Emetophobia Celebrities who smoke

Dr. Hans Morschitzky

Clinical psychologist, psychotherapist

Behavioral Therapy, Systemic Family Therapy

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Emetophobia - Fear of vomiting

Understand emetophobia better and analyze it in a helpful way


The fear of vomiting, of witnessing the vomiting of other people (often animals as well) and also of talking about nausea and vomiting is called Emetophobia designated.


Those affected prematurely associate any nausea with imminent vomiting and this in turn with an unbearable one Disgust and unacceptable Loss of control, in social situations also with feelings of embarrassment and embarrassment.

nausea and Thoughts of possible vomiting not only trigger feelings of disgust, but above all existentially threatening conditions in the form of situation-bound ones Panic attacks.

Those affected are not afraid of certain foods and drinks, but rather that they might vomit them.

Actual vomiting is no longer seen for what it is, namely a completely normal and healthy one Protective reflex against toxic substances, foreign bodies or viruses, but is viewed as a loss of control and a feeling of disgust towards yourself.

Sufferers know that they are over-focused on nausea, nausea, and vomiting and that their fears are exaggerated, but they cannot cope with them and their behavior causes them to suffer significantly.

Emetophobic people show typical attitudes and behaviors On the basis of the abundance of characteristics they distinguish from people with eating disorders and functional ("somatoform") gastrointestinal disorders, but also from people with other anxiety disorders such as panic disorder and agoraphobia: With harmless complaints such as mild nausea, you get diffuse non-organic Upper abdominal discomfort, normal digestive noises, occasional gagging sensations in the throat or dizziness, severe fear and fear of vomiting, and the worst possible pictures of vomiting in your head, even if this has never been the case.

Again and again they call up the memory of an actual vomiting a long time ago very vividly, as if it were only yesterday, even if they know about the circumstances at that time, which are no longer present at all. Without a specific reason, they show persistent fear of expectation about possible vomiting, which dominates the whole day, even at home alone, which suggests that it is not a primarily socio-phobic disorder.

They avoid many foods such as meat, minced meat, fish, eggs, dairy products, fatty foods, mushy foods that look like vomit, and many dishes that were not prepared in front of their eyes or with their knowledge of the contents. They avoid perishable foods for fear of food poisoning, which could lead to vomiting.

They even avoid various liquids like milk, soups, or alcoholic beverages for fear of vomiting. Above all, they also reduce the amount of food and the amount of fluids for fear of nausea, abdominal pain and vomiting, with the risk of malnutrition, severe deficiency symptoms and even dehydration.    

They refrain from eating before important events for fear of nausea, stomach ache, nausea, or vomiting, and use all kinds of excuses to justify why they cannot or will not eat.

You avoid many places and social situations for fear of vomiting and accept numerous restrictions in life, which in the long term can make you significantly depressed. They cannot differentiate between fear-related or stress-related nausea and physical nausea and therefore cannot deal with it appropriately if the fear of nausea triggers unpleasant sensations in the stomach area.

Even an anxiety-related queasy feeling in the stomach is already misinterpreted as nausea, so that body and emotional perception must definitely be improved.

They experience possible vomiting outside the home even more embarrassingly than at home, which can lead to socio-phobic tendencies, with the restriction of social activities, up to and including not eating out together or with friends at home.

You have trouble seeing vomiting from other people, as well as cats and dogs.

They therefore accept various detours in order not to meet people who are currently vomiting or could vomit, especially drunks or small children, especially to avoid vomiting at places such as train stations, folk festivals, fairs, company celebrations, parties, certain streets in the vicinity of restaurants or when traveling by air or ship.

They often refrain from using public transport in favor of the private car for fear of nausea, nausea or vomiting, but also out of concern about a possible infection by a gastrointestinal virus of fellow travelers, which could lead to vomiting. For these reasons, it is not uncommon for relatives to take them to school or work by car, similar to agoraphobic women. They are constantly looking for tips against nausea and vomiting and often assure themselves from confidants and experts that they do not have to fear nausea, nausea or vomiting in certain situations. If you are afraid of contagion, you wash your hands with soap or even disinfectants too often, like obsessive-compulsive illnesses, in order not to get an infection that could lead to vomiting. When buying and preparing food, they are very careful to buy the "right" food and only use certain additives to avoid digestive problems that could encourage vomiting. They control the use-by date of all food in stores and in the refrigerator at home for fear of mold and possible vomiting of spoiled food. For fear of infection, they often avoid going to school or work when gastrointestinal viruses are circulating there. They are often completely exhausted in the evening because they have spent the whole day dealing with the subject of vomiting and preventing it in good time.

They eat very little, especially in the evening, for fear of nausea or vomiting in bed and use certain distraction strategies such as reading, listening to the radio, watching TV or the internet to avoid possible gastrointestinal sensations until they are finally overwhelmed by sleep deficit late at night become.

It is not uncommon for them to feel in bed in the evening, when they can no longer consciously or unconsciously distract themselves from their body, a stressful nausea that prevents them from falling asleep normally, so that over time, anxiety about falling asleep can arise.  

They either visit numerous doctors to clarify their nausea and diffuse abdominal pain, or avoid doctors and hospitals for fear of infection. You are already taking a preventive medication, a herbal or homeopathic remedy for nausea, vomiting or diarrhea or certain "stomach drops" you have prescribed yourself. They often also carry bags with them. On the other hand, they often avoid all medication prescribed or recommended by doctors for fear of nausea, heartburn, nausea, and vomiting. It is difficult to induce them to take antidepressants knowing that nausea and nausea can be one of the most common side effects at the beginning of use. They fear certain physical illnesses in panic, such as gastrointestinal flu or vomiting diarrhea, even if this has never happened to them, and if they do, then even more than before.

More than twice as many Women like men suffer from emetophobia which, given its frequency, is relatively unknown to the public and even to many professionals.

The mild form is experienced by up to 3 percent of men and up to 7 percent of women, the severe form by 0.1 percent of the population.

Emetophobia often begins in childhood, on average at 10 years of age, in certain cases triggered by normal vomiting in the face of certain circumstances.

Vomiting of one's own in childhood or the experienced or reported vomiting of relatives or acquaintances can play a certain role in the development of emetophobia, but they do not explain the increasingly rampant symptoms of those affected, who develop an increasing reduction in attention to their disorder.

Those affected behave like people with a Obsessive-compulsive disorderwho do everything to avoid contact with certain foods and substances, or who would like to use washing rituals to prevent the risk of nausea and vomiting as a result of gastrointestinal diseases caused by germs and viruses.

The symptoms are not based on an eating disorder or a mentally induced digestive disorder, even if the misdiagnoses "atypical anorexia", "irritable stomach" or "irritable bowel" are made due to frequent weight loss, worrying malnutrition and complained of nausea. Those affected are not driven by the goal of weight loss like anorexics and do not feel too fat, they usually do not have any functional, i.e. non-organic (“somatoform”) disorder of the upper or lower digestive tract on a chronic basis, but rather live in fear and terror from corresponding sensations such as nausea and nausea. Even if those affected are “panic” afraid of eating because of the possible vomiting, there is no panic disorder, it is rather situation-related panic attacks in connection with the dreaded symptoms of nausea and nausea or the corresponding triggers in the form of certain food and food-related situations. While people with bulimia view planned vomiting as a form of controlling their body weight after eating, people with emetophobia avoid anything that could encourage unwanted vomiting.

Unlike anorexics, they do not pay attention to the amount of calories, but rather that they do not consume any food or drink that could lead to vomiting. Because of the considerable restriction and change in eating behavior, those affected often have the same effect on the social environment as those affected by eating disorders.

Only in rare cases are the symptoms related to anorexia, in which food intake is severely restricted due to the extreme need for control, but at the same time vomiting is decidedly rejected as a further means of weight control.

If, for fear of vomiting in public, the range of action is significantly restricted, similar to what happens in people with a pronounced fear of fainting, or urination or defecation, a secondary one can certainly also occur Agoraphobia arise.

A variety of excuses are then used to avoid certain situations such as public celebrations, eating and drinking with family or friends, as well as various excursions and trips.

Many emetophobic women fear one pregnancy only because they could suffer from vomiting in the morning and because they would not be able to bear the vomiting of the longed-for baby or toddler afterwards.

The desire to have children is often greater than the fear of vomiting, which is more likely to be accepted as a natural occurrence during pregnancy than any vomiting in any other context.

Some can adequately accept the vomiting of children in the context of normal childhood illnesses, while others are terrified of it, even if they can then look after a vomiting child in the best possible way in a specific case.

Root cause analysis
Although they help to better understand the disorder and the emotional and cognitive processing of the triggers, such as an alcoholic father or a family conflict, they do not help to make them more permanent due to the chronification process that has resulted from the strategies of permanent avoidance and control of food Modification.

The Therapy goal is not to "train away" the feeling of disgust associated with vomiting or vomit through habituation, but to be able to enjoy life better despite feelings of nausea and rapid disgust reactions without restricting eating and social behavior.

The specific form of self-treatment or psychotherapy depends on the type of emetophobia, but the central guidelines are healthy broad-spectrum nutrition and the perception of a normal feeling of satiety instead of prematurely stopping food intake for fear of nausea, as well as eating habits that are ready to be enjoyed when being together other people at home and away from home.




Coping successfully with emetophobia

1.    Change harmful thought patterns.


Structure your sickening thought patterns in favor of more helpful settings and perspectives that allow you to return to normal body sensations and all food, such as:


"Vomiting is a reflex and has nothing to do with failure", "Vomiting is also embarrassing to other people who, however, do not let their whole life spoil for fear of it", "Despite the nausea, the food stays in the stomach", "Nausea is often a sign of fear and not vomiting "," You can also fulfill your obligations with nausea "," Healthy nutrition is important for general well-being. "

2.    Improve your physical well-being.


Eat and drink enough to avoid malnutrition and dehydration, especially warm liquids to help your stomach feel and relax.


Anxiety and stress lead to one Reduced blood flow to the stomach, because in a fight-flight reaction, the blood is increasingly transported into the working muscles.


Put the Abdominal breathing to promote well-being in the upper and lower abdomen. Put both hands on the abdominal wall for a feeling of warmth and relaxation.


Move around if you are afraid of symptoms such as vomiting and urination, which are controlled by the parasympathetic nervous system.


The activation of the sympathetic nervous system effectively inhibits all excretory reactions in favor of physical activity.


Increase your range of motion with increasingly better nutrition in order to reduce internal tension on the one hand and to build up physical fitness on the other.

Be mindful of feared situations and physical reactions.

The basic problem is not vomiting, but the fear of vomiting and the evaluation of certain situations and physical sensations as threatening triggers.


Perceive all of the sensations in your upper digestive tract (esophagus and stomach) without being threatened by your nausea, diffuse stomach pain and gagging feelings.


Stay with what you are feeling in the here and now. Accept all spontaneous thoughts and ideas of nausea and nausea, as well as any feelings of nausea.


Keep telling yourself, "Nausea is just nausea, my ideas about vomiting are just imaginations and not reality."


Be very conscious of your sensations in the upper abdomen without using distraction strategies, especially after a large meal.

Draw your attention to what you want to do.

Be aware of what you can and cannot control. You cannot control body feelings such as nausea and spontaneous thoughts about them.

On the other hand, you can control your attention and behavior.

Accept your physical discomfort without fighting against it and, despite slight nausea, concentrate on what you are currently doing or want to undertake in order to celebrate a sense of achievement that can be achieved regardless of your current state of mind.

Learn from other people's role models.
You again together with your relatives and acquaintances at home and abroad as well as at your workplace in order to experience food intake as a social event and to be able to benefit from the behavior of others.

Talk to other people who do not associate occasional gastrointestinal discomfort with spontaneous vomiting.

Coach yourself with effective self-direction.
Encourage yourself in situations of psychological and physical discomfort that do not justify absenteeism from work or the place of training with helpful ones Self-instructions, such as:

“My nausea is just an expression of my fear, which I bravely face”, “I can also be successful with nausea at work, at school or at university”, “I am healthy and over time I will eat everything as I used to to strengthen my body ”,“ I trust my body and forego all controls ”,“ In the future I will not give as much power to my nausea and nausea, which has never led to vomiting except for a gastrointestinal infection my life as before. "

Prepare yourself mentally for dreaded situations.


Imagine as vividly as possible how you can enjoy the food and drinks you have avoided so far, despite the initial nausea and fear of vomiting.


Picture yourself eating out with other people and going on excursions including going to a restaurant.


Imagine as vividly as possible what you would like to do in the future and what beautiful things you have experienced in the past.

Gradually confront all feared situations. Tolerance of feelings of disgust. Accept your feelings of disgust in the face of thoughts, pictures, videos and real situations that have to do with vomiting and vomiting by consciously confronting such situations and gradually reducing your internal and external avoidance behavior.

Provocation of abnormal sensations in the upper abdominal area.
Consciously consume foods that can cause bloating or gas, such as nuts and beans. Sometimes eat so much that you experience a "full stomach". Drink enough water that you can feel the amount inside. Learn to perceive harmless abnormal sensations without vomiting.
Expansion of the menu.
Refute your fears with new experiences with foods that you have never eaten, or have not eaten in a long time. Step by step you will find your way back to normal eating habits and over time, consume more and more of the previously forbidden but healthy foods. You should also go out to eat out again to learn to trust foreign kitchens, as well as for a coffee with milk and cake or an ice cream parlor, because you are not a gastrointestinal or metabolic patient who has to adhere to a diet plan for your well-being. Eat more foods again that you have previously associated with nausea and vomiting.

Dismantling of all avoidance and control strategies.
Reduce your avoidance and safety behaviors that were used to prevent nausea, nausea, and vomiting. In the course of time, refrain from taking anti-emetics, emergency drops and vomiting bags with you.

Expansion of the radius of action.
Confront increasingly different situations that have been avoided so far, especially when you are in all kinds of public transport and in public spaces, such as school, university or the company, in order to reduce or prevent agoraphobic avoidance behavior to prevent nausea and supposed vomiting . Enjoyment training. Make eating an enjoyable experience again, something that you can look forward to and that you do not constantly fear as a physical threat. Eat more of what you used to enjoy and which is most likely associated with positive memories.

Social behavior training. Make sure you eat together at home and out so that eating becomes a social event again. Concentrate on being with people you trust, rather than on your physical sensations that are preventing you from closer emotional contact with people you trust.

Emotion training. Confront your feelings that are “behind” your physical sensations. Learn to perceive your feelings, to express them internally in appropriate words, ideally in the form of diaries, and then to express them appropriately to certain caregivers. Break the vicious circle of "fear of nausea - actually perceived nausea - fear of nausea and vomiting" by consciously allowing your fears in this regard and learning to better perceive the difference between mentally and physically caused nausea.