- Level 1 – Words
- Level 2 – Sentences and Paragraphs
- Level 3 – Silly Cartoons and Pics of Food
- Level 4 – Drawings and Cartoon Characters
- Level 5 – CGIs, Sketches, Graphic Comics
- Level 6 – Nauseous people
- Level 7 – People around toilets
- Level 8 – People after vomiting
- Level 9 – Pictures of people vomiting
- Level 10 – Videos
- Level 11 – Sounds
- LEVEL 12 – Smell
- Level 13 – Practice Cleaning Up
- Level 14 – Interoceptive Exposure
Level 1 – Words
Level 2 – Sentences and Paragraphs
Level 3 – Silly Cartoons and Pics of Food
Level 4 – Drawings and Cartoon Characters
Level 5 – CGIs, Sketches, Graphic Comics
Level 6 – Nauseous people
At this point, clients with children should work on Level 6 in the Kids’ Exposure Resource page – pictures of nauseous kids.
Level 7 – People around toilets
Level 8 – People after vomiting
At this point, clients may work on Level 7 in the Kids’ Exposure Resource page – pictures of just vomit.
Level 9 – Pictures of people vomiting
Level 10 – Videos
Videos begin again with very easy, such as a car engine “vomiting” oil it doesn’t like, baby spit-up, etc. If watching and listening to these is too difficult, try watching with the sound off the first time.
(This funny one is a “graduation video” for you!) Family Guy – when they drink Ipecac
Click on the link, above, “LEVEL 11 – SOUNDS” which takes you to a page with 88 different vomiting sounds. Clients can peruse through the descriptions, or randomly click on a few to see how they manage their anxiety
LEVEL 12 – Smell
Click here to order a bottle of butyric acid for $9 from Amazon.com. This acid gives vomit its particular smell. I encourage clients to add it to a can of vegetable soup or anything they remember as having vomited as a kid. One of my clients remembers a dinner with steak and green beans, so she mixed some of that up in a blender and added the butyric acid.
This link won’t work for international clients, but try finding some locally or ask your high school science teacher to order it for you. That’s where I got mine.
Level 13 – Practice Cleaning Up
A lot of my clients seem to believe that if a child vomits in their bed, or anyone vomits in their house then it’s a huge catastrophic event akin to the zombie apocalypse. To reduce this catastrophizing tendency, I’ve had clients mix up some “vomit” according to the recipe in level 11, and pour it all over a kids bed, then practice cleaning it up, washing the laundry, etc. I’ve had other clients brainstorm what they would do if someone vomited on their carpet or furniture and if they’re willing to do the same thing, it can be really helpful.
Level 14 – Interoceptive Exposure
This level will probably be the most difficult for any client. Many never agree to even try it, which is fine – what they do in therapy is always up to them. Will any of these things make someone vomit? The truth is, nobody knows! Here are a few ideas:
- spin around in an office chair to make yourself dizzy and nauseous
- Run on a treadmill after a large meal until you’re nauseous
- After a large meal, stand in a room and spin around until you’re very dizzy
- put a toothbrush or spoon handle far back in your throat until you gag
- put some oatmeal in your mouth, or any food at all and spit it into the toilet. Pretend you’re vomiting. Try it with different foods.
- try any of the above when you’re already not feeling well