Emetophobia: Symptoms, Causes, and Treatments

Emetophobia is the irrational fear of vomit, including the extreme fear of vomiting, of seeing someone else vomit, the fear of feeling nauseous, and the fear of seeing vomit.

People with emetophobia rarely vomit. Emetophobia affects mature adults, young adults, adolescents and even children. These people are usually very anxious, and when they see that someone is feeling unwell, or see someone cough or gag, they cannot help asking if they are going to throw up.

emetophobia

The anxiety that such a situation causes may make them want to run away. If they cannot do this they might have a panic attack.

Causes of emetophobia

There does not seem to be a specific cause for this condition: some emetophobes say that they have had a traumatic experience with vomit, for example gastroenteritis, or food poisoning in the past, or involuntarily seeing someone else vomit.

These episodes usually occur during childhood, and often result in the individual attaching negative emotions to the act of vomiting. This can then lead to the development of emetophobia.

Some people are unable to pinpoint a specific traumatic event that has led to their fear.

Complications

Many people with emetophobia also suffer from other disorders, such as social anxiety, agoraphobia, and fear of flying. This is because their worst fear is finding themselves in a situation where they might vomit, whether in public or private.

These people will likely avoid going to restaurants, drinking alcohol, and even going to social events. It’s likely that they will be afraid of travelling on buses, especially if there are children around who might get motion sickness and vomit.

It seems then that travelling on public transport or by plane is extremely frightening for an emetophobe.

Some women even avoid becoming pregnant out of fear of the nausea and vomiting that occur in the first trimester.

Many sufferers of emetophobia are very cautious when preparing food. They can’t just eat anything, anywhere. This may become a problem in their day-to-day life.

Imagine not being able to hold a baby for fear of throwing up, or being ubable to use public buses or planes, or even having to avoid eating in restaurants. Such anxiety and fear have the power to be completely paralysing.

The cycle of emetophobia

As with other phobias, the fear of anything vomit-related creates a cycle: thought-reaction-action (or avoidance).

Before the symptoms of emetophobia appear (anxiety, sweating, elevated heart rate, fear, feeling a need to escape), you, if you are a sufferer, will be reminded of vomit. Someone might mention it directly or indirectly, it may be mentioned on TV, or someone might simply say that they are pregnant or are having chemotherapy.

This might spark a thought about vomit, whether consciously or unconsciously. You may then think about whether you need to vomit. You might focus on how your stomach feels, or you might clear your throat to check that you don’t feel ill. You may try and look for signs that other people are going to vomit.

And then, you start to feel scared. Your symptoms can be mild, moderate, or severe. You feel a sense of dread, your hands start to sweat, your heart beats faster. All you want to do is run away.

Other avoidance behaviours caused by emetophobia may be: avoiding using the bathroom (you’re afraid that just the sight of the toilet will make you vomit); avoiding eating in restaurants (you are extremely (and unnecessarily) cautious when it comes to food as you are terribly afraid of the possibility of getting a digestive infection that will make you vomit).

These possibilities and the fear they entail cause the beginning of avoidance behaviour. When a vomit-related thought crosses your mind, the cycle starts again.

Despite this avoidance of every day situations, some people with this condition manage to live with it for many years, until it eventually becomes unmanageable. This is when they decide to consult a specialist and get treatment.

Related disorders

It is normal for someone who has a phobia of vomiting to be afraid of eating food that might make them throw up. Some emetophobes eat very little, putting them at risk of anorexia.

Emetophobes are often extremely careful when preparing their food as they are afraid of bacteria and viruses. They are also afraid of eating too much and vomiting, so they only eat small portions. Over time these fears may lead to anorexia nerviosa.

Treatment

If you suffer from emetophobia, whether mild or severe, you do not have to suffer from it for the rest of your life. Adequate treatment can help alleviate your symptoms.

On the US emetophobia association website it states that the standard treatment for this condition is cognitive behavioural therapy, which is not surprising given that this treatment is helpful in treating most phobias.

A therapist will work with the individual patiently and without invalidating their fear.

Therapy sessions will help the patient to control their anxiety when presented with stimuli, and to change their irrational, negative thoughts for other more rational and positive ones.

Graduated exposure therapy can also be useful. The therapist may begin by getting the patient to write about vomit. They will then show them pictures of people vomiting, or looking as if they are about to vomit, and will sometimes also use unpleasant smells, etc. It is not a good idea to force the patient to vomit to try and eradicate their fear. This does not usually bring good results.

Relaxation techniques can also be useful for controlling anxiety. These include yoga, breathing exercises, progressive muscle relaxation (PMR), and even medication, and can all be beneficial for those suffering from emetophobia (or any other type of phobia).

In severe cases anxiety medication can be very useful. If the patient suffers from any other disorder, such as agoraphobia, or OCD (obsessive compulsive disorder), etc., the therapist may be able to prescribe medication that will help them to control their phobia.

It is important to note that someone with extreme emetophobia may be afraid that medication will make them throw up. So, it’s important to make it clear to them that this is not the case, and to prescribe them an anti-emetic for the first two weeks of the treatment.

We must also remember that someone with severe emetophobia cannot be cured with just a few psychotherapy sessions. Treatment may last a long time, but if you commit you will probably get good long-term results.

As you can see, emetophobia can be overcome. If you have an irrational fear of vomiting and your fear stops you from living a normal life, seek psychological or psychiatric help: you can overcome your fear but you need professional support, especially if your symptoms are severe.

Cases of emetophobia

Emetophobia is more common than you might think, and is something that can affect anyone.

Read what this 21 year old man has to say about his experiences with the condition:

“Suffering from emetophobia has made me feel like I have a serious illness. Phobias can ruin your life. The worst thing about emetophobia is that you aren’t just worried about chucking up your own breakfast, you’re also worried that someone else might chuck up theirs in front of you.

It all started when I was around 7 years old. I was jumping on the sofa with my sister when all of a sudden I felt like I was going to throw up. I went to the kitchen and it all came out. I wanted to do it in the bin but I didn’t make it in time.

My mum took me to the toilet and I threw up three more times. The next day when I ate breakfast I felt ill but I managed not to vomit. From that moment emetophobia began to set it. I was terrified of everything to do with vomit. More afraid than is normal.

What scares me the most is your lack of control. When your stomach decides it’s time, there’s nothing you can do. It’s usually unexpected and disgusts everyone around you, even if they’re your friends or family.

I’ve avoided a lot of school trips because I’m scared of vomiting.”

Here is another case of a girl with emetophobia, perhaps it sounds familiar:

When Wendy was 3 years old, her mother became pregnant with her sister. One night, Wendy heard her mother crying in the bathroom. She went to see what was going on and saw her mother throwing up while her father tried to help.

Her mother groaned. She was inconsolable and said, “I want to die”. When her dad noticed that Wendy was standing in the doorway, he took her back to her room, where she stayed listening to her mum.

After this, she began to be afraid of vomit. She associated the fear of death with nausea and vomiting. This fear lasted for years and only got worse.

She wasn’t even able to say the word “vomit”. When someone coughed or choked on food she went running, scared that she would have a panic attack. Sometimes when she stopped she had forgotten why she ran away in the first place.

When these behaviours started to prevent Wendy from living a normal life, she saw a psychotherapist who helped her to control and prevent her anxiety, alleviating the symptoms of emetophobia.

Here is another example of an 8-year old girl with emetophobia:

When she was 8 years old the girl had severe stomach pain and a fever. She vomited several times. The doctor diagnosed her with appendicitis and she was given an emergency operation.

10 days after the operation, she developed a fear of vomiting and was scared of experiencing another episode like the previous one. She complained that she felt ill all day, but doctors could not find anything wrong.

Her symptoms began to get worse. The girl constantly thought about vomit, and she began to eat less and to avoid eating outside the house. She even stopped playing with her friends and refused to go to school in case she threw up.

Bit by bit, her fear started to affect her family: she was afraid that her parents would vomit, and she asked them not to travel by bus or use lifts.

When her parents took her to the psychiatrist, she was diagnosed with emetophobia. It is important to note that both her parents suffered from anxiety disorders and took medication.

The girl was given psychotherapy and anxiety medication. She also had graduated exposure therapy. In a few weeks her symptoms disappeared completely, although she continued taking medication.

References

  1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890925/.
  2. http://www.emetophobiahelp.org/fact-sheet.html.
  3. http://blog.psicoactiva.com/emetofobia-ese-miedo-oculto/.
  4. https://es.wikipedia.org/wiki/Emetofobia.

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