Supporting a Loved One with Emetophobia

Supporting a Loved One with Emetophobia
Dall.e

Emetophobia is an extreme fear—or phobia—of vomiting that significantly impacts a person’s life. People with emetophobia may be afraid of vomiting, seeing or hearing another person vomit, or seeing vomit. In an attempt to avoid vomiting, these people often end up avoiding many situations, activities, and even people they enjoy. For this reason, emetophobia can be a severe condition that largely impacts one’s quality of life.

People with a phobia of dogs or planes may be able to structure their lives so that they don’t encounter dogs or have to fly.  People with emetophobia, however, face a much broader range of situations that they deem risky. In life it is not possible to entirely avoid the sensation of feeling sick or situations that may cause one to vomit—so those who make this attempt more profoundly restrict their life experiences.  For example, people with a fear of vomiting may avoid:

  • Places where they believe they or others will experience motion sickness, such as flying, riding in a car, or boats
  • Amusement parks
  • Places where people may be sick, such as hospitals, doctors’ offices
  • Being close to children and places where children may be, such as schools, and playgrounds
  • Pregnant people
  • Drinking alcohol and places where people drink alcohol, such as bars or parties
  • Watching movies and television in which people may vomit
  • People, including loved ones, who may be sick
  • Medications that may cause nausea
  • Eating foods they deem risky, such as leftovers, foods that have sat out, foods others have prepared, any food from which someone has previously gotten sick, foods close to the expiration date
  • Even eating more than minimal amounts of any food

People with emetophobia may also experience weight loss and even meet the criteria for the eating disorder Avoidant Restrictive Food Intake Disorder (ARFID) if it affects their ability to eat enough.

Supporting Your Loved One

If you have a person in your life who has emetophobia, it may be hard to relate to just how scared they are. You may believe that their fear is irrational and be tempted to make jokes or just tell them to get over it. And yes—they do understand on some level that their fear is irrational, but that self-knowledge is not sufficient to “just get over it.”

Understand that they know that their phobia is likely frustrating to you and feel embarrassed when it impacts you as well as them.

Learn more. Reading and learning about emetophobia will help you to see that your loved one is not being difficult, but that they suffer from a severe anxiety disorder. They did not choose this disorder and they did nothing wrong to cause it. Phobias are caused by a complex interplay of genetic and environmental factors. It is the most common type of specific phobia that people seek help for. Treatment is available.

Recognize that you can’t talk them out of it. When a person with emetophobia is faced with a situation in which they think they or themselves may vomit, they are in a state of high anxious physical arousal. They are having a fight or flight reaction, and their body is responding as if they are in immediate danger. They will likely not be responsive to reasoning.

Show empathy. This can go a long way. Telling your loved one that you understand when they are feeling scared is validating. Saying, “I know you feel scared [because you’re afraid you’re going to throw up]” is all you need to say. Staying with them and staying calm, rather than getting upset, can help them to calm down. Compassion is calming because it activates the body’s soothe system.

Avoid giving reassurance. People with emetophobia often ask for reassurance—about whether throwing up is likely or about the safety of certain foods, activities, etc.—in hopes of reducing the anxiety and uncertainty they feel. This often compulsive act is inadvertently reinforced when reassurance is given. While it feels relieving to the person with the phobia, it’s not usually helpful in the long run because the person does not learn to tolerate the fear and uncertainty themselves. While it may be difficult to watch the person you care about struggle, resist the urge to reassure. Instead, offer empathy and perhaps a hug or hold their hand or get them some water.

Don’t make fun of them. Although your style may be to poke fun, a phobia is not something over which someone has control; it is something about which they may feel shame. When you make fun of someone’s vomiting phobia, they will likely feel very embarrassed. They are already struggling a great deal and being the subject of a joke can make it even harder for them to feel safe or seek support.

Don’t force them to face things before they are ready. Effective treatment for emetophobia involves exposure therapy. This is the intentional facing of situations they fear and wish to avoid. You may find spontaneous opportunities that would provide exposure (i.e. milk past its expiration date in the fridge) and want to help them face it. It’s really important that the person with the phobia gives consent for exposures. If they experience an unexpected trigger and have an urge to run away, you can try to support them in staying in and facing the situation, but this is always done collaboratively.

Ask your loved one how you can most help them. Talk to your loved one and let them know that you want to support them.  Ask them for specificity:  how they’d like you to support them around triggers, and whether you can help them with exposures. Recovery is hard work and your loved one will benefit from your empathy and support.

Express confidence in their ability to recover. Emetophobia can be successfully treated with cognitive-behavioral therapy. Keep a positive attitude and encourage your loved one to seek help from a qualified professional.

Your willingness to help—as exemplified by your taking the time to read this article—can make a difference in your loved one’s recovery from emetophobia.

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