Fear of Vomiting, or Emetophobia | Anxiety and Depression Association of America, ADAA

If you have a fear of vomiting, just reading the title of this article might make you a bit queasy. The mere mention of the "V word" might send you into a state of anxiety. If you can relate, I encourage you to press on despite your worry, so you can take the first steps to overcoming it.

If you suffer with this type of phobia (specifically known as emetophobia), you are not only repulsed by the idea of vomiting, you fear it. And you probably have at least one of these fears, too:

Not being able to find a bathroom in time
Vomiting over and over and being unable to stop
Choking on vomit and suffering physically
Embarrassing yourself in front of others
Being admitted to a hospital

Many people say that the anticipation of vomiting is often worse than the act itself.

How Did I Get This Way?

Vomit phobia can develop spontaneously or following a traumatic vomiting experience. Once it starts, your fear can escalate. Step by step, you avoid places and things you associate with vomiting, you become increasingly more hypervigilant, and the fear soon dominates your life. The more you avoid, the greater your fear becomes. Dietary habits usually grow strict, and anything unfamiliar or with the slightest possibility of causing sickness results in compulsive checking and avoidance.

People who suffer with this phobia often experience significant social and occupational impairment, going to great lengths to make sure they don’t vomit (similar to someone who fears elevators and walks up 10 flights of stairs). Kids refuse to go to school or visit a friend’s house, and adults miss work and stop eating at restaurants. Much of life is avoided all due to a fear of vomiting. This means missing out on much of life and a great deal of worrying and strategic planning — all to avoid something uncomfortable that seldom happens. The uncertainty of not knowing when it will happen is what causes so much distress.

And because you don’t know when it will happen, you are constantly on guard, rearranging your life to ward off any possibility of puking.

If this sounds like you, these protective behaviors may be familiar, too:

You avoid new foods, restaurants, or alcohol.
You avoid foods, beverages, or restaurants associated with past vomiting.
You avoid saying or hearing the words “vomit,” “barf,” “puke,” or “tossing your cookies.”
You close your eyes during vomiting scenes on television or in movies.
You check other people for signs of illness and avoid hospitals and sick people.
You refuse to shake hands with people.
You avoid garbage and other foul-smelling or dirty things.
You engage in excessive handwashing, as well as cleaning food and preparation surfaces.
You throw away food before it has reached its expiration date.
You smell and check food excessively.
You overcook food to kill potential pathogens.
You use antacids preemptively.
You avoid eating foods when you’re away from home.
You check the locations of bathrooms.
You restrict or avoid travel, school, work, and social activities.
You take your temperature excessively or monitor your body for other signs of illness.

What Causes Nausea and Stomach Discomfort?

Stomach discomfort and nausea can be caused by motion sickness, a stomach bug, food poisoning, excessive eating or drinking, food intolerance and…anxiety! That’s right: Anxiety and worry can cause stomach discomfort and nausea.

If you worry about the possibility of barfing and are hypervigilant to prevent it, you can cause the very symptoms you desperately do not want. Worrying about getting sick doesn’t prevent vomiting, it only makes you nauseated. And when you start to feel nauseated, that’s when the worry and anxiety really kick into gear, which of course intensifies your nausea. It’s a vicious cycle. Worries about vomiting can trigger nausea, and nausea and stomach discomfort can trigger worries about vomiting.

Anxiety has a way of fooling you into believing that you are going to vomit when you feel nauseated. You believe it even when it has never happened. Here’s the good news:

If you do not vomit when you’re anxious…you won’t! Anxiety may cause nausea, but not vomiting.

It’s important to remember that the only reason you might vomit would be due to food, alcohol, motion sickness, or a stomach bug —and you won’t be able to stop it. In fact, vomiting is the body’s natural reaction to harmful substances or irritation in the gut. People often feel better after they barf. In most cases it’s harmless and over within 24 hours. Rather than worrying and wondering if you’re going to puke, make peace with uncertainty.

You don’t know when it will happen and you don’t need to. Since you can’t stop it, you shouldn’t try.

Worrying about getting sick doesn’t prevent vomiting, but it does make you nauseated, which results in more anxiety, intensifying your nausea and causing greater anxiety until you flee the scene. Rather than worrying if you’re going to puke, make peace with uncertainty, live your life to the fullest, and accept the discomfort of the rare barfing experience. How do you do this?

Here’s Where Treatment Comes In

Treating vomit phobia is best accomplished through cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP). Treatment involves correcting faulty beliefs, reducing avoidance, and confronting challenging situations step-by-step. You are given tools, a new perspective, a winning mindset, and a strategy for facing your fears. Your motivation for ending your suffering is important because the therapy does take time, hard work, and courage. You must have self-discipline and determination to win. And if you do…you can beat emetophobia!

Read Ken Goodman's book The Emetophobia Manual: Free Yourself from the Fear of Vomit and Reclaim Your Life.

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