I was recently alerted to the fact that emetophobia, the fear of vomiting, is the fifth most common phobia in America. Phobia, as a general category, is the most common disorder in America. There are lots and lots of phobias, hundreds and hundreds of them. Whatever conceivable behavior, emotion, situation, circumstance or event you can imagine, there is a fear about it. Don’t believe me? Take a look at the list of phobias.
Phobia is the old word for “fear.” But then, what is fear? A one-syllable word that represents a complex host of intense feelings and emotions…mental images and internal dialogues. Shakespeare’s Hamlet said it best when he uttered “there is nothing either good or bad, but thinking makes it so.” Fear is beyond bad, it’s the worst. And yet, that which we fear is made so by our thinking. At its extreme, fear is terror, a well-known concept in the political world today. At its best, fear is a moderate anxiety. Hundreds of millions of people experience anxieties and fears, and terrors. Some people are terrified of driving, others are deathly afraid of spiders. Social anxiety is a very common disorder as is the anxiety that comes from simply going to the dentist. We can be afraid of strangers, or of germs. There is even a fear of fear, which is actually called “phobophobia.”
Emetophobia is not just the fear of vomiting, which, though unpleasant, is not, in and of itself, anything to be afraid of – rationally. It’s actually a signal that the body is working correctly by ridding itself of toxin, poison or foreign material. Emetophobia, more generally, and symbolically, is the fear of throwing up, and out, stuff from the inside. Although we tend to think in terms of stomach contents, it could also refer to emotional content. Emetophobia, the fear of vomiting, can also be related to the fear of intensely emoting, of fully discharging, vomiting if you will, anger, rage, pain or sorrow; emetophobia, in addition to the fear of vomiting, can also be a fear of the cathartic wailing that can accompany intense emotional discharge, which is called ’emotophobia’ – as distinct from emetophobia.
Vomiting is generally preceded by feelings of nausea and just that alone can trigger a phobic response which then spirals out of control creating a debilitating terror of a physiological process that is though terribly uncomfortable, not in itself debilitating, or harmful, if done “properly.” The proper way to vomit is to let go and let it happen. The body knows what it needs to do and our thoughts about it often just get in the way. Attempts to not vomit only make the anxiety and discomfort more extreme and add to the fear. The intense, severe wrenching, heaving, spasms that accompany vomiting, is a purely cathartic, bodily response. If a person can adopt an attitude of trusting their body to do what it needs to do, the vomiting is completed without undue anxiety or fear.
In addition to the phobic response to nausea, and vomiting itself, there are additional thought patterns that are often attached. It’s not uncommon for people to view vomiting as meaning something is wrong with them, and the corresponding thoughts about that, when in fact, it may mean that something is right. As stated, vomiting is the body’s natural process to ridding itself of poisons, toxins or foreign material. There are times when it is actually advised to induce vomiting to help expel what has been ingested. Despite that intellectual understanding, fear of nausea and vomiting may persist for other reasons.
There are also issues of “control” about vomiting. With the exception of self-induced vomiting, it is something that is out of our control; it happens to us. Granted, we may have eaten bad food…. but, still, the nausea and vomiting come upon us unbid, even if it is to expel rotten food. We feel out of control, and that in itself can often cause high anxiety and panic attack, which can then lead to a phobic response. We may be less frightened of the actual vomiting than we are of being out of control.
The irony is that by letting go and letting it happen, one gains control. By choosing to stop fighting it and, so to speak, go with the flow, one takes command of the situation. By trying to control the situation, one is out of control because it cannot be controlled and the anxiety and panic only increases to phobic and debilitating levels.
Emetophobia may be an irrational fear, but it is nonetheless a palpable one and can, like any phobia, overrun one’s life. As Franklin Delano Roosevelt so astutely pointed out, “the only thing we have to fear is fear itself.” It’s not just the vomiting itself that we fear; we fear the fear of vomiting for it is that fear which translates a natural organic, albeit a very strenuous, process into a hideous monster to be frightened about.
Some of the common interventions for emetophobia are Cognitive Behavior Therapy, Systematic Desensitization, Exposure, Hypnotherapy and Neurolinguistic Programming. You can obtain more information, and support, at the International Emetophobia Society.