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Episode 19: Jessie's story of emetophobia and recovery Emetophobia Help with Anna Christie

Jessie talks about the unique way she acquired emetophobia and also the unique way she worked on her recovery.  A very inspirational podcast!Host: Anna Christie, Psychotherapist and Emetophobia Specialist Anna Interviews: Jessie Mulanax from Seattle, Washington, USA  Trigger Warnings: The words "vomit" and "sick" may be used. No detailed stories. Opening Quotation: "Recovery begins from the darkest moment. "   ~ John Major Intro Music: YouTube Audio Library, "Far Away (Sting)" by MK2, Used with Permission.Support the show (http://www.buymeacoff.ee/emethelp)
  1. Episode 19: Jessie's story of emetophobia and recovery
  2. Episode 18: Sexual assault led to emetophobia
  3. Episode 17: CBT/exposure is NOT about licking your shoe!
  4. Episode 16: Anna's Christmas Message (Religious – Christian Content)
  5. Episode 15: Emetophobia therapist Peter Silin talks about his unique approach

Producing a podcast has weekly costs. If you appreciate the Podcast I’d love it if you just bought me a coffee! Click here: buymeacoff.ee/EmetHelp

Photo by Ben Libby on Unsplash

Are you afraid of vomiting or of seeing/hearing someone vomit? Do you experience anxiety or have panic attacks related to the fear of vomiting? Do you think about vomiting almost every day and especially when you don’t feel well? The fear of vomiting is called EMETOPHOBIA and it is much more common than you think.  6% of women and 1% of men suffer from a fear of vomiting. This means that 23 MILLION people in the United States alone have a fear of vomiting. 

Why have you never heard of it?  Shame and embarrassment. Emetophobics keep it hidden from everyone and suffer in silence.

Anna Christie, 2020

My name is Anna Christie, and I had a very severe phobia of vomiting for years. I don’t like to use the word “cure” because emetophobia is not a disease. But I am fully recovered thanks to conventional CBT, and I am now a licensed psychotherapist specializing in emetophobia. 

I offer treatment for emetophobia online via Skype, give professional consults, provide free resources to therapists, write, educate and offer guest speaking. My fee per 50-minute session is $200CAD. I see most clients for 16-20 sessions.

As of September 1st, 2020 my waitlist for ADULTS is several months long. Click here to add your name to my waitlist. I am no longer taking CHILDREN or ADOLESCENTS on a waitlist. 

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America the Beautiful

I am Canadian – 6th generation. My ancestors were among the first United Empire Loyalists to land in Nova Scotia from Britain in the late 1700s. Among my ancestors is also a First Nation’s woman of the Mi’kmaq tribes of eastern Canada. My family history does not record her name.

In 1925 my grandmother wished to divorce my grandfather for “physical cruelty” but women were not allowed to divorce men for any reason, although a man could divorce a woman for adultery. So grandma packed up a horse and cart with five children and rode all the way to Boston, Massachusetts where she settled for several years until she became a citizen and divorce her husband, as this was allowed in America. After the divorce she returned to Nova Scotia with her two youngest children: one was my mother, age 9.

So I have two aunts and an uncle in Boston, who were much beloved of mine in my childhood. We went to see them every year, often taking my Aunt Sadie with us to Nova Scotia to visit my grandparents. I also have several cousins in Indiana to whom I’m very close. Most of my clients are from the United States.

Needless to say, yesterday was a particularly painful day for all of us who love America – those living there and those who have relatives, friends and much-loved aquaintances – on “both sides of the aisle” as American politicians say. I thought for my blog this week I would just share with you the second verse of a very familiar song. Comments have been turned off.

O beautiful for pilgrim feet,
Whose stern, impassioned stress
A thoroughfare for freedom beat
Across the wilderness!
America! America!
God mend thine every flaw,
Confirm thy soul in self-control,
Thy liberty in law!1

_______________________________________________

  1. Katherine Lee Bates, 1893.

Kids and Emetophobia

The most important thing to remember is counter-intuitive to parenthood: don’t reassure the child if they ask questions. Reassurance, when it comes to anxiety disorders, is a real no-no. It’s called a “safety behaviour” and it makes the phobia worse. Think about it like this: if a child asks whether or not you think they might be sick, and you reassure them they won’t be, then the child feels better/calmer. So the kid’s brain goes “wow – I feel so much better when I’m reassured – I’ll ask for reassurance a lot now.” Reassurance also subconsciously tells the child that vomiting really is dangerous.

So if the child asks “will I be sick?” answer honestly: “I don’t know.” Shrug it off like it’s nothing. If you’ve been offering reassurance up until now, the child is going to freak out. That’s ok. Their freak-out won’t last forever. Remain calm – don’t get angry – just explain to them that nobody knows when somebody else will throw up, and besides it won’t hurt you – it’s just yucky and nobody likes it. Be completely nonchalant like it’s not a big deal (because it isn’t)!

I can’t possibly write everything you need to know about kids and emetophobia in one blog, so I’ll try to hit the highlights and give you a few tips to save your sanity. First of all, the best thing you can do is to order the Turnaround Anxiety Program (associate link) along with the Emetophobia Supplement of which I am an editor. It’s written by Chris McCarthy and my good friend and writing partner Dr. David Russ. David and I are busy writing a book to help therapists treat emetophobia. Anyway, check it out!

Very young kids are naturally afraid of vomiting. Unless they’ve been vomiting steadily since a baby, they may not experience it again until they’re two or three at which time they must wonder what the hell is wrong with the universe that this can happen! Parents normally comfort them and tell them that they’ll be ok. They teach them to vomit in the toilet or in a bowl/bin/bucket (the three B’s of not-on-the-carpet). If nothing else happens in that child’s life they may just forget about it, or tell you the next time how much they hate it. However, if there’s any kind of stressor (even a “good” stressor like a new baby or a new room/house) then they can start to channel all their anxiety in vomiting’s direction. You may not be able to identify the stressor but that’s ok because the treatment is the same anyway.

Reassurance-seeking can be tricky. They may ask “is it ok to eat this?” “do you think I’ll have a good day today” or “do I look pale to you?” and other such sneaky questions. Be suspicious of all questions. If repetitive questions are asked, explain to the child that you will answer any question only once. Use the Perry Mason, “asked and answered!” if you have to.

Without reassurance from parents (and clue in the teachers as well), the child will need some strategies to calm themselves down. You’ll find these in the Turnaround Anxiety Program, but briefly they will be such things as breathing more slowly, relaxing your body, art, music, or busying oneself with playing or schoolwork.

One final tip I have is the use of the “Get Out Of Jail Free Cards.” Except not about jail. Let’s take the example of a child missing a lot of school because of emetophobia or always feeling unwell/stomach aches. Decide what’s an acceptable amount of school to miss for an anxious child. Let’s say it’s 4 days per month. So make up 3 cards that say “Get out of school free.” Give them to the child and let THEM decide (no negotiating by you) when to use the cards. If they need to miss school they give you a card and you allow them to stay home, no questions asked (NO questions asked!). I had one client that was afraid to take the school bus so she got 3 “Get a ride to school with mom” cards. Another young boy asked his parents and teacher several times PER HOUR to feel his forehead to see if he felt hot. He got 5 “feel my forehead” cards for the month. In each of these cases both their parents and I were amazed at how well this strategy worked. Before using a card, the child had to decide for themselves if it were worth it to “waste” a card that day. Maybe they didn’t feel so bad after all. Maybe they could make it all day. Maybe they could feel their own forehead. In short, the child learns to solve their own problems and comfort themselves.

As a final word, I want to point out something that may be obvious to most of you: when a child has problems, you must address them in priority order. First, is the child actually sick or in pain? They must be taken to a doctor and be checked out that there’s nothing physically wrong with them. Don’t diagnose anxiety right off the bat. Are they eating? Losing weight? This is a medical emergency. Are they sleeping properly and for long enough? If not, this needs to be addressed, even with medication. Lack of sleep is serious. Are they going to school every day? If not, you must address this with their teachers and perhaps look at alternatives for their education, at least until their anxiety is under control. Are you seeking professional help for them for their phobia/anxiety? You must – anxiety disorders are not something a child just “outgrows” – they need help in coping with it. Finally, are they socializing with other kids such as playing sports, music, dance, or just hanging out with them? This is important for children. Hopefully, you find good therapeutic help for them to lessen their anxiety so that they can participate in life again, and enjoy their childhood.

an emetophobia thanksgiving

Today is Thanksgiving Day in America. As I’m Canadian I can only reflect back to our Thanksgiving which was in early October. It’s not as big of a holiday here. Family don’t fly home for it – we save that for Christmas, and we don’t have a history involving pilgrims or our First Nations people. It’s scheduled at the time of the traditional harvest. But interestingly, we have the same food! The turkey, the pumpkin pie, the green bean casserole, even sweet potato puree with those little marshmallows toasted around it. And of course, we also give thanks. At our house we do the go-around-the-table-stating-what-you’re-thankful-for thing. With three children, three of their spouses and seven grandkids it takes a bit longer now. Every once in a while someone says something not so typical and we go “oh…ahhh.”

Today I’m thinking of my beautiful clients, present and past. I thank God that because of them I have meaning in my life, and a great passion, and with my husband’s illness and Covid and him being retirement age, I have an income which pays our bills. I am also able to live out my calling, which, corny as it sounds, is “to help people.” I will never forget the feeling of having emetophobia when I was young, and not only could I not get help for myself but how helpless it felt that there just wasn’t anyone who could help anybody with it. In 1983 I was privileged to be part of Dr. Claire Phillipps’ original emetophobia study and group treatment program. She published her findings around 1985, one of the first in the world to publish about emetophobia (we didn’t even know the word “emetophobia” at the time). When I started working as a therapist in 2010, treating exclusively emetophobia on Skype (another word nobody knew at the time), I could find only about ten research articles on the phobia, and just one other psychotherapist who was treating it – Dr. David Veale in London, UK. He is a psychiatrist and has now become an emetophobia researcher force to be reckoned with. Many of the studies published today (still only about 60) have his name in the group at the top. I thank God for him. Perhaps if he is a religious man, he might thank God for me as he points people and therapists to this website all the time.

Enough about me, though. How about the people still suffering with emetophobia? We’re told not to gather this year, no thanks to Covid-19, and if your family decided to honour that guideline, then perhaps as an emetophobic you’re pretty happy. All those people, especially the germy little kids, amIrite? And the food! Heavy, greasy gravy, sweet desserts never mind the sheer volume of it. I’m sure there are people with emetophobia reading this who are nodding their heads and heaving a sigh of relief (dare I say, thanksgiving?) that it’s not happening.

Yes, it’s 2020, the year of the global helldemic. Sickness, death, isolation, job loss, George Floyd (and so many others), conspiracy theories, economic disaster, civil unrest in the streets, Trump losing/winning/stealing/being robbed of the election. But there’s the vaccine! Unless you’re suspicious of vaccines, that is indeed something to be thankful for. Kamala Harris – someone who represents something, that about half the country is thankful for. As someone with emetophobia, can you even think on these things, or does the phobia grip the very life out of you, day after day after day?

The poet and all-around amazing human being, Maya Angelou, once said “[in a time of crisis] first, thank God.” I remember hearing her say it on Oprah early in 1996. I nodded and smiled and thought it was so wise and wonderful. At our church we met in small groups every week and we decided to start each group time with this phrase “First, thank God…” Then I got cancer. It was diagnosed on a Thursday and I was leading a small group that night. I didn’t think of it until I was driving there. I could not think of a single thing at the time to be thankful for. I had young children; I was only 37.

At the group I cried as I stumbled through the opening. A young woman, new to the faith, timidly offered up “I’m thankful you live in Canada.” Yes, of course. We have some of the best cancer treatment in the world here, and it’s all free. This opened a pandora’s box of thanksgivings. My family. My children. My job. My faith. Today I can certainly offer up thanksgiving that I’m still alive and healthy 24 years later.

If you are so inclined, what can you thank God for today? Allow me to make it a bit more challenging: apart from your partner, your children, your family, your health care, your job (house, car). What are you thankful for apart from these things? Think on it long and hard. After all, you’ve got lots of time that would normally be spent arguing with your drunk uncle who’s either 1) a Trump supporter, or 2) a flaming liberal snowflake.

Why can’t I burp?

Inability to burp is a medical condition known as retrograde cricopharyngeus dysfunction (R-CPD). According to one of my clients who suffers with this condition, many folks with R-CPD are also emetophobic. I’m not sure what the connection is, but I can well imagine how uncomfortable it makes you feel to have trapped gas in your stomach, bloating and painful gas in your colon. Never mind that your incidence of flatulence (farting) would be much higher than the average person.

People with R-CPD have a type of deformity in their upper esophageal sphincter, which cannot relax so as to release the air bubbles. When we eat or drink, that sphincter muscle relaxes for a second. It’s also supposed to relax in order to burp.

Every once in a while I’ve felt like I can’t burp when I need to, and it’s not a nice feeling at all. Sometimes it can even be painful. For those of you with children, remember the lengths we would go to in order for our newborn to burp after feeding for a few minutes? Patting or rubbing (or downright pounding on) the back, sitting baby up, laying him down then sitting him up, putting her over our knee on her stomach and on and on it goes. If you don’t get the burp up, you’ll pay for it a few hours later (well, technically the baby will pay for it with extreme discomfort, but you’re the one enduring hours of screaming).

Some people with R-CPD experience nausea, hypersalivation, really bad hiccups, difficulty breathing and excessive flatulence. Much like emetophobia, people with R-CPD are often misdiagnosed as having IBS or acid reflux, but the treatments for these don’t help. If you think that you’re actually suffering from R-CPD, you need to get a formal diagnosis from a gastroenterologist. The best way to do this is to have the doctor look down your throat (esophagoscopy) or do a swallow study.

Once diagnosed, there is a treatment that can help. Botox is injected into the sphincter muscle which weakens it for a few months. This may eliminate the problem or at least make it much better. After this treatment, you can burp and keep practicing burping so that when the Botox wears off you’re still able to do it. Some people with less severe R-CPD can learn to burp without the Botox and after a lot of practice they can do it well enough to eliminate the problem.

Emetophobics with R-CPD will feel much relief once they receive treatment. Burping will help diminish their feelings of nausea and bloating which can be very triggering of anxiety.

For more information, visit https://laryngopedia.com/

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