by Ken Goodman, LCSW

Ken-Goodman-websize.jpgKen Goodman, LCSW, practices individual and group therapy in Los Angeles to help anxiety and OCD sufferers free themselves from debilitating fear.  He is the producer of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, a step-by-step self-help audio program. Visit his website. 

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.clinicalfellows.jpg

Emetophobia?

No one enjoys vomiting and everyone thinks it’s disgusting, but most people are not afraid of it. But 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. Many people say that the anticipation of vomiting is often worse than the act itself.

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.

What Causes Nausea?

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. And if you don't vomit when you’re anxious…you won’t!

Treatment Works

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!

Additional Resources:

I think I have this phobia. Not very strong but I known exactly how it feels. I'd rather die than throw up, seriously. I remember being much worse when I was younger. I would freak out whenever I heard the word vomit, I would start to panick whenever I would get a stomach ache, I would try my best to avoid people who are nauseous. I would even get anxious to get on the school bus when we had to go do outdoor activities!

I'm glad it's gotten better. Though I must say it's been a while since I haven't been sick. Let me tell you one thing though.

Last year, while I was on a trip, I was starting to feel sick. I was shaking, I was really freaking out. But then I told myself. Why are you freaking out? What's the worse that could happen? You just, let it out, you'll eventually feel better. I let myself go. I thought I was going to throw up, but I didn't.

I know some people won't be able to read this, but I hope that someway, you could find a way to rationalize this fear. It could make your experience less.. daunting.

Hi, thanks for sharing your story. It's amazing how one fear can affect the entire scope of your life. If you have a fear of elevators you can avoid elevators the vast majority of time, but the fear of vomiting can be much more pervasive. I like the way you respond to the fear by asking yourself, "what's the worst that can happen. If I throw up I'll feel better." Anxiety is very tricky. When you feeling nauseous you believe you will vomit even though you never do. It's similar to the person who feels dizzy and believes they will pass out even though they never do. Or the person who feels his heart race and believes he's having a heart attack but has been told by his doctors multiple times that his heart is strong. Don't be fooled.

Thanks for all of your tips I have this phobia and it stops me eating for a while I usually get so scared and start shaking and looking anxious Ive got it now so im going slow only eating curtain stuff at a time

I have the exact same issue. It's a big problem and consumes my entire life. It's good to know I'm not alone with these symptoms. My advice: distract yourself. Call up a friend or loved one. Call a therapist. And don't starve yourself. When you don't eat, you feel worse. Tell yourself, "I'm not gonna be sick I am not going to be sick." Until you beleive it.

I have had this for ages and it never has gotten better it started when I was in grade three and I am now in grade 11 it has stopped me from eating what I like being away from my mum because I'm scared of vomiting there and I used to always every 5 minutes I'd ask my mum 'mum I don't feel right am I going to vomit' and I was just wondering if someone else has my story

Don't worry about it, I have a severe anxiety disorder and one of the things I fear most, although I find being sick releaving, I am VERY scared. Don't worry, it will go away soon, and if you weren't sick it would be even worse, remember, it's your bodies way of getting rid of the bad stuff. Good luck -Mark

I'm exactly the same! I'm in year 11 and I'm still terrified of being sick. I also ask "do you think I'll be sick?" When I get a stomach ache and it really gets in the way of me doing fun stuff :( I can't even go on rollercoasters with my school when we go on trips - I just want to get over the fear so that I can start having more fun again :(

This made me feel a bit better of being sick. Im still scared of it, This stops me from doing a lot of things. But what you said about "Why are you freaking out?, What's the worse that can happen?" Made me feel a bit better

I am terrified of throwing up. Originally it was not that bad I would just shake if someone threw up. Now I am terrified. Ever since my brother threw up all over the car I have not only been scared of him I have also been scared of the car. My grandparents were also on the trip and I convinced them to take me home. I am traumatized by what happened that day. We also went skiing right after the incident. I avoided my brother the whole time even though he was feeling better. I also started to feel sick because I was so scared. I stopped skiing early, and just wanted to leave. I thought I was going to throw up but I never did. Whenever I am around my crazy nice brother I am afraid he will barf all over me. I am also afraid of my best friend because she got sick on a field trip. I will say this again she is my best friend. Whenever someone has a stomach ache I avoid them as best I can. Now my family is going on a vacation to Hawaii! I do not want to go! I am scared I will throw up on the plane, or at my hotel, in the car, or on the beach. I can picture myself vomiting to! I have so many images in my mind of myself vomiting that there is nothing I dread more than going to Hawaii! This has ruined my life! I am so sad! Please help! I am only eleven!

Hi; I'm so sorry to hear about how this has taken over your life. A fear of vomiting can be all consuming and even ruin a trip to Hawaii. Most people with a fear of vomiting feel sick to their stomach but never actually throw up. Would this best describe you? If so, that's great news! Anxiety will cause nausea but NOT make you throw up. The nausea just fools you into thinking you will barf but you really won't. You CAN beat emetophobia and it won't ruin your life. You just need to get treatment and be determined to beat it. Avoiding won't help. It will just make the phobia worse. Accept the nausea as a symptom of anxiety and get angry at the anxiety for trying to fool you into thinking you're going to vomit. You won't. Do you get motion sickness? If you don't then the airplane won't be a problem either and neither will any boats you go on in Hawaii. Don't let the anxiety monster fool you with his tricks. Find a therapist who specializes in anxiety to help you overcome this problem.

I know exactly how you feel I avoid eating out with people and some at home if I know I am going to go out after eating to a friends incase I'm sick it is ruining my life I have just started a new relationship and it fills me with fear the silly thing is I haven't been sick in nearly 4 years and even then it was through too much alcohol alone I can really relate to you I have started sertaline and looking into counselling to help

Me too every time I go on vacation I am absolutely terrified that I will throw up on the plane or at the hotel or literally anywhere where I'm not at home. I'm 14 and there's a lot of stuff I love that I can't do anymore.

Jennifer Shannon

Wed, 2017-03-22 17:01

Thanks Ken for this great article. Of all the phobias out there, this is the most common one I treat! I think that is because it can cause significant disruption in a person's life. You can avoid spiders to some extent, but it is very hard to avoid physical sensations like nausea, or people who might be sick, or germs! Luckily it is a very treatable phobia.

I am afraid to be around my kids. My son is school aged so im always afraid hes going to come home sick. When my kids are sick i get so panicked that i cant be around them. I worry myself to the point i get ulcers. My son is afraid to tell me he doesnt feel well. My daughter has been sick all weekend and my nerves are so shot i feel like i cant breath. I need to get through this.

Anon

Sat, 2017-04-01 09:11

In reply to by Anonymous

There are many ways to get this treated. Now if it's linked to PTSD (Which happens a lot), it may be more complicated, but whatever it is, just find a therapist that specialized in this stuff and talk it out with them, and they'll find a way to help that'll be comfortable for you.

Ashley

Mon, 2017-04-03 21:45

In reply to by Anonymous

I'm so glad I'm not the only one who gets like this. I feel like a weight in sitting on my chest. I don't want to be in my own house! My daughter is sick and she wants me but I can't even do it. I feel like a failure as a mom, it's causing me a lot of stress and anxiety and I feel like my husband doesn't understand

Dear Jennifer,
My daughter is 27 and has had this fear most of her life. Her mind is completely consumed with germs, any way to avoid this kind of sickness, to the point that she can barely go to work. She was in therapy for years and on numerous anti-depressants, with absolutely no relief. She is currently on Xanax, and has been for years. This fear is barely touched by even 4gm or more daily. It is to the point she fears she is losing her mind. I am beside myself, with helplessness. Please direct her to help.
Thank you so much.

I have the worst fear of vomit. I wake up in the night having panic attacks, my whole body shakes at the thought of throwing up. Yesterday my 5 year old son developed the sickness and upset tummy bug, he has been sleeping in my bed, thrown up in my bed, on my feet, and so close to my face I just know I'm going to get it! I couldn't sleep last night with the panic of thinking if I went to sleep I might wake up suddenly to throw up, today I can't even look at food without thinking it will come back up. As dramatic as this sounds I would rather have most things than have to go through this. Does anyone have any ideas on how to be less frightened of being sick, it literally takes over my life, if I go on a bus, a plane, a restaurant, takeaway anything. It just sits on my mind I wake up most nights feeling sick and end up in a panic!

The gold standard for all anxiety treatment is Cognitive Behavioral Therapy and Exposure and Response Prevention. In terms of treatment of Emetophobia I'd throw some ACT "Acceptance and Commitment Therapy" and Mindfulness in there as well. Find a therapist who only treats anxiety and OCD. Don't go to a therapist who is a generalist (someone who treats everything). You can tell by their website. If you can't find an anxiety specialist in your area, the next best option is Teletherapy - treatment via video conferencing with a provider in your state. Search ADAA and IOCDF websites for providers. There is one book on Emetophobia - "Living with Emetophobia." I have never read it. Good luck.

hi—
i am not only tremendously afraid of vomiting, but am also afraid of the word being said near me, or anyone that throws up. it's gotten to the point that if a kid throws up near me, or even puts their hand on their stomach, I will scream and start shaking and hyperventilating. it's pretty embarrassing and scary because it's gotten so much worse. ive of only thrown up once in my life (when I found out I was allergic to peanuts, chicken and eggs) and I was thrown up on in kindergarten. i don't know what to do with this problem as the it's consuming my life. thank you so much for this article, I hope it helps:).

Hello!
I'm so so glad more professionals are able to understand and treat emetophobia. Back in the 90's when I was a child suffering from emetophobia and anxiety disorders, my mom tried to help me but doctors wouldn't really know about the phobia to vomiting so I never had a successful therapy until I was an adult approximately 2 years ago when I was around 26 years old.

Now I can say I'm definitely much better. When I was around 10-12 years old I stopped eating completely due to strong fear of vomiting. I would think that anything I would eat I could throw it up. I lived hell, and nobody could understand me.

It does take time and effort to keep up with the treatments. I was doing great when I was working with my doctor but due to lack of funds I couldn't continue. He was nice enough to give me the tools I needed on how to proceed but I lack the will to do it sometimes on my own, but after the therapy, I don't freak out anymore at movies or shows that show people vomiting. Now if my husband feels nauseous I don't go into panic mode. Before therapy, one day he really needed to throw up, he even apologized to me before going to the bathroom and I felt so bad because obviously he didn't have to apologize so I left the house running, crying and into a complete state of panic.
Before my therapy I would feel nausea VERY VERY OFTEN, after my therapy I haven't felt it at all! it's been 2 years.

Anyway, if you are an emetophobe and you are reading this, just know that there is hope and YES we can be cured no matter how impossible it seems at this moment. I remembered getting freaked out when I was told therapy involves exposure to the feared object/situation. TRUST ME, it is not like it sounds. I was perfectly comfortable throughout the therapy and of course you don't do anything you don't want to do, but it never even got to that point.

Sorry for the long post.

Suzanne Leake

Mon, 2017-04-17 18:53

13year old granddaughter developed Emetophobia after a bout of strep with throwing up at age 10. Probably Pandas since she had all the symptoms come on at once. She avoids everything, no more school, no sleepovers, no activities without one of the grandmothers present. Her therapist thinks telling her to not to think of throwing up should help her. She obviously has not researched at all. I worry so much that her life is being ruined...I don't know what to do. She gets nausea off and on all day, mouth watering, etc. She is a beautiful child who had so much promise.

I am so glad that I found this. I have a SEVERE issues with vomit. I don't vomit and haven't in years. If I feel the sensation coming on - even to the point of the sweats or my mouth waters, I talk myself out of it. However, if I'm around someone that even brings up that they are nauseous, my heart starts beating out of my chest. I'm constantly asking them if they are ok, if they need to lie down, need water. Then I realize I'm making the situation worse and I try to just leave it alone but I still worry. I'm terrified for when I have children because if they are sick, I mentally and physically wouldn't be able to help them. I know that's terrible. This has been going on since I was a kid. Do you know what the therapy entails? I'm already anxious about thinking about having to face this fear. What a yucky thing to be plagued with, no pun intended.

I never realised there was a fear of being sick until I started getting anxiety. My family thinks I'm mad (not literally) for having a constant fear of being sick. I think about it every day and it's gotten to the point now where I'm not really that keen on going different places just in case I feel sick. I don't like being anywhere but home when I'm ill as do most people. Most of the time it's all in my head, if you keep worrying about feeling sick then you actually will be. The mind is very powerful! ive found TUMS very helpful if I sometimes feel sickish. I'm glad to hear I'm not the only one that has this sort of fear! Although I wish nobody had to have this fear as it's not nice!

I've been a medical assistant for 10yrs. Currently I am in urgent care but would love to work in ER and full fill my dreams of becoming a nurse. But as you all know the ER is the most likely place I will run into vomit! I cannot do it with my overwhelming fear! Thankfully in urgent care we dont deal with it on a regular basis, but obviously some days are worse than others. Also my symptoms are becoming worse! Before I would totally freak now I have intense palpitations, break out in a sweat/full on body rash and can barely breathe! Luckily my coworkers know me way to well and will take the pukers for me..I'll see 10 pts to the 1 puker anyday!! Any ideas how I can get past this?? The doctors think im nuts and we would all joke about it but now I see how real it really is...in 10+yrs of medical training I had no idea!

Please help me. I had an awful bug nearly 7 months ago and haven't felt right since. This is crippling me. I've missed a lot of school and have cancelled on plans numerous times due to the constant feeling of being sick and being nervous that I might vomit around others. It's even gotten to the point where I am afraid of nighttime because that's usually the time people tend to get sick. This is really ruining my life and I need help

Ken Goodman

Wed, 2017-05-31 01:02

In reply to by Mat

I'm glad my article has sparked so many people to share. Clearly a lot of people suffer from emetophobia and are having a difficult time overcoming it. The best thing you can do is find a therapist who treats only anxiety and OCD. Ask them if they use CBT, ACT and ERP. If they don't know those acronyms then move on. You can find a good therapist on this site. If there is no one in your area look for a therapist that will work with you over the internet with secure video web conferencing. You can find these folks at ADAA.org as well.

Afrikia Avant

Sun, 2017-06-04 16:28

I'm so glad that I am not alone. I would REALLY love to get over this fear because I am a preschool teacher, a wife, and a mother. I want to be able to help out when anyone is sick. I feel so helpless when someone vomits or say their tummy hurts. Please help me get over this fear.

For 9 years I'm fighting this feeling .... Sometimes i can conquer sometime I have to vomit to feel relief ... I use prayer and more courage when fighting this .. most of the time in the middle of sermon or what I do this feeling go away it self I just fight it ....

Anonymous97

Sun, 2017-06-11 05:41

I really struggle with this. Whenever i feel a slight twinge of nausea or unease, i immediatly start to freak out and worry. I've been afraid of this for as long as i can remember and it has ruined my sleep and activities throughout the day. Im afraid anything will make me sick, rollercoasters, food, beverages. It really bugs me and there have been instances where i've been sick multiple times in only a couple hours. It really sucked. But in a way, it helped me overcome my fear quite a bit. So i thought i would share a bit about the situation. Being sick three times made me realise it isnt as bad as i think it is. After the sickness stopped i felt a whole lot better. By the time i got sick for the third time, i was used to it. Yes, it is very scary but sometimes just letting what needs to happen is the best. Maybe letting what your afraid of happen could help. It has helped me a whole lot. I dont fear it as much. If that doesnt work, i have more ideas. Try thinking to yourself that this will make you feel better and it doesnt last extremely long. Try to think to yourself, you are going to be ok. Another thing is try not to worry too much. I know its easier said than done but the more you worry could make it worse. Breathing helps too. Just know you are not alone and one day you can conquer your fear. I just got over feeling nausea but when i calmed down and said to myself, im not going to be sick, i felt way better. I hope this helps someone out there!

Hello. Reading your article made it clear that this is definitely what I have. When I was a teenager, I had food poisoning and threw up for days. Sadly, I started to panic and the panic made me vomit all the more. Fast forward almost 20 years and I still live in absolute fear of vomiting. It is the single thing I am most afraid of. I do have OCD/OCPD but trying to overcome my fear of throwing up has led me to not eat much in general. I have a deeply seated fear of eating, for fear that I might throw up. Just recently I had a virus (not a stomach virus) and I started to panic so bad that I ended up vomiting. I am so scared of this and don't know how to live a fuller life due to my PTSD (from the past experience) and panic/severe anxiety. This fear/phobia has affected both my personal and professional life and I just want to be able to eat something without worrying if I will be sick. :(

Helen Williams

Fri, 2017-06-16 18:10

Thankyou so much for your article, it's really calmed me down. I have had a fear (dare I say phobia) of sick and being sick ever since I was about 8 years old. When I was younger, it used to change my life. Whenever anybody said they felt sick in my family then I would lock myself in my bedroom and open all the windows. However, I slowly got over the fear when I hadn't been sick for about 5 years. Last year, I had been on some strong acne medication which made me vomit. It was the worst experience of my life and ever since, I have had extreme anxiety. I used to be so active and carefree. It sounds so ridiculous, but it has had such an effect on my quality of life. I am afraid to do things adventurous in fear of feeling or being sick. This has been going on for about a year now. The problem is, my fear of feeling sick makes me feel sick and every single time I feel a little sick, I start to get panicky and shaky and I go cold. I always think that I am going to vomit but I never do. What can I do? It's officially because sometimes anxiety causes sickness or sickness causes anxiety and worsened sickness. Please can someone help me, it's having a really huge effect on me and I have been constantly feeling sick for about a year now. Thanks

Yes, this is what I have. I'm twelve now and experience frequent panic attacks because of my fear of vomiting. It started when I was seven and I went to therapy, which helped and I was okay for a while. I didn't nearly get panic attacks. Now, a month ago, I was in vacation with my dad and I threw up twice due to overeating. This brought all the attacks back. I'm having them more frequently than I ever did. I'm sometimes refusing to eat, making it worse. Last week I went to a church camp overnight for five days and I had two attacks a day and I was more scared than I had ever been in my life. All because I was scared of a stomachache and vomiting. When I panic, my stomach hurts. So imagine how that worked! I got one each morning and one each night. Late at night and I felt bad because I had to wake up my counselors so they could calm me down. A technique I found was to get some fresh air. The camp was in a beautiful forest area so I busied myself with finding different pine cone shapes that were funny or unusual. Also, at night taking walks with my favorite counselor helped. But I am worried because next week I am taking another family vacation to Colorado for ten days with my dad and six hours in the car both ways. I'm nervous I will panic or vomit again! My therapist doesn't have any time to fit me in before then. Does anyone have any coping tips for me? I'm scared I will get sick or panic! I hate throwing up and doing it never makes me feel better. Any tips? Sorry for the long post.