Both Busler and Garcia know what it’s like for emetophobia to disrupt their routines—for example, both have avoided restaurants and potlucks, favoring food they prepare themselves, and they prefer not to eat foods they associate with sickness, like seafood. Busler, who works in a school, says her fear has interfered with her work, too. If she hears a stomach bug is going around—common among her students—she feels paralyzed with anxiety. “I have a recurring nightmare that my coworker or partner has it, and then I’m exposed,” says Busler.
How can you treat emetophobia?
If the fear of nausea or vomiting is debilitating, it may be time to seek out professional support from a therapist. While avoiding throwing up might feel comforting in the moment, Appenzeller says it actually reinforces the fear, potentially making emetophobia worse. For that reason, one of the best treatments for phobias is a type of cognitive-behavioral therapy called exposure response prevention (ERP), which Krinsky says involves “putting people in situations that are distressing to them and preventing them from engaging in safety behaviors.” Over time, exposing yourself to the object of the phobia can reduce anxiety by desensitizing people to their fears, explains Ashwini Nadkarni, MD, assistant professor of psychiatry at Harvard Medical School.
One study found addressing the underlying trauma with a type of therapy called eye movement desensitization therapy (EMDR) may also help, but the majority of research on phobias (and specifically emetophobia) is about cognitive behavioral therapy, which focuses more on addressing thoughts and behaviors. Studies show cognitive behavioral therapy (and specifically ERP) can lead to significant symptom reduction.
In the case of emetophobia, someone might simply say the word “vomit” or imagine themselves throwing up. Then, over time, they’d engage in more triggering behaviors, like going on a car ride or eating at a restaurant. In extreme cases where it’s medically appropriate—for example, if a person doesn’t have an eating disorder or another medical condition—a therapist might encourage someone to actually throw up as part of ERP.
Exposure therapy should be done in a careful, supportive way, which is why it’s a very systematic process (and why it’s important to see a therapist who’s trained in this therapy). “There’s a process where you create a hierarchy of all the different triggers and rate them on a scale of perceived distress,” says Krinsky. “You don’t want to start too easy or too hard, or you’ll burn them out and they might quit. You want to help them be successful and slowly work their way up.”
