Emetophobia, SPOV (Specific phobia of vomiting) or more commonly known as a fear of vomiting is a condition that causes an intense an irrational fear of vomiting and/or witnessing other people vomiting. Dr David Veale, a consultant psychiatrist in cognitive behaviour therapy at the South London and Maudsley NHS Trust and the Priory Hospital in north London stated that "A fear of vomiting is quite common in about 7% of the population but a specific phobia of vomiting where there is significant distress and avoidance is less common, about 0.5% of the population, and mainly in women."

This specific phobia can be greatly debilitating to one's life not only because it forces the individual to create a very unhealthy and limited lifestyle but it can also lead to several other conditions as severe anxiety, depression, panic attacks, obsessive compulsive disorder (OCD), social anxiety, agoraphobia, generalised anxiety disorder and many others. Because of this close correlation with other mental conditions Emetophobes are often misdiagnosed. One of the most common misinterpretations is that Emetophobia is a form of eating disorder. The fact that a person is severely underweight and has unhealthy and limited eating habits does not mean they suffer from an eating disorder. It is very important for an Emetophobe to be rightly diagnosed, as that's the only way they can get the specific treatment they require. One of the most common misdiagnosis of Emetophobia is anorexia nervosa, obsessive compulsive disorder (OCD), agoraphobia, social anxiety, generalised anxiety disorders and even Irritable Bowel Syndrome (IBS), which is often an anxiety related condition. 

Emetophobes will often present some of the following symptoms or behaviours: 

  • moderate to acute anxiety, mainly related to vomiting

  • digestive symptoms as nausea, cramps and diarrhoea, which are mainly a consequence of the severe anxiety they're experiencing at all times (or else a consequence of IBS which again arises due to the high level of anxiety)

  • compulsive cleaning and over-sanitising

  •  a series of severe avoidance behaviours which will inevitably end up reinforcing their feared beliefs

  • a particular anxiety around the preparation of their food. They will often avoid eating out as well as eating food prepared by others

  • a restricted diet which will often categorise food  as "safe" foods and "unsafe" one. They will often compulsively check expiry dates and avoid eating any unfamiliar foods 

  • avoidance of places where they might be more likely to encounter a virus (like public restroom or even nurseries) or places where they might see other people vomiting such as bars and nightclubs 

  • consuming alcohol in very little quantities, or none, due to the risk that it might make them sick

  • many women suffering from Emetophobia develop a fear of pregnancies due to the fear of morning sickness and some of them will even go to the extend of not having children due to their intense fear

The cause of Emetophobia can sometimes be identified as a traumatic event when the sufferer experienced a particularly unpleasant and scary episode of vomiting or witnessed someone else going through it. It can also occur in people who have had a history of heath problems that caused them to vomit frequently. Dr. David Veale stated that "Their experiences of vomiting may have also occurred before clear memory." The underlying fear of the sufferer is often identified as the fear of losing control, the vomiting going on forever, choking, embarrassing themselves in public and feeling humiliated. 

This phobia can be extremely debilitating to one's life as the sufferers become afraid of their own body and as much as they can avoid any foods that have even the slightest chance of making them sick or any places associated to feeling sick in the end they cannot escape their own body which leaves them in a state of constant worry. They live in a constant state of fight or flight mode and often monitor any sensation from their body, any noise from their belly or weird movement which could be a sign of potentially having a bug. This constant monitoring inevitably increasers the anxiety and often provokes panic attacks which do end up creating a feeling of nausea and causing in such way the sufferer to live in a never-ending vicious cycle.

The most common treatment for Emetophobia is Cognitive Behavioural Therapy (CBT), which helps the sufferer to modify the thoughts that are causing the phobia in the first place and helps to create a new belief system around the fear gradually including exposure to sensations associated with vomiting and situations that trigger the fear of vomiting. It's important to say that none of the treatments involve the sufferer experiencing vomiting itself. The treatment is mainly focused on changing the belief system around the fear of vomiting and helping the sufferer to feel capable of coping with any circumstances, even vomiting itself if this happens to occur. 

What is Emetophobia