Most people don’t enjoy vomiting, but don’t think about it much—unless they’re dealing with a stomach bug. However, some people experience an intense fear of throwing up. If you have this fear, you might panic when you see someone who is sick, hear others talk about vomiting, or even think about it. Fear of throwing up can trigger overwhelming anxiety, and is often referred to as emetophobia.
In some cases, the fear of throwing up can be linked to a specific phobia—which is an intense, persistent, and irrational fear of an object or situation. In other cases, it may be a symptom of obsessive-compulsive disorder (OCD), where fear of vomiting may be part of a larger pattern of obsessions and compulsions.
Fortunately, exposure and response prevention (ERP) therapy can treat both phobias and OCD. Read on to learn more about causes of emetophobia and how treatment works.
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What is emetophobia?
Emetophobia is one type of specific phobia—intense, persistent, and irrational fears of an object or situation. Some research on the prevalence of emetophobia suggests that it’s rare, affecting about .02% of the population. However, an estimated 12.5% of U.S. adults will experience a specific phobia at some point in their lives.
If you have emetophobia, you may fear being unable to stop throwing up, or needing to vomit in public without access to a bathroom.
“Emetophobia can be completely debilitating and miserable,” says Tracie Zinman-Ibrahim, LMFT, CST. Constant worry about vomiting can interfere with personal relationships, work, and everyday activities—leading to significant distress and avoidance of certain foods, locations, or social situations where vomiting could potentially happen. It’s also common for people with emetophobia to feel ashamed of their fear.
In some cases, emetophobia can also lead to physical symptoms like nausea, dizziness, or panic attacks.
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Signs of emetophobia
If you’re dealing with a fear of throwing up, you may find that you’ve developed one or more of the following behaviors:
- Avoiding foods that you think will make you feel nauseous, overly full, or cause an upset stomach.
- Avoiding eating or drinking things that you’ve associated with vomiting in the past, such as alcohol.
- Always needing to know where the nearest bathroom is.
- Taking antacids even if you don’t have an upset stomach.
- Avoiding taking any medication that has a side effect of nausea.
- Avoiding getting pregnant out of fear of morning sickness.
- Inspecting every single thing you eat to make sure it doesn’t have mold on it, or hasn’t expired.
- Avoiding surfaces that could have germs on them, like door handles or toilet seats, out of fear that you could catch a stomach bug.
- Washing your hands excessively, to avoid germs that could cause a stomach bug.
- Avoiding hospitals or the doctor’s office, where there’s a possibility of seeing or hearing someone vomiting.
What causes emetophobia?
While emetophobia can develop spontaneously, research suggests it most often occurs after a prior experience with vomiting that was distressing or traumatizing. This could include a particularly severe episode of illness, witnessing someone else vomit in an upsetting situation, or even hearing graphic details about vomiting.
Specific phobias like emetophobia fall under the category of anxiety disorders—but these fears can also sometimes be related to obsessive-compulsive disorder (OCD). Read on to learn more about these distinct mental health conditions, how they relate, and how you can learn to manage them.
Specific phobias
Specific phobias are a type of anxiety disorder, which are mental health conditions characterized by excessive fear or worry that can interfere with your day-to-day life. These conditions involve intense and persistent anxiety related to specific situations, objects or activities, and can center on anything from heights, to animals, needles, and more. While not all phobias require treatment, the term “specific phobia” refers to intense fears about specific objects, situations, or activities that impair daily functioning.
In the case of emetophobia, the phobic trigger is vomiting, or situations where vomiting could occur. Avoidant behaviors are a hallmark of specific phobias, as people will go to great lengths to prevent encountering the feared stimulus, making it more difficult to break the cycle of anxiety.
Obsessive-compulsive disorder (OCD)
People with OCD may also have a fear of vomiting, but OCD symptoms often go beyond this. If you experience OCD, you deal with obsessions—recurrent and intrusive thoughts, feelings, urges, images, and sensations that cause anxiety. In response, you perform compulsions, which are repetitive behaviors or mental acts that are done to alleviate that distress.
For someone with OCD, obsessions can center around all kinds of fears including contamination, death, harm, and loss of control. Fear of vomiting might become an OCD obsession, leading to compulsions like checking for sickness, excessive handwashing, or compulsive avoidance.
Fear of throwing up can be related to a couple of different subtypes of OCD. Contamination OCD, for example, is rooted in a fear of germs and contamination, and can extend to fears of illness. Health concern OCD is characterized by health anxieties. Both of these forms of OCD might lead to an intense fear of vomiting.
Phobia vs. OCD
Just because you’re afraid of throwing up—or dealing with another phobia—doesn’t necessarily mean that you have OCD. While both phobias and OCD can involve intense anxiety and avoidance behaviors, they are distinct diagnoses (though they can occur together). Let’s take a look at how they differ:
- A person with a specific phobia has an irrational fear of a specific object, situation, or activity, such as vomiting. As a result, they avoid situations where this could occur.
- A person with OCD has recurring, unwanted thoughts about vomiting—which may persist even when not confronted with vomit. Unlike phobias, OCD-based fears can and often do switch themes. OCD compulsions are a direct response to these intrusive thoughts, and are often attempts not just to escape a difficult situation but to neutralize the thoughts themselves. These compulsions can include avoidance but may also extend to other behaviors such as checking or reassurance-seeking.
For example, someone with emetophobia might avoid situations where they might throw up, while someone with OCD might repeatedly check for signs of nausea or perform compulsions to ward off the fear of vomiting and other associated anxieties.
While phobias are not the same as OCD, both can be treated effectively using exposure and response prevention (ERP) therapy.
Treatment for emetophobia
If your fear of vomiting is impacting your daily life, making it hard to engage in social activities or eat, it’s important to seek professional support. Regardless of whether your fear is tied to a phobia or OCD, the most effective treatment is ERP therapy—a specialized form of cognitive behavioral therapy (CBT).
ERP involves working with a therapist to gradually expose yourself to fears that help you build tolerance to anxiety. The goal of ERP is to help you learn to face situations that once caused panic without resorting to avoidance—or other unhealthy coping mechanisms.
Your ERP therapist will have you start with less anxiety-provoking scenarios and work up to more challenging ones. For example, you might begin by imagining catching a stomach bug, while allowing yourself to experience the anxiety you feel. You might then work up to more challenging scenarios such as looking at pictures of vomit, while you note and sit with your emotions. Eventually, you might work up to situations you’ve previously avoided, such as certain restaurants or medical facilities.
The goal of ERP is to help you resist using safety behaviors to cope with your fears, and learn to tolerate the anxiety that arises facing them head on.
Bottom line
Emetophobia can cause immense anxiety, and may make it hard to function in daily life. Fortunately, help is available. ERP therapy can teach you to confront your fears—regardless of their cause. Working with a trained ERP therapist is important for making sure your ERP exercises are adequately paced. ERP therapy can take time, but with patience and diligence, you can learn how to live a life that isn’t ruled by fear.
Key takeaways
- The fear of throwing up (emetophobia) is a specific phobia, which is characterized by an intense, irrational fear of a particular object or situation—in this case, vomiting or witnessing others vomit.
- Some signs of emetophobia include an avoidance of places, activities, or foods that might trigger the fear of vomiting and physical symptoms such as sweating, rapid heartbeat, nausea, or dizziness when exposed to vomiting.
- Emetophobia may be caused by a specific phobia or obsessive-compulsive disorder (OCD), where obsessions are intrusive thoughts about vomiting, and compulsions are behaviors done to alleviate that anxiety.
- Emetophobia is treated using exposure and response prevention (ERP) therapy, where you’ll be gradually exposed to feared situations or thoughts related to vomiting, helping you build tolerance to the anxiety that these triggers cause.