Adventures in Exposure, No. 1

A fact about me: I’ve had emetophobia, for most of my living memory. How it began is a mystery to me, but I suppose like a lot of my conscious and unconscious decision-making, it came from issues of control.

In this day and age I think you’d be hard-pressed to find a person who didn’t have some control-oriented ‘issue’, much less a person who has grown up constrained by a label like ‘girl’ or ‘boy’ which they don’t identify with. Let it be known that my family, my wonderful, blessed family, have never been the source of this pressure. I’m talking from the perspective of someone with a supportive family, regardless of how terrible some of my choices may have seemed to them. More on that later.

So the vomit thing. At this point in time, I’ve been receiving Cognitive-Behavioural Therapy for the problems I have been living with for most of my adult life. At my worst, I was afraid to leave my house or use public transport. The control freak which lives in me – no, the control freak which is me – still managed to persevere and force me to do it anyway, but the overall level of anxiety I was living with on a daily basis was intolerable. I would spend evenings in my room, wracked with a mental tiredness only assuaged by binge-watching uplifting YouTube videos, which in turn drained what little drive I had to do the things I wanted to do.

My therapist is a sweet person. Sarah. We’ll call her Sarah. She and I met through the random lottery of NHS referrals, and within our first 3 sessions she already knew the most difficult truths about my life; the ones I don’t even like to tell myself, even though they’re true. She was the perfect foil to my self-destruction, my determination not to change things, even though I’d carried my phobia in the form it eventually took for at least 11 years, heavy on my broad shoulders, and things desperately needed changing.

Sarah has set me up with gradually-increasing levels of exposure therapy, something that had me shaking and crying at the mere mention of during our first session. There was something raw and animal about me in those first few weeks of seeing her, something I’d tried my best to bury under my layers of Capricorn stoicism and self-sufficiency; an anguish and defeat I felt at finally having admitted to being ill, and needing someone else’s help and validation to get out of it. One day I’ll talk about the power of admission, but for now let’s just have an intro.

So each week since about session 4, I’ve been assigned bits and pieces to do, to gradually expose myself to the things which frighten me. When I speak about being frightened I’m speaking about the terror of panic attacks which end only to begin again, the tightened chest, the hyperventilation, the terrible wish for sudden death. Not suicidal tendencies, exactly, but the wish I’d just simultaneously combust or drop dead so I didn’t have to continue being assaulted by my worst fear. I used to wish I could press a self-destruct button every time I rode the Tube, my fixation and fear – brought on by one instance of seeing someone vomit on the tube, at 9 in the morning on a Tuesday – was so great.

I started with South Park vomit clips, far more challenging stimulae than a lot of Sarah’s other clients, some of whom cannot even read the word without crying. Animation wasn’t as awful, though the sounds were enough to quicken my heart rate and send the blood rushing from my extremities. I progressed through this to looking at photographs of people being sick. This was particularly difficult, ‘frat boy vomits into toilet’ being the benchmark for progress so far. Now I’m watching films with non-graphic vomiting scenes in them. This is probably the worst because I am having to watch terrible films I would never watch in a million years. Again, the control issue comes into play; having to force myself into hunting down things which repulse me is the least natural act I’ve ever committed, but if I want to get better, I simply must watch Pineapple Express* from start to finish.

At some point I have to watch Bridesmaids and Pitch Perfect, two films which I know people love and yet I’m hugely traumatised by. I’ve watched the former before, and strongly disassociated after the infamous bad Mexican food aftermath scene, so now the only thing I remember is that particular scene in detail. My rational brain knows it was pretty funny apart from that but the rest of me just remembers the humiliating cold which sunk into me as that scene played out, the hot burning tears of frustration at myself, the wondering why I couldn’t just laugh like my friends were, and the detached stillness that took hold after the jump cut, where I didn’t feel a thing and the rest of the film passed silently in front of my glazed, impassive eyes.

Sarah reminds me to be kind to myself every week. I’m good at being kind to my loved ones and friends, I’ve learned to do a good impression of someone sociable and extroverted, and I’m generally regardless in a positive light, but the standards I hold myself to with self-love generally begin and end with eating what I want and masturbating regularly. Consciously examining my feelings, writing down affirmations, doing things I actually want to do in the outside world? This is a foreign world to me. I’ve viewed myself as a cyborg for so long that the idea of growing compassion for myself often seems impossible. My self-esteem is high, yes, but my ability to be my own care-taker? To realise when to say no to my own expectations?

I mentioned earlier that my phobia comes from problems with control. This entire experience has been a class in using that self-discipline, the control I’ve had which taught me to wear noise-cancelling headphones on the Tube, travel mostly by bus, play Color Zen, keep my head down, be back home by 9pm (safety behaviours, all of them, means for survival when things were truly dire), to instead confront things head on. Grab the proverbial bull by the horns and look unflinchingly at the thing which causes me so much pain and shame. Being a control freak has its benefits, and one of them is the ability to suffer intolerable pain, and analyse it, breathe through it, and move on.

So far recovery is mostly this: sitting down at my desk, notebook open. Pen in hand. Deep breaths, writing. 1. Something I can do now, which I couldn’t do before. Write it down. 2. Keep going. You’re doing so well. Another. Sip of tea. Pause. Look out of the window. 3. Good. Another. 4.

I’ve reached number 22. One day I’ll watch Bridesmaids.

Until next time,

Lilith x


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