Emetophobia

What is Emetophobia?

Like many phobias, Emetophobia can be more easily understood when you separate the prefix from the suffix. In this case, the meaning is reasonably clear: the suffix, phobia, means a fear while the prefix, “emet” is close to emit, or vomit. Therefore, emetophobia is defined as an excessive or irrational fear of or the possibility of vomiting. This is why it is commonly referred to as “vomit phobia” among some children and their parents. Either way, the fairly straightforward definition belies many complex factors that surround this intense fear of vomiting.

Symptoms of Emetophobia

Symptoms of Emetophobia can be diverse and include:

  • Behaviors that are aimed at reducing or eliminating the possibility of throwing up
  • Checking behaviors used to detect early signs of illness (eg. “I’m feeling warm. Does that mean I’m getting sick.” This ache and that ache “is that a sign I’m getting ill?” Checking temperature wanting a medical checkup often.)
  • Health-promoting behaviors used to reduce the consequences of illness (eg. Excessive exercise, overly conscientious about eating healthier foods, excessively checking the internet for the “right” vitamins and nutrients to have in your diet).
  • Avoiding situations in which vomiting might be especially embarrassing or distressing

Given these dynamics, Emetophobia can be incorrectly diagnosed as something else – most commonly as separation anxiety, panic disorder, health anxiety and/or an eating disorder. Therefore, a thorough examination is necessary. A practitioner will look for other “red flags.”

Behavioral Signs of Emetophobia

If your child displays 10 or more of the following behaviors, Emetophobia could be the true source of your child’s anxiety:

  • Expresses worry about throwing up
  • Frequently asks if he or she is sick or might be getting sick
  • Seeks reassurance that he or she is not getting sick
  • Complains about stomach distress
  • Takes his or her temperature frequently
  • Rubs his or her stomach frequently throughout the day
  • Refuses to eat
  • Complains about the selection of available food
  • Avoids people and places that could cause him or her to vomit
  • Avoids and checks for food that might be contaminated, unsafe or past its expiration date
  • Washes his or her hands compulsively
  • Avoids school or school activities if news spreads that a flu bug is going around
  • Sidesteps pictures, TV programs and other visual elements that depict people getting sick
  • Insists on a parent being nearby in case of illness
  • Frequently checks on someone whom he or she suspects of being ill
  • Avoids car rides, boat rides, park rides and other forms of movement that might trigger dizziness and then a vomiting episode
  • Worries that sweating – even under normal circumstances – will set off a wave of nausea
  • Cannot fall asleep or stay asleep because of fear of becoming ill during the night
  • Resists falling asleep alone out of fear that he or she might choke in vomit
  • Vocalizes regular fear of choking or gagging

What Triggers the Onset of Emetophobia?

Emetophobia usually emerges in childhood, though it also can surface in adulthood. Left untreated, it can follow a relatively chronic course for people of all ages. The triggering event usually is an unfortunate experience, such as developing a case of food poisoning or experiencing (or witnessing) an episode of severe and/or uncontrolled vomiting.

What Behaviors can Emetophobia lead to in Children and Teens?

Children and teens who suffer from Emetophobia most often try to avoid attending school. As a consequence, their academic performance often plummets.  Another common behavior is to avoid places and things associated with throwing up, even refusing to say or write the word “vomit.” Likewise, limiting their diet so as to avoid anything that is unfamiliar and compulsively checking expiration dates on food products. In some cases, malnutrition can become an issue.

A child or teen who is afraid of throwing up may avoid social events, such as shopping excursions, birthday parties, sleepovers and dating. He or she also is more likely to avoid eating at restaurants, where their fear of unknown food is heightened. Missing out on these activities can affect a child’s relationships and impair his or her social development. Even when long-term social problems do not develop, children with Emetophobia are likely to grapple with a great deal of Anxiety, fear, unhappiness and distress.

Recommended treatment is Acceptance and Mindfulness with Cognitive Behavioral Therapy.
Note: Refer to  the “Anxiety Cycle” for a description of how it relates to Emetophobia.