Emetophobia, if you have never heard of it, is an extreme fear of vomiting, seeing vomit or catching diseases from someone else who vomits. The fear tends to get progressively worse unless treated.
It’s a condition that has a severe impact on the life of sufferers. Things that most of us do without really thinking about it, like travelling on public transport, going to restaurants or going to social events become almost impossible. Often the fear becomes so intolerable that emetophobia sufferers seek to protect themselves by isolating at home and disengaging from events, friends, and even family.
If emetophobia sounds pretty niche, you might be surprised to know that it is surprisingly common especially among teenagers and young people. And in my experience of treating it, it seems to have come even more prevalent after Covid (where sufferers became overly used to isolation from others).
If you are a sufferer, the first thing to know is that emetophobia can be overcome. The process of recovery is usually easier with a therapist who has worked with emetophobia previously.
Limiting Beliefs Are More Important Than a Trigger
The therapist’s priority is (or should be) to get the sufferer functioning again. In practice, this translates into the therapist helping them understand that emetophobia is caused by their beliefs specifically, their limiting beliefs, about:
- their competence (e.g. “can I cope with the unexpected?”)
- how lovable they are (a.k.a – self esteem)
- how they handle social situations (a.k.a – social confidence)
Strong positive beliefs about our competence, self-esteem and social confidence are fundamental for healthy living. When any one of these beliefs is not as strong as it could be we are not living our best life. Sufferers of emetophobia usually have really limiting mind-sets around all three of these key beliefs. Until that is reversed, they won’t get better.
This can be hard for sufferers to accept at first, because many believe that a specific event caused the emetophobia. “It was after I saw my mum vomit that I started to get scared of being sick”, they say, or “I got a stomach bug on holiday and that’s when it started….” Also, on the outside some emetophobes look incredibly “with it” – highly capable people with high powered jobs, busy family lives etc.
But beliefs are funny things. If someone spends years secretly believing they don’t have any personal power, are unable to look after themselves properly, are “not very interesting”, “not very likeable”, “a failure at parties” they build up a hugely unstable psychological foundation for themselves. Even though in a worst case scenario they would almost certainly respond highly effectively, they don’t believe, deep down, that in certain circumstances they can cope. Before the onset of emetophobia, most will already have been highly anxious, catastrophising, overly worried about what others think, maybe depressed (it just wasn’t so evident to themselves or others).
Someone being sick near them is just the trigger. It just gives their beliefs – already focused on finding more negative evidence about themselves and their environment – another disempowering idea to latch onto.
Changing Those Limiting Beliefs
I will read my clients a series of statements related to each of the three key beliefs and ask them if they agree or disagree. For example: “If you can’t excel at something there is no point doing it – do you Agree or Disagree?” It might seem to them at first that the way they answer the question has nothing to do with the immediate problem in hand. But actually, their response is incredibly revealing about their mindset. And pretty soon my clients start to see that for themselves.
We do a lot of work getting them to regularly take notice of their beliefs and to start to challenge negative beliefs by finding examples in their lives of all the good things they are doing or being that they are simply not noticing.
Doing Beats Talking – Exposure Therapy
It is only by action that we prove to ourselves that we are making progress.
So the second key step is getting sufferers to start achieving small goals which they were struggling to perform before therapy started.
Depending on the client, I might set them the goal of travelling on a bus or train for a couple of stops, or inviting a friend over to their house for half an hour. Gradually as they get more confident, they can take on more stretching goals like eating with friends in a restaurant or going on holiday.
The Past May or May Not Be Important
For most clients this combination of CBT-style questioning and pro-active goal setting provides them with a platform from which they can get back to living a completely normal life. At some stage in the healing process, most just realise they are not frightened anymore and are starting to live a normal life again.
Mental health is not an end point, it’s a process – a process of moving (perhaps slowly at times) ever upwards through layers of higher, and more balanced and more advanced, consciousness. Some people are completely cured after 10 sessions. Others end up tolerating certain situations (like a flight on a plane) without being able to fully relax. But that is still a considerable improvement on where they were when they started. For this latter group, it tends to take more sessions and different kinds of therapy to finally be freed of emetophobia.
You may have noticed that I haven’t mentioned anything about exploring the sufferer’s past – perhaps their relationship with their mother or father. Certainly early on this is not the priority. But once a sufferer’s situation has stabilised, it can sometimes be useful to go into family dynamics in more detail – and find out which parents, siblings or friends are still shaping certain beliefs the sufferer still holds.
Some clients already well on the road to recovery also gain a lot from exploring the underlying spiritual meaning of emetophobia – what the symptoms are trying to tell them. They realise that, even though they are getting better, they can’t just go back to being the old version of themselves. Many end up not just changing self-beliefs but changing their whole life narrative and becoming calmer, stronger, more authentic versions of themselves – unlocking the potential they always had inside them.
If you suffer from emetophobia, or know someone who does, why don’t you reach out to me on [email protected]