If you have a fear of vomiting, even reading the title of this article might make you nauseas and want to stop reading. Continuing to read, however, could be the first step you can take to being free of that fear.
Few people, if any, enjoy vomiting. It’s gross and unpleasant, but also completely normal and necessary for the body to rid itself of gut toxins. While it’s natural to find vomiting repulsive, some people experience intense fear at the idea of vomiting or seeing someone else vomit. This fear is known as emetophobia.
The specific cause of emetophobia is unknown but it’s been found to develop more often in childhood and in people who:
Have a genetic predisposition to anxiety (i.e., a family member experiences or experienced anxiety),
Tend to associate anxiety with gastrointestinal distress (e.g., nausea or “butterflies”), and
Had an adverse experience with themselves or someone else vomiting.
The fear of vomit/vomiting usually starts small and gradually increases and spreads until it is significantly dominating most areas of your life. You will find yourself constantly worrying and planning to avoid the possibility that you might vomit. You will rearrange and miss out on much of life (e.g., school or work), while being constantly hypervigilant to signs that you might vomit. The fear of vomit can take over and stop you from engaging in the things you enjoy and seeing the people you care about.
Although emetophobia is known as a fear of vomit, it also involves a fear of anything to do with it. This can include the sight, smell, and sound of vomit, as well as the things that might make vomiting more likely. Because of this, people with emetophobia might also worry about being able to find a bathroom in time to vomit if they had to, being trapped somewhere it would be inconvenient to vomit, being admitted to a hospital, being unable to stop vomiting if they started, embarrassing themselves by vomiting in front of others, and/or choking on vomit. The anticipation of these things and of vomiting itself are usually worse than the actual experience.
Given these fears, you may find that you:
Avoid things you associate with a bad experience with vomit (e.g., a shirt you once vomited in or a food/restaurant you associate with vomiting)
Excessively wash your hands or clean surfaces
Avoid certain or new foods (e.g., chicken, dairy products)
Check the location of the bathroom
Avoid drinking too much alcohol
Only eat food you cooked
Overcook certain food (e.g., chicken)
Throw out food well before the best before or expiration date
Avoid bad smells
Avoid settings you may not be able to escape from easily
Avoid touching certain things to avoid germs
Check others for signs of illness
Avoid people and settings that might make you sick
Avoid handshakes and/or hugs
Constantly check for feelings of nausea or illness
Avoid saying or hearing the word “vomit” and any synonyms of it
Avoid seeing others vomit on television or in person
What makes emetophobia more difficult is the fact that anxiety can trigger gut discomfort, including nausea and butterflies, which can trigger more anxiety and, therefore, more nausea. Since people with emetophobia are constantly hypervigilant to signs that they might vomit, they are also constantly checking for any signs of nausea or butterflies, which can further exacerbate the feeling and, in turn, the anxiety (and so forth).
Avoiding things that trigger emetophobia provides very short-term relief but, long-term, only fuels and maintains the fear. In other words, avoiding the things that make you anxious makes you more anxious. Treatment involves learning strategies to manage anxiety and identify and let go of unhelpful thoughts. It also involves gradually confronting your fears, from easiest to hardest. This can look like writing the word “vomit”, eating certain foods, drawing or looking at a photo of vomit. The goal is to realise that vomit/vomiting isn’t the problem – anxiety is. This realisation will help you to tolerate the feelings of anxiety without trying to avoid or get rid of it. This will, paradoxically, lead to a reduction in anxiety and nausea.
Emetophobia can be successfully managed with gold standard treatments, such as Exposure and Response Prevention (ERP), and that the OCD Clinic has helped countless people struggling with emetophobia to reclaim control over their lives.
Blog post written by Sally Youdale, Clinical Psychology Registrar at The OCD Clinic. If you have questions about psychological therapy please contact our intake team: email@example.com