Raising a Child With Emetophobia: How to Cope With a Fear of Vomiting

child's drawing of girl crying and various animals vomiting
child's drawing of girl crying and various animals vomiting

Illustration by Caitlin-Marie Miner Ong

Vomiting. No one likes it. Some people hate it more than others. Then there are the individuals who have a phobia about it, like my 8-year-old daughter. She's afraid she will vomit, that she will be near others who have vomited or could vomit. Just the word vomit can put her into a tailspin.

So, I bought my girl a book called Guts, the latest installment from the graphic novelist Raina Telgemeier, author of the popular autobiographical books Smile and Sisters, which my daughter adores. In this book, Telgemeier has honestly and thoughtfully illustrated and narrated her real-life struggles with emetophobia—an overwhelming anxiety about vomiting. I didn't even know my daughter's hang-up had a name until I read this book.

Then she read it. And we proceeded to have the worst week of third grade.

Why I Couldn't Ease My Kid’s Phobia

I didn't give her the book without carefully plotting my timing. She had developed a cold, and that little sniffle was enough to make her start worrying about fevers and puke and flu shots and everything that can come during the cold season. She couldn't get to sleep, her panic was ever present, she didn't want to go to school, she was imagining the worst. "How will I survive this?" she asked me.

When my daughter's anxiety is sky-high, I do my best to allay her fears about what she touched in the cafeteria or who may have touched her backpack or whether she will vomit in school like her BFF. I try to help her make sense of the fear before it becomes a tornado, but as it turns out, rationalizing the feelings isn't always the best move, nor is empathizing.

"When a child experiences a phobia, she seeks comfort and avoids the things that trigger her fear. The natural parental response is to provide reassurance, which can worsen the problem by reinforcing the avoidance and strengthening the fear," says Ricardo Rieppi, Ph.D., a New York City-based psychotherapist in private practice.

Tips to Help Your Kid Conquer Their Fear

My daughter isn't afraid to enter a class full of new people and make her presence known. She has no worries about talking to the neighbors or a restaurant server. She is confident in her appearance, abilities, and voice. Her anxiety is specific. Giving the phobia a name has been a relief, at least for me.

We now work with a therapist who has helped our daughter develop an action plan for managing her anxiety when it appears. Practice is what makes these efforts truly effective—something we're still working on. But it’s important that a child has the resources at her fingertips, like a sixth sense, in order to relieve anxiety at the exact moment it's needed.

54321 grounding technique: Look for five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste. The brain must work hard to identify these items, distracting from the stronghold of the anxiety in that moment.

Explosion breathing: Start standing, breath in, and crouch down at the same time, then jump up and spread arms and legs while breathing out.

Tear it up: Write out worries on paper then rip the paper up. Acknowledging the anxious thoughts and feelings is important—and so is having the power to symbolically destroy those worries.

Fidget: Squeeze a squishy or use a designated fidget tool for distraction and calming.

Finger breathing: Pretend you're tracing a Thanksgiving turkey and slowly move up and down and in between each finger, taking deep breaths in and out along the way. This act is a meditation that takes focus and time to complete, redirecting the anxious feelings so they become more manageable.

Alas, Telgemeier's book is tucked deep into the back of a bookshelf (sorry Raina—we still love you!). We're sticking to The Wimpy Kid and The Baby-Sitters Club for now.