OCD and Emetophobia


by marin freedigitalphotos.net


The fear of vomiting, or emetophobia, affects people of all ages. It is often seen in childhood and if left untreated, can become debilitating. It is also known to develop during adulthood, perhaps after an associated experience such as a severe stomach illness or episode of vomiting. The consequences of vomit phobia can be extreme, leading to such things as school refusal, social isolation, and job loss. Emetophobia can also take away any joy in life, hindering travel and leisure activities, romantic relationships, and even pregnancy (afraid of morning sickness).

To be clear, emetophobia is not just being afraid of throwing up. Rather it is an excessive or irrational fear about the possibility of vomiting. In fact, says Dr. Steve Seay, most of the people he treats for emetophobia have symptoms of other conditions such as social anxiety, agoraphobia or obsessive-compulsive disorder (OCD).

Some examples of behavior that present with all types of emetophobia:

  • Avoidance behaviors such as not eating certain foods (severe cases could lead to anorexia), not going to specific places, or not participating in certain events you might associate with vomiting (could be something as simple as avoiding parties with food).
  • “Health-conscious” behaviors such as refusing to shake hands with others in case they are/were sick, excessive handwashing, and unreasonable amounts of time and attention paid to food selection, preparation and cleanliness.
  • “Checking” behaviors to detect early signs of illness, such as being hypervigilant with your own health (taking your temperature 5 times a day), as well as being keenly aware of the health of others (watching other people eat to make sure they are not or don’t get sick).
  • Actions done specifically to reduce the possibility of throwing up, such as the performance of rituals (If I repeat “I won’t throw up” over and over in my head, then I won’t throw up).

For those with OCD who suffer with emetophobia, symptoms are also likely to include the concern that vomiting signals something much worse than it typically is, such as indication of a deadly disease. People with obsessive-compulsive disorder also might believe that if they do vomit, they will not be able to cope with the situation. Not surprisingly, those with OCD and emetophobia demonstrate more cleaning and checking rituals than others with emetophobia. While they know intellectually these rituals make no sense, they are not able to control them.

As with all types of OCD, exposure and response prevention (ERP) therapy is needed to battle emetophobia. For example, a child who will only eat certain foods because she is afraid of vomiting might be asked to eat something different, and then feel the subsequent anxiety. Another exposure might include watching videos over and over of people vomiting, sitting with the anxiety and not engaging in avoidance. With more exposures (and no rituals) the person with OCD will get used to the idea of vomiting, lessening the hold of OCD and emetophobia. This is known as habituation.

I think it’s safe to say that nobody enjoys vomiting. But if the fear of it is overtaking your life, please seek help. With a competent therapist, emetophobia, with or without OCD, is absolutely treatable.








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8 Responses to OCD and Emetophobia

  1. Claire says:

    Oh, I had this big time. Not fun. People think it’s less severe than it is and don’t understand when you freak out over it. Unfortunately I had a whole lot of exposure therapy after getting sick for a few months last year, but it sure was effective, it’s not a phobia of mine anymore. I never knew it had a name until now! Thanks for sharing!

  2. Renate says:

    I also suffer from this fear and always thought I was the only one. I do suffer from OCD too. My daughter is always trying to talk me into going on a cruise with her, but I am too afraid of getting seasick. To me the feeling right before you throw up and the act of throwing up is the worst feeling in the world. It makes you wish you were dead. I am very scared of getting cancer some day and needing chemo, knowing that it makes you horribly sick to your stomach. Getting pregnant scared me too because of the morning sickness, but I got lucky and only threw up once during my whole pregnancy. I’m seeing a therapist for my OCD (Scrupulosity) but we don’t discuss emetophobia although I did mention it once..

  3. Can you comment on differential diagnosis between OCD and emetophobia?

    • Hi Sherry, Obviously emetophobia is just one of countless ways in which OCD might be expressed. The article above gives some examples of the typical characteristics of emetophobia with and without OCD. There is no question it can get tricky, which is why it’s so important to be diagnosed by an OCD expert (of which I am not), who will figure it all out :).

  4. I suffer from this phobia very severely. I have suffered from it for 25+ years but I never talked about it until I was diagnosed with contamination based OCD. I never talked about this fear with family or friends.
    I am still affected by these fears daily and often avoid foods which may cause food poisoning (meats, fish etc). I have recently started introducing certain foods back into my diet but I will still not handle those ingredients in their raw forms.
    I certainly avoid social situations unless I am with someone who fully understands my fears (1 or 2 friends). I am barely able to see or visit family, especially those with school aged children or those who work with or around children because of the risk.
    I avoid drinking alcohol except on very special occasions and certainly couldn’t go into a pub or club where the risk of hearing and seeing people being ill is very high.

    • Thanks for sharing, and I’m so sorry you have suffered with emetophobia for so long. It is definitely treatable, and I hope you can move forward and find a good therapist to help you overcome it. I wish you all the best!

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