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,
Lauren Goodman, MS, MFT