#Fearless Family Writer
The future… It is something that I have always been encouraged to plan for, no matter how old I was. I was encouraged to get good grades as a child so that I could get into a good college. I was encouraged to be social so that I would have a supportive group of friends as I grew up. I was encouraged to think about careers that would make me happy and support me financially to ensure a comfortable life. When you think about your future, what are some things that you see? Marriage? Children? Your perfect career? For a while, I had big dreams. Then emetophobia began to cloud them and suddenly, my future seemed uncertain rather than bright.
Like many of you, I have had emetophobia for as long as I can remember. I would cry out “I don’t want to die!” every time I was ill as a child. I would tremble when classmates got sick in school. I vividly remember every single experience I had that involved the dreaded symptom.
What lovely childhood memories, right? I was formally diagnosed with GAD (generalized anxiety disorder) at age 8 after my elementary school teacher noticed I was struggling. There is no doubt that this diagnosis was accurate, but I always felt like there was something else. Something was not addressed. I was unaware that emetophobia existed until I came across it while doing some research in an attempt to find other people like me. Those terrified of anything related to vomiting. I found comfort knowing that I wasn’t alone or “crazy.”
At this point, I was in my early 20s & working towards getting into graduate school for occupational therapy (OT). I submitted my applications but I ended up having to take a year off because I was not accepted into the program. After spending the year working and bulking up my application, I was finally accepted. My dreams were about to come true! Or so I thought…
I began graduate school in September of 2012. It was much more intense than I imagined, and I was only in my first semester. During my winter break after completion of my first semester, I fell apart. It was wintertime and like most people with emetophobia, my phobia was out of control. I was desperately trying to control absolutely everything in my environment to avoid getting sick.
I was also terrified to miss school considering zoning out for 2 minutes in class was risky enough. (After about a year of therapy, I realize that I am not only fearful of vomiting, but I also have this intense need for control, which often goes hand in hand with those with emetophobia).
But anyway, things went downhill.
My boyfriend of 8 months was trying desperately to help me however he could (Bless his heart!). Nothing was helping. My family threatened to bring me to the emergency room. I was unable to eat anything but my safe foods (which consisted of just breads/bagels at that time). This caused me to lose a ton of weight. I was chronically late to my classes and struggled to maintain my concentration.
A classmate would get up to go to the restroom and I had myself convinced that they were going there to be sick. I cringed at the sound of a cough or burp. I was fearful of every sounds and feeling of my own body. I ate the same things everyday because I knew they were safe. When I was 8, I was medicated with Paxil but eventually weaned off of it when I learned how to manage the generalized anxiety on my own. At this point in grad school, I became so frustrated that I caved and decided to try medication again. Long story short, the medications made things worse rather than better, so I stopped it under supervision of a physician and started seeking a therapist.
(*Please know that this was my personal experience with psychiatric medications – this is NOT the case for everyone as they are often very helpful)
I cannot say it enough – keep searching until you find a therapist that is a good fit for you. I went through a few mediocre ones, and even a terrible one (He came into my session looking as though he wet himself… I sat there the entire time, trying to focus on the session, but wondering, “Does he know his pants are all wet? Or is he trying to hide it like I am trying to hide my facial expressions?” Needless to say, I never went back to him.)
After some searching, I finally found the perfect therapist for me. I will refer to her as Francine throughout the remainder of this post. She has been my saving grace throughout the last 3 years, at times being the only one who understood how I was feeling when everyone else rolled their eyes or shook their head. She continued to give me hope to push through. But, I could go on and on about how to find a therapist and what makes a great one in another post.
Francine is a big reason why I was able to get through graduate school. There were so many moments where I felt like I was fighting an uphill battle destined for failure. My occupational therapy curriculum involved multiple internships. It started off slow, with the internships being 1 day a week while spending the rest of the week in traditional classes. Once traditional classes were completed (after 2 years), there was a required 6 months of supervised full time interning at 2 different settings (3 months in each setting).
All throughout the program, I was working on doing exposure therapy with Francine. For those unfamiliar with exposure therapy, it is a cognitive behavioral treatment approach that gradually exposes you to the things you fear (AKA – torture.. Just kidding!). Together, Francine and I created an “exposure hierarchy,” a list of things rated based on the level of anxiety they provoked (ex: getting take out from an unfamiliar restaurant, going out to eat at a familiar restaurant, eating with my hands, etc.). Ironically, we often didn’t need to plan out my exposure because… well… life happened!
There were so many unplanned exposures that I had to endure throughout my schooling. Some of these included: being around sick children, watching children receive feeding therapy (and often gagging), being on a traumatic brain injury unit where the most common issue was dizziness, nausea & vomiting, having to deal with not knowing what viruses I was exposed to while working in hospital settings, having patients tell me they were feeling nauseous and being unable to run & hide, working with patients on ADL skills (bathing, toileting) in their hospital restrooms & more.
I continued to see Francine on a regular basis to process all of my exposures and subsequent feelings about them. Despite my level of anxiety and the constant thoughts that I would never make it through, I was doing it. And doing well. My grades were above average. My internship supervisors had nothing but great things to say about my performance. I was succeeding in every aspect of the word.
Despite all of this positive feedback, I lived in a world where I did not think I was doing well enough. I continued to struggle to focus. It was difficult to put the patient’s needs first when I was trying so hard to avoid running away at any discussion re: nausea. There was one instance during my full time internship where I broke down. A patient I had been working with was given new pain medication due to severe pain. I wheeled her to the therapy gym to do some exercises once she said she was ready to do so. She kept asking for tissues to spit phlegm into (this was something she did often so I didn’t think anything of it). Once I stepped away for a second, it started. I don’t need to go into details here as you all can fathom what happened next.
Another therapist rushed to her side as I ran into my supervisor’s office. I nervously exclaimed, “I’m sorry, I can’t be out there. My patient is throwing up and I just can’t tolerate that at all I actually have a phobia of it…” Other random words continued to run out of my mouth out of nervousness and an attempt to normalize my reaction to the event. I was shaking and stuttering. I got a funny look and was asked, “You have to go help your patient. Is someone with her?” “Yes, yes. The other therapist handled it.” At this time, I was watching my patient get wheeled back to her room by other therapists. None of them were I, and I was her OT. I was supposed to be there for her in her time of need.
The guilt trip began.
Not only was I a shaky, stuttering mess but I began to doubt my entire career choice. “I can’t do this. This is clearly something to expect quite often when you work as an OT. How will I ever make it through? How will I ever be a good therapist? Maybe I should just get a desk job. I can’t be unconditionally there for my patients. They don’t deserve that.” I was bummed. I was contemplating other career choices.
Luckily, I had Francine to process this event with during a session. After decatastrophizing the event and focusing on my little successes (which were actually pretty darn big!), I still felt unsure about myself. I continued to push through with her support. At this point, my boyfriend joined me for a few therapy sessions and was also a huge supporter during my difficult moments.
I continued through my internships. You might be expecting me to say that the rest went smoothly but it was the exact opposite. I believe that I was a magnet for all nauseous patients. It got to the point that I had to laugh at the frequency or else I would lose my mind. I could easily say I was targeted, or that I was unlucky.
However, I can look back now and believe I was the luckiest person in the world. I was given all of the exposures I needed in order to continue to succeed. I was pushed way out of my comfort zone. And I handled it. I have to be completely honest, at the time that this was happening; I did not see the benefits. I was struggling. I was in frequent contact with my Francine. I was using safety behaviors and PRN medication. I was on edge all of the time. Each exposure I endured was less anxiety provoking but the fear was definitely still there.
By the end of my internships, I was able to grab a basin for a sick patient, hand it to them, and stand outside of their door while they were sick. I am still unable to stand there with them but hey, that’s asking a hell of a lot for an individual with emetophobia! A large piece of recovery for me was my perception of events. I really began to resonate with the quote “When you change the way you look at things, the things you look at change.” It was my personal mantra when I endured those difficult moments. It helped me to change my perspective and see challenges as opportunities to recover.
If you ask me if I am cured of emetophobia, I will surely laugh. No, I am far from “cured.” But I am living. And being able to live with emetophobia is much more valuable to me than being cured. Why? Because I can prove to myself that I can do it. That I am stronger than this phobia. That I can succeed. I can sit with the uncomfortable feelings that emetophobia creates after much work in therapy. I still use some safety behaviors. I am entitled to have a bad day. I am gentle with myself. I continue this fight and I refuse to give up. Although it may not seem like it at times, you too can reach your dreams despite having emetophobia – I am living proof.
I have attained my goal of becoming an occupational therapist. I graduated in January 2015. I am currently employed in a hospital (yes, you read that right!). I am an occupational therapist on the behavioral health units, helping others to live life despite their mental health conditions. The coolest part? I spend 50% of my time working on a specialized eating disorders unit & I would be lying if I haven’t worked with individuals similar to myself, fighting the tough battle with emetophobia.
I have been able to advocate for appropriate treatment for this phobia and helped others to see that it is not to be confused with anorexia or bulimia. What are the chances that I end up in this setting?! I am a firm believer that we are all placed here for a reason, and your struggles will bring you to where you are meant to be. Embrace them & trust the process.
Thank you to JCB for sharing their personal story!
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Lastly, I run an Emetophobia Support Group on Facebook. Emetophobia is the intense and irrational fear of throwing up, and it is one struggle I am passionately engaged in. The group is a closed, by request only group to help facilitate sharing and support by all members. It is also private, meaning that the posts you and others make will not show up publicly in your newsfeed.