Emetophobia — The Reality Behind The Phobia Most People Think They Have (But Don't)

As long as I can remember, our daughter has been afraid of throwing up. Not just averse to the idea, but truly, deathly afraid of it.

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My husband and I didn’t fully recognize the difference until the past year or two though. We assumed our teen just had a more-intense-than-most disdain for vomit and some anxiety that went along with it. It wasn’t until she stopped doing things she loved and found herself unable to go to even the most mundane of places, like the grocery store or out to a restaurant, that we realized it was something deeper.

Our daughter obsessively checked expiration dates and constantly asked us to smell her food, needing reassurance that things were okay to eat. She wouldn’t go anywhere near someone who had complained of any stomach discomfort. If someone even mentioned the word “vomit,” she’d go into an anxious state. She always had to sit in the middle back seat or front seat of the car, even though she hadn’t actually gotten carsick since she was a year old.

I started putting two and two together and asked her one day if all of her anxiety had to do with throwing up. She said yes. Aside from a little social anxiety, every fear that consumed her thoughts was about that.

I googled “fear of throwing up” and came upon the official word for it — emetophobia. Now, none of us like to throw up, of course. It’s totally natural to have an aversion to vomiting. But emetophobes don’t just dislike it or even hate it, they fear it.

Unlike many fears, emetophobia can easily affect a person’s everyday life and eventually become totally debilitating. Emetophobes are essentially afraid of their own body, and there’s no getting away from the possibility of getting sick. Anyone, at any time, could be carrying around a contagious stomach virus and not know it. Any food could be contaminated with food-borne illness. Most of us live our lives understanding those lingering possibilities, but don’t give them a second thought. And even if we do, we’re able to brush it off quickly.

Emetophobes can’t do the brush-off. They worry about the possibility of throwing up all the time. Ironically, the fear and anxiety over it often causes digestive distress, and when you have a clinical fear of vomiting, any sensation in the stomach gets interpreted as nausea, which begins a vicious cycle of anxiety and nausea (or perceived nausea), which leads to more anxiety, which leads to more nausea.

For our daughter, that anxiety eventually took over everything. Over a period of months, we watched our bright, sweet, fun, talented 16-year-old become a hermit. She started struggling to do everything she used to love. She plays the violin and had to leave her orchestra concert during intermission because she once heard a story about a kid vomiting onstage during a performance. She was taking college classes and loved school, but had a hard time that quarter even getting herself to walk into class.

Some might think that if she just threw up, she’d get over it — it’s been about five years since she’s vomited. But emetophobia isn’t cured by being thrown into the deep end. It would be like trying to cure a soldier with PTSD by putting them back into a war zone. That’s just not how it works.

The good news is that emetophobia is usually very treatable with a combination of cognitive behavioral therapy and exposure therapy. The bad news is it’s not always easy to find therapists who know this. We’d taken our daughter to two different therapists when we thought she just had generalized anxiety, but they were only marginally helpful. Finding someone who had experience treating emetophobia proved difficult in our small town. I called therapist after therapist, and they’d all either never heard of it or had no experience with it.

So we tried helping her ourselves. We found a website that teaches therapists how to treat emetophobia and started to go through some of the steps together. The first exposure step is to look at this:

V * * * *

And while you’re looking at it, bring the anxiety down through relaxation exercises. Next comes reading the actual word “VOMIT.”

That’s how incremental the exposure is, and it took time for our daughter to even do something that simple without fear. We got through the first few stages of exposure together, but the anxiety was digging in its heels and it became clear that we needed professional help to treat her effectively.

I finally did find a local counselor with emetophobia experience. She told me the therapy takes about eight sessions, patients start seeing improvement quickly, and the long-term prognosis is excellent. Honest to goodness, I could have kissed that woman. I actually cried on the phone with her. She was booked a month out, so we had to wait a bit, but I was so relieved to find someone who could help.

Our daughter is now almost halfway through therapy, and we’re seeing enormous improvements. She’s able to do so much more than she has for the past year. We’re watching our girl come back to life, which is an indescribable relief to this mama’s heart.

If your child seems extra anxious about getting sick to their stomach and starts avoiding things or places because of it, look for a therapist who has experience with emetophobia. And if you have a kid whose anxiety seems largely health- or food-focused, and it hasn’t responded to traditional anxiety treatment, look into emetophobia symptoms and see if they match up.

It’s not an uncommon phobia, but many won’t talk about it because mentioning anything about throwing up — even saying that they worry about it — freaks them out. It’s commonly misdiagnosed as an eating disorder or generalized anxiety, but treatments for those things won’t effectively treat the issue. It’s also not uncommon for it to become debilitating over a period of months or years, so getting help early is paramount.

Thank god for people who have studied emetophobia to learn how to treat it and for effective therapy. I shudder to think what would have become of our daughter without it.