What Is Emetophobia?
Specific phobias are a category of the anxiety disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM). One phobia that may fall under the category of a specific phobia is emetophobia. Understanding this phobia can help you support yourself or loved ones experiencing this condition or symptom.
What is emetophobia?
The American Psychological Association defines a 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), and nyctophobia (fear of the dark).
Emetophobia refers explicitly to a disproportionate fear of vomiting. While a mild fear of vomiting is common, emetophobia is rarer, estimated to affect roughly 0.1% of the population, with women being four times more likely to experience it. Those with emetophobia may fear choking on vomit, being hospitalized for vomiting, or vomiting and being unable to stop. They often have an aversion to words like puke, barf, or throw up and may look away from vomiting scenes in films and television shows. The topic of vomiting may be enough to induce panic in someone with this phobia.
Those who experience this condition may experience anxiety when they hear that they have encountered someone who has recently had a stomach virus. They may be hypersensitive to the slightest sign of illness in themselves, afraid that it could cause them to vomit. Unless they have no choice, they might avoid leaving the house for fear of contracting germs. They may avoid shaking hands with people and being near any unclean or malodorous items that could incite nausea. They may throw away food long before its expiration date or overcook food out of fear of bacteria that could 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 common side effects.
Emetophobia causes and comorbidities
Some experts believe that emetophobia is tied to a fear of losing control. Vomiting may be difficult or, at times, 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 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 disorder (OCD) associated with germ avoidance compulsions, 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. These episodes may result from eating a restricted diet or refraining from eating at all or from digestive issues resulting from extreme stress associated with the fear of vomiting.
Individuals with this condition may worry that their food has not been cooked long enough or properly stored, which could cause them to get sick. Others may limit the types of food they eat, sticking to what is "safe" (i.e., foods they don't associate with vomiting) or refusing to eat enough to fill their stomachs because they believe overeating might lead to nausea and vomiting.
Those with emetophobia may adjust their behavior or develop obsessions that keep them "safe." For example, some people may experience more emotional comfort 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 to vomit.
Some individuals with this phobia could be reluctant to leave home entirely for fear they might end up in a place or situation where they may witness vomiting or are unable to make it to the bathroom in time. Others may get 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 attending school or socializing at others' homes. Adults might miss work or avoid eating with friends and 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.
Can emetophobia be treated?
Emetophobia is often treatable with exposure and response prevention therapy (ERP), cognitive-behavioral therapy (CBT), and eye movement desensitization and reprocessing therapy (EMDR). Some doctors may prescribe anti-anxiety medications in conjunction with psychotherapy.
Forms of psychotherapy for emetophobia often 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. However, with time and regular treatments, the client may gain an increased ability to cope and reduce symptom severity.
Studies on emetophobia treatment
A study published in 2017 showed the results of a randomized controlled trial that assessed cognitive-behavioral therapy 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 CBT treatment includes reframing a client's thought patterns around the challenges that cause discomfort or difficulty. With emetophobia, this process may consist of exploring how vomiting may naturally benefit the body. For example, vomiting is the body's natural way of purging food or items that could cause illness.
While the act may be unpleasant, people often report feeling significantly better after they vomit. Often, whatever is causing a person to vomit is purged from the person's system within 24 hours. To someone experiencing emetophobia, this timeframe may seem like a lifetime. However, the purpose of therapy is to help the client gradually put these ideas into perspective.
Alternative support options
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 can be essential for those experiencing it to seek help from an experienced professional. However, some people may face difficulty receiving support due to their symptoms. Conditions like emetophobia may cause an 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.
Online therapy on platforms like BetterHelp can provide a solution to these barriers to treatment. With an online platform, you can speak with a licensed mental health professional experienced in using techniques like CBT that help clients with phobias, anxiety, depression, trauma-related disorders, and other conditions. You may attend sessions from the comfort of your home on a schedule that's convenient for you.
The rise in virtual therapy has also given rise to several studies comparing online treatment with traditional treatment. The research indicates that psychotherapy is as effective online as in-person for treating phobias and co-occurring conditions. Additionally, some find online therapy more affordable.
What are sufferers of emetophobia afraid of?
Emetophobia is an extreme, specific fear of vomit and vomiting. People with type of phobia experience intense discomfort at the thought of encountering vomit in any circumstance.
What do people with emetophobia avoid?
People with emetophobia tend to avoid situations where there is a risk of vomiting or witnessing other people vomit. This may include:
- Scenes in movies or on TV involving vomiting.
- Shaking hands or being near others if they’ve been ill.
- Hospitals or doctor’s offices.
- Dumpsters, trash cans, public restrooms, or other places one may associate with vomit.
- Types of foods or beverages associated with vomiting in the past.
- Conversations about vomiting or hearing words associated with vomiting like “puke” or “barf.”
- Objects or circumstances where one may be exposed to foul smells.
- Taking medications in which nausea or vomiting may be a side effect, even if there’s only a very slight chance.
How does emetophobia affect daily life?
A vomit phobia can be extremely debilitating— impacting many areas of one’s mental and physical health. For example, one with emetophobia might experience intense anxiety at the idea of needing to be sick in a public place or exposure to sick people, so they may avoid going out entirely.
They might develop unhealthy dietary habits for fear of becoming ill due to a specific food. They may stop eating at restaurants or other people’s homes because of fears surrounding trying new foods, or a lack of control over how food is cooked, or whether food has spoiled.
People with emetophobia sometimes avoid travelling by plane, train, boat, or car for fear of motion sickness. Emetophobia can create occupational impairment, problems with school, social anxiety, and difficulty in other areas of daily life.
When left untreated, it isn’t uncommon for emetophobia to evolve into a more severe mental health condition like obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), and other phobias such as germaphobia (fear of germs) or agoraphobia (fear of going outside).
OCD symptoms associated with emetophobia might include compulsive hand washing, excessive consumption of anti-nausea medication (even if the individual isn’t experiencing stomach discomfort or feel nauseated), and constantly monitoring for fever and other signs of sickness.
Why is emetophobia so hard to treat?
Emetophobia is difficult to treat because it’s a complex and relatively rare condition. Its co-occurrence with other conditions may require long-term treatments involving a combination of methods, including things that may have triggered the very symptoms responsible for the phobia.
Emetophobia can also be particularly problematic because vomiting is the body’s natural reaction to harmful germs and toxins, and it isn’t something one typically has control over. Even when we aren’t sick, nausea is a typical symptom of anxiety. When an individual feels anxious or afraid that they may vomit, it can induce nausea, which can in turn cause more anxiety, creating a vicious cycle that is difficult to break.
How can people overcome emetophobia?
How one overcomes emetophobia depends on the individual’s unique experience(s). Treatment methods are typically focused on confronting and processing the specific memories that trigger the fear.
Methods for treating vomit phobia include:
- Eye Movement Desensitization And Reprocessing (EMDR)
- Exposure And Response Prevention (ERP)
- Cognitive Behavioral Therapy (CBT)
- Medications To Treat Symptoms Of Depression Association And Comorbid Anxiety
Can therapy help emetophobia?
Therapy can be extremely effective for helping emetophobia. By working with a therapist, one may address the obsessive thoughts that contribute to emetophobia and reshape certain behaviors associated with the phobia that disrupt daily functioning.
What is the fastest way to cure emetophobia?
While there is no one fastest way to cure emetophobia, many find that psychotherapeutic techniques like CBT and ERP provide the fastest relief.
How can I help my child with emetophobia?
Fear of vomiting in children is typically treated with exposure and response prevention therapy. This type of therapy exposes the child to the things that trigger their anxiety—first in smaller increments, then increasing the exposure as the child becomes acclimated to the stimulus.
This type of therapy helps the child cope with troubling thoughts about vomiting, but also reduce the OCD behaviors that accompany them. Once the child understands that the avoidance and behaviors associated with their fears don’t serve them, the anxiety eventually decreases until they no longer fear vomiting or being in situations where they may encounter it.
How many people struggle with emetophobia?
Emetophobia affects roughly 3.1% to 8.8% of the US population, and appears to be more common in women than men.
Why is my emetophobia so severe?
Again, the etiology and severity of emetophobia depends on individual circumstances. Your emetophobia may have been caused by a traumatic vomiting experience from childhood or other time. It may be rooted in physical health problems in which vomiting is a common side effect. Or it may be from experiencing traumatic feelings associated with being ridiculed for vomiting in public.
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