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One Way To Curb Worrying

Hi, my name is Lauren and I’m a chronic worrier.  I worry about the future, things I’ve said in the past, how I’ll get through my to-do list, what direction society is heading, if my kids are growing up right, etc.  It’s fine to think about those things, but I excessively overthink them.  As a therapist who treats anxiety, this sounds not-so-good, right?  Actually though, it means I know which tools are helpful.  Here’s one of my favorites.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

The story of a girl who overcame her fears

Overcoming Anxieties and Overcoming Fears Image courtesy of scottchan at FreeDigitalPhotos.net

Overcoming Anxieties and Overcoming Fears
Image courtesy of scottchan at FreeDigitalPhotos.net

This week I conducted a session with a 14 year old girl who has really worked hard to overcome her anxiety.  I felt so incredibly proud of her, that I asked her permission to write a little bit of her story here.  Just to help you understand what kind of person she is, she answered, “Sure, you can write my story.  Especially if it might help someone else.”

 

A few months ago she was finishing Freshman year of high school.  She says she was struggling with her attitude toward school, and really toward life.  She had days where she felt very anxious about attending school.  The anxiety could be bothersome enough to cause physical symptoms, or make her want to miss school.  She says this really affected her grades.

 

A lot of kids in this situation just give in to the anxiety.  They let it wash over them until they become fearful of any social situation.  This girl did the exact opposite.  She decided to walk straight towards her fears with a rare tenacity.  She has a dream of becoming an editor someday.  So, she applied to become the editor-in-chief of the school newspaper.  She told me it was a longshot because that’s typically a position reserved for upperclassmen.  She also decided to join the cross-country team; this is a girl who told me she’s not sure she could have run one lap around the track when she made this decision.  She said she wanted to get healthier and have the chance to make more friends.

 

All summer long she worked on building endurance.  She stuck to a running schedule and joined the summer team practices as often as she could.  She frequently had to walk, and sometimes felt sick.  She said she was usually coming in last on the runs.  Sometimes she felt discouraged and thought she didn’t add any value to the team.  After a short time of struggling with self-doubt, she gathered her courage and decided to play a different role on the team; if she couldn’t be the fastest runner then she was going to be the spirit of the team.  Imagine for a second how difficult it must feel to be inwardly shy and even socially anxious, but outwardly be consistently cheerful and encouraging.  She’s done such a good job at it that other teammates have started to notice.  Now you are beginning to see why I felt so proud of this girl!

 

She also was just named the editor-in-chief of the school newspaper as a sophomore.  Thought she had felt terrified to try, she decided she had nothing to lose.  You can’t get what you want if you don’t at least ask.

 

This 14-year-old has something most of us don’t get until we’re much older, if at all.  This 14-year-old girl has learned to swim against the current of her anxieties to pursue her goals.  She wanted more school involvement, experience editing, a chance to make some friends, and a way to get in shape.  All of these things scared her, but she went after them anyhow.  It has not been easy at all; she says she is just starting to feel the reward for several months of going outside her comfort zone.  She has come to understand what it means to work hard for a goal even though the payoff takes time to realize.  She is learning lessons that will bear fruit for the rest of her life.

 

How does this story help you help your teen?  Hopefully your child can realize that even though risking failure and facing fears is overwhelmingly scary, it can be done and it can be rewarding.  So, for those of you facing tough situations, hang in there because the payoff is somewhere around the corner.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Fear of Vomiting (Emetophobia), Part 3

Counseling can often be helpful for emetophobia.
Credit: freedigitalphotos.net/David Castillo Dominici

To quickly summarize last week’s post on emetophobia, we covered that it is a really ovewhelming anxiety response to the idea or feeling of throwing up.  We also covered that one of the first things done to treat it in therapy is determining the fear’s origin.

 

The next step taken is to find out what things are avoided because of the fear.  For example, does the emetophobic refuse to eat sushi?  Does the emetophobic wish to go on a cruise, but won’t because of the reputation cruises have for viral outbreaks?  What else is avoided?  I knew someone when I was younger who wouldn’t drink alcohol because he associated drinking with throwing up.

 

Then we find out what the safety behaviors are.  When I was more frightened of vomiting than I am now, I would make sure there was medication in my purse for a stomach ache.  Sometimes safety behaviors don’t even really relate to the problem.  Someone with emetophobia might make sure she always wears a lucky bracelet because she has never gotten the flu since she bought the bracelet.

 

With the list of avoided behaviors and safety behaviors in hand, a fear hierarchy is created.  This is when therapist and client work together to make a list of most scary event to least scary event.  At the top would likely be “vomiting.”  At the bottom might be something like, “Write the word ‘vomit’ and all its synonyms on a piece of paper and then read them out loud.”  Yes, for someone with emetophobia even that can induce anxiety.

 

Together we work our way up the fear hierarchy as much as possible.  Some things can’t be replicated in therapy.  For example, a therapist doesn’t really have a way of making a client actually vomit, so they probably aren’t going to do that in a counseling session.  A therapist can have a client imagine doing it though, which still helps alleviate overall anxiety when done properly.

 

The point of all this is to say, emetophobia is almost always treatable.  If you or your teenager is living a less fulfilling life because of a fear of throwing up, please call.  It doesn’t have to stay this way.  Things can improve if you’re willing to put in a little work.  One of us here at Teen Therapy OC would be honored to walk through this difficult journey with you.  I personally have been quite afraid of it at one point in my life, and had to work myself back to a place of it not interfering with my daily happiness.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT

Fear of Vomiting (Emetophobia), Part 1

For someone with emetophobia, a stomach ache is a scary event. Credit: marin/freedigitalphotos.net

When I first became a licensed therapist in 2010 I knew about fear of vomiting, but I hadn’t come into contact with it as a therapist.  Then one sweet young teen girl came in to see me and one of her primary problems was a fear of throwing up.  At that time I had no idea how common this fear was.  As one client jokingly tells me, “There’s the big 3: fear of death, fear of public speaking, and fear of vomiting.”  According to anxietyuk.org, 2-3% of males and 6-7% of females deal with fear of vomiting.  That tells us it’s pretty common.  That means either you or somebody you know is not just uncomfortable with the idea of throwing up, but actually feels a fear response when they have to vomit.

 

Emetophobia has a wide range of how much it can affect someone’s life.  For some (like me), fear isn’t experienced until it is actually time to throw up.  Then a panicked feeling comes over the body and it takes a concerted effort to calm down before allowing the vomit to come up.  For others though emetophobia can dominate their lives.  The sweet girl I wrote about above spent nearly all her time obsessed with the question of when she might next throw up.  She wouldn’t eat any foods she associated with any kind of stomach ache, even when those associations logically didn’t make sense.  She wouldn’t spend time around young children because she assumed they were more likely to spread germs, and she had vowed to never get pregnant for fear she might have morning sickness.

 

I wish I could give you a happy ending to the story of the sweet little girl, but sadly I was an inexperienced therapist back then.  I did a passable job with the necessary type of therapy someone needs to go through when they have a strong phobia.  However, it wasn’t good enough for her to feel all the way better.  I know so much more now about how to deal with this kind of challenge.  That said, even now, I’m still learning.

 

Here’s a little sample of what I do know about the treatment of emetophobia: We start with trying to ascertain when and why it began.  In my case, I became fearful of vomiting because I hadn’t gotten the flu since I was 11 years old.  When I finally had a stomach virus at 22 I didn’t remember how it felt to vomit.  I was caught off guard when I threw up even though I had been feeling nauseated.  Because of this it went through my sinuses at the same time as coming out my mouth.  I felt like I couldn’t breathe, which caused me to panic.  It’s taken a lot of cognitive-behavioral work since then to completely overcome this frightening experience.  I’ve thrown up many times since then and none of them have been anywhere near as frightening as that.  In fact, none of them have ended up being a big deal at all.

 

Once we know where it started, we move on to a fear hierarchy.  I’ll tell you more about that when I continue this post next week.

 

Helping teens grow and families improve connection,

Lauren Goodman, MS, MFT