Subtype Spotlight: Emetophobia

Emetophobia, the extreme fear of vomit, is a common phobia and subtype of OCD that can affect individuals of any age. Those with Emetophobia suffer from disturbing intrusive thoughts that involve themselves or others vomiting, which in turn causes significant avoidance and reassurance seeking behaviors. It can feel truly debilitating for the individual experiencing it, as there are often physical symptoms that accompany the obsessions and compulsions that further reinforce the idea one may get sick or otherwise be exposed to vomit. It is not uncommon for those with this subtype to seek treatment for an eating disorder, as a common compulsion is to resist eating goods that would make them sick. It is crucial to find specialists in these areas to distinguish between the two conditions.

At CalmOCD, we see this subtype frequently show up in school aged children when they begin to refuse to go to school. Oftentimes there is a triggering event that precedes school refusal, such as the child themselves throwing up in class or a peer vomiting near them. This event often causes the child to feel significant symptoms of anxiety and they fear returning to school in case it happens again. I personally enjoy working with children refusing to go to school, because it allows for some hands-on exposure to take place at home and at the school itself. At CalmOCD, we’re able to be flexible to conduct therapy sessions wherever is most helpful and appropriate for the client. I’ve found it to be extremely important to do ERP in the places the client is most familiar with (and where fears are strongest!) to provide them with long lasting relief from their symptoms.

Similar to other OCD subtypes, Emetophobia is commonly rooted in core fears of being out of control and a fear of being unable to tolerate discomfort and uncertainty. To someone with Emetophobia, there is nothing more scary than not being able to predict when they might vomit or be exposed to vomit. There is an extreme fear about how it will feel and if they’ll be able to handle that feeling. The person struggling will find any method possible to reduce risk of their fear coming true and to feel safe navigating their day. 

Common obsessions with this subtype include:  fear of how vomiting will feel, fear of being judged by others if they vomit in public, fear of being near someone else vomiting, fear of not being able to stop vomiting, fear of eating undercooked or expired foods, and fear of contracting illnesses that commonly cause vomiting.

Something tricky about experiencing Emetophobia is it will often cause physical symptoms of stomach aches and nausea. It can be thought of as a cruel self fulfilling prophecy: the fear one will vomit causes anxiety to the point one begins to feel a stomach ache and nausea, which in turn reinforces the fear they will vomit. As such, one typically engages in a plethora of compulsions to temporarily “fix” this fear.

Common compulsions with this subtype: avoiding people who were recently sick, avoiding someone who they have seen get sick previously, avoiding places where someone got sick, bringing bags to places, carrying mints or a water bottle, asking others if they feel sick or if they’ll vomit, avoiding movies or TV shows with vomit scenes, checking expiration dates on food, avoiding certain foods one believes could make them vomit, reassuring themselves they are not sick and will not vomit, taking anti nausea medication, and checking physical symptoms for signs they could vomit.

Emetophobia is one of the most common subtypes we treat at CalmOCD. The first course of action in treatment is to provide education about this subtype, how OCD functions, and what ERP treatment would be like for Emetophobia. Next, the client and therapist will collaborate to learn the ins and outs of how OCD shows up for the client and design exposures to rewire their behaviors for long lasting relief. If you or someone you know may be experiencing Emetophobia, please don’t hesitate to reach out to us. We are here to help you work through this!