Nobody loves throwing up… but if your aversion to vomiting is extreme, you may be dealing with emetophobia. Fortunately, the condition is treatable.
What Exactly Is Emetophobia?
Let’s face it – vomiting is an uncomfortable, disgusting experience. But everyone will vomit at some point in their life (usually many times). The ability to vomit is actually a healthy survival mechanism – sometimes it’s important to get out harmful substances you’ve ingested (e.g., poisons, spoiled food, germs) as quickly as possible.
For some people though, vomiting can also be a source of significant fear or anxiety. The fear of vomiting is also called emetophobia (the medical term for vomiting is emesis). We often fear things that are uncomfortable and not within our control – and vomiting is both.
Let’s look at several ways that vomiting and vomit can become a source of fear:
One-Trial Learning and Evolution
There is a powerful connection between vomiting and learning to avoid things that lead to it. For example, it is common that people report not being able to return to a restaurant where they previously contracted food poisoning. Often, they feel nauseous if they even consider doing so. Usually, knowing that going back there won’t necessarily make them sick isn’t powerful enough to prevent the aversion to that restaurant.
This is called one-trial learning – it only takes one instance to learn to avoid the situation that made you vomit. Most things take us numerous repetitions to learn (think about homework assignments in school!), but nausea and vomiting often lead to one-trial learning.
Additionally, many people experience increased nausea if they see someone else vomiting. They may even then vomit themselves. This response is part of an evolved social survival mechanism. In early human groups, the people nearest to you most likely ingested the same foods as you. So, if others started vomiting, it could be a sign that those foods were harmful, and thus important to get them out of your body as well.
Sometimes, vomiting becomes associated with something else that is really upsetting, scary, or threatening on its own. For example, you might vomit a due to a health condition, extreme motion sickness, or intoxication from substances like alcohol or marijuana. In these situations, vomiting is paired with something else that is naturally aversive. Through a process called classical conditioning, the fear of vomiting can grow from this and start extending beyond these situations. In other words, vomiting and nausea become a source of anxiety and fear in general, not just when they happen as part of something else upsetting.
Nausea and dizziness are two sensations that can occur as a result of the body’s fight-or-flight response. They also happen to be sensations that often precede vomiting. If you feel these sensations before you vomit, they can become triggers for fear, even if they happened for an unrelated reason.
We feel surprise when something happens contrary to our expectations. Although surprises aren’t always negative, many people experience fear or anxiety alongside surprise. If a wave of nausea or bout of vomiting comes unexpectedly and surprises you, it’s easier to become fearful of it. Likewise, if you’re caught off guard by someone near you vomiting, this can lead you to think of vomiting as totally unpredictable. This can contribute to increased fear of vomiting.
Unhelpful Coping with a Fear of Vomiting
A common response to anxiety or fear is avoidance. So, if you’re suffering from emetophobia, you may do things to try to avoid vomiting or reduce the chances of vomiting as much as you can. These are called safety behaviors, because they lend a sense of safety or protection from vomiting. Sounds good, right? The problem with safety behaviors is that while they lower anxiety in the short term, they actually make it worse in the long term. As mentioned above, vomiting is an inevitable part of life. So, avoidance and safety behaviors are not helpful in managing anxiety about vomiting.
Here are some common safety and avoidance behaviors that arise in emetophobia:
- Using anti-nausea or anti-vomiting medications or remedies preemptively or in response to the slightest hint of stomach discomfort. This often includes antacids, acid reducers, Dramamine (motion sickness medication), acupressure wrist bands (like Sea Bands)
- Avoiding media (stories, videos, music) that show or talk about vomiting
- Avoiding situations that feel “high risk” for other people vomiting, such as bars, doctors’ offices, or public transportation
- Avoiding activities that feel “high risk” for bringing on nausea or vomiting, such as using alcohol, or going on amusement park rides
- Avoiding foods that feel “high risk” for vomiting, or only eating “bland” foods
- Being overly cautious/conservative in discarding food that may be spoiled
- Scanning your body repeatedly for even slight signs of nausea or stomach discomfort
How Can CBT Help with Emetophobia?
A fear of vomiting can cause significant disruption in your day-to-day life and have a negative impact on your mood. Cognitive-behavioral therapy (CBT) has many techniques that are effective at reducing anxiety, and these also work for vomiting fears. Some of these include:
- Reducing safety behaviors and avoidance
- Reducing and eliminating these breaks the cycle that keeps emetophobia going over time.
- Exposure therapy
- Exposure therapy treats anxiety by helping you approach, rather than avoid the things that cause anxiety and fear so you can learn you can withstand it. This desensitizes you to those things so that they no longer trigger anxiety.
- Examining your thought processes
- CBT helps you identify and change unhelpful patterns in your thinking that keep you anxious.
Working with a CBT therapist can help you live without limitations stemming from a fear of vomiting. If you struggle with emetophobia, contact us if you’re ready to get started with treatment.