How did I recover from emetophobia? Most of it involved six or so sessions of EMDR, the rest was my footwork, doing the EMDR practice at home when I felt like I needed to.
Note: EMDR stands for Eye Movement Desensitization Therapy. If you're interested in it, put the phrase or the acronym into Google or your favouriet search engine and see what you get. There's lots of information on the web.
First, I went about it by finding my EMDR therapist online. He's the head of EMDR Australia (where I live) and when I emailed him and asked if he could give me a referral he said he was moving to my city and would like to treat me himself! So firstly I know I have a great EMDR guy.
Then, as I have many other health problems besides emet, I got him to talk with my GP about stuff. My GP was initially very skeptical about it and did not really want me to go but after talking to him she was eager for me to try it and had high hopes as I did.
I asked him heaps of questions first, in email and on the phone and in our first consultation. I asked him if he'd heard of emetophobia (no) and was he willing to learn about it (yes) and what did he need to know (everything).
I think one important factor was I really REALLY wanted to give up this phobia. Even if it took away my emet-based "inability to throw up" that we seem to have. Even if it took a year of EMDR. NO MATTER WHAT, I wanted this gone with all my heart. Even if the treatment was the scariest thing on earth (it wasn't).
So I was really ready.
I know that people always say they want the phobia gone, but I think for a long time I clung to it as a safety-net and all-purpose excuse not to need to do anything. That's okay, but while I was doing that there was no way I could get rid of the phobia. I said to the EMDR guy, "I'm terrified, but I want this thing gone NO MATTER WHAT." and he said that was a great attitude.
At our first session first we talked about my other health and psych problems and if/how they would affect our EMDR sessions. I won't go into that now, since it won't be relavant to the story.
Then he made a "safe space" for me. He asked when I felt the absolute safest in all the world - for me this is when my boyfriend is holding me tight and I feel nothing bad could happen. So he did some EMDR reinforcing that and said that if I got too scared at ANY time I just had to ask and we could go back to that safe scene.
By this time I had established he was a nice guy and so after all the talking and the safe space stuff I wasn't afraid of the rest of the EMDR session.
He asked me if I knew how my emet started so I told him my theories and the bad throwing-up-related stuff that had happened to me when I was young and he was totally validating, saying stuiff like, "That would be terrifying for a toddler, yeah" and stuff like that.
Then he asked me what I was most afraid of, a scenario. For me this was a restaurant, being in a restaurant and unexpectedly throwing up with no time to leave the table. I described it to him in graphic detail, as much as I could (he kept asking more questions about the scene) which wasn't too hard as the scene is in my head a lot. He asked me what was the scariest part of the scene - people laughing at me or being disgusted at me if I threw up - and why I thought it was the scariest - I didn't know.
When he had it, he asked me to get the scene into my head and asked how I felt (shaky, cold, clammy, nauseous, scared), and then did some EMDR pen-waving for a minute or two and asked how I felt again (about the same).
I told him around this time that I didn't know how I was "supposed" to respond, what I was "supposed" to say after the pen-waving bits and I didn't want to get it wrong. And he said, "it's not a test, there IS no wrong. If you don't improve then it's my fault, not yours." That made me feel less stressy but I still worried I'd say the wrong thing after each bit of EMDR.
We repeated this a few more times and gradually I got to be feeling less scared of the scene. After each EMDR "bit" we talked for 5-10 minutes about how I was feeling right then, and how I felt about the scene and talked a little bit. We DIDN'T tackle emet in general, in that consultation, only the restaurant scene. But by the end of it, after about an hour and a bit, I was feeling not scared of imagining the scene in my head anymore, and interested and curious as to how I would react in a real restaurant. I wasn't scared but I wasn't exactly not-scared or confident or anything either.
I described this feeling to the EMDR-guy and he said that was exactly the feeling that meant I was probably going to be fine and that I should try not to have any expectations of what would happen, especially not to expect it to be a catastrophe if I did go into a restaurant, but just to keep an open and curious mind and notice my reactions.
I also privately started keeping a notebook of things I noticed and questions I had for him and took it along to sessions so I didn't forget anything.
Between my first and second sessions I spent 6 weeks in hospital for something connected to my physical problems. That included 2 operations and quite a lot of nausea feelings, but I felt that overall everything was a little better. That when the nausea came I wasn't quite so terrified of it. Even though we had NOT worked on that at all. It still scared me and I still took my Xanax (anxiety med) and Maxolon (nausea med) when it hit me, but it wasn't quite so bad.
I did go to the hospital cafeteria on a few occasions and felt mostly totally at ease, not needing to sit by the entrance, not automatically scanning for the closest place I could run (or rather, wheel, as I was in a wheelchair) if I felt like I was going to vomit. But as I have been in that hospital so often, I have a lot of "practice" with that cafeteria and I'm not really very scared of it anyway. I always figured in hospital they -expected- people to get sick occasionally so nobody would laugh at me. So I didn't really count those cafeteria times as "restaurants".
So I never had the chance to go to a "real" restaurant between my first and second sessions, as I had been planning. When I went back for my second session, about two months after my first, EMDR-guy was very interested in how I had been and what had been happenening with me and seemed to care about me as a -person- not just "a case" which was nice. I explained how I hadn't been to a restaurant, just the hospital cafe, but that I thought I -could- have gone to one if I'd been healthier. I also explained how I felt like everything was a little better, like spin-off effects and he said that was pretty common but he hadn't liked to say it to us because he didn't want to disappoint us if it didn't happen for us. That made me pleased, and feel like the EMDR really WAS gonna work.
By this time I was very comfy working with him and had the feel of the mechanics (what I called pen-waving) of the EMDR and how he structured his sessions and stuff so I was relaxing a bit in the sessions which was good.
In the second session I got out my notebook and read what I'd written over the last week (I'm famous for forgetting what I want to tell therapists by the time I get there!) and asked if we could tackle the EMDR in general, not just a specific scene. To do that we had to figure out what it WAS about vomiting that was scary for me. I had already worked on this part for ages with my regular therapist so I went over it again with him. For me, it's the social part of it - being out of control and being -seen- to be out of control, people might laugh at me, people might be disgusted, people might laugh behind my back afterwards, etc etc. That sort of thing.
So we worked on imagining a more generic vomiting scene with people laughing at me and stuff like that, and did some EMDR on that. It took a while of pen-waving sessions and talking in between about what I felt (and being -honest- about what I felt, even if it felt silly) but gradually I got more de-sensitized to that too.
After my second session I went to a restaurant!
I was always more-or-less OK with sidewalk cafes and had, on occasion, been inside this cafe and sat at the table RIGHT near the door. But never further in than that. This time me and my boyfriend went confidently in, he asked me to choose a table so I chose one in the middle on purpose to "test" myself. I chose gnocci pesto to eat, and it was yummy. We told everybody it was our first date, even though we've been together 6+ years, because in all that time we'd never been really IN a restaurant together. A few times I got nervous and had to take a deep breath, but my anxiety never got worse than that. I had a WONDERFUL time. I was so HAPPY!
I wrote down in my notebook about the event and also noted the nervousness that sometimes cropped up but could be breathed away. NOTHING like the emet-panic I usually got. At my next session I excitedly told him of my adventures and asked about the nervousness. He said it was probably my mind remembering somehow it felt it was "supposed" to be nervous because it was so used to it. But that deep breathing like I'd done and not obsessing over it was the best thing, and my mind would get more retrained over time. We also did some EMDR over it.
In the third session we actually concentrated on more general things than emet! Like being scared of people not liking me, and of them laughing or not understanding if I did something dumb. I think this sort of stuff is the roots of the emet anyway so it's important to express. We also worked on stuff related to school (I'm planning to go back to school to do 1 subject next year) and being worried what people will think of me. Also worrying that my parents' problems are all my fault, "I ruined their lives" etc.
The only thing that was really left to resolve at that point, was that every time I got some nausea for no apparent reason (and my physical problems produce this fairly often, a couple of times a week) I felt scared that the whole EMDR thing isn't working anymore and my lovely cure is gonna fall down around my ears. After working on this for one session I can now say I'm basically recovered. Wow.
What can I do now? Well, just the other day I was in the emergency room (aka casualty) at the local hospital, and the guy in the next bed was throwing up noisily and continually. Sure, I felt uncomfortable and wished I could get away but I didn't freak out and I didn't run away. It turned out he had a bowel obstruction so it wasn't contagious, which helped me some after I knew, but even before that I had no panic attacks, just a level of anxiety I think maybe a bit more than a regular person would have had. I'm so proud of myself!
-- Ricky
