Terrified of throwing up? The fear of being sick is surprisingly common. We speak to a chartered psychologist about the best method of treatment for this phobia.
By Izzy Capelin
Emetophobia is the extreme fear of being sick, seeing someone else being sick, or a combination of the two. Despite being one of the most common phobias in the UK, there is very little understanding about the disorder.
We speak to chartered psychologist and expert in treating phobias Professor Kevin Gournay CBE about the fear of vomiting and how to manage your phobia:
What is a phobia?
From heights to bird feathers, people can be scared of pretty much anything. But a genuine phobia is no laughing matter and it can cause severe anxiety for the sufferer. But many people use the term incorrectly. A fear is considered clinical severity if it either upsets or interferes with your life.
A fear is considered clinical severity if it either upsets or interferes with your life.
‘Most of us have fears which are perhaps a bit more than they should be, so lots of people don’t like spiders or high places, but it only becomes a phobia once it really does interfere with your life,’ says Professor Gournay.
‘There’s a continuum between normal fear at one end of the spectrum and a clinical significant phobia at the other, where you’ve got the need for treatment. And there are people in between that, who have an exaggerated fear but it doesn’t become clinically severe.’
What’s the impact of emetophobia?
Emetophobia is particularly difficult to treat, as it’s quite complex. Emetophobia tends to arise in the context of someone who has more general obsessive fears, so the fear of throwing up is often associated with the fear of being contaminated.
Emetophobia also often comes with secondary concerns including:
✔️ Food avoidance.
✔️ Hand washing.
✔️ Preoccupation with others who have a virus which might make them sick.
✔️ You might also fear other people throwing up or a mental disgust to vomit.
On a rational level, people with emetophobia understand that vomiting isn’t life-threatening or going to do them any long-term harm physically, but they are horrified at the prospect of it happening.
‘The other important thing is that what undermines the fear of oneself being sick is quite often not very well defined by the person,’ explains Professor Gournay. ‘I’ve seen literally hundreds of people with this phobia and, quite often, there’s a fear that vomiting will lead to a loss of control, but other times people can’t quite put their finger on what exactly it is they fear as a consequence.’
How to treat emetophobia
The main treatments available for emetophobia involve cognitive behaviour therapy. Most people with a vomiting phobia will have a list of avoidance behaviours such as, avoiding certain foods, and certain places to eat.
Some sufferers also avoid public places, especially if there’s a fear of being contaminated by others. Treatment for the disorder often involves gradual exposure to certain situations, in order to gradually break down avoidance behaviours.
Treatment involves gradual exposure to certain situations, to gradually break down avoidance behaviours.
‘You might get people to eat different foods that they’re avoiding, because at the heart of this is helping the person demonstrate to themselves that actually their fears of being contaminated in some ways are greatly amplified,’ says Professor Gournay. ‘What they’ve got to do is take a few risks.’
Coping with catastrophic thinking
On top of dealing with the list of avoidances, sufferers often have to cope with the aspect of central fear in their mind. Here, cognitive strategies may help someone see the problem as less catastrophic. Sufferers often catastrophise being sick, so the aim of cognitive therapy is to try and reduce the level of catastrophic thinking.
‘People often respond quite well to exposure by looking at videos, clips on the internet, of people being sick,’ adds Professor Gournay. ‘That sometimes helps because the person can get used to the idea, particularly people who have a lot of disgust of being sick, that helps reduce the level of negative emotions attached.’
Sufferers often catastrophise being sick, so the aim of cognitive therapy is to try and reduce the level of catastrophic thinking.
‘Treatment for this condition is complex, and I know that recent research efforts have been put into treatment packages,’ adds Professor Gournay. ‘It’s not like treating someone with a spider phobia, I can treat spider-phobics in a couple of sessions lasting a couple of hours each but vomiting phobias, treatment often involves many hours of therapy.’
The importance of self-help
Self-help methods have proven to be effective for management of the condition.
‘It’s worth emphasising that you should try self-help before you look for referrals,’ says Professor Gournay. ‘These treatments are available on the NHS, but there are long waiting lists, and sometimes you have to wait months or even longer to get the right kind of treatment.’
Some people resort to taking anti-vomiting medication, but this can be very dangerous and is not advised. There is also no evidence that psychiatric drugs, antidepressants or tranquillisers have any effect on the phobia, so sufferers should consider talking therapies as the best method of treatment.
Further help and support
If you are struggling with any type of phobia or anxiety disorder, for additional support try one of the following resources:
- No Panic: a registered charity which helps people who suffer from panic attacks, phobias, obsessive compulsive disorders and other related anxiety disorders.
- BABCP: a multi-disciplinary interest group for people involved in the practice and theory of behavioural and cognitive psychotherapy.
- Anxiety UK: a charity which specifies in helping those suffering from anxiety.
- The Samaritans: a charity providing support to anyone in emotional distress.
- Mind: a charity that makes sure no one has to face a mental health problem alone.
- Net Doctor