Guest Blogger 4: Sick of it: Coping with Emetophobia


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The thing with emetophobia (the overwhelming, intense anxiety pertaining to vomiting, including a fear of vomiting in public, a fear of seeing vomit, a fear of watching the action of vomiting or fear of being nauseated, according to the internet), is that the dreadfulness of being sick is constantly being reinforced all around you. You never hear someone saying “I was up all night being sick, I bloody loved it.” All you see and hear are people looking absolutely miserable, pale and unwell describing how they had been sick all night; the “worst thing ever,” the “most unwell I have ever felt,” “it came on within ten minutes and I could barely move,” and “my daughter was sick first thing on Christmas morning with the norovirus and it spread like wildfire, taking down the whole family one by one” like the apocalypse.

The other thing that distinguishes emetophobia from other phobias is that it’s often completely out of your control. Don’t like heights? It’s in your control to not go up a ladder or on a plane until you feel prepared. Don’t like small or crowded spaces? Take the bus instead of the tube and stand at the back of a big crowd. Don’t like snakes? You’d be hard pressed to find a situation where you’re confronted with a snake on a night out, or on a school trip, or your family keeping a snake in the house for a few days. I’m not saying that these phobias aren’t as terrifying, but to me they seem more controllable.

Don’t like seeing people being sick, or feeling sick yourself? Well, your friend could say off the cuff that he/she feels nauseous, or a colleague at work could go home ill, or a younger sibling could pick up a bug at school. You could even see someone just being sick in the street on your way to meet a friend. All of these things will send an emetophobe into frenzy. Days spent washing your hands and applying anti-bacterial, googling whether there has been an outbreak of the norovirus, and repeatedly asking the ill person: “How do you feel now?” “Was it better or worse than yesterday?” “What do you think has caused it? Food poisoning (aka I’m safe) or a bug (I’m going to die)?” “Do you think you’ll be sick again?” “Was it really awful or was it actually fine?” “Is it the kind of ill you feel when you have a cold?” “Will I be OK?” “Will I be sick in the night?” “Please can you promise me that I won’t be sick too?”

My friends and parents joke that I attract situations like this. There have been countless times where I have been confronted with it face on, with no warning. The time I was on a school trip and the boy next to me (no control – alphabetical order…) was sick into a see-through plastic bag with holes in it, and I wasn’t allowed to move or switch seats the whole way home. Or the time I was at waiting at the bus stop when a mini-bus pulled up, with a sickly kid climbing off before vomiting right in front of me. Or when someone gets sick next to you on the plane during take-off, and you’re unable to escape until they turn the seatbelt sign off, and even then you could be trapped with them for 10 straight hours with no control over whether it happens again.

I must point out that I completely realise how selfish I sound. The poor people described above must be feeling awful, right? Well yes, they do, they’re being sick, which everyone describes as being absolutely horrific. The fuss made by people around them, people rushing to get water to sip, comforting them with a pat on the back, reassuring them they’ll be ok and to “get it all up.” I rest my case – positive reinforcement that your fear is justified and proving it to be correct, allowing it to grow stronger and stronger. You’re essentially afraid of your own body.

Another thing I should point out is that I suffer from overwhelming panic attacks (just in case you hadn’t already noticed I happen to be an anxious person). I had my first panic attack when I was six years old. They come on with extreme intensity, not rising up slowly. The anxiety attacks are usually always brought on by feeling sick, or seeing someone being sick, which brings on extreme nausea. Cognitive “tools” are not always a possibility, which is why emetophobes often rely on a number of other “coping” mechanisms. This involves slowly ruling out all reasons why you could become ill or vomit.

Imagine you’ve just got onto a coach for a few hours (this is a situation that often makes me anxious) – you can’t easily get off the bus and won’t be near home. A typical thought process is as follows:

  • I haven’t eaten or drunk anything for 5 hours before. This means I feel hungry, and you can’t be sick when there’s nothing in your stomach;
  • I haven’t been in contact with anyone in the last few days who has been unwell, but I did eat out last night, which could easily make me unwell;
  • If I don’t have a bug or food poising, I might somehow develop travel sickness (which I have never suffered from), because I read that article once of someone who developed travel sickness in their twenties, and that could happen to me;
  • If by some miracle I don’t feel sick, I might be sat next to someone who does. Do they look pale? They don’t have any food with them… That might mean they feel sick. I’m sat near the front of the bus, which is where people who get travel sick sit… 5-10% of people get travel sick, so the likelihood is that they quite easily could get ill next to me;
  • If they are sick, I have a plastic bag to give them, but some might splash on me, which could be contagious;
  • Other people on the bus will also start to feel sick and might even be sick, because the percentage rises when you see someone being unwell;
  • There is a spare seat over there that I can move to if they start to look unwell;
  • I could speak to the driver and ask him to stop and let me off. Even if I don’t know where I am, I can call a taxi to drive me the rest of the way.

This sounds ridiculous, right? I completely realise that it does sound crazy, and it’s interesting to write this down.

I wrote this because this is a very common phobia – an estimated 1.7-3.1% of males and 6-7% of females experience emetophobia – but is so often misunderstood; “Well, no one likes vomiting, do they?” It’s hard for me to describe how I have learnt to cope and live with the phobia over time. The best piece of advice I can give to someone who is experiencing similar anxiety is that it will end. Even if you experience a series of intense anxiety attacks, your body will eventually relax and you will feel better. It is possible to live very normally with this phobia, but don’t expect it to disappear overnight.

Everyone will have different mechanisms, but I found that my recovery started when I read Cure Your Emetophobia & Thrive: The Research-backed Self-help Programme to Overcome Your Fear of Being Sick. It really helps to explain the negative thought process behind the phobia, and very useful ways to train your mind to think differently. With this tool I also found that my anxiety was significantly reduced as a result. A lot of people find that CBT is very helpful, as are exposure techniques, but this needs to be handled with care.

In the last year, I have been on a trip to Canada on my own (which I admit wasn’t without anxiety, but something I never would have even considered a few years ago), I have comforted friends who have been unwell and I have even been sick myself, and come out the other side relatively unscathed.  Which, coming from someone who couldn’t go on a school trip for 5 years, is a pretty big deal.  I completely expect my anxiety to return and fluctuate in time, but I hope that it won’t control me in the way it once did.

Finally, please understand that people can be seriously dramatic – people love drama (including myself)! Although being sick isn’t nice, you can choose be as dramatic as you like.

If you identify with any of this, or know someone who is living with emetophobia, I hope that the following links might be useful or help with further understanding:

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