Cognitive-Behavioural Therapy is often considered the best treatment approach for emetophobia.  This could involve identifying any negative thinking patterns such as "If I do this, I'll feel sick" and replacing them with more constructive, positive thoughts, such as "I've done this so many times and it's never made me sick - in fact, I actually really enjoy the activity sometimes".  

Similarly, destructive behaviours which reinforce the phobia can also be identified and replaced.  If you always retreat home as the first indication of any 'catastrophic' thoughts or feelings then, as well as challenging these thoughts (above) then you will be asked to change  your behaviour and remain in the situation until your anxiety has reduced.  Another option is to retreat slowly from the situation, e.g. a shop queue, calm down a little and then REPEAT the activity a few minutes later.  CBT involves confronting fears via challenging destructive thoughts and behaviour patterns.

These would not (necessarily) involve confronting the fear or undergoing any 'Systematic Desensitisation' in which we would have to look at pictures of 'the dreaded', watch videos of vomiting (simulated or the real thing), dangle our hands into anything unpleasant and would certainly not include having to consume an emetic or deal with the result of one!

You might be asked to keep an 'Anxiety Diary' in which you record experiences of anxiety/nausea which can help identify triggers.  These would involve recording:

Over time, you may see a pattern emerging, possibly linking anxiety/nausea to a specific event or certain time of day.  In this case, you could try to work out the reasons for this and tackle those.  Alternatively, if you find that there is a set pattern to nausea attacks which are not triggered by anxiety, then you may find your nausea is linked to certain foods  you eat, certain activities or your menstrual cycle.  

A Clinical Psychologist in South Wales drew up a hierarchy of symptoms to be confronted systematically, starting with: 

Of course, there are obvious impracticalities involved in this approach such as - how should symptoms be created within an office setting during appointments?

A major UK psychiatric hospital which specialises in the treatment of phobias, including emetophobia, recommends 5 different treatment approaches based upon systematic desensitisation, including:

1. Making a loop tape telling yourself you feel sick and listening to it for an hour daily. This 'chanting' should be accompanied by writing words such as 'vomit' on Post-It Notes and sticking these onto bedroom walls.
2. Going out for an Indian Curry during a nausea attack. If this failed to induce vomiting, then an emetic drug would be administered (see also emetic-confrontation for the result of this approach)
3. A third therapist said the above was a very 'naïve and ill-advised approach' and prescribed watching Vomit Videos
4. A fourth therapist advised AGAINST watching Vomit Videos as these fail to have much effect if the fear is of ONESELF vomiting
5. A fifth therapist recommended induce as much nausea as as possible by being driven as a passenger along winding country lanes, rotating on a children's playground roundabout and inhaling white spirit fumes or, alternatively, taking regular rides on a fairground roller-coaster(!).

Gut Reaction's founder has tested the above approaches (with the exception of the Indian curry and emetic) and found that, although they induce nausea and giddiness as intended, they fail to have any beneficial effect upon the emetophobia. Interestingly, none of the therapists suggested first treating any underlying nausea problem.

One Gut Reaction member tried the approach of deliberately inducing vomiting via the use of emetic drug, ipecacuanha. Her experience is included on this web site at : emetic-method