December 25, 2013 § Leave a comment
These are notes on a video project I once imagined releasing on YouTube, about my lifelong experience with emetophobia (phobia of vomiting and seeing others vomit). I still may complete the project one day, although emetophobia has lessened its grip over my day-to-day life to the degree that I’ve learned about and treated the underlying–and also lifelong–anxiety disorder of which it is simply an expression. That being said, I still feel like the video would be helpful for others, from fellow emetophobes to scholars of embodiment to therapists.
–introduction (purpose of videos. inspired by series on anorexia. why this format – anonymous, but also simultaneously public and intimate. who i am – academic, emetophobe – and how that informs my approach/goals.)
–what is emetophobia (clinical understanding, statistics, what kind of research has been done, gaps in research, most helpful information comes from largely online community. It is not just a fear of vomit or vomiting, but a complex condition characterized primarily by shame, anxiety, and panic at the prospect of violating social proscriptions against “losing control” of one’s body, especially in public settings)
–my story (prob several parts, draw on essay i wrote for kudlick’s class)
–emetophobia as metaphor: the western excretory imaginary and where vomit fits in (relation to my project on excreta…the negativity of the body, the desire for social acceptability through bodily control, the status of vomit relative to other kinds of excreta, vomit as irredeemably abject.)
–story of my treatment attempts: what i did, what worked, what didn’t (talk therapy as a means of exploring personal metaphoricity of emetophobia, necessary approach but ultimately not sufficient for me.)
–the anxiety and phobia workbook and how it changed my thinking about the phobia (led me to realize that altho technically a specific phobia, involves significant dimensions of other anxiety disorders, i.e. social phobia, agoraphobia, panic disorder. “cure” came from getting away from specific content of phobia and dealing with its symptoms as I might agoraphobia, social anxiety, panic attacks, etc)
–emetophobia and eating disorders (personal history of anorexia, how emetophobia complicates this history, overlaps/differences between anorexia and emetophobia. Example of Intervention episode with Nicole – diagnosed as eating disorder, but primarily panic disorder or PTSD as a result of sexual assault that manifests as struggles around eating/swallowing. As in this case, emetophobia is primarily an anxiety disorder that gets expressed physically in ways that can resemble anorexia. That being said, my body doesn’t know the difference between intentional starvation and not eating because I’m anxious about throwing up, and the ramifications for my physical health have been enormous. I have been underweight pretty much all of my adult life, and in my 20s I have had to deal with a diagnosis of borderline osteoporosis and dental problems stemming I think from loss of bone density—thinning enamel. This is damage I can’t remedy easily, if at all, and it’s taken me 5 years to work through my grief over this damage enough that I can be proactive about doing what I can do preserve my health. Only now can I face the reality that there are life and death stakes in learning how to better deal with my anxieties about embodiment without this reality overwhelming and paralyzing me. And so I make a conscious effort to eat even if I’m anxious about eating, and I do weight bearing exercise regularly, and I floss daily and brush with an electric toothbrush and get regular cleanings.)
–for the therapeutic community: 5 misconceptions about emetophobia, 5 suggestions for improving treatment
–emetophobia and pregnancy/parenthood: how i coped/how I am coping
- did not have morning sickness very bad. However, when I did it wasn’t very bad, and for me was mixed up with hunger. Somehow nausea I felt in pregnancy was less scary than other nausea, bc it meant something different, because it was mixed up with joy I felt at being fertile and pregnant.
- So if you’re emetophobic and wanting to get pregnant but feeling scared, remember that being PG doesn’t necessarily mean you’ll feel sick or get sick
- toward the end of my pregnancy, I was terrified not of feeling pain, but that I would feel sick and vomit during labor (my midwives said about a third of women did). When I actually went into labor, my stomach was totally unaffected. The process felt like it was happening somewhere else in my body and didn’t reach my stomach. Afterwards I recognized that even if I had, I might not have cared—labor is that intense; it puts you outside your normal mental and physical frame of reference.
- One major way I personally handled anxiety about the unknown physicality of labor was to give birth at home with midwives. I realize this is not necessarily desirable for everyone. but for me, so much of emetophobia is about fear of losing control of my body, esp in a social setting where I’m surrounded by people I don’t know. I knew that giving birth in a hospital would intensify my anxieties, so I chose a setting where I knew I’d feel most relaxed, uninhibited and unconcerned about being judged and evaluated. Others might conversely feel safer and less anxious in a hospital. The point is that thinking about birth setting and what will make you most comfortable is important, and can help with anxieties around the labor process.
- that being said, I really really worked hard while I was pregnant to anticipate what underlay my deepest anxieties about labor and how I would cope if the worst happened. This exercise turned out not to be necessary during labor, but it is the basis of the practical strategies I recommend in other video
- Something my therapist said that helped a lot when I was dealing with anxiety about flying (related to emetophobia—scared of being trapped and feeling sick, being unable to leave, scared the plane would make me feel sick): think of the end goal and focus all energy on that. yes, the getting there is uncomfortable, but in the end it will be worth it. Keep yr eye on the prize. And the more I did it, the less scared I became of flying. Today I’m not scared at all.
- This is also helpful when thinking about the bigger challenge of having kids who inevitably get sick. when my daughter has been sick, it has been hard for me. I get really stressed out and anxious. But I HANDLE IT. And one of the ways I’ve been able to handle it is to keep reminding myself that the uncomfortable situation of dealing with throwing up and worrying about throwing up myself is worth the end goal, which is to make sure my daughter feels cared for and loved when she feels bad. That is more important to me than the getting there, as hard as the getting there is—just like arriving and seeing my family is worth the discomfort of the plane ride.
- I also reframe these situations mentally in a similar way to how they teach you to reframe childbirth. Instead of thinking of it as suffering, painful, horrible etc, think of it as intense, challenging—something that you will get through, and that will make you stronger.
–for emetophobes: general strategies that have helped me
- Anxiety and Phobia Workbook, esp breathing exercises
- Recognizing that the problem is not vomiting, it’s anxiety. Realizing that feeling of anxiety/panic (about whatever) is 1000 times worse than actually feeling sick
- So, learning to distinguish fear of vomiting from feeling sick. being able to redirect fear chatter to more meta-level statements: from “what’s my stomach doing, what if, I feel scared!” to “I’m feeling a lot of anxiety right now” which puts me in a more practical frame of mind, i.e. I’ve identified a problem, which leads me to come up with potential solutions.
- Shifting ultimate goal from “getting rid” of anxiety/phobia to learning how to live with it, meaning how to compensate for it. Anticipating that living with realistically includes a certain amount of setbacks, where anxiety takes over and affects my eating habits. Thus, not beating myself up over setbacks, but learning how to get back on the wagon and continue to make progress (for me, exercise and eating to gain weight).
- Exercise and eating right refocuses attention on body but in a positive way. I have found that when I avoid eating because I’m anxious about my body, my anxiety gets worse. I now try to take an empirical approach: I’ll try eating a little something and see how I feel. If I really don’t feel like eating, I can stop. But 9 times out of 10, I find that eating makes me feel better—physically, but also psychologically in that I’ve confronted my fear and moved through it.
- Writing exercises I did in preparation for childbirth useful for anyone
–phobia in a disability studies context – invisible disability and the importance of resisting shame and stigma (paradox of its being 5th most common phobia yet surrounded by shame and silence) and the necessity of talking about it (to “come out”, to draw attention to need for more research, to draw attention to how it’s been framed in unhelpful ways). Personal, psychological, political importance of destigmatizing the body itself, of refusing a social refusal of its excretory functionality.