Category: Features of Emetophobia

Anna S. ChristieLeave a comment

Safety Behaviours

Do Safety Behaviours Work?

Along with avoidance of the feared stimulus (nausea, someone else saying they feel or were sick, seeing something associated with vomiting), a safety behaviour is something that you actively do to avoid vomiting at all costs. Some examples of typical safety behaviours are:

  • Sucking on mints
  • Taking ginger (candies, tablets, tea)
  • Drinking ginger ale or another fizzy drink
  • Sipping water
  • Chewing gum
  • Sniffing peppermint or eucalyptus essential oils
  • Taking an OTC stomach medication such as Gravol (Dramamine), Pepto Bismal, Divol, Tums,
  • Taking a prescription anti-emetic such as Ondansetron (Zophran)
  • Taking a prescribed “Rescue Medication” tranquilizer such as Xanax, Ativan
  • Taking prescribed stomach medications such as Omeprazole
  • Carrying a plastic bag in your purse or pocket at all times
  • Carrying a “safety kit” with any of the above items with you at all times
  • Wearing a face mask before Covid-19
  • Washing hands, changing clothes, showering
  • Opening doors or pressing buttons with your sleeve
  • Checking “best by” dates on food
  • Drinking alcohol, smoking marijuana, taking illegal drugs
  • Asking someone for reassurance, when you know what they’ll say every time
  • Practicing large muscle relaxation and/or slow breathing not to calm down, but so you won’t vomit
  • Needing to be with or talk to a “support” person when anxious/nauseous.

How many of these can you relate to? Are they helpful or do they work? Well, what if I told you that they most certainly don’t work and that you should really try to slowly give every one of them up? I imagine that might make you very anxious. Without working with a therapist, it might be difficult to give these up on your own. It is the same with avoidance behaviours – stopping them is really difficult without some sort of professional help. Nevertheless, there are determined people out there who are reading this right now who can do it if they try!

So, do safety behaviours work? The answer is yes and no. Yes, they make you feel better in the moment. They calm you down. Some of them most certainly prevent vomiting although the odds of you vomiting without them are pretty slim anyway. But no, they don’t work to lessen your anxiety and in fact most of them will make your anxiety worse over time. So the more you use these behaviours the worse your phobia will get. Let’s look at why that is.

Engaging a safety behaviour presupposes the wrong thing: that the problem is vomiting. I’m sure it will surprise many of you to hear that vomiting is not the problem. Vomiting is normal, natural and neutral. It isn’t dangerous or harmful. It can’t hurt you, so there’s no need to avoid it or fear it. (I know that’s not what you actually think right now; I’m just pointing out the logic.) The problem is anxiety. Your anxiety around vomiting is what’s not normal. It’s way out of whack for what vomiting is – just a yukky, unpleasant thing that nobody likes. There are many of these things in the world: diarrhea, Pap tests, proctology exams, colonoscopies, doing your income tax, picking up dog poop, flossing your teeth. None of these is dangerous or harmful, but if the universe could eliminate any one of them we’d all be happy about it.

Anxiety/fear/terror should be reserved for dangerous things like alligators, grizzly bears, home invasions and nests of gigantic furry venomous spiders. It doesn’t have any place in the normal yet yukky things of life. Your emetophobic brain has somehow mixed up vomiting with all the other deadly things you need to be terrified of. So you avoid it at all costs and then come up with these safety behaviours to keep you “safe.” The thing is, you ARE safe, whether you vomit or not! But I know it doesn’t feel that way.

The road to recovery is long and hard with emetophobia. One important part of the journey, however, is slowly giving up your safety behaviours so your brain comes to realize that you’re just as safe without them as with them. You also need to slowly stop avoiding the things you’ve been avoiding. Either with a therapist or on your own, you also need to slowly change your thoughts from the catastrophic “OMG vomiting is horrible/terrible/awful/the worst thing ever” to something more normal such as what your non-emetophobic friends think about it (ask them, write down what they say, memorize it, replace your catastrophic thoughts with these thoughts every time you think them.) It will take time, but eventually it will work.

Once you come to realize that anxiety is your real problem, you can focus your energy on working on that, instead of on preventing vomiting. This will make your phobia better, which is really what you want.

There is a ton of information on this website that will help both you and your therapist get your anxiety under control!

Anna S. Christie4 Comments

Emetophobia and Control

One of the things that I absolutely hated being called, ever, was a “control freak.” For one thing, if I were such a thing (and I don’t think I am) why does it have to have the word “freak” in the expression? Who likes to be called a freak? If someone is insistent on being in control, that does not necessarily make them a freak, a weirdo, an oddball or, as my mother used to say in 1950 “a queer duck.” People who are very disciplined, or very careful, or very responsible, or even very manipulative, authoritarian, or natural leaders are not all known as freaks. So ya. I hate that expression.

I think it is because I hate the expression “control freak” that I have done a lot of thinking over the years about emetophobia and control. The infamous Dr. Phil believes that all phobias, and most other anxiety disorders are about control. Don’t get me wrong, I kind of like Dr. Phil. He sure sees things clearly, which can be helpful, even though I don’t think anyone would want him for their therapist and he pretty much agrees with that. I don’t, however, think he’s right about everything and I definitely don’t think he’s right about this.

Many of my emetophobic clients talk to me about control. They don’t like the fact that vomiting seems to be out of their control. And furthermore, it’s a bodily function that’s out of their control. I point out to them that most bodily functions are out of their control: breathing, heart beating, blood circulation and oxygenation, digestion, urination and defecation. Sure you can hold your urine, your feces or your breath for a time but not forever. At some point, your body would take over and you would not be able to control it.

You can also control vomiting to a certain extent as well. I remember reading an article many years ago by Dr. David Veale, the world’s leading researcher on emetophobia (or as he likes to refer to it, “SPOV” or Specific Phobia of Vomiting.) He believed at the time that there was absolutely nothing that you could do to stop you from vomiting, so there was no point in any safety behaviours such as hand sanitizers, avoiding sick people, taking mints, ginger or over-the-counter (OTC) medications. After doing part of a research study some years later he discovered that people with emetophobia do indeed vomit less than the general population. So we do have some control over it, although if you get sick enough or poisoned enough you will vomit, no matter what you try to do to prevent it.

People who are often labelled as control freaks, in my opinion, are just people who want things under control. They don’t want the whole situation to be chaotic, out-of-control, crazy. Sometimes situations do get that way, and so people who have natural leadership qualities tend to take charge to get things under control. Many people labelled control freaks are quite happy to sit back if someone else who is a responsible leader is the one getting things under control. If they jump in and take charge regardless, I believe that they’re just scared. If you’re all on a raft heading down the river to Niagara Falls and the leader is not coaching everyone to row to shore, then you’re going to freak out and take over the lead.

The thing is, sometimes you just think you’re headed for Niagara Falls and you’re terrified so you take over when you don’t need to. We phobics can be like that sometimes. But don’t let anyone tell you that you’re a freak.

Anna S. Christie1 Comment

Sex and emetophobia

It wasn’t until a client once asked me if it were ok to talk about sex that I started to think about sex and emetophobia. I reassured them that they can talk to me about absolutely anything. One might think that we 60-something grandmas don’t know much about the subject except for the missionary position in a long flannel nightie, but let me revamp our image for you: we went to college in the 70s. THE SEVENTIES. All the girls were on birth control pills, and there wasn’t any disease you could catch from a partner except gonorrhoea, which if you were so unfortunate, could be cleared up with one dose of penicillin. The good old days before herpes and HIV. Imagine it.

My first counselling gig was at the University of Waterloo “Peer Counselling Centre” in 1976. With some good, solid training, we volunteered a few hours a week talking to our peers about sex, birth control, abortion, being gay, being born in the wrong gender. Yes, 44 YEARS later we’re still talking about that.

But I digress. Emetophobics actually have a few things to worry about when it comes to sex, especially with some of the latest activities that many couples enjoy. What’s worse is that they’re often afraid to share these fears with their sexual partner.

I’ll try to be crystal clear, so you may want to read this blog in private.

Oral sex

Oral sex can present a problem to either male or female emetophobes. For the (straight) female or gay male the possibility of gagging on either the penis or the ejaculate can be terrifying. Men can become equally terrified of their partner gagging and even vomiting during oral sex. There are some emetophobic queer women who are quite reluctant to perform oral sex on another woman.

anal sex

Considering that Norovirus particles are contained in fecal matter, anal sex can be daunting whether one is the giver or the receiver. The problem is that the penis (or sex toy) is removed, theoretically contaminated. And then what do you/they do with it? We all know it’s not getting near your mouth anytime this century. But does he know that?

anilingus

Yep. I had to look that one up. Thanks to a comedy routine by Chris Rock, I heard it was called “tossing his salad.” Apparently there are a plethora of other terms. Suffice it to say that your average emetophobic would not be caught dead doing this one, which involves your tongue and your partner’s anus.

anal-digital stimulation

What’s he going to do with that hand now?

the solution

This may seem ridiculously simple, but you have to talk to your partner about the kind of things you like to do, and what you feel uncomfortable with. If you’re afraid to do just about everything, and your partner really wants to be adventurous then perhaps they aren’t the right partner for you. But if you’re already married to them, then there needs to be some give and take. Explain what frightens you. It’s easy enough for him not to push his penis too far into your mouth, and to let you know when he’s about to ejaculate. If they want anal sex, you might have to negotiate a shower afterward before doing anything else. You get the idea. Talk. If you can’t talk to someone with whom you’ve taken off all your clothes, then who can you talk to?

The other, perhaps more obvious solution, is to get treatment for your emetophobia. It really is treatable, and you don’t need to be afraid of the many things in life that non-emetophobics enjoy forever.

Best of luck, and remember that you can discuss anything with your therapist if need be.