Emetophobia: How to get through the anxiety storm – learn how to drop anchor.
Those with Emetophobia often feel a strong sense of anxiety and fear. These emotions are powerful and are designed by nature to prompt us into action to prevent or escape the cause of our anxiety.
However, it is the act of trying to prevent or escape these fears and emotions which is prolonging the phobia. The more you escape, the more you try to prevent, the more fear and anxiety you feel. And to make matters worse, it is hard to escape from the fear of vomiting because it is internal. Your anxiety wants you to run from it, but it is impossible. It simply does not work.
So, what’s the solution?
Anxiety is a warning sign of danger. However, it has become way too overactive. It overreacts to even the slightest possibility of your fears occurring. So, we need to teach it to calm down and become less reactive.
We can achieve this by validating our feelings but not letting them control our actions. Each time we tolerate anxiety and do nothing and our fear does not come true, our anxiety system learns to calm down slightly. Over time and repeated attempts this restores balance to our anxiety system. It learns too not overreact. We also learn we can cope with uncomfortable feelings without needing to try and control them.
You may be thinking “well that’s good in theory… but how can I tolerate anxiety and fear. It feels awful”.
We can achieve this in various ways. One is the traditional use of exposure and response prevention therapy. However, this blog will focus on a different technique called “dropping anchor”. This comes from a type of therapy called Acceptance and Commitment Therapy (ACT) which is highly effective and helping you learn to accept and tolerate uncomfortable thoughts and feelings.
The term “dropping anchor” comes from the idea that feeling strong emotions is like being in a boat during a storm. Trying to escape and outrun the storm is not an option (i.e. avoidance or safety behaviours). Neither is trying to argue and debate with the storm (i.e. trying to convince yourself that your fear isn’t going to happen). But what you can do is drop an anchor and wait for the storm to pass with a sense of calm, knowing it will end and that you can get through it.
Dropping anchor is achieved by using something called the ACE method - which stands for Acknowledge, Connect, and Engage.
Acknowledge thoughts and feelings:
First you need to acknowledge what you are feeling. Take a moment to acknowledge your anxiety, fear, stress or apprehension. You didn’t ask for these feelings, but they are here regardless. They are challenging and unwanted, but they are here. Acknowledge and accept their presence. Either in your head or out loud, label the feelings you are having.
Now turn your attention away from these feelings for a moment and into your mind. Acknowledge your worries and fears going through your mind. Name your fear either silently or out loud. Again, you didn’t ask for these anxious thoughts, but here they are. Acknowledge and accept the fact they are there.
Connect with the body:
Once you have acknowledged your difficult thoughts and feelings shift your attention towards your body. Recognise all these thoughts and feelings are contained within your body. Try to connect with your body through small movements. Try a gentle stretch, or wiggle your toes, or move your fingers. Place your hands over the parts of your body you feel tension or stress.
Engage in the world:
How shift your attention away from your body and into the external world. Look around you and name something you can see or hear. Touch an object in your surroundings and really take time to notice how it feels. Try and do something mindful at this point such as eating, drinking or doing something slowly and placing your complete and total focus on it. Try to imagine you are an alien visiting earth and doing this for the first time. Really focus and examine what you are doing with all the curiously you would do if it was your first time. Taking in all the sensations.
If you are unsure on how to do this, you can choose from this list:
Focus on something you can see - What interesting objects are within view? Can you see any interesting shapes or colours?
Focus on something you can hear - Try putting on a nice song and focus on a particular instrument, sound, beat or lyrics. Or focus on what can you hear in your room or outside on the street.
Focus on something you can smell - Feel free to grab an orange, perfume or a nice candle.
Focus on something you can taste - Grab something tasty. Try getting a single raisin and eating it as slowly as possible. It is surprising how good something that small tastes when you focus your full attention on it.
Focus on something you can feel - Focus on how your clothes feel against your skin or the sensations of the chair you are sitting on. Or how the floor beneath your feet feels.
Shifting between them:
Now you have done this, shift your focus back to your uncomfortable thoughts and feelings. Acknowledge they are still there. The storm is still going on. You are not trying to hide or escape it. Just to get through it. After about half a minute, shift your attention back towards your body. Notice your sensations and gently move. After another 30 seconds, now engage back into the world around you.
Keep alternating between these three tasks.
Acknowledging your thoughts and feelings.
Connecting with your body.
Engaging with the world.
Do this until the storm passes, or when you start to feel you are able to accept and tolerate your uncomfortable thoughts and feelings.
Now the important part!
Make a conscious decision on how to act:
Once the storm passes. Decide on how to act. This pairs up nicely with exposure therapy. Do you try and escape or prevent your fear, or do you decide to get back on with your day with a sense of calm and acceptance?
Remember, one of these actions will feed your fear and one will help you in the long term.
The key message:
Uncomfortable thoughts and feelings are a normal part of life. We don’t need to run from them. We can learn to accept, tolerate and get through them with a sense of calm. During dropping anchor, you were instructed to continue to shift between your thoughts and feelings, connecting with your body and engage in the external world. This was to demonstrate you can get through your feelings without trying to push them away. Once you learn to accept and tolerate uncomfortable thoughts and feelings, you can move past it and make a conscious effort to act and live the life you want without acting on your anxiety.
Cold Water Experiment: If you struggle with dropping anchor try this.
Some people cant see how you can accept feeling uncomfortable. It’s a hard concept. But it’s easy to demonstrate.
Next time you have a shower, put it on the coldest setting possible. Walk in and feel how awful it feels. Stay there for 10-20 seconds if you can. I can tell you right now, it feels pretty awful and every fibre of your body will want to jump out.
Now try it again, but don’t fight the cold. Accept it calmly. Breathe through it. Remind yourself it’s only for 10-20 seconds. Stay still and just feel it. Even though you are going through the same experience, it often feels very different. Somehow easier and more tolerable. Taking this approach of tolerance, many people actually realise they can stay in the cold much longer than they expected.
This experiment should demonstrate the benefits of how accepting uncomfortable feelings is possible. Now apply this to your anxiety.
Therapy:
Emetophobia is treatable. I recommend reaching out to a BABCP accredited CBT therapist or self-referring yourself to the NHS talking therapies services which can offer Emetophobia support.
Written by David Kaneria - CBT Therapist