What is emetophobia (the fear of vomting)
What is Emetophobia?
Emetophobia is a common phobia and is the fear of vomiting and feeling nauseous. This fear can be about yourself being sick, someone else being sick, or not being able to cope if it happened. If you’re living with it, you’ll know it can take up a lot of mental space and be exhausting. You may be scanning for signs of sickness, planning “just in case”, and avoiding situations that feel risky. The good news is that emetophobia is highly treatable, and cognitive behavioural therapy can help you overcome this phobia [Therapy for Emetophobia (fear of vomiting) — Emetophobia UK].
Quick definition
Emetophobia is an intense, persistent fear of vomiting that leads to extreme anxiety, fear and changes in day-to-day behaviour, even when the actual risk of being sick is low.
Key characteristics of emetophobia are:
An excessive fear: The fear of vomiting is out of proportion to how those without the phobia view being sick.
Consistent anxiety response: Those with emetophobia always become afraid when presented with the chance of vomiting.
Avoidance or extreme distress: Those with emetophobia go out of their way to avoid situations linked to being sick, or endure situations with extreme distress. It affects choices and routines (what you eat, where you go, how you socialise), not just how you feel.
Significant impact of life: Emetophobia causes a significant impacts the individual’s school, work, or personal life.
Six months duration: In both children and adults, the duration of symptoms must last for at least six months.
Not caused by another disorder: Many anxiety disorders have similar symptoms. Other disorders must be ruled out such as agoraphobia, obsessional-compulsive disorder (OCD), before diagnosing a specific phobia of vomiting (emetophobia).
Common emetophobia symptoms
Symptoms of emetophobia typically fall into four categories. Emotional, physical, behavioural and cognitive symptoms.
Emotional symptoms of emetophobia
The main emotion those with emetophobia often experience is high levels of anxiety (feeling on edge) and fear. This is often a daily occurrence and can feel exhausting and draining. However, it is also common to feel exhausted, depressed, upset, guilty, shame or anger.
Physical symptoms of emetophobia
As emetophobia is an anxiety disorder, suffers often feel all the typical symptoms of anxiety such as:
Increased heart rate or palpitations.
Shortness of breath or feeling “breathless”.
Sweating, trembling or shaking.
Dizziness, light-headedness or feeling faint.
Muscle tension.
Restlessness or feeling on edge.
Sleep problems (difficulty falling or staying asleep).
However, one of the biggest complaints is the sensation of nausea. This can often be a daily occurrence for those with emetophobia. This symptom is caused by anxiety and the disorder itself. However, this symptom is nearly always misinterpreted as a sign of impending vomiting which leads to a lot of anxiety and fear.
Behavioural symptoms of emetophobia
Those with emetophobia start to go to great lengths to monitor, prevent and avoid vomiting. This often leads to:
1) Things done to verify danger and the chance of vomiting:
Checking behaviour.
Reassurance seeking.
Body scanning.
Hypervigilance (looking for threats).
2) Things done to avoid vomiting:
Avoiding reminders of vomiting.
Avoiding physical sensations.
Avoiding places and situations.
3) Things done to prevent vomiting, nausea or anxiety:
Preventative safety behaviours. Such as using mints, anti-sickness medication, excessive hand washing etc.
4) And mental strategies for controlling vomiting:
Worrying.
Mental planning.
Positive Affirmations.
Distraction.
Cognitive symptoms (thoughts and mental images) symptoms of emetophobia.
Those with emetophobia often get intrusive thoughts about vomiting. Often thoughts can become consumed with “what if” questions about the potential chance of vomiting. It is also common to have intrusive mental imagery of either memories past episodes of vomiting or mental pictures of what they fear is going to happen.
What is the impact of emetophobia
Emetophobia doesn’t just effect suffers when they are being sick but starts to shape their routines, choices, confidence and infects every area of their life. Many people find they spend a lot of time planning, avoiding, or trying to stay in control, which can make life feel smaller over time. Often these areas are greatly affected:
Work or study: avoiding commutes, meetings, or shared spaces, school, work or enduring these situations with anxiety.
Relationships: tension and arguments can occur around food, plans, due to excessive reassurance-seeking or the avoidance of certain activities. Often those with this phobia can feel misunderstood or embarrassed about their fear.
Parenting: worry about children being ill, difficulty managing normal childhood bugs, or avoiding situations (soft play, school events) where they fear sickness might happen.
Travel and holidays: avoiding public transport, flying, long car journeys, or trips abroad. Often struggling to relax away from home or needing “escape plans” if their fear was to occur.
Food and eating patterns: restricting to ‘safe’ foods, skipping meals, avoiding restaurants, or feeling anxious after eating.
Social life and spontaneity: saying no to invites, leaving early, avoiding busy places, or feeling you need to stay close to home and in control.
Health behaviours: delaying medical appointments, avoiding certain medications, excessive online searching, or repeatedly checking symptoms for reassurance. Often women with emetophobia can delay pregnancy or even elect for abortions rather than face morning sickness.
When to seek help for emetophobia
Emetophobia slowly starts to take over a person’s life. If you notice your world has become smaller, less safe and your need to prevent vomiting has become controlling, help is available [Therapy for Emetophobia (fear of vomiting) — Emetophobia UK].
How many people have emetophobia
Emetophobia has been estimated to effect around 5-9% of the population. Despite its high prevalence rate, it is often not talked about openly and it can often feel like no one else has this phobia.
Emetophobia typically develops in childhood or adolescence and without treatment often continues into adulthood.
Do you need treatment for emetophobia
Yes, treatment is needed. Emetophobia can often shrink and grow over the year but without treatment emetophobia rarely goes away on its own. This is because anxiety is self-reinforcing. It feeds itself. Without treatment, emetophobia only grows with time. Fortunately, treatment is highly effective for emetophobia.
What help is available for Emetophobia
There is a lot of support available for emetophobia. The best treatment currently available is cognitive behavioural therapy (CBT). However not every CBT therapist knows how to treat emetophobia and it often requires a therapist with specialist knowledge. If you are in the UK, support is often available on the NHS. Click here to find your local NHS provider [NHS Talking therapies service].
If you are interested in private therapy with an emetophobia specialist you can book a free consultation with myself [Free Therapy Consultation — Emetophobia UK].
Click here for more information on how therapy can help [Therapy for Emetophobia (fear of vomiting) — Emetophobia UK].
Written by:
David Kaneria - Emetophobia Specialist