My mental health isn’t one that I talk about much on here. I’ve had anxiety since I can remember, although the doctors were reluctant to give it a name until I was twenty. Since I can remember, I’ve had certain triggers that can set off what I now understand to be panic attacks.
These attacks are vile. I am often left frozen to the spot, unable to move, while retching. In recent years, this retching has turned into actual vomit; in childhood, it was just retching. I don’t fully understand all the triggers I have, but I know some of them.
One of the main ones that stood out was my phobia of anthropoids. Insects, arachnoids… that sort of thing. It had stopped me from eating outside during hot days, stopped me from going on picnics, and if I saw any prior to eating, could stop me eating all together. It got to a point where I was nervous going anywhere because “what if I see an insect and I have a panic attack”, and it happened a lot.
Fear of a name increases fear of the thing itself
J.K Rowling may not be perfect, but there is a phrase that she uses in the Harry Potter books that rings true here, and that is, the fear of a name increases the fear of the thing itself.
I was afraid to say the name “daddy long legs”, I could manage “crane fly” sometimes but not all the time. The word “spider” could send me into a panic attack. I was only really safe around bees, wasps, ladybirds and butterflies.
I tried to avoid seeing these creepy crawlies. Tried leaving the room, not to mention them. This only made things worse as they moved when I was not watching them, so my brain is then trying to work out where they went. By not using words like spider or daddy long legs in conversation, I was validating my fear.
If a quiz show had a question about insects, I often found I went into a panic attack, images and videos also gave the same affect. It got to a point that I was anxious all the time because I didn’t know when I’d see the next spider, hear it, or see it—whether that was through a medium or in person.
As I said, it wasn’t my only anxiety, but it was definitely a main one.
Getting Help
This is the third time that I have tried to get help for my anxiety. The first time was at university, where they gave treatment similar to Cognitive Behaviour Therapy, and it helped, but it was temporary. The second time I had self-referred to my local mental health clinic, the queue was long but they assured me that they’d see me before I started my masters course. They forgot, and I had four out of twelve sessions. Each session was a week apart.
The four sessions were rushed, and although originally, I came out of it with my symptoms improved, a few months in and my symptoms seemed to of escalated from just heaving, to throwing up.
This third time, I have just finished my CBT. I self-referred again, but with the pandemic, I didn’t have to fit in any other commitments, so it didn’t matter how long the queue was. The queue actually was shorter this time as I was classed as high priority.
Starting my new Cognitive Behaviour Therapy Treatment
I started my CBT in October 2020, and only finished it last week, so it wasn’t rushed at all. At the beginning, each session was a week apart. This was so that my therapist could get an understanding of who I was and just how much help I needed. Once she got this information, our sessions were between 2 and 3 weeks apart.
My therapist was really nice and understanding, which helped a lot. One of the first things we did, after looking at causes, was to create a hierarchy of anxiety and fear. What caused it to increase the quickest and what gave me anxiety but was manageable.
This was so that we could start exposure therapy without jumping into the deep end. One of these would be to look at images of insects. I mentioned to my therapist that the thing I struggle with the most was unpredictability.
Changing Thought Patterns
The part that I had the most difficulty with was changing the way I saw anxiety. To see it as something that would help. The idea is to break the circle of
insect = anxiety —> symptoms —> something bad will happen —> panic attack
The inability to control this circle means that I am more likely to do safety behaviours… and that’s where we come back to the fear of a name increases the fear of the thing itself.
I wasn’t just afraid of insects, I was afraid of panic attacks, which I associated with insects.
I needed to see anxiety as a good thing to break this cycle, and that’s hard when my experience of it are all the symptoms mentioned in the diagram: Freeze, nausea,retching, hot & feverish, forgetting how to breath.
To do this I needed to break the vicious cycle of anxiety, and the first step of that was to stop my safety behaviours. Safety behaviours are things that you do to make sure that you don’t end up in an anxious situation, but they often make anxiety worse as the diagram suggest:
anxiety –> increased scanning for danger & physical symptoms –> escape / avoidance –> SHORT TERM: relief–> LONG TERM increase in physical symptoms and worry, loss of confidence
For me, this meant that I couldn’t scan the room, leave the room if I saw a spider, I also couldn’t put music on or place my feet somewhere off the ground or pinch my nose. All things I did because I was convinced it helped with my anxiety.
In the end, it is meant to give the desired effect of:
feared situation confronted without safety behaviours -> SHORT TERM: increase in anxiety -> use of coping techniques -> long term: greater belief in ability to control responses.
Positive thinking
It was hard to tell myself that anxiety was ok, that it was trying to help, and harder still while having a panic attack. Stopping the safety behaviours is hard too—it’s natural to do the things that make you feel safe.
My therapist also wanted me to work on my self-esteem; use affirmation to praise and complement myself, toot my own horn. This is another weird technique for me. To say to myself out loud that I’m a good person, and kind, and other similar phrases, it didn’t come naturally.
In British culture you’re taught modesty, to not hold yourself up in high regards, but to complement others. Complimenting others is fine, but it’s important we see our own value as well as the value of others. This is probably the hardest part for me.
I told my therapist I struggled with this task, and she said that it’s like trying on a new jumper. It’ll feel odd the first few times, and then we get used to it. I kept attempting this and it did get easier. Even though my sessions have ended, I am still trying to say these things to myself a bit more frequently.
Exposure therapy
It may seem unappealing, but it has been proven to help with phobia. Exposure therapy is exactly as it says on the tin, but it’s not full-blown exposure, that wouldn’t help anyone. My therapist and I made a hierarchy of what I find the hardest to do around insects. 12 was the hardest and 1 the easiest. We started with the photos of anthropoids.
Part of my anxiety is to do with the predictability of insects, so we agreed that, for the next two weeks, my friends would send images to me without warning. I was surprised by how much I was able cope with that. Gradually, over the 11 sessions I had, we moved up the list.
- Stay in room with Crane Fly
- Have Windows Open
- Go on a picnic or to a restaurant without worry
- Watch videos of daddy long legs / crane fly
- image of daddy long legs / crane fly
- deal with spiders in the home
- deal with other anthropoids in the home
- videos of anthropoids
- photos of anthropoids
- saying either name of the crane fly
- saying names of other anthropoids
- hearing others say anthropoids.
I tried this in my second CBT attempt but I think trying to do this in four weeks was a bit of a rush. The extra time meant I was able to cope with this easier, and hopefully I’ll be able to keep managing now.
As I was working through the list, my therapist also encouraged me to practice 7/11 breathing. She also told me to practice when not anxious as this helps me remember when I am. I do find I am able to breath better now when I do have a panic attack. Due to the pandemic, I can’t try step 10, but I will once opportunity allows.
Stop and Analyse
One of the things that I found the most useful, was to stop and analyse. Why am I anxious about this situation, what is the cause?
We’re not born with fears of insects, clowns, rats… but they’re common fears nowadays. Often, something has triggered them and conditioned us to fear something. Just like Pavlov trained his dogs to associate a bell ringing with food. Similarly, Little Albert was conditioned to fear a rat.
It’s trying to reverse whatever the cause may be. Sometimes you may not know the cause, sometimes it may make sense. I found mine made sense, and this really helped me understand where it came from.
Thanks for reading
So far, I feel better in terms of anxiety around insects; their are other anxieties I need to work on, but the tools I used for insects are transferable, so I will put those in place when I can.
I think mental health, especially in the UK, needs to be talked about more. For me, it is more disabling than my cerebral palsy, and that’s only looking at one mental illness. Some people have more than one, and I can’t imagine the struggle.
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Also feel free to look at any of my other posts, I have some that talk about my cerebral palsy, and dyslexia.