At first, you may have dismissed your anxieties. I mean, no one likes throwing up or seeing someone else throw up, right? You probably reassured yourself it would be just like your other fears — after all, you did successfully grow out of your childhood fear of the dark and monsters under your bed.
But as the years went on, you noticed your anxiety around vomiting wasn’t going away — in fact, it just kept growing. And as your anxiety got bigger, you noticed your world started getting smaller and smaller.
You might have started double (and triple) checking expiration dates on food to avoid getting food poisoning. You may have ghosted friends after hearing they got the flu, making sure to keep a wide berth between you, their vomit and their vomit-causing germs. You might not even be able to read the “V” word without feeling yourself start to sweat.
In the process of picking up behaviors and habits to avoid anything vomiting-related, you might have started to worry something was seriously “wrong” with you.
If you can relate to any of what we just described above, we want you to know you’re not alone. You might have an anxiety-related condition called emetophobia, characterized by an intense fear of vomiting. But here’s the good news: like most phobias, emetophobia is highly treatable. Keep reading to learn more.
What Is Emetophobia?
Emetophobia is the fear of all things related to vomiting.
“People who experience emetophobia can have intense anxiety when they believe they or others around them are ill or will vomit,” licensed clinical psychologist Jameeka Moore, Psy.D., told The Mighty. “This phobia can range from the fear of seeing the word ‘vomit,’ seeing the action of vomiting, to a fear of vomiting in public, or [feeling like] they will have to be admitted to the hospital because of chronic vomiting or a vomiting-induced injury.”
To deal with the anxiety surrounding vomiting, people with emetophobia typically engage in “safety” or avoidance behaviors, which they hope will eliminate or reduce the chances of them getting sick. According to Alina Khomenko, Psy.D., who specializes in obsessive-compulsive disorder (OCD), specific phobias and Tourette syndrome, some common behaviors and symptoms of emetophobia may include:
- Repeatedly checking the expiration dates of food
- Overcooking food to kill pathogens
- Checking and smelling food before eating it
- Asking for reassurance from loved ones about whether something is safe to eat or not
- Repeatedly checking your temperature
- Monitoring your body to look for signs of nausea or illness
- Repeatedly going online to read about warning signs of illness
Mighty contributor Claire Fox knows what it’s like to struggle with extreme avoidance due to emetophobia. In her piece, “The Reality of Emetophobia and How I’m Beating It,” she shared:
When I think about some of the things I have done to avoid being sick, or to get away from a situation where someone else may be sick, I realize just how real a phobia this is. Once, I got off a train at a station in the middle of nowhere at night, just because I heard someone in the same carriage say they felt like throwing up. I can count the number of times I’ve tried seafood on one hand because I once read it can be notorious for causing food poisoning. I’ve concocted excuses upon excuses to avoid car sharing on long journeys with people who admit to suffering from travel sickness.
As Fox’s examples illustrate, emetophobia is not merely being “grossed out” by vomit, it’s an intense fear that can affect daily functioning.
“While none of us are really ‘fond’ of thinking about vomiting and generally feel disgusted at the thought or at the site of someone throwing up, a person with emetophobia experiences significant distress and anxiety at the possibility of throwing up and/or seeing someone else throw up,” Khomenko said.
What Causes Emetophobia?
Emetophobia is often (but not always) triggered by a past traumatic or negative experience with vomiting. When combined with a genetic predisposition for anxiety, situations like going to the hospital for uncontrollable vomiting or having a humiliating experience vomiting in public can sometimes result in an individual developing emetophobia.
Some researchers believe emetophobia is a manifestation of a desire to be in control — or on the flip side, a response to the fear of lacking control. In one study, researchers found participants with emetophobia believed their avoidance actions gave them greater control over their circumstances (both health and otherwise) when compared with the two other groups of participants in the study — people who had other non-emetophobia phobias and people who didn’t have a phobia at all.
Though safety behaviors and avoidance may feel like they give you more control in the moment, the reality is engaging in these behaviors actually strengthens the anxiety you feel around vomiting, leaving you less in control. It’s important to remember you don’t have to do it all on your own, and there is no shame in needing professional help to deal with a mental health struggle.
If you struggle with emetophobia but can’t identify a “cause,” don’t worry. Clinical postdoctoral fellow Samantha Myhre, Ph.D., told The Mighty identifying a root cause isn’t a key part of treating emetophobia, and in some cases it may be too difficult to pinpoint a cause at all.
Treatment for Emetophobia
When you’re struggling with any kind of mental health issue, it’s easy to become discouraged at times. And while your feelings are always valid (health challenges can be difficult!), we want you to know recovering from any kind of phobia is extremely likely with the proper treatment. In fact, many psychologists find treating phobias particularly rewarding because they get to see patients overcome the fears that held them back for so long.
The gold-standard treatment for phobias is exposure and response prevention (ERP), a type of therapy that involves gradually exposing yourself to your fear and resisting the ways you’ve typically responded to it in the past (usually by avoiding or engaging in safety behaviors). An ERP therapist will typically lead you — very, very slowly! — through a series of “exposures” designed to gradually acclimate you to your fear so it becomes less anxiety-inducing over time.
“Through exposure work, a client is exposed to images, foods, activities, places and sensations they avoid to help them learn to better manage anxiety, facilitate learning and to help them conquer their fear,” Dr. Moore told The Mighty.
For example, if emetophobia keeps you from eating seafood for fear of getting sick, a therapist might create exposures for you that involve getting closer and closer to that fear. They might start you out by having you sit in the same room as someone eating seafood. After repeatedly being exposed to this situation, you might notice your anxiety receding. At this point, a therapist might “up the ante” in the next exposure — perhaps by opening a can of tuna and asking you to smell it. With each exposure, the therapist will support you as you work your way up to the bigger fear — in this case, eating a meal with seafood in it.
If this sounds difficult, it’s because it can be! Facing your fears is hard, but with the support and guidance of a therapist, you’ll learn that you will no longer need to rely on the behaviors you once believed kept you “safe,” because even if the “worst-case” happened, the world wouldn’t end. A core part of treating emetophobia is learning to cope with the reality that when you’re exposed to your fear, you might indeed get sick and vomit — but you also might not. You’ll learn that either way, you will be OK.
“It’s all about facing uncertainty and taking the risk,” Stacey Wochner, LCSW, LPCC, director and owner of OCD Specialists treatment center, told The Mighty. “The more you face your fears, the easier it will become. With ERP, you start to feel like you’re winning. Sticking with it, even though it’s hard, usually shows pretty good results.”
If you are considering treatment for emetophobia or any other anxiety-related fear, we want you to know we’re proud of you. Wherever you are in your health journey, thinking through your treatment options can be a difficult but important part of recovery. For anyone who is on the fence about seeking treatment, Dr. Khomenko has a few words of encouragement:
Often, anxiety has a way of making people feel hopeless. In an effort to cope with anxiety, you may find your world getting smaller, anxiety getting bigger, and you may find that you can no longer do the things that you previously enjoyed doing. Emetophobia is a common phobia that responds very well to treatment. If you take the brave and often challenging step to seek help through therapy with a qualified mental health professional, you can get your life back and get back to doing all of the important things that emetophobia has taken from you.
You deserve the treatment you need on your health care journey. To find a therapist who specializes in ERP, we encourage you to use this therapist finder tool from the International OCD Foundation. To get support from our Mighty community, we encourage you to post a Thought or Question with the hashtag #CheerMeOn. Our community wants to rally around you, no matter what you’re facing today.