feeling and that it might lead to v*, which also can make it difficult to enjoy anything.
- What exactly makes you think it may end up with v*? For me personally, n* alone, unless it’s really intense, isn’t a valid argument, because like I said I experience it a lot due to anxiety and n* itself never made me v*.
- Totally hypothetically, would you be able to eat something, and what could it be? By being able I mean physically, not whether your emetophobic brain thinks it’s safe to do it or not, but, like, what’s your reaction when you think about food? If you had it guaranteed that, regardless how bad you’re feeling and what you’ll choose to eat, you will not v* after eating, would there be something you’d actually like to eat right now? Or does thinking about any food make you feel worse and eating is the last thing you want to do? Or maybe you’re actually hungry but your brain doesn’t want you to know? People could have n* when they’re very hungry or have low blood sugar, maybe it’s the case with you?
Distraction
Then the next key thing in my opinion is effective distraction. I know, it’s fiendishly difficult when you’re feeling anxious, so it’s good to have some sort of distraction toolbox prepared beforehand, so that you don’t have to frantically come up with ways to calm yourself down and distract while already in the grip of emetophobia. Read something interesting. Watch your favourite series. Go for a walk if you’re feeling well enough, play a game. Talk to someone, preferably not about your fears as that won’t really distract you, unless you clearly feel that that’s what you need to talk about. Personally I don’t like talking to people about my emetophobia too much at the time when it’s really bad, because it only makes me feel worse and sort of like that if it’s so bad that I need to talk about it to someone, it must be really bad. I only talk to people about it when I absolutely can’t cope. Otherwise, I think it’s a lot better to just chat about something as far from it as possible that will engage your brain or make you laugh, just shift your emotions from hyperfocusing on all things n* and v*. Listen to music. Or engage in any other activity that you find interesting, but also sufficiently emotionally involving, so that there’s no space left for the anxiety. I find that what works best for me specifically is some intellectual activity that requires focusing a lot, or sometimes listening to other people and whatever problems they might be having, unless things are too rubbish and I just can’t focus. Lite and rather passive activities like reading hardly ever work.
Breathing
That’s quite crucially important imo. I’m shitty with it, it’s really difficult, but breathing properly really makes a difference with anxiety, it’s not just a cliche. Breathing also comes in very handy when things totally spiral out of control and you’re about to v*. When you breathe deeply through your nose, chances are you can make the feeling go away. It’s also definitely a good thing to find some relaxation technique that you like and that works for you. I find mindfulness not very helpful with this specific kind of fear because, really, focusing on your sensations is the last thing you want to do when your emetophobia gets triggered. 😀 What I like a lot is some kind of imageries, visualisations, and, even more so, grounding exercises. I don’t know if grounding can work for everyone, probably part of why it works for me is because it can sometimes help me more or less with dizziness, and dizziness triggers my emetophobia. Have something, or someone, that you find comforting close to you, like your pet or your favourite fluffy blanket, or your safe person, or some object you have a strong connection to, whatever works. I like to have Misha around in such situations, listen to his breath and heartbeat, feel his fur, it’s really calming.
Exposure and trying to overcome your fear
When you have managed to get through the crisis safely and are no longer triggered, you might think about how to reduce or completely get rid of this fear. I think this is very comforting news that it so often seems to diminish over time as people age. That does seem to be the case with me, although other things have come into play. Exposure therapy can be a great thing, if you’re brave enough. I know a couple people who have managed to overcome emetophobia with great success largely thanks to it. I perfectly realise though that it sounds very scary to many people and it takes guts (hehe) to make such a decision, and many of us don’t have enough of them for that. I, for one, did not. I had some experience with it with my first therapist, who was mostly CBT but also used other modalities a lot, and she encouraged me that we could try it with one of my anxieties, not emetophobia-related). After some initial fears and hesitation and with a lot of reassurance on her part I courageously decided I’ll give it a go, as I was actually very curious what’s at the core of it and why that thing scared me as badly as it did, and still does. But unfortunately we didn’t even go through it fully because there was just one mini thing that didn’t go quite the way it was supposed to, which resulted in my fear getting worse and me not wanting to hear about exposure therapy ever again, and I still feel the same way about it.
Still, even those of us who don’t like the idea of exposure therapy can do some mini exposure by ourselves as much as it’s possible, and slowly, gradually go out of our comfort zone. Can you think of something that you CAN handle about v*? It may be still scary and/or uncomfortable, but doesn’t scare you quite as badly as other aspects of v*. For example such thing for me is the words relating to the v*. Yes, they ARE scary, they are gross, and when I’m feeling very unwell mentally they can trigger me, but usually I can handle hearing them quite well with minor or sometimes no distress at all, unlike v*ing myself or hearing someone do it or reading some graphic descriptions or eating something that is very very risky.
So, if you’re like me, you could try and expose yourself at least to these words a bit more, so that they feel even less scary. Say them out loud, think about them, or write them on a piece of paper, or read in a book, as long as they don’t appear in any graphic scene, unless you feel brave enough for this then sure, why not. I remember once reading an article somewhere about emetophobia and there was a suggestion, mostly geared at children, I think, that I really liked, about how you can try to deal with fear of the words. Take some well-known song, or even just its title, or a book title, or a film title, a nursery rhyme, a saying, whatever simple thing like that, and replace one word in it with v*, so that it’ll sound funny or weird or just silly and meaningless, or gross. Like: “Jack and Jill went up the hill to fetch a pail of v*”. I believe this technique is called reciprocal inhibition, where you try to replace one feeling with another. And so while it might still scare you at first, at some point humour will likely win and you’ll be less scared. Also it’s just meant to show you that these are just words and can’t harm you as such, and it’s a way of familiarising yourself with them and desensitising your brain to them. I have done things like that and, while I still consider these words grosser and more unpleasant than an average person, and still they can mess things up if I’m not feeling well, but generally they are nowhere near such a big deal as they used to be.
Or if you are scared of v*ing yourself, but less so of other people doing so, you could watch a movie where someone does it. Or if human v* is too scary, do what I did and get yourself a cat, they have such sensitive digestive systems that most of them v* very regularly and at this point I don’t find it as extremely disturbing as I did at the beginning, especially that Misha takes great care to always do it in my room and makes sure that I get my dose of exposure.
When you’re feeling relatively stable overall, you could try and eat something that you particularly liked and miss from your unsafe food items list, even just a very small amount. And then, if you feel okay afterwards, try to eat more of it. And then another product. And so on and so forth. It’s an extremely gratifying feeling whenever you manage to succeed at that and realise this product no longer needs to be considered unsafe. Especially that a lot of things that we cross out, we actually like to eat. My most recent achievement in this field is from about half a year ago when I started to eat waffles again. I don’t even remember now how they ended up on my no-no list. You could also try eating out if you struggle with this, even just a very small meal at first.
Daily life coping strategies
But exposing ourselves to things won’t always eliminate the fear entirely, therefore I feel it’s important to have your strategies as for how to deal with things on a daily basis, to make life easier and less scary.
I recently had a thought that it’s a bit of a pity that we have all those no-no foods, but not many emetophobics put quite as much thought in making something like a mental oh-yeah food list, so basically a list of things that we consider safe and like to eat. Maybe that doesn’t make sense since you usually know what you like and what you can eat pretty automatically, but I feel like it’s still good to acknowledge this somehow, because having all those unsafe foods it’s easy to subconsciously jump to the conclusion that food in general is unsafe, when I think most of us do have some food items that are safe, even if for some people they are rather few.
And speaking of safe foods, I believe it’s also a good idea to have some kind of edible things that you find to be helpful for you with things like n*, for when you actually feel bad and like you may v*, whether it’s caused by anxiety or a tummy bug or illness. My best friend in this department is ginger, I really really really love it, just plain because of its taste as well as for its antiemetic properties. I like to suck on it when I’m feeling n* or add it to my tea. Speaking of teas, I think chamomile is the most trustworthy when it comes to emetophobia, although It also has loads of other properties. Another one I drink when I’m worried I might v* is… sheesh, I don’t even know the English name for this plant! 😀 We literally call it wild rose in Polish and apparently it’s rosa canina in Latin. But chamomile is always my first choice. Peppermint is a good substitute for ginger. I know people who find sucking on ice cubes helpful. I think this idea probably comes from that it’s often recommended for people who actually DO v*, like after chemo, and ice is given to them to help with hydration, but I don’t really see how it could help with preventing potential v*. Still, since a lot of what we experience is psychosomatic, there’s nothing wrong with having your own little strategies that work even if they aren’t proven or anything, because they work for you and that’s what matters, as long as your entire quality of life isn’t dependent on it, regardless whether it’s a placebo or not. As some of you may know, I have a weird affinity with ice so I like sucking on it sometimes regardless. 😀 Eating more protein-rich meals (as opposed to more rich in carbs or fats) also may potentially help with n* or queasiness a bit.
Also, find scents that help you, if you haven’t already. Scents that help you both with n* and feeling s* as well as scents that you find generally relaxing. Can’t say much more on this as I myself can’t really feel most scents.
Have some strategy for a crisis situation like when someone in your family is s*. This will be different for everyone, what things you want to use to keep yourself healthy and how you will want to deal with the situation and make it bearable. My safe bet is apple cider vinegar, although it’s not wise to go over the top with it or use it long-term, as then it can actually make your gut worse, and different people have different opinions on its effectiveness. While it’s not a very healthy way to cope, if you really have no other way of coping at the moment and you’re very scared, there are antiemetic drugs that you can get over the counter for the time being like Hydroxyzine which is also anxiolytic. Probiotics may also be helpful, or foods/drinks that have such properties, my fav here is kefir.
And last, but not least, whether you do decide to go the exposure therapy route, I think it’s important, or at least really beneficial to have someone who understands those things. Find a talk therapist who has some experience with this, some fellow human being with this phobia, or tell your friend about it if you feel they will be able to empathise, so that you aren’t alone with this. As I said earlier, talking and analysing it all through isn’t always the best way to go, at least not for me, but there are times when you just need to put it all off your chest and in such case of course it’s important that the other person understands what you’re talking about. Having someone like this is also helpful for making progress, as they can motivate you and be there for you while you’re trying to overcome your v* fears.
That’s all I’ve come up with. Do you have any other ways in which you calm down your emetophobia? Or if you have any other kind of phobia, how do you cope with it? 🙂
My Inner MishMash 