Emetophobia: Fear of Vomiting
Jonah Lakin PsyD
Emetophobia is a type of phobia in which individuals experience an intense fear of vomiting. Although virtually everyone on the planet finds vomiting to be unpleasant, people with this fear are terrified of it. Individuals with emetophobia will often go to great lengths to avoid vomiting or anything that they believe might lead to vomiting. This could involve avoiding certain foods that they think will upset their stomach, or it may involve avoiding people who appear sick, or large crowds where there may be sick individuals. Because they fear illnesses that could lead to vomiting, some people with emetophobia might appear to have a significant fear of germs.
When avoidance is not possible, people will often engage in compensatory behaviors. For instance, a person who fears certain foods may be willing to eat them, but only if they can take an antacid, or with ginger. Or a person who avoids sick people may be willing to visit a friend in the hospital but will wear a mask and use lots of hand sanitizer to prevent getting sick. Or a person whose most afraid of vomiting before they can reach a bathroom may carry around a plastic bag with them everywhere they go. These compensatory behaviors are also called “safety behaviors.” (For those interested, here’s our blog on why safety behaviors appear helpful but actually make anxiety disorders worse).
People with emetophobia tend to experience high levels of anxiety when their stomach feels upset. This unfortunately creates problematic feedback loops as being anxious tends to lead to an upset stomach. So a person might eat a new food and feel a bit nervous about doing so. Because they are nervous their stomach hurts, and because their stomach hurts they fear they will vomit. All of this serves to strengthen their beliefs that they should avoid eating new foods in the future.
Not only are people with this fear prone to fear when their stomach is upset, but they can also misinterpret normal bodily sensations as signs that something is wrong. For instance, a normal gurgling in the stomach that occurs during digestion or a normal feeling of tightness from being full may trigger a thought that they might throw up. This will inaccurately lead them to label whatever they ate as a “trigger” food and they will likely avoid it in the future, even though this food didn’t lead them to throw up.
As is the case in treating all phobias; effective treatment involves gradually approaching anxiety-provoking situations and eliminating compensatory behaviors that make a person feel “safe” but are inadvertently strengthening their fears. Although this therapy can be scary, it is effective and results are typically seen within a few sessions.
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