Emetophobia – An overview of the fear of vomit

I hope that this post will help someone with emetophobia relate to my experience. Before you read this and have emetophobia, I would like to stress that these thoughts and behaviours are not normal – When reading emetophobia blogs and forums it is easy to tell yourself that your fear is valid as people in that context emphasise that vomit is indeed something to be scared of, therefore your fear must reflect the reality. That is a very unhelpful process and will simply enable you to keep your fear alive, so you have to realise that you are the one who is creating this fear as vomit really is nothing to be scared off (Otherwise everyone would be scared of it).

What is emetophobia?

Simply put, emetophobia is an irrational fear of vomit. Different people experience this fear differently, some being more scared of others vomiting, or vomiting in a social context. Emetophobia can be a tricky phobia, due to it being based mainly on having a high desire for control, while feeling unable to control one’s life. Someone with an irrational fear of, for example, heights, will experience that fear when they are in a situation where they are directly challenged. They might avoid certain situations, such as hiking and climbing on ladders, but their everyday life is usaully not affected. For someone with emetophobia, everything in their life suddenly starts to become focussed around vomit, even if it seems completely unrelated when thinking about rationally. Eating food, going out, exercising, cooking, travelling, taking public transport, drinking alcohol – all of these simple life experiences become focussed around the idea of how vomit in any way could be involved.

What if I or others will get food poisoning? What if a drunk person throws up, or alcohol makes me throw up? How can I cope with being car sick? Is that person coughing going to be sick? Can I safely go to a public bathroom without catching a virus?

Often times when I explain my phobia to others, they like to say “But nobody likes vomit” – This is true, but most people don’t revolve every life experience around vomit in the way I just explained. And from experience when talking to people about my phobia, that is a concept they found pretty hard to get their head around. I have been told “Just stop thinking about vomit then” or “But that is not even related to vomit, so why would you be scared”, but unfortunately it’s not all that simple. It took me months to shape my mind around to not focus on vomit so often, and while I see my phobia as having decreased hugely, there is still moments where I make vomit out to be a very bad and scary thing. I will make a separate post on how I (mostly) overcame my phobia and have also developed better coping skills with every day situations and increased my self-esteem.

My Experience with Emetophobia

These days I rarely feel anxious in my daily life about vomit, and I have improved significantly. In my first year of university, I let the phobia take over my life – I avoided the busses, did not eat much (and if I ate, it was something I knew and was used to), locked myself in my room when people were drinking alcohol, avoided going to the toilet, and so much more. I am planning on making a separate post on dealing with emetophobia at university, as I found it to be a particularly difficult environment to keep perspective in. Nowadays, I take the bus without care (or any forms of travel/ public transport), exercise after eating, eat without cleaning my hands and whatever i want to eat, and just generally live a lot more freely and independently. 

Safety Seeking Behaviours

The vicious cycle of safety seeking behaviours keeping a fear alive © Think CBT Ltd

Emetophobia is mostly kept alive by taking part in safety seeking or avoidance behaviours. I don’t want to list many of them, as I know for myself most of my safety seeking behaviours developed by reading about them on forums (and I will explain why this is a bad thing), and I am very keen on not enabling that. If you have emetophobia and are reading this please remember that safety seeking behaviours are bad for you and will not help you, even though they make you feel better at the moment by temporarily relieving anxiety. 

For those who don’t know what safety seeking behaviours are, it is an action that someone engages in to escape their state of anxiety. For example, when my phobia was quite bad, I would always carry ginger sweets with me and take one when I felt nauseous (which ended up being about 5 sweets per day), so that I would not get sick. Did this help in any way? Nope. To me this is almost comparable to self-harm. It is a type of coping that helps alleviate anxiety in the moment, but eventually just strengthens the negative beliefs around vomit.

This part is particularly important to those suffering from emetophobia: To clarify, when you engage in a safety seeking behaviour, you are telling yourself that you cannot cope with potentially being sick. You reinforce that being sick (or seeing someone sick) is a scary thing, as you need an external force to take away this fear. This then also makes you feel powerless, as you put the idea in your head that you can’t cope with this situation by yourself. Control is a huge, if not the main, theme in emetophobia – Emetophobes really want to be in control, while feeling completely out of control. Safety seeking behaviours are a way of making them feel more in control, as they are taking themselves out of the anxiety, but they are doing that by relying on something external. They are reinforcing the belief that vomit is indeed something they need to be scared of, which is why they are doing everything they can to avoid it. Instead, it is a lot more important to build internal coping behaviours and slowly step away from any external and ineffective coping mechanisms. For doing this, I really recommend the Thrive book by Rob Kelly. It has helped me hugely, expresses what I have described so far in much more detail, and is a really empowering programme as you are recovering by yourself, completely from within. Everyone has different preferences, but to me the Thrive programme just makes sense and works well – If you have shaped your thinking around vomit being something you cannot cope with, you can shape your thinking back to gain internal control.

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