What Causes Emetophobia?

This post has been moved from my previous website.

Like any other phobia or anxiety disorder, the exact cause is unknown. Why do some people develop a phobia of dogs after being bitten by a dog as a child, but others do not? Some folks remember a traumatic incident involving vomiting when they were young. Perhaps they were vomited on, or they vomited in school and were embarassed. Yet this happens to many children and not all develop phobias. So although scholars do not know the exact cause, there are many things they do know.

  1. Phobics have a genetic predisposition to anxiety. Probably your mother, father, or one of your grandparents was an anxious person. It may be an aunt or uncle. Whoever it is, it’s in your family. That person may have been able to hide it, but it will be there. Genetics (nature) only accounts for about half of the cause, however. The other half is experience (nurture).
  2. Most emetophobics that I have spoken with online (thousands) or worked with as my own clients (over one hundred) had something happen to them in childhood that disrupted the normal resolving of attachment with their mothers. When I say “resolving” I mean that as babies we have a very close attachment to our moms, however with the passage of time this naturally resolves and we begin to trust the world, other people, and can manage on our own (“independence”/”interdependence”). The disruption of the attachment resolve does not need to be dramatic, however it certainly can be: death, abuse, neglect, abandonment (trauma). It can be something quite minor: mom returns to work, mom is in hospital having another baby, mom is concerned with her ailing parent. It can also be a trauma or attachment event that happens before you were old enough to remember. Adoption is a one example. 
  3. Regardless of your genetics or your childhood experience, there are three major factors that turn these into a phobia, and keep the phobia going: 

I believe that one of the reasons that the fear of vomiting presents as so severe in most cases is that we naturally “avoid” vomiting throughout our lives. It just doesn’t happen that often. Young children vomit more often as their gut has not yet fully developed. But by about 13 your gut is an “adult” and you may only vomit once every 10 or 20 years. This kind of avoidance cannot be helped, so the factors of safety behaviours and anxious thoughts are  much more prevalent in keeping emetophobia going or getting worse. There are two types of safety behaviours, and there is disagreement among scholars as to whether both are problematic for emetophobia or just the first one:

  1. SAFETY BEHAVIOURS TO AVOID VOMITING
  2. SAFETY BEHAVIOURS TO AVOID PANIC (CALMING DOWN)

Let me begin by saying that I only believe that safety behaviours which avoid vomiting (germs, norovirus) are problematic, and behaviours to avoid panic and calm down such as slow breathing, muscle relaxation, etc. are a big part of the way out. 

Some common examples of emetophobia safety behaviours are:

  1. ​OTC medications (Dramamine/Gravol, Pepto Bismal, Tums)
  2. Prescription medications (Zofran/Ondansetron, Ativan, Xanax)
  3. Ginger, gingerale, ginger tea
  4. Mints, gum
  5. Sipping water
  6. Excessive cleaning (bleach)
  7. Excessive hand-washing or using hand sanitizer
  8. Not touching doorknobs, light switches, gas pumps
  9. Not touching your face
  10. Running away/avoiding sick people

There can be any number of others. The problem is that as soon as you employ a safety behaviour and don’t vomit, your brain will assume that the safety behaviour “saved you” and the situation was actually a dangerous one that you avoided this time. In reality, the situation wasn’t dangerous at all, because vomiting isn’t dangerous. Nobody likes it, but it’s actually helpful to you as opposed to a danger to you.

SLOW, DEEP BREATHING, relaxing large muscle groups, meditation, or imagining yourself going through a situation like a “normal” person are behaviours used to calm oneself and I do not consider them safety behaviours. Some schools of thought disagree with me, but I’m not alone in this idea. Learning to truly relax in the face of what I once considered was danger, was the way I got over my phobia.

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AnnaSChristie

B.A., M.Div., RCC (Registered Clinical Counsellor) I specialize in the treatment of emetophobia.