Often before people with a fear of vomiting can get help they are left alone, terrified and feeling hopeless. They might not even know that being afraid of vomiting has a name: emetophobia. Some academics refer to it as “Specific Phobia of Vomiting” or SPOV. The treatment for emetophobia involves making a list of all the things that you avoid because you’re afraid, and all the safety measures you employ so you don’t get sick. This website has a “Resources” section that thousands of therapists already use for gradual exposure to some of those things. You start with the easiest thing on the list and work your way to the most difficult. You’ll normally need the help of a qualified therapist with experience treating emetophobia.
The goal in treating emetophobia is to have you come to the realization that vomiting isn’t the problem – anxiety is the problem. Once you get there, you’ll be able to tolerate your anxiety and do nothing to stop it. And once that happens, you will stop getting anxious in the first place. For some of you reading this, that may seem like a long way off. Others of you may think (as I once did) “I’ll never be able to tolerate that much anxiety! It’s terrifying and horrible!” It’s true that tolerating anxiety that goes immediately from 0/10 to 8, 9, or 10/10 is probably not possible. If it’s a slow rise, however, you may be able to avert it from getting to those high numbers, but if you’re like I was, it was usually zero to 10 in a millesecond.
So I came up with a plan that I call the S.T.A.R. Plan©. My S.T.A.R. Plan was inspired by the writers of “Coping Cat” and “The Cat Project” who came up with a “F.E.A.R.” plan for anxious children. It wasn’t quite right for emetophobia, but I loved the idea of a plan.
If you find yourself in a situation that triggers your emetophobia, it’s always good to have a plan. If you’re anything like I once was, your plan would be to get triggered, freak out and run. If you are triggered by your own nausea, however, it’s impossible to run, so you apply safety behaviours like asking for reassurance online or at home, or taking some stomach medication. This may help calm you down in the short-term, but as far as helping to treat your emetophobia for good, ass Dr. Phil might say, “How’s that workin’ for ya?”
S stands for “Scale” which refers to the 11-point scale that therapists use to determine how anxious you are. Zero means no anxiety at all, and 10 is the worst panic possible. When your emetophobia gets triggered, your anxiety will go up to one of the numbers on the scale. If you want to get better, it’s important for you to know what number you’re at. Sometimes you may become so anxious that you forget the S.T.A.R. plan, so it’s good to have a support person remind you by asking “what number are you at?”
T stands for “Tolerate.” The best way to get over a phobia is to stay in the situation and tolerate the anxiety without doing anything or thinking anything to make it go away. Different people are able to tolerate different levels (0-10) of anxiety. Your ability to tolerate the anxiety may also be dependent upon how quickly the number went up. If you can tolerate it, great. If not – move on to the “A.”
A stands for “Action.” If you can’t tolerate the anxiety, you can ask yourself “what actions could I take to bring down my anxiety?” These actions require learning and practice, which is the topic of another blog, but basically here are four actions that should help (They spell “BRIT”):
- Breathe slowly and deeply. Slow is more important than deep.
- Relax the major muscle groups in your body, head to toe. Relax your body. Try doubling your relaxation, then doubling again.
- Imagine yourself in a safe, peaceful place if you can.
- Think. I teach my clients to come up with a “mantra” of sorts to say to themselves. Mine was “You’re not in any danger,” but there are many more that my clients have come up with over the years. My favourite is “Vomiting is not dangerous or harmful. It can’t hurt me, so I don’t need to be afraid of it.”
R stands for “Repeat.” So all you have to do is go back to the beginning (the “S”) and ask yourself what number on the Scale of 0-10 are you at now? Most of the time you’ll find that your anxiety has gone down a point or two. So maybe you can Tolerate it now. If not, keep going through the S.T.A.R. plan until your anxiety is low enough to tolerate. Good luck!