Anxiety / Emetophobia / OCD advice

[AnxiousRobin]

I’m struggling with anxiety at the moment. I’ve had it on and off all my life but it feels really overwhelming now. I have two little ones, up until now I was dealing ok with the risk of germs and sickness but after hearing of a few unwell people my anxiety has gone sky high and I feel tearful, on edge etc

I’ve had various ocd themes over the years that have locked me into an anxious state for months at a time. But my fear of germs/sickness has always been a “background” theme that I can’t seem to get over (I feel like the other themes were awful at the time but once they were gone, they were gone!)

I’m currently having CBT but I don’t feel it’s helping much. It’s all about living in the moment and not trying to predict whether we will get ill. But the “I can’t know the future” aspect is just making me feel anxious :(

I’ve tried so hard to understand how my brain works, but I’m just not getting it. I know rationally that I’m being over the top but there’s another part of me that takes over. I read an online post recently about someone that had recovered from emetophobia and they said they realised they were doing it to themselves (making themselves anxious) and once they realised that they recovered. I’ve tried thinking this way but it very much feels like the anxiety is being done TO me and I just can’t face what I’m afraid of. At the moment it’s endless thoughts about what will happen if we get a contagious bug, how will I protect my baby, how will I cope etc which repeats until I become upset.

the thoughts feel so full on and repetitive that I can’t understand how to change the way I think. I’ve been given sertraline to try but as I’m still breastfeeding I’d rather wait before starting it.

Any positive stories or advice to help in the meantime would be much appreciated…Thank you if you’ve got this far!

Hello, I'm so sorry you're going through this. My DD is now 17 and has OCD and anxiety, and for years emetophobia was by far the biggest driver of her fears. It had a terrible impact on her life, but exposure therapy has made a massive difference (and was the only thing that helped). Have you tried this type of therapy? It's tough but has been very successful for her. She is still wary of things like food safety but compared to how it used to be, it's night and day.

More generally, is your therapist an expert in OCD? (As I'm sure you know, treatment for that can look very different from treatment for generalised anxiety, with ERP being the gold standard).

Best wishes 💐

Hi @Bewildermum thank you so much for your reply. I’ve looked into exposure therapy but never fully started it. I don’t really have much issue with sick unless I know it’s contagious, which is the thing that makes me spiral! But perhaps it could still help? I don’t really relish the idea of starting it so I’m probably avoiding it to a certain extent. How did your DD do the exposure, was it online?

My therapist said that some of the techniques are used for OCD and some for general anxiety. It’s “high intensity” CBT and at the moment I’m just making thought diaries and then coming up with alternative responses and also trying to validate and be compassionate regarding my thoughts. But as I said, I don’t think it’s doing much when my mind is racing.

Im so glad to hear your DD is doing well! I struggled in my teens and had a lot of avoidant/anxious behaviours but managed to live fairly normally… I think it’s catching up to me now though. I don’t think there was much awareness back then! Your DD is so lucky to have your support x

I believe you can carry on breastfeeding on sertraline.

I’ve tried so hard to understand how my brain works, but I’m just not getting it. I know rationally that I’m being over the top but there’s another part of me that takes over.

This is how I explain how the mind works.

The mind is like a ship and, like all ships, it is staffed by a captain and a crew. The captain is your logical, conscious mind; the captain knows where we are sailing to, why we are sailing there and how we’re going to get there. However, the part of your mind with its hands on everything that steers and sails this ship is the crew. The crew is your subconscious mind.

Every member of the crew has a job to do and each member is only concerned with their specific task. Some are doing the right things and some are doing what the captain now recognises to be the wrong things. The reason why
members of the crew might be doing the wrong thing is because they decided what jobs they were doing before there was a captain on board - there's no captain until we're about 10 years old and the captain takes years to fully grow into their role.

When we were young with no idea about how the world worked and what our part in it was, the mind (e.g. the crew) had only one priority…to keep the ship afloat. As a result, the mind developed certain strategies that were only designed to keep us out of trouble at a time when we didn’t understand much about how to do that. Often the patterns of thought and response the crew
developed in those early years were focused mainly on keeping us safe and happy. For example eating chocolate or biscuits were pretty much guaranteed to solve any problem when we were little, hence this strategy still being deployed into adulthood.

As we grow and start to develop purpose and long-term goals and ambitions, we will sometimes recognise that our core beliefs, behaviours or responses aren’t falling in line with what we consciously wish to achieve. Our captain knows the direction we want to sail in but we have members of our crew steering us in a different direction.

@AnxiousRobin In your particular case the part of your mind that takes over is not doing it to distress you, it's genuinely worried - picture a small sailor (mine all wear Bretton t-shirts) asking for reassurance and a handhold from the boss - you. You, the captain, know you have internal knowledge, experience and external resources such as health professionals, friends and family to deal with just about any issue that comes up. People cope - it's the amazing thing about humans; whatever life throws at us we have the brain power and the resourcefulness to deal with it.

A maxim to remember is that your record for getting through bad days currently stands at 100%.

I don’t really have much issue with sick unless I know it’s contagious, which is the thing that makes me spiral!

Ah so maybe you'd want therapy that concentrates on your core fear, which might not actually be fear of sick - but more fear of illness, germs etc.

(For DD it was kinda the other way around - her core fear was that she'd throw up - e.g. fear of illness or food contamination because it might make her vomit, rather than a fear of being ill for its own sake, if you see what I mean!)

I'm SO not an expert on any of this but as far as I know exposure therapy can be turned to any theme (if it is OCD-related)? Not sure if this helps?

How did your DD do the exposure, was it online?
No, she saw someone in person locally (who was also an OCD therapist).

I struggled in my teens and had a lot of avoidant/anxious behaviours but managed to live fairly normally… I think it’s catching up to me now though. I don’t think there was much awareness back then!
Having watched my DD go through it I feel so sorry for you having to cope with that - you're right that there is much more awareness now, although it still hard to know where to turn (and it still took us ages to figure out what the hell was going on!).

Have you mentioned to your therapist that you don't feel the current approach is quite working for you?

I suffered from emetophobia for about 15 years, it is utterly miserable! Have a look at this https://www.emetophobia.co.uk/, this is what i used to cure myself of it, absolutely life changing. It explains how your phobia is created and how to change your thinking to get over it, and also explains why exposure therapy and CBT won't work. There is loads of free info and podcasts there, and testimonials from people it's worked for. Feel free to ask me any questions.

I've suffered for at least 30 years, kept it mainly under control for 15 years with citalopram, it's recently stopped working for me, totally spiralled out of control this winter with all the illnesses going about and catching norovirus after a flight.. I've now switched over to fluoxetine so hoping it works!

@ClimbingGreySquirrels thank you - the doctor also said this but I guess it’s just another anxious thought, I wanted to finish feeding before trying any medication! But I might just get started.

@Bewildermum thank you - that link was helpful! I think I do fall more into the ocd category. I’ve also had health anxiety over various things but the sickness seems so hard to overcome. I think I do struggle with sick even when it’s not contagious but I don’t have the awful anxiety that I have around bugs. I definitely do have a few funny behaviours around food - I hate touching raw meat and just let my husband do that part! And cook things to a crisp if I’m cooking. I’ve only had 3 sessions of therapy but perhaps I will mention that I feel it’s not really helping. I’m worried she will think I’m not trying hard enough! 🙈 I know the change needs to come from me but it’s hard to actually understand how to do it!

@Eyesopenwideawake thank you for this explanation, it makes a lot of sense! I wish I could fire the unruly crew member that keeps bringing me back to anxious thoughts 😂
I know I have coped in the pass and will again, but the anxiety feels overwhelming. When I first had panic attacks years ago my anxiety was absolutely awful - I went through a phase of not being able to go into shops/crowds. But once I understood that it was just a faulty anxiety response in my brain, the attacks stopped almost straightaway. It doesn’t seem to work for emetophobia though ☹️

@ghostofadog is this the thrive programme? I have the book but I don’t think I finished it 😬 i found the approach quite hard though as it’s very much “you’re doing this to yourself” which I can’t really get my head around.. I guess it still feels like a very real threat! I will listen to the podcasts though and try to revisit it!

@Midnightlove interesting to hear that you had some success with medication! It’s such a tough phobia to beat. I mean I don’t even want to fully beat it… just make it manageable!! I hope you find success with fluoxetine. This winter feel particularly hard doesn’t it… I found myself missing the lockdown where the germs weren’t circulating as much!

It doesn’t seem to work for emetophobia though

Can you remember when and why this started? Finding the original trigger is the best way to stop it.

Yes @AnxiousRobin , it's the Thrive Programme. Really worth revisiting, they have developed the specific emetophobia programme a lot, they really understand what is going on in the heads of emetophobes! It is hard work, but very worth it, you will see progress really quickly if you give it a go. I had the book for ages and dipped in and out of it but you have to really commit to doing the whole thing. If I'd done this at the start I would have got over my emeto much much quicker! Also recommend working with a coach if finances permit.

I was very resistant to the idea that I was creating a phobia myself but it turned out to be true. Try not to think of it as blaming yourself, emetophobes are very good at beating themselves up! In fact, its a positive thing, emetophobia is something you have wound yourself into, which means with a bit of help and effort, you can actually un-wind yourself, and get your life back.

I would really recommend listening to the podcasts to get started.

@Eyesopenwideawake i definitely can remember two incidents of having a bug when younger and feeling an incredible amount of anxiety before I was sick. On one of the occasions I remember pacing around the house trying to will it not to happen and my heart was racing. But then it happened and I had to go and get my parents. I remember feeling relieved and better after being sick so not sure whether this occasion could have triggered it? A couple of years ago I spend a few hundred pounds on hypnotherapy where I revisited some of these memories and I did have a reaction with tears running down my face but I also felt I was searching for something to say to the therapist … ultimately it didn’t seem to have an effect!

@ghostofadog thank you for sharing your experience, I’ve started listening to the podcasts and it does all make a lot of sense! I just feel quite rubbish today though, it feels like the anxiety just puts a fog over my days and I can’t feel much joy, I’m very jittery and didn’t sleep well last night. Is this the kind of anxiety you experienced with it?

That's interesting, I wonder why you were so worried about being sick. I'd be looking to talk to that crew member that believes being sick is so bad that you have to avoid it at all costs. There's always a reason and your mind knows what it is, you don't have to revisit memories.

If it's not cbt etc, how does it work? Just train you into thinking differently? Would you say you're totally cured? I would love to be!

It has elements of CBT @Midnightlove but it goes a lot further. So CBT will maybe focus on dealing with the situations when they arise but the Thrive prog also helps you understand why you think the way you do, and how to actually stop creating anxiety rather than just dealing with it when it arises. There is a lot of work on building your self esteem and reducing social anxiety, challenging unhelpful thinking styles (perfectionism, black & white, catastrophic etc) and also challenging your beliefs that keep you locked in a cycle of anxiety because you keep thinking things are happening to you and you can't do anything about it but actually you can! Not sure I'm explaining this very well but I think that CBT could definitely help you with emetophobia but it is unlikely to cure you because it's only part of the jigsaw, whereas the Thrive approach covers the whole lot and allows you to understand how not to create anxiety in the future.

And yes, I am definitely cured now! Took me a while because I was quite resistant to the idea that it really was me creating the anxiety rather than sickness being objectively terrifying 😂

Yes @AnxiousRobin I was in a permanent state of anxiety, especially when my kids were younger - always bugs going round nursery and school. I found it really hard to sleep because every time there was a tiny noise or someone coughed I was convinced they were being sick - heart pounding, panicking etc. Or if I'd eaten anything I wasn't 100% sure was 'safe' I would be unable to sleep in case I was ill in the night. It was like being on hyper-alert all the time, totally exhausting, I really feel for you if you're experiencing the same.

@ghostofadog thanks that really explains it well! I'm totally the same as you jumping at any cough in the night thinking DS is ill, I'm so exhausted and over it now

@Eyesopenwideawake yes I’ve heard that visiting old memories is not necessary so I’m not sure why the therapist focused on that. I honestly don’t know why im so afraid, I just hate it (well hated it when it happened) even though I felt better afterwards… it feels like my brain is stuck on that moment of hate/fear! I also have wider fears about my children becoming very unwell which is upsetting and adds to the anxiety.

@ghostofadog yes that's exactly how I feel and I’m totally exhausted. I want to be there for my kids and be the strong one which I usually am except when it comes to sick! Saying that it has happened before and I’ve dealt with it ok. It very much feels like I’m obsessing over the sick part and how awful it will be… just wish I could break the cycle! Thank you for your insights xx

It might help to have a read through my AMA on remedial hypnosis - lots of info on there about how the mind works.

Thanks @Eyesopenwideawake I will do! ☺️