Most of us, getting sick—yes, that kind of sick— from time-to-time is
something that we accept and try to not think about any more than we absolutely have to. In fact, please allow me to apologise in advance for bringing up the subject if it wasn’t already on your mind! For millions (yes, millions it’s the 5th biggest phobia in the UK), getting sick is something that is glued to their minds 24-7. The slightest twinge in the stomach, or even just the mere mention of the word vomit or any of its equally noxious synonyms, can send vomit phobia sufferers into a panic spiral—What is that hot feeling in my throat? Is it a sign? Am I going to get sick? What if it happens now? Did that guy just cough or was he actually gagging? What if he’s sick?! Should I eat that? What if it makes me sick?
The fear of vomiting (fear of being sick, or emetophobia, afflicts millions; it is in fact the most common fear among the children I see in my anxiety disorders practice. Many adults come to treatment for that fear as well. They come to treatment because their life has come to a screeching halt—kids refuse to go to school, take the bus, or go to friend’s houses for fear that they (or someone else) will suddenly throw up and they’ll be left to cope on their own. Adults imagine terrible scenarios as well and may stop eating at restaurants, going out on dates, driving, or doing public speaking all because of the fear of the surprise sickness attack (which, by the way, never materialises).
None of us would like to get sick, and getting sick far from home even less so, but picturing it vividly and preparing for it daily doesn’t change the stats. It’s still as rare and unlikely for people with this fear as it is for any one else. Worry won’t prevent us from getting sick (our body is already programmed to do an excellent job of that all by itself) but it will stress us out and make us feel as if we are taking a huge risk by simply going about our normal business as others do every day.
So are emetophobics any more likely than the rest of us to actually be sick? You may think so but amazingly they tend to be the least sicky people on the planet! So overly controlling is their reaction to thinking about being sick leads them to be very careful of their environment and what they touch and you can bet your bottom dollar that the last time they were actually sick was a very long time ago (sometimes, if ever). But this doesn’t mean they don’t feel sick. If you worry about something every hour of every day, you are bound to feel uneasy, be hypervigilant, over react.
So how do they (bright, intelligent and kind people) manage to maintain such a distorted fear?
The power of suggestion.
Think about “throwing up” or “vomit” a few times, and you will notice your anxiety level jump slightly; think about it a few more times with the a “what if I?!?” statement and not only will your anxiety rise, you may even start to feel nauseous. This is what is called the power of suggestion. Just like thinking about falling in a bed of nettles or the walk home after having your hair cut will make you feel itchy even though you haven’t done either. Thinking about anything for hours on end and your stomach will feel tight, queasy and on the edge of your seat anxious; but it can’t make you sick! Your reaction to your (unreliable) thoughts is cause of your worry and subsequent discomfort. So even though sufferers may experience chronic digestive uneasiness and believe that unless they are vigilant, for example, checking their temperature, focusing on every sensation, gastric blips, avoiding people who “look sick,” avoiding the one food they ate the time they threw up 10 years ago, that throwing up is perpetually imminent the reality is it is their now ingrained reaction is a temporary emotional reaction to an unpleasant thought, it’s not in any way a prelude to being sick. More on that in a second…
The issue is not being sick but the disabling effect of the anticipation of being sick – the constant worry and ceaseless effects of continual avoidance behaviours leaves sufferers unable to break the cycle and hold on to perspective long enough to give themselves a break.
So how can sufferers of emetophobia overcome their fears? Not by stopping the thoughts (there’s no “off” switch that does that directly) but rather by changing their thoughts and reaction to their thoughts when the thoughts come along. Why should they under-react to vomit thoughts? Because it is worry, not being sick that is the problem! By realizing that the thought has no real connection to that moment—that nothing is actually wrong in their body (it’s all anticipation). Nothing is happening now, their body is fine— then they can train the brain to filter these thoughts out and not bother sending them.
It’s the thinking styles and obsessive worry thoughts that keep emetophobes locked in their self protective avoidance behaviours. Add in a little catastrophising and you have a perfect storm. If you change your reaction to having the thoughts, then it follows fairly logically that your behaviour and reactions will change alongside.
The solution is to learn what you are doing to create and maintain the phobia and, in essence, test these beliefs out. Do not trust the thoughts that tell you that you have to avoid eating out, test the thoughts that tell you that touching that shopping trolley handle bar will require hand sanitiser. Another factor is not to run away from the thoughts and find comfort. Acknowledge you are feeling worried and rather than reassuring, taking your temperature or avoid events, lean in to the feelings and say, “I know you’re feeling worried right now but I have a better way to deal with myself now I understand more about why I’m anxious. I can do this and it’s not going to make me sick. Only I can do that.”
Worrying about getting sick doesn’t change what happens, but it immediately changes our ability to enjoy and focus on what is actually happening in our lives. Don’t let your thinking cloud your perspective on life and stop you from living the life you want to in the way you want to live it. I have many emetophobes in the clinic and each one is learning a new way to manage their thinking on a relatively short time. Each one of them was fed up with themselves before they arrived and each one of them can see a little hope for the future with every session of Cure Your Emetophobia and Thrive.
Get in touch and beat this!