Overcoming Emetophobia (Vomit Phobia) with a CBT Therapist

Updated on October 24, 2024

What is Emetophobia?

Emetophobia is also known as the fear of vomiting or throwing up (or vomit or barf phobia). People with emetophobia experience intense and persistent anxiety and fear around the possibility of vomiting or seeing others throwing up.

If you struggle with the act of vomiting or seeing other people barf, you could be struggling with emetophobia. If you worry about others judging you if you vomit, then you might be struggling with social anxiety. If you worry about becoming contaminated from vomit, then you could be struggling with obsessive-compulsive disorder (OCD).

You will need to determine what your “core fears” are to determine if it is truly emetophobia. You can ask yourself: what I am worried will happen if I vomit? Or, what I am worried will happen if someone else vomits?

At Virtual CBT Psychotherapy, we have a variety of therapists who treat emetophobia. Book a free consultation to learn how we can help. * Must be Ontario resident. Our therapy fees.

Signs and Symptoms of Emetophobia

The far of barfing can cause a variety of physical and psychological symptoms. These may include:

• Intense emotions like anxiety, disgust or shame. You may even be struggling with symptoms of depression because you feel hopeless and different.

• Avoidance of situations, places or activities that may trigger anxiety or vomiting. For example, you might avoid: certain foods like chicken or sushi, young children, groups of people, avoiding sick people and children, public washrooms, alcohol, etc.

• Obsessive thoughts and rituals (or safety behaviours) around cleanliness or avoiding germs. Some examples of safety behaviours with people who have a fear of vomit: are overcooking meat like chicken, excessive hand washing, tossing food items before their expiry or best-before date, overusing hand sanitizer, excessive cleaning routines, excessive hand washing routines and distracting themselves from anxiety. People may also carry a water bottle with them, or anti-nausea medications like Gravol.

• Physical symptoms when thinking about vomit, such as nausea, sweating, and rapid heartbeat.

• Catastrophic thoughts about vomiting, like “I will never stop vomiting”, “people will judge me”, “I won’t be able to cope”, I could choke on my vomit and die”, and “I could lose control”.

Prevalence of Vomit Phobia

If you struggle with emetophobia - you are not alone! According to the American Psychiatric Association (APA), specific phobias, including emetophobia, are among the most prevalent anxiety disorders in the United States, affecting an estimated 7-9% of the population at some point in their lives.

This phobia can significantly impact your daily life and make it difficult for you to engage in normal activities, such as going to school, work, or social events. You may even avoid a lot of things like certain foods, young children, or social settings.

Causes of Emetophobia

The exact causes of emetophobia are not well understood. However, researchers believe that it is likely caused by a combination of genetic, environmental, and psychological factors. Traumatic experiences, such as a severe illness or a bad experience with vomiting, can also contribute to the development of emetophobia. Overall, there are probably several reasons why you developed a fear of vomiting. If you can’t identify any causes - no worries - sometimes we develop phobias for no particular reason.

"Courage is not the absence of fear, but the triumph over it." - Nelson Mandela

Treatment Options for Emetophobia

Cognitive-behavioural therapy (CBT)

CBT is a type of counselling that is particularly effective for treating emetophobia. CBT involves identifying and challenging the thoughts and behaviours that contribute to anxiety and fear.

Exposure therapy

Exposure therapy is a type of CBT treatment that gradually exposes the person to the feared object or situation in a controlled and safe manner, is also used to help people overcome their fear of vomiting. Learn more about exposure therapy for anxiety.

Examples of exposures for emetophobia:

• Writing trigger words (e.g. vomit, barf, puke, hurl, gag)

• Write trigger sentences (e.g. I will vomit)

• Looking at images of vomit or people vomiting

• Watching videos of people vomiting

• Listening to sounds of people vomiting

• Making fake vomit

• Approaching places that you avoid because of fear of vomit

• Spending time around kids without using safety behaviours

• Imaginal exposure is also very effective for emetophobia because it is a hypothetical situation (in other words, it’s in the future)

• On occasion, interoceptive exposure should also be integrated into treatment (e.g. purposely feeling dizzy or like you could gag or vomit)

Eliminating Safety Behaviours

An effective treatment plan will also include eliminating safety behaviours. This is something that is often overlooked by therapists. In fact, many therapists will inavertendly teach you safety behaviours or "coping tools". If you struggle with emetophobia, you may have quite a few of these. Although these behaviours make you feel better in the short-term they could be worsening your symptoms in the long-term. To learn more about safety behaviours.

It’s suggested that you write out a plan to reduce and ultimately drop your safety behaviours. You can stop all your behaviours at once, or you can gradually cut them out.

Medications for Emetophobia

If you struggle with severe emetophobia and are not willing to try counselling, you may want to meet with your doctor or a psychiatrist and discuss the possibility of starting medication. Some people will need a combination of mental health counselling and medication.

Alternative Treatments for Emetophobia

For those looking beyond traditional therapies, several alternative approaches can help manage emetophobia.

Eye Movement Desensitization and Reprocessing (EMDR) can serve as a valuable alternative treatment for people dealing with phobias. Although most research focuses on PTSD, studies suggest that EMDR may also help reduce anxiety related to phobias. EMDR helps by processing memories and altering the emotional responses associated with fears. Case studies have demonstrated improvements in phobic reactions following EMDR therapy (Ironson et al., 2002). Integrating EMDR with other therapeutic approaches, such as exposure therapy, can enhance its effectiveness for phobia treatment (Hensley & Mork, 2020). Meet our EMDR Therapist, Catherine Sullivan, RSW, MSW.

Research supports the use of mindfulness in managing anxiety and stress. Studies show that these practices can improve emotional regulation. This means that it may help with anxiety related to emetophobia (Keng et al., 2011). It’s important to practice mindfulness regularly to see it’s full benefits.

Hypnotherapy is another option that some people find helpful. It can address underlying fears and anxieties in a relaxed state. Research specific to emetophobia is limited. But some studies suggest that hypnotherapy may aid in reducing anxiety and phobias (Wagner & Sweeney, 2018).

While these options may be supportive, they aren’t as strongly evidence-based as CBT or exposure therapy. CBT and exposure therapy have substantial research backing for phobia treatment. Incorporating these approaches can provide complementary support in managing emetophobia.

Will I Have to Make Myself Vomit to Overcome Emetophobia?

No, you don’t have to make yourself vomit to overcome emetophobia. Facing a fear doesn’t mean experiencing the worst-case scenario. CBT focuses on understanding and managing your reactions to the fear without needing to actually vomit.

CBT uses gentle, gradual steps to help reduce anxiety around vomiting. The goal is to build your comfort and confidence over time without forcing you into distressing situations. Exposures should feel challenging but manageable.

Tips for Managing Emetophobia

In addition to seeking professional help, there are also several things that people with emetophobia can do to manage their anxiety and fear. These may include:

• Practicing relaxation techniques, such as deep breathing or meditation. It’s best to schedule a time to practice relaxation techniques so that it does not become a “safety behaviour” (which helps you to feel better in the short-term but will maintain your symptoms in the long term).

• Consider gradually cutting back your avoidant behaviours and eliminating your safety behaviours.

• Challenging negative thoughts and beliefs that contribute to anxiety and fear using a thought record.

• Learn how to practice mindfulness.
  

The fear of barf can be a debilitating anxiety disorder, but it is also highly treatable. With the right support and treatment, people with emetophobia can learn to manage their anxiety and overcome their fear of vomiting. If you or someone you know is struggling with emetophobia, it's important to seek professional help and support. Remember that you are not alone and there is hope for recovery.

How to Help Someone with Emetophobia

Supporting someone with emetophobia requires understanding and patience. Here are some ways to help:

• Listen Without Judgment. Take time to really listen. Validate their fears without minimizing them, even if you don’t understand. A calm, accepting attitude helps them feel safe.

• Be Patient. Recognize that this phobia can be deeply ingrained and won’t disappear overnight. Avoid pushing them into situations that might feel overwhelming. Instead, let them set the pace.

• Ask What They Need. Everyone’s experience with emetophobia is unique. Ask them what would be helpful in stressful moments or when their anxiety spikes. Some people find it calming to have company, while others may need quiet or reassurance.

• Encourage Small Steps. Celebrate any small progress they make. It could be as simple as talking about their fear or making small steps to approach their fears. Small victories build confidence over time.

• Educate Yourself. Learning about emetophobia can help you better understand what your loved one is going through. The more informed you are, the better equipped you’ll be to offer meaningful support.

• Encourage Professional Help. Let them know it’s okay to seek professional help, like Cognitive Behavioral Therapy (CBT). Therapists can guide them through techniques that gradually reduce their fear and help them feel more in control.

Vomit Phobia Resources

Books on Emetophobia

Free Yourself from Emetophobia: A CBT Self-Help Guide for a Fear of Vomiting

The Emetophobia Manual: Free Yourself from the Fear of Vomit and Reclaim Your Life

Websites about Emetophobia

• We also like this website on emetophobia for exposure and treatment ideas for vomit phobia (although, you may want to meet with a therapist who can show you how to do exposures, create a fear hierarchy and help you to identify your safety behaviours).

Getting Started with an Emetophobia Therapist

Most of the therapists at our mental health clinic are trained in providing exposure therapy for emetophobia and have had several clients overcome their anxiety symptoms related to their vomit phobia. Treating emetophobia has become one of our specialties.

You can book a free consultation with a CBT therapist by clicking the tab below. Check your benefits to see if you are covered for psychotherapy by a social worker, psychotherapist, psychologist or RN psychotherapist and get started on your path to wellness today. Learn more about our therapy fees.

*The psychotherapists at Virtual CBT Psychotherapy are registered to provide services to Ontario residents (adults, teens and children).

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). 

Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the efficacy of EMDR for the treatment of trauma and PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 5(3), 206-212. https://doi.org/10.1037/a0021642

Seidler, G. H., & Wagner, F. E. (2006). Is EMDR an effective treatment for PTSD? A meta-analysis. Journal of Consulting and Clinical Psychology, 74(3), 456-464. https://doi.org/10.1037/0022-006X.74.3.456

Van der Kolk, B. A., McFarlane, A. C., & Weisaeth, L. (2007). Trauma: A psychosocial approach. In B. A. Van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Trauma and memory (pp. 267-280). Guilford Press.