Emetophobia fear of being sick

Fear of being sick

No one likes being sick, it's safe to assume given the option it's not something you would do often. However for those that have an extreme fear of vomiting it can feel like the worst thing that could happen to them. The fear disrupts everyday life, there is a good chance it may come up on a daily basis, undoubtedly causing considerable anxiety and stress. Even the most wonderful occasions like a holiday or Christmas day can be ruined by this fear. The worst part is that the cause of the fear (sick) doesn't even need to be present. This is what differentiates it from a more specific phobia such as flying, if we aren't going or thinking of going on a plane there is no reason to feel afraid, with a fear of being sick you never know when this may happen and so become extremely hypervigilant to every situation often reading peoples symptoms and listening out for tell tale signs. The other issue if the fear affects you is that you cannot escape from your own body, the very thing that would create the thing you fear, this means you have to avoid the trigger the multitude of things that may create the unwanted outcome, it also means you become hypervigilant to your own body and potential symptoms - more on that later.

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Why do some people have Emetophobia?

The cause itself can vary from person to person, some have a primary response which may have been traumatic - it's not always something you remember exactly but if there was a situation where you felt very scared it's likely that may have been the trigger the created the association with being sick and fear. It can be secondary in that we learnt it or witnessed it, so we weren't directly involved but we felt afraid in some way.

For the sake of treatment if there is a specific and traumatic memory at the onset of this fear it can be resolved with a rewind treatment, this will be discussed later. However it's not always known why, we can work with disrupting the conditioning and avoidance that has occurred instead to interrupt the phobia.

Classical conditioning and phobia creation

Classical conditioning, a concept developed by Ivan Pavlov, plays a significant role in the development and maintenance of phobias, including complex phobias like emetophobia (fear of vomiting). Classical conditioning involves associating a neutral stimulus for example a white rat with an involuntary response, a loud noise scaring you. Over time, this association can lead to a learned fear response, which we associate with the neutral stimulus.

An example of how this would work in the creation of phobias such as fear of sickness:

In the context of phobias, a neutral stimulus (NS), which initially does not evoke a fear response, becomes associated with an unconditioned stimulus (UCS) that naturally triggers fear. For example, if someone has a traumatic experience involving vomiting (the UCS), any stimuli present at that time (like a certain place, food, or smell) can become associated with the fear response. Initially these things were neutral - they didn't evoke a fear response, but now the brain has matched the stimuli (food) with the unwanted response (vomiting) the food becomes conditioned to create that same fear response. It usually requires repeated exposure to the fear and the stimuli but as our experience is physical it can trigger that same reaction, perhaps we think about the food and remember the experience, our body responds by mimicking the physical symptoms, our stomach churns and we feel nauseous, perhaps we create excess saliva and we go hot - all the same reactions as if we were to be sick. Now we just have to imagine the stimulus and we get that same conditioned response.

In order to stay safe we may learn to avoid the food or situation in future, this is operant conditioning as we are now changing behaviour as a direct response to the stimuli and the conditioned fear.

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Anxiety and emetophobia

Obviously the fear and avoidance will create anxiety and stress related to the phobia, it is extremely likely that it causes huge disruptions to daily life. The more we avoid things including being sick the more we actually increase the fear and therefore anxiety surrounding the act. It's important to recognise that anxiety is created as a result of the fear, it doesn't mean there is anything else that is causing anxiety issues, although that may be the case for some people. For the sake of this article we are only discussing the anxiety related to emetophobia.

People with emetophobia are likely to be physically sick very rarely, they do a fantastic job of avoiding and 'protecting' themselves from it. The problem is that when we are sick our body is doing something quite un-natural, it is working against gravity and our ability to keep food down and digest it. This means that after our body has gone through an extraordinary feat of expelling the toxic body, we get a rush of the chemical oxytocin - this is a feel good chemical that wonderful feeling of relief. It signals to our nervous system we are safe and all is well. Because this isn't happening through the avoidance there is very little natural resolution to the fear itself.

Our body has created a fantastic immune system, and part of that is to get rid of any toxins that may make us very unwell, but the act of doing this creates an intense short lived physiological response. We will feel sick first, this is the gut reacting, when the balance is disrupted it sends the message to the nervous system and our body responds with sweating, heart racing, stomach cramps - to expel the toxin, even dizziness. It is a complete physiological takeover and this can leave us feeling very much out of control of our own body. The physical symptoms as mimic a panic attack, something that is not pleasant particularly if you have had one before due to fear.

It can be overwhelming and scary, if you have this experience at a young age and aren't comforted or reassured, or if you have this as an adult under certain circumstances that they create uncertainty or fear.

Our mind pattern matches, so if we were left embarrassed, or even criticised or felt scared and lonely this can be enough along with the unpleasantness to create the fear of being sick. Then add the avoidance and the classical conditioning and we become scared of more than just the sickness but the things that might cause it.

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Treating Emetophobia with hypnotherapy

Fear extinction is a process through which a conditioned fear response is diminished or eliminated by exposing an individual to the conditioned stimulus (CS) without the presence of the unconditioned stimulus (UCS) that originally elicited the fear. The aim is to weaken the association between the CS and the fear response.

What this means is we don't have to have the unconditioned stimulus (vomiting) involved at all to reduce the fear, we can slowly and gradually start to re-introduce the stimulus that have been conditioned to evoke the fear response - the things that we have avoided that may cause the sickness. In hypnotherapy we will work to do some gentle visualisations of coping, this may be starting to imagine eating that food you have avoided and how you might do that. It could also include thinking about a fear response will doing some emotional regulation techniques such as breathing or progressive muscle relaxation.

We will work together to start to re-introduce things that make your life easier and back to normal, alongside working on some of the unhelpful belief systems and the fear response itself.

As mentioned earlier, if there is one or two specific traumatic memories associated with the fear we may use a technique called rewind, this will allow you to remove the intense emotional response to the memory and neutralise it.

We can embed some new anchors which will support a feeling of calmness if panic does happen, and this is something that can be practiced at home and will increase in benefit the more it is used

We will focus on what you would like to do rather than the fear and the past situations, we don't need to imagine anything unpleasant and I certainly won't make you do anything or expose you to anything physically

How long will it take to overcome emetophobia?

It is not going to be a case of 1 or 2 sessions as this is something that has been conditioned over a long time and has been avoided and intensified. However most clients find a significant improvement in between 6-8 sessions, and many find they are living a normal life with an expected level of fear after 12 sessions.

More information on Hypnotherapy for Emetophobia package

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