How to overcome Emetophobia:

Step 2: Tackling excessive reassurance seeking

What is reassurance seeking?

Those with emetophobia often try to get reassurance that their fears won’t happen. This can be in person by asking repeated questions to friends or family or it can be online by googling Norovirus rates, looking for social media information, or by posting questions on Facebook such as “I have eaten X, will I vomit?”.

Getting reassurance seems natural and everyone will do it from time to time. The problem is that reassurance-seeking is too effective at reducing anxiety. If you have a fear and someone tells you it’s definitely not going to happen. Bam! Your anxiety is gone. Great right?!….

From a therapy perspective…. not so much! If used too much, it turns you into a reassurance addict.

Types and examples of reassurance seeking:

-Asking questions to friends or family members for verbal reassurance that they or others are not going to vomit.

-Asking questions about food poisoning or the chance of catching an illness.

-Asking friends or family members if they have recently been around anyone who was sick.

-Asking if certain activities, like eating out, could increase the risk of vomiting.

-Repeatedly asking if they look pale or unwell.

-Seeking reassurance that they will not get sick from touching certain objects or surfaces.

-Asking if it is safe to travel or attend events.

-Checking with others if they have experienced any side effects from medications.

-Asking if it is safe to eat certain foods during specific times, like before bed.

-Googling symptoms.

-Googling or looking up infection rates.

-Looking for reassurance on social media.

-Asking AI questions.

-Asking others if they are unwell.

-Asking repeatedly if the food they are about to eat is safe or has been prepared properly.

-Asking if food has expired or potentially contaminated.

-Asking if the environment has been cleaned or is dirt free.

-Asking if certain foods can lead to vomiting or are safe.

So why does reassurance seeking make Emetophobia worse?

Quite a few reasons…

1) It is addictive.

As reassurance-seeking is so effective at reducing anxiety it can become an automatic response for dealing with any hint of anxiety. Each time you are anxious, you feel the need to get more reassurance.

The problem with this is that reassurance acts just like a drug. You have the downsides of tolerance and dependence to deal with.

With each hit of reassurance, it starts to become less effective. Prompting you to need more of it. Think back to when you started reassurance-seeking, maybe you only needed to ask a single question before you felt relief. But now you may have noticed that you have to ask multiple times for the same level of reassurance. You may also notice you have to ask more frequently than you used to.

When your tolerance to reassurance builds up, you often start to doubt the answers you are getting. With this increased doubt comes more anxiety and more opportunities to reassurance seek.

2) Reassurance strengthens the belief that if you didn’t ask for reassurance something bad would have occurred:

Usually, most of our worries do not come true. If we do nothing to try and prevent it from happening, then we can learn that our fears are less likely to occur than we thought and we naturally become less anxious over time. Looking something like this:

If we do nothing to prevent our fears then we can learn they are not as likely as we feared.

However, the act of reassurance seeking can disrupt this learning. When your fear doesn’t occur after getting reassurance, your body unconsciously thinks that the reassurance some how prevented your fear. This strengthens your belief in how likely your fears are to occur. Feeding your anxiety in the future and prompting more reassurance-seeking. Basically, when you reassurance seek you only increase your fear, even when you do not throw up.

The cycle looks something like this:

3) Dependence on others:

Reassurance seeking creates a dependence on others for comfort and validation. This can reduce your own self confidence and ability to cope independently.

Frequent reassurance seeking can strain relationships, as it can become annoying or irritating for others to constantly provide reassurance about the same things.

4) More doubt:

Seeking reassurance is an attempt to reduce your own doubt about what will happen. However, over time actually increases doubt and uncertainty as you start to never feel fully satisfied with the answers you receive.

5) More thoughts

The more we reassurance seeking about something the more our brain see that topic has important and so it often produces more thoughts and mental images about it in the long term. So, in the long term you end up getting more scary thoughts about being sick or other problems.

6) More anxiety and nausea

When we have more thoughts and mental images about being sick or other worries we typically cause an increase in either our anxiety or our disgust response. Both of these can directly produce nausea. This nausea then gets used as a sign that you ae going to be sick. Prompting more anxiety and the need to seek more reassurance.

So, if reassurance seeking has all of these downsides why do we do it?

When people decide to use reassurance seeking as a strategy to manage their anxiety, it is because they think its helpful. This is because they struggle with tolerating any uncertainty about if they are going to vomit or not and it is so effective at reducing their anxiety (in the short term).

It basically comes down to these views:

I need to reassurance seek because:

1) If I don’t get reassurance I might be sick.

2) I can’t tolerate not knowing what will happen.

3) It is the only way I can reduce my anxiety.

You need to stand up to your emetophobia without reassurance seeking:

To overcome emetophobia you need to reduce, delay or stop reassurance seeking.

We can do this by standing up to your anxiety by imagining anxiety is just like a phone notification. Just because you receive a notification, doesn’t mean you have to open it.

This notification is just a thought that something will go wrong (e.g. “I might vomit”, “this food might be off”, “what if I catch a stomach bug”) but thoughts are not fact. It doesn’t mean it is true.

You need to recognise this notification and choose not to react to it because 99% of the time, these thoughts are not accurate.

You have to be willing to endure some short-term anxiety, to reduce your anxiety in the long term. The next page shows us how we can actually stop this unhelpful reassurance seeking.

Are you ready to try to stop reassurance seeking?

Yes

I specialise in treating Emetophobia, especially if cases where previous therapy has not worked. If you are exhausted from the constant battle against your phobia and its impact on your life, consider looking for 1:1 support.