What Is Emetophobia?

The American Psychological Association defines phobia as “a persistent, irrational fear of a specific situation, object, or activity.” Some examples of phobia include thalassophobia (fear of the sea), acrophobia (fear of heights), nyctophobia (fear of the dark) and more. Emetophobia refers explicitly to a disproportionate fear of vomiting. While a mild fear of vomiting is relatively common, emetophobia seems rather rare, estimated to affect roughly 0.1% of the population, and women are four times more likely to experience it. 

Those with emetophobia may fear choking on vomit, being hospitalized for vomiting, or simply vomiting and being unable to stop. They often have an aversion to words like puke, barf, or throw up and usually must look away from vomiting scenes in films and television shows. 

Those who experience this condition may have feelings of anxiety when they hear that they have encountered someone who has recently had a stomach virus. They may be hypersensitive to even the slightest sign of illness in themselves. 

Unless they have no choice, they might avoid leaving the house for fear of contracting germs. They may avoid shaking hands with people and refrain from being near anything unclean or malodorous (like garbage) that could create feelings of nausea. They often throw away food long before its expiration date or overcook food out of fear of bacteria that may cause vomiting. 

Emetophobia is sometimes associated with other fears, such as a fear of food, eating, or encountering partially eaten food. People with emetophobia may avoid trying new foods for fear of succumbing to food poisoning that may lead to vomiting. Similarly, they may avoid overindulging in alcohol out of fear of vomiting while drunk. In some cases, the fear is so extreme that the individual will forego getting pregnant out of fear of experiencing morning sickness or taking necessary medications because nausea and vomiting are side effects. 

Emetophobia Causes And Comorbidities 

Typically, emetophobia is caused by a negative experience with vomiting, usually at a young age. For instance, a stomach virus leading to a long night of violent, uncontrollable vomiting may be a trigger, as might an unexpected instance of vomiting in public. Sometimes emetophobia can also spontaneously occur for no known reason.

Some experts feel that emetophobia is tied to a fear of losing control. Vomiting may be difficult or, at times, even impossible to control. It can happen at inconvenient times and in potentially embarrassing locations, which can cause high levels of distress to those experiencing it.

People with emetophobia may find that their condition leads to additional fears or obsessions over time. Some people develop cibophobia, which is the fear of food. 

In addition to its potential association with other phobias, comorbidities may include obsessive-compulsive disorders associated with germ avoidance, such as excessive hand washing or cleaning. Emetophobia may also accompany generalized anxiety disorder, depression, panic disorder, social anxiety disorder, and hypochondriasis. 

Symptoms And Behavior

One of the most common symptoms of emetophobia is frequent episodes of nausea and indigestion. This may result from eating a restricted diet or refraining from eating at all, or it may result from digestive issues resulting from extreme stress associated with the fear of vomiting. 

They may worry that their foods have not been cooked long enough or properly stored, which could potentially cause them to get sick. Others may place hard limits on the types of food they eat, sticking to what is "safe" (i.e., foods they don’t associate with vomiting) or even refusing to eat until they feel full out of fear that overeating can lead to feeling nauseated and vomiting. 

Those with emetophobia may adjust their behavior or develop obsessions that will keep them "safe" if they need to vomit; for example, some people feel more comfortable in a particular room in their home or sleep with a towel or bowl next to them every night, just in case they wake up needing to vomit. 

Some are reluctant to leave home entirely for fear they might end up in a place or situation where they may be witnessed vomiting or are unable to make it to the bathroom in time. Others may feel distressed upon entering an unfamiliar building because they don’t know where the restroom is in the event of an emergency. They may also be afraid of seeing another person vomit. 

Children with emetophobia may fear going to school or socializing at others’ homes. Adults might miss work or avoid eating with friends/family. Riding in a car, boat, or airplane can also cause anxiety for those with emetophobia because they fear they or someone around them will experience motion sickness resulting in vomiting.

Treatment For Emetophobia

Emetophobia is treatable with exposure therapy, cognitive behavioral therapy (CBS), and eye movement desensitization and reprocessing (EMDR). Some doctors may prescribe anti-anxiety medications in conjunction with psychotherapy. 

Forms of psychotherapy for emetophobia usually aim to uncover the source of the phobia and examine the details associated with those circumstances. Because psychotherapy requires honesty and a willingness to explore personal topics, it can be difficult, particularly if the suspected source is related to a traumatic event or maltreatment in childhood. But with time and regular treatments, the patient may learn to cope with these issues and move forward. 

A study published in 2017 showed the results of a randomized controlled trial that assessed cognitive behavioral therapy (CBT) treatment usage for emetophobia. The study’s authors found that more than half of the participants receiving CBT reported improvement in their condition compared to 16% of participants who didn’t receive CBT. Participants who received CBT treatment reported a reduction in distress.

Part of CBS treatment includes reframing a patient’s thought patterns around the issues that cause discomfort or difficulty. With emetophobia, this may consist of exploring how vomiting may naturally benefit our bodies. For example, vomiting is the body's natural way of purging something that may make us seriously ill. And while the act may be unpleasant, most people report feeling significantly better after they vomit. In most cases, whatever is causing a person to vomit is purged from the person's system within 24 hours. To someone experiencing emetophobia, this may seem like a lifetime, but the purpose of therapy is to help the patient gradually put such distortions into proper perspective. 

Takeaway

Emetophobia can be a complex phobia to diagnose and treat because of the other phobias and anxiety disorders that can develop in conjunction with it. Therefore, it is essential for those experiencing it to seek help from an experienced professional.

But those who need help the most are often the people who have the most difficulty getting treatment. Conditions like emetophobia may create an aggressive aversion to leaving home or meeting a therapist in person. People with phobias may also worry about the stigma that some associate with the condition and mental health treatment. Others experience barriers to treatment around accessibility or scheduling restrictions. Many assume they can’t afford to begin or continue therapy long-term if needed.

Online therapy on platforms like BetterHelp provides an excellent solution to these barriers to treatment. With BetterHelp, you can speak with a licensed mental health professional experienced in using techniques like CBT that help patients with phobias, anxiety, depression, trauma-related disorders, and more. You may attend sessions from the comfort of your home on a schedule that’s convenient for you. If you need help between appointments, you can text or message your therapist and receive a timely response. 

The rise in virtual therapy has also given rise to several studies comparing online treatment with traditional treatment. The research indicates that psychotherapy is just as effective online as in-person for treating phobias and their frequently accompanying disorders. Additionally, many find online therapy more affordable than traditional therapy without insurance.