What is emetophobia / specific phobia of vomiting
Whilst no one likes to feel nauseous or to vomit, for some people this can be a serious problem that interferes with their day to day life.
Emetophobia, or a specific phobia of vomiting, is characterised by a marked fear or anxiety of oneself vomiting, or seeing others vomit. It can be associated with a fear of losing control or being unable to escape from a place or situation. It is often accompanied by distressing physical symptoms of anxiety such as increased heart rate, changes in breathing, nausea and light headedness. People often monitor themselves or others for signs of illness, and avoid places or situations that that they believe will increase the likelihood of vomiting. People may repeatedly check best-before dates of food, avoid cooking or eating certain foods, wash and cleaning themselves excessively to reduce the risk of contamination with disease, and seek reassurance from others.
Emetophobia can become very severe if left untreated, including weight loss or injuries associated with excessive cleaning. It can have a significant impact on quality of life resulting in complete loss of meaningful occupation. Emetophobia also appears to be highly co-morbid with other anxiety conditions including OCD and panic.
Fear of vomiting is estimated to affect up to 8% of the population, more commonly reported in women than men, and typically with an onset in childhood. It is often misdiagnosed due to overlap in symptoms with conditions such as health anxiety, OCD, panic disorder and eating disorders, when accompanied by food restriction and weight loss.
Can treatment help?
Emerging evidence suggests that Cognitive Behaviour Therapy (CBT), is effective. A short course of CBT may be effective when the problem is less chronic or severe, but for people experiencing the problem over a longer period of time, or accompanied by additional difficulties, a longer or more intensive course of treatment may be required.
Aims of treatment
An assessment at OHSPIC will include use of standardised questionnaires that assess the severity of the problem, how it impacts on daily life, what thoughts and beliefs are associated with the problem, and an assessment of other difficulties.
Cognitive Behaviour Therapy (CBT) at OHSPIC will includes:
• Developing a shared understanding of the problem with a focus on what is maintaining the strong beliefs about the likelihood and unbearable nature of vomiting
• Collaboratively devising goals for treatment
• Exploring ways to approach change and how to go about day to day life without constant preoccupation and anxiety
• Approaching feared or avoided situations and items
• Planning how to maintain progress and work towards longer-term goals.
OHPSIC will liaise with local teams to ensure that the work on overcoming emetophobia can successfully continue, including offering joint work and supervision, as necessary. Home visits or out of office sessions will be included and encouraged as part of joint work with local teams.