Counseling can often be helpful for emetophobia. Credit: freedigitalphotos.net/David Castillo Dominici
To quickly summarize last week’s post on emetophobia, we covered that it is a really ovewhelming anxiety response to the idea or feeling of throwing up. We also covered that one of the first things done to treat it in therapy is determining the fear’s origin.
The next step taken is to find out what things are avoided because of the fear. For example, does the emetophobic refuse to eat sushi? Does the emetophobic wish to go on a cruise, but won’t because of the reputation cruises have for viral outbreaks? What else is avoided? I knew someone when I was younger who wouldn’t drink alcohol because he associated drinking with throwing up.
Then we find out what the safety behaviors are. When I was more frightened of vomiting than I am now, I would make sure there was medication in my purse for a stomach ache. Sometimes safety behaviors don’t even really relate to the problem. Someone with emetophobia might make sure she always wears a lucky bracelet because she has never gotten the flu since she bought the bracelet.
With the list of avoided behaviors and safety behaviors in hand, a fear hierarchy is created. This is when therapist and client work together to make a list of most scary event to least scary event. At the top would likely be “vomiting.” At the bottom might be something like, “Write the word ‘vomit’ and all its synonyms on a piece of paper and then read them out loud.” Yes, for someone with emetophobia even that can induce anxiety.
Together we work our way up the fear hierarchy as much as possible. Some things can’t be replicated in therapy. For example, a therapist doesn’t really have a way of making a client actually vomit, so they probably aren’t going to do that in a counseling session. A therapist can have a client imagine doing it though, which still helps alleviate overall anxiety when done properly.
The point of all this is to say, emetophobia is almost always treatable. If you or your teenager is living a less fulfilling life because of a fear of throwing up, please call. It doesn’t have to stay this way. Things can improve if you’re willing to put in a little work. One of us here at Teen Therapy OC would be honored to walk through this difficult journey with you. I personally have been quite afraid of it at one point in my life, and had to work myself back to a place of it not interfering with my daily happiness.
Helping teens grow and families improve connection,
For someone with emetophobia, a stomach ache is a scary event. Credit: marin/freedigitalphotos.net
When I first became a licensed therapist in 2010 I knew about fear of vomiting, but I hadn’t come into contact with it as a therapist. Then one sweet young teen girl came in to see me and one of her primary problems was a fear of throwing up. At that time I had no idea how common this fear was. As one client jokingly tells me, “There’s the big 3: fear of death, fear of public speaking, and fear of vomiting.” According to anxietyuk.org, 2-3% of males and 6-7% of females deal with fear of vomiting. That tells us it’s pretty common. That means either you or somebody you know is not just uncomfortable with the idea of throwing up, but actually feels a fear response when they have to vomit.
Emetophobia has a wide range of how much it can affect someone’s life. For some (like me), fear isn’t experienced until it is actually time to throw up. Then a panicked feeling comes over the body and it takes a concerted effort to calm down before allowing the vomit to come up. For others though emetophobia can dominate their lives. The sweet girl I wrote about above spent nearly all her time obsessed with the question of when she might next throw up. She wouldn’t eat any foods she associated with any kind of stomach ache, even when those associations logically didn’t make sense. She wouldn’t spend time around young children because she assumed they were more likely to spread germs, and she had vowed to never get pregnant for fear she might have morning sickness.
I wish I could give you a happy ending to the story of the sweet little girl, but sadly I was an inexperienced therapist back then. I did a passable job with the necessary type of therapy someone needs to go through when they have a strong phobia. However, it wasn’t good enough for her to feel all the way better. I know so much more now about how to deal with this kind of challenge. That said, even now, I’m still learning.
Here’s a little sample of what I do know about the treatment of emetophobia: We start with trying to ascertain when and why it began. In my case, I became fearful of vomiting because I hadn’t gotten the flu since I was 11 years old. When I finally had a stomach virus at 22 I didn’t remember how it felt to vomit. I was caught off guard when I threw up even though I had been feeling nauseated. Because of this it went through my sinuses at the same time as coming out my mouth. I felt like I couldn’t breathe, which caused me to panic. It’s taken a lot of cognitive-behavioral work since then to completely overcome this frightening experience. I’ve thrown up many times since then and none of them have been anywhere near as frightening as that. In fact, none of them have ended up being a big deal at all.
Once we know where it started, we move on to a fear hierarchy. I’ll tell you more about that when I continue this post next week.
Helping teens grow and families improve connection,
Don’t take things so seriously in high school. Image courtesy of Arvind Balaraman at FreeDigitalPhotos.net
1. You’re not going to be a professional athlete. There are so few of us that have the talent, resources and support necessary to become professional in any sport. I spent hours and hours working at becoming the best soccer player I could be. I was convinced that soccer was my ticked to free or reduced college tuition. Eventually there were some scholarship offers, but they were very limited. It was part of my tuition, or only one semester, etc. When it came down to it I had to use a lot of my own money to pay for school, and a lot of the academic scholarships I was able to earn. I put tremendous pressure on myself in my sport and it turns out the main purpose of youth sports was for making friends and staying in shape, not paying for college.
2. You will not marry him. I took my high school dating relationships far too seriously. It seemed to me that having a long-term boyfriend was some kind of sign that I was worthy. I dropped friends for him, ignored morals for him, changed hobbies for him, etc. It is extremely uncommon to marry your high school sweetheart. Though you’ve heard it before, really and truly, just have fun and don’t take the opposite sex too seriously yet.
3. Get more sleep. It was so normal to practice sports until dinner, eat, and then do homework until midnight. Sleep was considered a low priority. It’s not surprising then that sometimes immunity was low and exhaustion was high. I now understand that a full night of sleep has more to do with happiness and productivity than almost any other factor.
4. You look how you look. Yes, it is a good thing to groom, keep up with styles to some extent, and care about physical appearance. However, in many high school age teens it goes way too far. Teenagers (I was one of them) are overly self-conscious about their skin and their weight. Unless it’s recommended by your pediatrician, don’t start dieting and trying to be thinner. Don’t let yourself believe the world is coming to an end because you have a zit. These things happen to everyone in the school. If you look at the adolescents who have a lot of friends, they all have their flaws. It truly is what’s on the inside that counts.
5. The most prestigious college isn’t necessarily the best college for you. Like so many, I was caught up in the belief that I had to be accepted to the best school possible. If I fell short of one of the top universities then I would be forever at a disadvantage. What a bunch of crap! The best college is the one that is the best fit for each individual student’s life and personality. That varies tremendously based on finances, personal circumstances, preferences and academic ability. Harvard (even if I had been accepted) would have been a horrible school for me because it is too far from my family. Seeing my family a few times per month is essential to my mental health and quality of life. If I’d moved to Boston for college I would’ve wilted. It is better to spend your time attending to all the facets of life (physical, emotional, spiritual, familial, etc.) than just your academic future. Otherwise, you might end up like I did. I was Miss AP class, straight-A student. However, I missed out on a lot of personal growing opportunities and a lot of fun because I was doing homework. In hindsight the brand name of the university has had absolutely nothing to do with my professional success. With rare exceptions, this is true for you too.
At the end of the day, what is most important is that you responsibly enjoy your time while attending to your growth as a person in all areas of life. Work hard in school, but even this can be taken too far.
Helping teens grow and families improve connection,
One of the best things you can do to make yourself more happy is live right now. Look around you. What do you notice that you weren’t “seeing” until I asked you? For me it’s the play of shadows on the adjacent building. There is a palm tree and I can see the silhouette of its leaves dancing against the white stucco. It’s something beautiful I’ve never taken the time to notice in the eight years I’ve been in this office building. It is a small thing, but it made the last 30 seconds of my life better.
You have things like that all around you too. It is essential to “see” these things if you’re going to be happy. Otherwise all you do is live in the future and the past.
Helping teens grow and families improve connection,
Teens, it’s so hard when you feel let down. This is particularly true if you’ve worked at something for a long time and it didn’t pan out. One of our family friends has a daughter who is a senior in high school. She’s worked her whole high school career with her eyes set on UC Berkeley. She didn’t get in. She can’t seem to cope with the disappointment. She is blaming everyone else. She is stomping around mad. She is especially picking at her dad. She’s so upset over this disappointment that she isn’t grateful for what she does have. She has been accepted to some incredible schools, and will likely attend UC San Diego, but she can’t see that for the blessing it is.
When something happens to you, do you handle it better than she has? Her problem is that she thinks this result defines her value. Newsflash: It doesn’t! And whether or not you made a certain team, got a particular prom date, or were mentioned in a certain social media post doesn’t define your value either.
Here are some quick thoughts on recovering from a disappointment.
Helping teens grow and families improve connection,
Hello, I’m Lauren! If you notice your teen struggling, you might be feeling helpless, hopeless, frustrated or concerned as a parent. Try to remember, there is hope. I want to help your adolescent feel better. My hope is for them to enjoy their life again. I want them to feel confident they can handle whatever situations arise.
