Emetophobia is a serious fear of vomiting!
Nobody likes to puke, but emetophobia is a serious fear of vomiting.
Rats can’t vomit, that’s why rat poison is so effective. Frogs just throw their entire stomach out a bit like turning out your pocket…and horses, while they can keep their heads down all day grazing, sadly, they probably die if they vomit. Humans can and do vomit and it usually isn’t pleasant. Emetophobia is a serious fear of vomiting. But is it a phobia? Can it be treated?
The DSM 5 defines a phobia as follows:
Unreasonable, Excessive Fear: The person exhibits excessive or unreasonable, persistent and intense fear triggered by a specific object or situation.
Immediate Anxiety Response: The fear reaction must be out of proportion to the actual danger and appears almost instantaneously when presented with the object or situation.
Recognition the Fear Is Irrational Not Required: In previous DSM editions, adults with specific phobias had to recognize that their fears are out of proportion to reality, but children did not. The 2013 edition now says the adult patient no longer has to recognize the irrationality of their behavior to receive a diagnosis.
Avoidance or Extreme Distress: The sufferer goes out of her way to avoid the object or situation, or endures it with extreme distress.
Life-Limiting: The phobia significantly impacts the sufferer’s school, work, or personal life.
Six Months Duration: In 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. Therefore, your therapist must rule out other disorders before diagnosing a specific phobia.
If emetophobia is a phobia, it is the most common one. It is an intense and irrational fear of vomit or of oneself vomiting. For some people it is extremely distressing and is life limiting. People might avoid places such as school, restaurants, pubs, crowded places, public toilets, GPs, clinics, or any place where people might vomit. People might avoid situations such as pregnancy, social gatherings where food is involved, transport, medication, exercise, and alcohol. They can experience health impacting weight loss, food restriction, isolation due to avoiding others, obsessive checking or cleaning, problem use of alcohol, and medication too.
The mean average onset for emetophobia is age 9.2 years. The average duration of emetophobia is 22 years. Estimated prevalence seems to be anywhere from 0.1% of the population, to 8.8% of people who have a more general fear of vomiting. It is more prevalent in females (four times as likely in childhood) and it will often sit alongside other problems such as panic disorder, worry, social phobia, OCD, or depression. Emetophobia often gets missed and so a chance to effectively treat it goes begging.
There are good treatments available for emetophobia, but it needs to be assessed well, have good measures in place, and maintenance cycles clearly defined and treatment strategies in place that flow from this. Relapse management measures are essential, and booster sessions highly recommended. An aversive memory can be part of the problem. Cognitive behaviour therapy looks at the links between our feelings, actions, physical sensations and thoughts. Thoughts are also images and memories from the past, or flash forwards from the future. Addressing these memories and images can be a crucial part of successfully treating emetophobia as well as anxiety and depression. Good CBT has a clearly defined start (assessment and formulation), a middle (treatment), an end, and review (recovery).
Common fears in Emetophobia are of losing control, or of it never ending, but effective treatments address these concerns and give the person back control of their life and offer an end to the distress of Emetophobia and allow the life you choose to be lived.
Specialist CBT offers an effective treatment to Emotophobia.