Recovery Pyramid

William, January 10, 2024

When I built Bia, I started using it every day. I spent 15 or so minutes using it in the morning, I used it on the bus on the way to work, I used it while waiting in line at the bank. Things were finally clicking for me. I noticed myself sitting through vomit scenes in T.V shows without shutting my eyes. I noticed myself feeling full after a meal and not spiraling into thinking I had the flu. A positive cycle was forming where I was doing new things and feeling good, so doing even more new things was becoming easier and easier. I shared all this progress with my therapist. He asked me 'Why do you think everything is working right now?'. This post is about my answer to that question.

I had attempted therapy for emetophobia multiple times, but never felt like I could fully conquer it until now. What was different? I had to compare the two versions of myself - me now vs me from 7 years ago. I realized that my recovery from emetophobia was only a little bit about vomiting and a lot about confidence and empathy for myself. I used to visualize recovery from emetophobia as a line. If the line goes up I am recovering, if it goes down I am feeling terrible. Obviously life is more complicated and as my phobia retreated from my life I started visualizing my recovery as a pyramid. Each stone in the pyramid as essential as the rest.

The Foundation: Practicing exposure and response prevention gave me the skills and confidence to tackle other problems in my life. I called my closest friends and I told them about my emetophobia - they had never known. I explained how I had wanted to go to the bars with them but always found an excuse not to go. I told my parents that phobia is why I quit playing soccer in high school, and I asked my wife if she remembered I made us leave our high school prom early (She didn't). I felt connected and closer to the people around me for sharing my emetophobia. A foundation to my pyramid was formed.

Empathy for My Past Self: Thinking back I could so clearly remember all the times that phobia was behind the wheel of my actions. I was so frustrated with myself for letting phobia dominate me. I wanted to scream at myself. I pictured it, this little 8 year old boy - terrified to eat pizza or ride in the back of the car - and I'm just screaming at him. Releasing this guilt and understanding that boy was just doing the best he could was a massive part of my recovery. A weight was lifted, more stones were laid.

Emetophobia is Not My Identity: I honestly didn't understand other people. Were they just pretending that the movies, concerts, and bars were fun? These places are cramped, full of germs and potential sick people. I wondered why in the world people enjoyed traveling. How do they get to the bathroom quickly when they needed to? I accepted all of this as my personality and had resigned from the possibility of enjoying these things. However, I started to realize these were decisions my phobia was making. I actually wondered, will I enjoy going to concerts now? My emetophobia didn't like traveling, but I ordered a passport because I was going to find out if I liked traveling. I went to a concert. I met some friends downtown for drinks. I paid attention to discomfort that was specific to my phobia (dirty discomfort) or discomfort that was just me not enjoying the activity (clean discomfort). I learned that I love live music, I love riding the subway into town for lunch, and I don't like bars because they are just loud and not my style. I was discovering my personality - and because I had connected with my friends and family about my emetophobia I could share my true personality with them. I finally felt like myself for the first time. Importantly, I was happy about this revelation instead of frustrated that it took so long to happen, because I had already forgiven that 8 year old kid. The pyramid was climbing higher and higher.

Work Life Balance: As you might know, life with emetophobia sucks. Nothing is fun, and mundane things like going grocery shopping are challenging and terrifying. I was a software engineer for work and it was easy to bury myself in work. It was safe, but I sat on the side lines while my friends went camping and traveled abroad. Again I wondered if this was just a personality thing - maybe I like working? Well, as I become more successful at telling my phobia to f*ck off, my life became bigger. My wife and I would catch the train downtown for a day of coffee, shopping, and lunch, and I could ride the train home with a full belly (and have zero anxiety). For the first time in my life going out after work was fun. I started to work a bit less and my perspective on life changed a bit. My career ambitions changed - this was scary. But closing my laptop at 5:00 pm meant I was free to do what I want and it became easier and easier.

Crafty Emetophobia: Through all of these life changes emetophobia tried every possible avenue to break back into my life. I had frequent dreams related to vomiting, I worried about a relapse, I wondered if I was just telling myself I was recovered but I actually wasn't. Over the span of 20 years emetophobia had perfected its arguments - it was like a professional debate team ready to twist every point I made. Ken Goodman says in his book, The Emetophobia Manual, that beating emetophobia is a move by move game. He says when anxiety comes back, don't fret and think 'oh no'. Instead welcome it back with open arms. Say 'Hi anxiety, nice to have you back. Are you ready for me to beat the sht out of you?'.

"Hi anxiety, nice to have you back. Are you ready for me to beat the sht out of you?"

I've accepted that either through chemical imbalance, physical neuron connections, or 20 years of habit, emetophobia (and OCD) will continue try to creep its way back. But I have my recovery pyramid foundation built, of which I stand on top and say 'Come on anxiety, I dare you'.

Your Recovery Pyramid: Everyone's recovery will look different. Bia is designed to help you build your recovery pyramid, and we add new content and activities each week to help expand the foundation you need to take your life back from phobia. Thank you for reading about my journey with emetophobia and I'm wishing you all the best in yours.