Overview of Topics
What is Emetophobia?
Emetophobia is the fear of vomiting. This fear includes not only one’s vomiting, but also seeing or hearing others vomit or seeing vomit. Of course, almost everyone finds this unpleasant. However, while most people quickly forget about vomiting after an illness, people with emetophobia are constantly worried about it.
How do you recognize if you have Emetophobia?
Emetophobia is much more than just finding certain situations “disgusting.” Affected individuals are constantly afraid of vomiting themselves or witnessing someone else do so. Even reading this text requires great self-control from someone with emetophobia.
Many don’t even realize that they suffer from an anxiety disorder; they believe they are simply particularly sensitive in certain situations. Others are aware of their emetophobia but still do not talk about it because they find it embarrassing, and the topic alone can trigger physical and psychological problems.
Emetophobia Test
If you suffer from emetophobia, just the thought of the following can cause you fear, terror, and shame:
- Your own or someone else’s vomit
- Hearing or saying words related to vomiting
- Being near food or drinks that have caused vomiting in the past
- Having a stomach or intestinal illness
- Losing control
If at least three of the above things cause you significant discomfort, then you very likely suffer from emetophobia. This fear can severely impact your life. It makes it difficult to relax, restricts social activities, and can even lead to avoiding full meals. Constantly being on guard can be incredibly stressful and significantly limit daily life. But fortunately, there are ways and means that can help.
How common is Emetophobia?
The fear of vomiting affects about 0.1% of the population, or one in a thousand people, with women being more frequently affected than men. In a city like Berlin, this means there are statistically around 3,650 emetophobics.
Emetophobia can occur at any age. Many adults have had this fear since childhood. Incidentally, the given number seems too low to me, as we have already helped many people with emetophobia in our practice to overcome their fear. Perhaps this is because traditional therapy approaches for emetophobics can sometimes be a terrible ordeal. But more on that later.
Where does the fear of vomiting come from?
The fear of vomiting is linked to the feeling of losing control. While we try to control our lives and surroundings, vomiting remains unpredictable. This lack of control can intensify the fear of vomiting.
Most people remember how they had to vomit in public—an embarrassing and disturbing situation. Stomach flu, too much alcohol, or food poisoning. It happens. But for some people, just the thought of vomiting is a real horror. Some also had a frightening experience because they choked badly or had to endure a night of uncontrollable vomiting. Such experiences can be deeply ingrained.
Emetophobia usually arises after a negative experience. It is often associated with other fears or mental disorders such as eating disorders or obsessive-compulsive disorders.
Emetophobia largely restricts social life
Everything that is fun and enriches life, such as a vacation abroad, is considered a potential danger by those affected and is therefore avoided. This often leads to conflicts in the social environment, as leisure planning must always be tailored to the fears of those affected, which can cause frustration for partners, family members, and friends.
Important: If you suspect that someone around you suffers from emetophobia, do not judge their behavior. Emetophobia is not a harmless quirk, but a serious condition that can cause extreme anxiety and even panic attacks. Support the affected person in finding an effective therapy.
If you suffer from emetophobia, you may develop certain behaviors to feel better. You might sleep with a towel or even a bucket next to the bed in case you feel sick at night. Or you may feel most comfortable in a specific room of your house or even outside.
People with a fear of vomiting tend to know the quickest route to the bathroom in any new building. Long car rides can be extremely stressful, and many feel safer if they are driving themselves. The fear that someone might see them vomiting if they don’t reach a toilet in time can lead to them not wanting to take passengers.
Symptoms of Emetophobia
If you suffer from emetophobia and are confronted with nausea or vomiting, you are likely to feel:
- Anxious
- Nervous
- Stressed
- Panicked
- Overwhelmed
These feelings can lead to physical symptoms such as:
- Increased heart rate
- Trembling
- Nausea
- Feelings of tightness
- Tightness in the chest
- Dizziness or fainting
- Difficulty swallowing
- Tingling sensations in various parts of the body
- Sweating
- Feelings of derealization
- Hot flashes or chills
- Stomach upset
The nausea and stomach issues that people with emetophobia experience are common symptoms of anxiety and can create a vicious cycle. They fear vomiting, and this fear causes nausea, and nausea, in turn, intensifies the fear of vomiting. The fear can escalate into a panic attack, where sufferers feel a real fear of dying. Dizziness, rapid heartbeat, nausea, shortness of breath, and the feeling of completely losing control overwhelm the sufferers like a tidal wave. For someone who does not suffer from this anxiety disorder, this is hardly imaginable.
Research shows that this cycle can be caused by excessive sensitivity and/or misinterpretation of nausea and other gastrointestinal symptoms.
Further Signs and Avoidance
Especially burdensome for sufferers is that everyday bodily reactions, such as digestive sounds or hunger, can trigger fear. Even a brief cough can set off a chain reaction of anxiety. Therefore, people with emetophobia often try to avoid situations that could be associated with vomiting. This may lead to behaviors such as:
- Flinching or closing their eyes when someone even mentions vomiting.
- Immediately locate the nearest bathroom to stay close.
- Frequent hand washing.
- Sleeping with a trash can or similar container next to the bed.
- Avoiding long car rides, boat trips, or roller coaster rides.
- Avoiding medications that have nausea or vomiting as possible side effects.
- Regularly checking for signs of illness, such as taking their temperature.
- Strictly limiting what and how much they eat.
- Overcooking food to kill bacteria.
- Throwing away food that is close to its expiration date.
- Not trying new foods and drinks.
- Avoiding restaurants or foods that previously caused vomiting.
- Eating only at home.
- Minimizing contact with sick people or places like hospitals.
- Limiting social contacts and travel.
- Avoiding pregnancy to exclude the risk of morning sickness.
These behaviors are typical for people trying to control their fear of vomiting and feel safer. This constant vigilance can be very burdensome and greatly restrict one’s life.
Can emetophobia be cured?
Yes, emetophobia can be cured. Although it rarely disappears on its own, it can be very well overcome with appropriate therapy. Untreated, emetophobia can unfortunately lead to further anxieties and eating disorders, such as anorexia nervosa or agoraphobia. People with emetophobia often have other mental health conditions, such as depression, generalized anxiety disorder, obsessive-compulsive disorder, or social anxiety disorders.
Is emetophobia a mental illness?
Yes, emetophobia is a mental illness. For a diagnosis, the following four criteria must be met:
- Intense and irrational fear:
The fear of vomiting is persistent and disproportionate to an appropriate level of fear. - Anticipatory anxiety:
There is a tendency to constantly think about or fear future situations or experiences that could be associated with nausea and vomiting. - Avoidance:
One actively avoids vomiting and anything that could lead to it, going to extreme lengths if necessary to prevent vomiting. - Impairment of daily life:
The fear restricts daily life in some way.
How to get rid of emetophobia
Emetophobia, the fear of vomiting, is a specific phobia. Fortunately, there are various ways and therapeutic methods to treat this fear. Usually, cognitive behavioral therapy, exposure therapy, or medication is prescribed. Additionally, there is a much gentler alternative, which we will discuss shortly.
Ways to treat emetophobia:
- Cognitive Behavioral Therapy (CBT):
This talk therapy aims to help manage the thoughts and behaviors surrounding the fear. It usually works well but can often be very lengthy. - Exposure Therapy:
I could tell you a lot of terrible stories about confrontation therapy. We have heard countless accounts from emetophobics in our practice who were previously treated classically. The ruthless and inhumane way exposure therapy is conducted for emetophobia is beyond me. The desired success is rarely achieved, and I prefer not to describe the techniques reported to me in detail. I’ll just say this: it would have made even me sick. Fortunately, there are much better techniques that are not only much more pleasant but also work faster. This is not only pleasing for the patients but also their therapists. - Pharmacotherapy:
Sometimes sedatives, known as benzodiazepines, can help alleviate the symptoms of anxiety in the short term. However, I would not recommend them as they can quickly lead to dependency and have numerous side effects. Antidepressants are also often prescribed for pathological fear of vomiting. Since many of these medications can cause nausea as a side effect, I consider this treatment approach inappropriate for emetophobics. - The Bernhardt Method:
About seven years ago, a new method was developed that allows emetophobics to overcome their fear of vomiting gently. Whenever we first talk to affected individuals about the Bernhardt Method, they are skeptical. After all, they have often fought long and desperately against this anxiety disorder without seeing real success. But even if you can’t imagine it: with this approach, it is possible to leave even severe emetophobia behind. Best part: it works without exposure therapy and medication.
What to do about the fear of vomiting
It is generally known that emetophobia is not “normal.” However, knowing that this fear of vomiting is exaggerated does little to help those affected. They know their fear is irrational but feel powerless to overcome it. The constant focus on potential triggers of nausea only intensifies their phobia. Brain research has shown that our brain builds synaptic connections that repeatedly trigger these fears. But just as these fear connections form, they can also be dissolved. This is where the Bernhardt Method comes in. It is based on the latest findings in brain research and helps sufferers replace their negative fantasies with positive ones. This gradually dismantles the neural basis of emetophobia until the fear eventually disappears completely. And all this without confrontation, medication, or painful reflections on the past.
An example: Imagine you have an invitation to a dinner with friends. For someone with emetophobia, this can be an enormous challenge. Immediately, thoughts like: “What if I can’t tolerate something?” “What if someone drinks too much?” or “What if the others notice that I’m barely eating?” Such negative thought patterns often lead to social isolation.
How to combat emetophobia
The Bernhardt Method helps replace these negative thoughts with positive ones. Using techniques like the 10-Sentence Method or the Zoom Technique, sufferers learn to focus on the enjoyable aspects of dining together. Gradually, positive inner images and a sense of anticipation replace the old fears.
Exercises to overcome emetophobia
In addition, the Bernhardt Method offers effective fear-stopping techniques such as the Pitching Technique or the Visual Sliding Technique. These strategies are effective even when breathing exercises and muscle relaxation fail. Naturally, it takes some practice and daily repetition, but with just 20 minutes of training a day, you can significantly reduce your fears.
Many former sufferers have reported that after just a few weeks, they were able to do things that previously seemed unthinkable. The duration of the healing process naturally depends on how long the phobia has existed, but usually, it takes only a few months for significant improvement to occur. Numerous doctors and former patients confirm the effectiveness of the method.
The best part is that you don’t need a therapy appointment to address your fears. The Bernhardt Method is excellent for self-therapy and can be conveniently conducted from home as an online therapy.
Whichever form of therapy you choose, we sincerely hope that, like most of our patients, you will soon be able to live a life where the fear of vomiting no longer plays a role.
Troy A.
Tampa, Florida