Emetophobia is an excessive fear of vomiting. Emetophobia is often classified as a Specific Phobia, however, there is also thought that it could be considered under the umbrella of Obsessive Compulsive Disorder.
We can probably say with quite a bit of confidence that none of us really like vomit. The difference between individuals with and without emetophobia is that those with emetophobia truly fear vomit and the act of vomiting. Like with other excessive fears, there is often a lot of avoidance, safety behaviors, or compulsions put in place by the individual to help alleviate the fear. People who experience emetophobia might engage in some of the following (this list is not exhaustive):
- Avoiding eating foods that they once vomited.
- Avoiding being around people who have had a stomach bug.
- Avoiding going on swing sets, fair rides, in the car, or other situations that might lead to feelings of nausea.
- Avoiding going to the doctor given other sick people would be there.
- Avoiding going to a pharmacy.
- Avoiding restaurants, schools, grocery stores, public transportation or public restrooms.
- Avoiding children.
- Checking expiration dates on food.
- Over-using anti-nausea medications.
- Excessive cleaning of food and utensils.
- Excessive hand-washing.
- Excessive cleaning of surfaces.
- Relying on harsh cleaners such as bleach only.
- Using gloves to prepare and eat food.
- Seeking reassurance from others about whether food is safe to eat, whether they are going to become sick, whether someone has washed their hands, or whether someone has been sick recently.
- Carrying safety items when they leave the home such as medications, mints, etc.
- Throwing out food before it is spoiled or expired.
- Limiting self to a very specific set of foods.
What we know about avoidance, safety behaviors, and compulsions, however, is that they only provide temporary relief from our fears. In turn what can happen by achieving that temporary relief is the brain can take in the message that the situation that person was just in is DANGEROUS and MUST be avoided at all costs. While we can likely all agree that vomiting is unpleasant, it is unlikely that it is a threat.
So, how do we help individuals who are suffering from emetophobia? Current evidence-based treatment recommendations for emetophobia include Cognitive Behavior Therapy (CBT), more specifically, Exposure and Response Prevention (ERP). Through the use of CBT and ERP, individuals with emetophobia can learn how to shift their beliefs about their ability to tolerate feelings of nausea or physical discomfort and face their fears in order to increase their ability to cope with an episode of vomiting if it were to occur! It is crucial that an individual’s ERP plan is tailored to their specific presentation of emetophobia and their core fear, though I will share some common examples that might be found in ERP plans for emetophobia (again, not an exhaustive list):
- Looking at pictures of vomit
- Watching videos of people vomit
- Listening to audio clips of vomit sounds
- Fake vomiting into a sink, trash can, or toilet
- Making fake vomit (yes – those recipes exist!)
- Attending medical or dental appointments
- Crossing out expiration dates on food
- Interoceptive exposures (purposefully bringing about sensations such as nausea and dizziness) through jogging, jumping up and down or spinning in a chair after eating
- Playing BeanBoozled
- Eating new foods or foods previously avoided
Some therapists might also incorporate Acceptance and Commitment Therapy (ACT), where you can learn additional skills to support your goals rooted in acceptance, mindfulness, and values.
Like other anxiety and OCD-spectrum disorders, it can feel incredibly scary to face your feared outcome. Once you gain the willingness and tools to do so, however, you are rewarded with increased bravery, freedom, and independence. It can open up your world to be able to access people, places, foods, and situations that you once felt were impossible. YOU get to make the decisions YOU want for your life rather than emetophobia making them for you. If you believe you or a loved one suffers from emetophobia, please contact our office at 512-246-7225 or [email protected] to be connected to one of our fantastic clinicians who can support you on your journey to recovery!