My old friend 'Emet'

"Emetophobia (from the Greek etmos, to vomit, and φόβος (phóbos), meaning "fear") is an intense, irrational fear or anxiety pertaining to vomiting. This specific phobia can also include subcategories of what causes the anxiety, including a fear of vomiting in public, a fear of seeing vomit, a fear of watching the action of vomiting or fear of being nauseated.^[1]"

Not only am I battling anorexia, a lot of my issues with anxiety around food stem from a phobia I have been having therapy for since I was 7 years old. Emetophobia. 

It used to dramatically affect my everyday life and led to daily panic attacks throughout my childhood and teenage years. Its direct association with food and eating was the first reason I was referred to the EDU in 1993, then in 1995, 2000. I have had extensive counselling, therapy, CBT and battles with Emet and as I have grown up, it affected my life less as I've gotten older, I suppose, mainly because I learnt how to control the anxiety and panic attacks and 'faced the fear.' during my years at university and in my working life. It doesn't 'go away' and I could think of nothing worse than vomiting (especially in public) and the thought of being sick or feeling sick fills me with dread if I stick with the thoughts too much. 

It has direct links with restrictive anorexia and can, in some cases, lead to people suffering with Emet being wrongly diagnosed with a clinical eating disorder, but in my case it's all mixed up. 

Although my Emet hasn't 'caused' my clinical diagnosis of Anorexia Nervosa. They are intrinsically linked by food and diet, yes, but they are not the same thing. In going over old notes with my current therapist (at the same unit) I have started to realise that I used my EMET to HIDE my struggles with AN as 'Ana' became a louder voice.

However, now in recovery I am tackling the left over anxiety and habits linked to well-engrained obsessions (and compulsions) with food. They are all still present and cause problems as I am recovering. It's a case of 'balancing' the phobia, OCD behaviour and AN at the same time - what a juggle ehy?

A few problems are: 

-My list of 'Emet' SAFE foods are my AN 'Bad' foods.

This means I 'blamed' my EMET for the conflict I used to feel about not 'listening and following' Ana - I was tied to my safe options and gave myself a hard-time about not leaving them - and this lead to Ana telling me I was TOO WEAK to listen to her.

-I 'banned' so many foods throughout my life, I don't actually know which as AN or Emet choices.

-I get set in a rigid structure with food and meals 

-I don't mind eating the 'same old foods' I always have.

-I am scared of 'new' foods making me sick

-I have deep rooted 'good and bad' foods

-I find it hard to separate my AN thoughts, OCD habits and EMET anxieties.
-I have always had 'disordered eating'  

and a long, long list of other conflicts that make sessions with my therapists multifacial to say the least! 

Eating Disorders, OCD & Anxiety

This week's video from one of my favourite Recovery Warriors, Arielle, is relevant to the way in which my anxiety, OCD and ED work together. How one (or two) can lead to, be a result of, and maintain the other(s).

WATCH IT HERE

I have suffered from OCD and Anxiety most of my life but only been diagnosed with anorexia in my twenties. My ANX and OCD have always surrounded body image, food, will-power and control. Through lots of therapy and support I manage to control my OCD and ANX, but find it hard to control my ED.

It's hard to separate the three and try and figure out if my anxieties and obbsessions with food, health, calories, weight and body were always an ED or whether these teamed with my perfectionism, self esteem and control issues lead to my anorexia.

Which ever way round it is, the three have a massive impact of my life and all three are hard to overcome.

Click the links above this or below to watch the video on Arielles website.

Arielle says;

"Actively Arielle: A Voice With A Commitment: Eating Disorders, OCD, and Anxiety: This week I discuss these 3 and how they are linked. I also discuss ways of dealing with anxiety, and disclose a bit of personal information..."

Yellow Eggs and Red Sauce

Sitting at breakfast this morning, E and K have scrambled egg on toast. The doorstep toast is warm and the butter is melting nicely, the eggs are scrambled perfectly and look like little egg clouds floating in the jug. The condiments are put in the centre of the breakfast bar, more butter, salt, pepper and tomato ketchup. 

Where's your red sauce? 

Tomato ketchup is delicious on scrambled egg (so I’m told!) as E drizzles the RED sauce on his breakfast; K adds salt to her eggs. “I WISH I could put RED sauce on my eggs, I could just eat that, I bet it’s really tasty” She says. So, on overhearing this, I ask “why don’t you then?” Pause. “Well its RED sauce on YELLOW egg isn’t it? If red and yellow go together I WON’T be able to eat it, I just COULDN'T!” Pause.

My Dad, E,  pushes and pushes for K to try adding RED sauce to YELLOW egg, trying to persuade her that it is (as she suspects) extremely tasty. “Go on, just put some on if you want it.” He suggests. Even sacrificing a slice of his own breakfast for the cause in an attempt for her to try the mixture. They both suspect that it would REALLY complete her breakfast. But it’s no good.  The yellow and red together thing is too much for her to handle. There is NOWAY, no matter HOW tasty it may be, or not matter how much she’d love to, that K will add RED sauce to YELLOW eggs.

This conversation was all too familiar to me. It’s usually me in the ‘Why CAN’T you JUST eat more of what you know will be tasty?” Why CAN’T I just eat more substantial meals, or have full-fat cheese or whole milk? Why can’t I have pasta two nights in a row or eat a slice of cake I’ve lovingly baked for everyone? It doesn’t even work when people sacrifice what I suspect is a yummy sweet, just so I could perhaps TRY it. Nope, it’s just too much sometimes.

It’s what it’s like for me. It’s not a choice, it’s not something I can ‘just do’ and in the same way that there is NOTHING physically stopping K putting tomato ketchup on her eggs, there is nothing PHYSICALLY stopping me eating more, stopping me eating high calorie foods, foods with a higher fat content. I have those foods there in front of me, ready and waiting.  I wish I could eat them, like K wishes she could put red sauce on yellow eggs, but it is a fear holding us back. It can seem irrational to those around us, that can’t understand WHY if you like the taste of something, if you WANT something that you CAN have, why don’t you just do it?  

It’s not even a case of not eating now, because I am eating and to me I am eating a lot. Almost five times more than in the grip of my anorexia, five times more calories, five times more food. I’m Five times BETTER than at my worst and better at battling the fears.  My calories are very nearly back to normal (okay, with the help of Fortisip) but I still can’t JUST EAT high-calorie foods, foods I have labelled ‘bad’ for most of my life and foods that I have fears around. I wish I could help people understand that I have this fear, this barrier, and this power stopping me with EVERY bite. 

The foods I have now re-introduced in to my diet were once dangled in front of me, teasing me, but I just couldn’t eat them. Every bite of food I now eat was once K’s red sauce and yellow yolk situation, each one I now eat required me to face my fear front on and put it in my mouth. Each food I still won’t touch is going to require me to be brave enough to just face it and eat it. Each time E and K see me eat something new, something on my ‘bad’ and ‘fear food’ list, they need to remember it’s like K facing her fear head on and adding the sauce to her breakfast, which today, she didn't. I was just too much. 

Too much to handle 

Yes, to other people my fears probably seem ‘irrational’ - food is, so I'm told, to be enjoyed. It's the same way I can’t understand why red sauce can’t be put on yellow egg yolks. 

When I attempted to explain this concept this morning I was greeted with ‘Yes, but, at least I am eating.” Au contraire, dearest K, you’re not. You are denying yourself the red sauce on your eggs, despite knowing it’ll be tasty. It maybe be on a different scale. But the concept is the same! Right? Well, apparently not.

But when K says she CAN’T put it on her eggs, despite really wanting to, I am able to apply my fears of gaining weight, of food and of fat and understand that when she says she CAN’T enjoy ketchup on eggs, she just CAN’T at that point in time. Not only that, she can’t explain WHY she can’t. And so she goes without something she KNOWS she would enjoy, and the eggs go without the sauce.

It’s exactly the same concept. Why can I see it and they can’t? 

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