What is it?
Emetophobia is the fear of throwing up. Though this may sound common, often children who struggle with emetophobia have difficulty with anxious thoughts and behaviors relating to their fear. You may begin to notice that your child is struggling when their worries become more intense than the average person. If your child is suffering from emetophobia, they may be experiencing the following symptoms (including anxiety symptoms, avoidance symptoms, and behavioral symptoms):
- Frequent and intense stomach aches
- Frequent headaches
- Increased sweating
- Avoidance of school or social activities
- Avoidance of physical activities
- Avoidance of certain foods
- Excessive hand washing
- Avoidance of the word “vomit” or other similar terms
This list of symptoms is not all inclusive. This phobia can manifest in many different ways in different children. Experiencing this phobia or living with someone who is struggling with this phobia can be incredibly challenging. Children with this phobia may avoid school, refuse to watch certain movies, avoid eating certain foods, continuously wash their hands, or avoid people who seem sick. Emetophobia, if untreated, can lead to additional phobias such as mysophobia (fear of germs) or social phobias (fear of being around other people).
How common is it?
There is no one thing that we can point to to say “this caused your emetophobia”. Many times, a mixture of genetics and stress lead to the development of symptoms. This phobia can develop either spontaneously or after a child witnesses a traumatic scene relating to vomit. For example, some children may develop this phobia after battling a nasty bout of the flu or witnessing a friend at school get sick in the hallway. Emetophobia can develop at any age, however, the most common age of onset is approximately 9 years old. The statistics relating to the prevalence of this phobia are inconsistent. However, this is not an uncommon fear to have! Many anxiety and OCD therapists are well versed in working with clients and families who are impacted by emetophobia.
Health Impacts:
It is important to seek help as soon as possible. Emetophobia can have numerous impacts on the client’s physical and mental well-being.
Physical Impacts:
- Inadequate consumption of food leading to significant weight loss
- Less exposure to physical activity due to avoidance of exercise
- Dry or cracked hands to to frequent washing
Mental Health Impacts:
- Increase in anxious thoughts that may distract client from relationships or school
- Decrease in engagement in social activities
- Difficulty focusing on things other than fears
- Increase in panic attacks and somatic anxiety symptoms
How to treat it?
Emetophobia can be treated with exposure therapy, which is a therapeutic technique rooted in cognitive-behavioral therapy. This form of treatment involves a client continually facing their fears in order to become habituated. In other words, the client will continually practice being uncomfortable so that their anxiety symptoms decrease over time. For emetophobia, this means that the client will continually face their fears relating to vomit.
How does exposure therapy work?
Creating a Fear Hierarchy:
Exposure therapy begins by creating a hierarchy of situations that provoke your child’s anxiety. A fear hierarchy is a list of different situations that are ranked from the lowest anxiety provoking to the highest anxiety provoking. Items on this list might be things like sounds of coughing, sounds of vomit, saying or writing the word “puke”, looking at pictures of vomit, or watching throw-up videos.
Gradual Exposure:
In therapy, we begin introducing each fear-inducing situation, starting with the item that causes the least amount of anxiety. This is to ensure that the client eases into the process and learns how to complete exposures successfully. An “exposure” is when your child is facing something that causes their anxiety to increase. Over time, your child might work through their exposure list and realize that they are able to go to school, be with friends, or eat different foods without fear of throwing up!
Coping Skills:
While it is important for your child to feel slightly uncomfortable when doing exposures, we want to ensure that the client has tools to use when their anxiety becomes unmanageable. Alongside exposure therapy, we will begin to find skills that fit your child’s needs to help them manage their anxiety. Examples of different skills could be deep breathing, muscle relaxation, mindfulness, meditation, grounding techniques, or even cognitive restructuring.
Homework:
While doing exposures in the therapy office is important, it is also important that the client begins to face their fears in other environments. This is so that the client will be able to generalize their skills, and begin to practice facing their fears at home, school, or even with friends. Depending on the age of the client, they may need assistance in completing these exposures. However, the more that they practice, the more that they will notice that they are less sensitive to their fears.
Resources:
Written By,
Jordan Adamson, LPC
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