Migraines, Phobias, Mean Investment Bankers and Creating Your own Misery

I was sitting in a dank Irish pub last night *, working on my book, when I noticed I was getting a slight headache. It might have been from staring at the screen for too long, or thinking about the countless rejection letters from publishers over the years but, for the most part, tension headaches never seem to have much of a pattern with me. I was drinking club soda with lime the entire time I was there so it certainly wasn’t dehydration that was causing the discomfort.

I worked for another ½ hour and the pain in the front of my skull started to worsen. I might be getting a migraine. I asked both the barmaid and the one other patron there – an exhausted looking 50-something, salt-and-pepper haired man in a black suit with an undone tie – if they had any aspirin.

“Why? Your vagina hurt, soda boy?” he said.

Miserable investment banker.

“No, my vagina doesn’t…I have a headache. Do you have any aspirin or not?”


I closed up my laptop and started the five-block trip back home. As I walked, I started to get the “aura” of a migraine. The street lights I passed had massive coronas around them and I started to feel nauseous. By the time I got home I couldn’t even walk in a straight line, and I imagined the douchebag from the bar yelling to me from afar: Better go easy on the club sodas next time, Buddy. They pack a punch!

I got upstairs, made a cold compress and lay on the bed. The throbbing in my head felt like a mallet crashing into my skull, chipping away at, soon to crush my brain, rendering me reliant on life support.

This is the worst pain imaginable. Nothing can hurt more than this. I’d rather be dead than have to experience this catastrophe.

Note the emotionally-loaded, absolute terms used in that self-talk: “worst pain imaginable,” “nothing,” “dead,” “catastrophe.” Are any of the statements I made factually accurate? No, they are not. I’m sure Jigsaw from the “Saw” franchise could think of significantly more intense pain than a migraine. Hell, my friend in college dislocated his shoulder and looked in way worse shape than me on my bed, holding a wet rag on my face. Did I actually want to be dead? Not really, although it seemed like the only viable option to get rid of the pain at the time.

This is a classic example of thoughts influencing mood. By using such extreme language, I (again) placed myself in a position of being simply in pain to being both in pain and emotionally miserable by telling myself that this was the worst, the most absolute horrible, God-awful thing that one could go through. I myself increased my own suffering exponentially.

Fortunately I vomited a few minutes later and fell asleep.

Years ago I had a client who needed to have a closed MRI. Claustrophobic by nature, the very idea of being inside of a giant tube for 45 minutes terrified her. The test was not optional, however, and it needed to happen within a few months.

Systematic desensitization is the treatment of choice here, but we added a specific visual/cognitive element. I asked the client, a mid-20’s woman I’ll call Gail, to describe the entire day leading up to and including the MRI. This meant telling me the details of the upcoming afternoon, beginning with waking up in the morning and ending with her completion of the MRI. I stressed that word to her because there was to be no room for doubt that she would succeed.

As she described her morning: getting dressed, eating breakfast, getting on the subway, emerging from underground and walking to the office where the MRI was to take place, she didn’t feel very nervous. However, when she mentally arrived in the room, her anxiety quickly escalated.

“Tell me what you see as you describe it,” I said.

“They are forcing the cage over my face.”

“I’m sorry, cage? What do you mean?”

“There’s a sensor, it kind of looks like a catcher’s mask or something, that acts like a sensor.”

“Okay,” I said. “So it’s not a ‘cage,’ it’s a sensor. And they are not ‘forcing’ it, you are allowing them to place it over your face to facilitate the process.”

“What’s the difference?” she asked.

“Think about your self-talk. The words ‘force’ and ‘cage’ make you sound victimized. That inner monologue doesn’t allow you to be your own agent in the medical process. Make up your mind, right now, that you are going to allow all of these to occur by your own choice, to engage in appropriate medical care for your body. There is no cage and there is no forcing here.”

Sometimes in therapy you’ll see something ‘click,’ an almost visible shift in perception and mood. Gail didn’t immediately lose all fear of the MRI, and she wasn’t going to until she completed her task, but something happened for her at that moment.

“I’ve been saying these words over and over for weeks,” she said.

“No wonder you’re so anxious about it. What have you been telling yourself about what happens next?”

“They shove me into the machine and I can’t get out for 45 minutes,” she said.

“Okay, so change that for me. Make it a more active experience on your part.”

“I…go in the machine and can’t get out?”

“That’s close. Is that true you can’t get out?”

“Not exactly. If I give a signal the technicians come in and turn off the machine.”

“Okay, so you will choose to go into the MRI machine, and you will decide to stay in there as part of your medical care. If it becomes too much, you can always get out and try again at another point, but you will always have the ultimate say. Is that accurate?”

“Yes,” she said, with a small, almost embarrassed smile. “That’s fair to say.”

Because Gail was such a trooper, she actually obtained a refrigerator box from an appliance store and practiced lying inside of it for 45 minutes a day. While simulating the MRI experience, she told herself the “active” words, dropping the extreme terms that were generating such a strong anxiety response. And while she couldn’t ever say that she actually enjoyed the MRI – who could unless you took a nap or had a bottle of pinot noir in there with you? – she got through it. Pretty painlessly, in fact.

The morals of the story:

– Monitor your self-talk for extreme terms that generate misery

-Correct your phrasing to allow for more accurate perceptions of your experience

-Cold compresses are useless for migraines, although vomiting helps

-Don’t drink club soda in a bar unless you want to be branded a woman. Or at least some sort of vagina-having man-type creature

* For those who are wondering, I don’t sit in Starbucks to write because their coffee sucks, it’s overpriced and the very idea of sitting for four hours in some pretentious, glorified Dunkin Donuts makes me sick to my stomach.

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26 Responses to “Migraines, Phobias, Mean Investment Bankers and Creating Your own Misery”

  1. Zyron says:

    Well, you are sitting at a bar so you should at least order a beer or something.

  2. Dorothy says:

    That guy was so rude. I want to punch him in the neck.
    I can’t believe he actually said that to you.

  3. Shay says:

    Pimped on FB as per usual. I try to point this out to some of my overly dramatic friends, that their self talk leads them into making the situation worse then it actually is. Sometimes it helps them out. Other times, they can’t understand why I’m being so insensitive to their pain.

  4. BL1Y says:

    It’s amazing how effective self-talk is. I went three winters in NYC without wearing a heavy coat because getting on the subway with full winter gear means getting to your destination drenched in sweat. Whenever I started to think about how cold it was I just told myself that it wasn’t really cold, it was crisp and invigorating and then thought about how pumped and excited the polar bear club people get when they jump into near freezing water.

    But can we get a term other than self-talk? It sounds kinda…frou-frou, the kind of term a woman would use, or a man who drinks soda at a bar.

  5. Pete says:

    I’ve never shared the MRI phobia – it would seem to be a lot like sleeping in a tent. The refrigerator box was a good trick. And drink a beer for your first draft, and a coffee while you’re editing.

  6. CookedLobster says:

    Starbucks is horrendous. I think you need to write a book on the “Starbucks Nation” and get Will Ferrell to do a movie on it.

  7. BL1Y says:

    I don’t see why people have such a hatred towards Starbucks. If you don’t like their product, don’t buy their product. Problem solved.

  8. LC says:

    Ugh, I’m really scared of getting a migraine (BECAUSE of the vomiting part!) but this actually made me feel better haha.

    Shay, I relate to your comment for sure. For me, learning how to reassure myself with positive self-talk has been THE KEY to growing out of a lot of the anxiety that totally plagued me growing up. But one of my close family members has a lifelong struggle with depression, and when I try to help her by talking about this, the concept doesn’t translate. I think I come across as having no empathy, or making light of what she goes through. Sort of like I’m saying, “well, just stop being depressed!” Not what I intend, but apparently I haven’t figured out a better way to communicate haha.

  9. Colleen says:

    LC, I have the exact same issue with a friend who has chronic depression. I really think that if she didn’t constantly berate herself for being a “stupid ugly failure” she would stop feeling like one all the time. But any time I try to explain this, all she hears is “my asshole friend is condescendingly telling me that if I think happy thoughts my life will suddenly not be a mess.” Everything goes through the depressed filter.

  10. Wayland says:

    Rob, I think the migraine and that guy were both a spiritual attack. I didn’t put the two together for some reason until I started writing this. Maybe God is speaking. Interesting. I’m going to leave the rest of this alone. Good article.

  11. Dr J says:

    Colleen, LC,

    It is difficult to get through to someone who is really depressed since part of it is not thinking anything will help; particularly not something as simple as changing the language you use to talk about the cause of depression. I suppose if they were receptive they probably wouldn’t be depressed in the first place. In any case, the reaction you describe (“my asshole friend is condescendingly telling me that if I think happy thoughts my life will suddenly not be a mess.”) contains exactly the kind of language you’re suggesting they change.


  12. BL1Y says:

    How’s this for an asshole telling you that if you just change the way you see problems everything will get better:

    My mom gave me a copy of Who Moved My Cheese.

  13. Jay says:

    Agree, agree, agree! The way I see it, there are at least three places where pain comes from: the injury itself, the nerves and feedback to the brain, and the person’s relationship to that pain. Pain hurts, despite what Swayze says, but if you’ve been shooting heroin, pain is that much worse because your body has been sensitized to pain. And then if you’ve been beaten as a child and are terrified of something, that makes it even worse. God help you if all three come into play. Interestingly, I see the combination of all three come together all the time. Thanks again for the great piece.

  14. Alice says:

    FYI, I don’t mind being “branded” (or “called”) a woman, because I am one. This insult suggests that people with a vagina are somehow inferior to those without – it’s a sexist insult and you’re sexist to be offended by it.

    I agree with you about Starbucks though.

  15. Rob Dobrenski says:

    Where, exactly, do I say I’m offended by the insult?

  16. kyle says:

    Alice, wouldn’t you be offended if a man asked you how your testicles were doing? The joke of asking about a man’s nonexistent vagina is funny (sorry rob) not because women are inferior, but because vaginas on men are incongruous.

  17. Amber says:

    See you had me til you said that Starbucks’ coffee sucks. For shame 😛

    In my little, okay not so little, blogger community we’ve discussed this many times. Negative self talk. Whether it applies to a situation, or self image. Most of us know that we can change it, and make it what we want to make it, that we do make it what it is, whether consciously or not. It’s changing the negative that’s a problem, your client made some killer progress, but a lot of us that deal with negative self talk don’t find it as easy to change.

  18. Guy says:

    Really interesting comments. Keep them coming!

  19. Patrick says:

    I found your blog on google and read a few of your other posts, really good stuff.

  20. Remi says:

    Nice post, sorry to hear about the headache…

  21. Oralee Halwick says:

    Great info, thanks for the post!

    PS. Sorry about the headache…

  22. Chater says:

    Alice sounds like she has sand in her vagina.

    This is a great point. I’ve always explained and researched the power of words, but what they’re loaded with is extremely important. The ideas that come with a word are extremely important, not only in psychology but in all aspects of life, especially when it comes to success. Dead-end words like “impossible” is a good example.

    But they can alter the answers to questions. For example, “I think it would be fun to go. Want to?” vs. “It’ll be a blast. Lets go.” The subtle yet significant power of words is always underestimated and overlooked.

    Great post.

  23. Scott says:

    I dislocated my shoulder playing rugby. I had to get an MRI for it last month and napped for 30 minutes of it. It was surprisingly comfortable.

    I also had a severe migraine recently whilst my airplane was landing. I don’t know if it’s just me, but here is the order of things that I’d prefer:

    Dislocated shoulder > Death > Migraine

    Migraines are the worst.

  24. Telma Cova says:

    It’s too bad there isn’t a single med that eliminates all of those problems…including the bankers.

  25. […] had mentioned previously that I experience migraines a few times per year. They are, in fact, brutal. Fortunately I had never struggled with one during […]

  26. Logan G says:

    I’m not sure if it’s OK to push other people’s books here or not, but there is a really excellent book about self talk called “What to Say When You Talk to Yourself” by Shad Helmstetter that I recommend to anyone who wants to consciously improve their self talk.