What is Emetophobia? 

EMETOPHOBIA is defined as a fear of vomiting and people who suffer from it are known as emetophobes.

Emetophobes fall into two categories:-

1. Those who primarily fear THEMSELVES vomiting and
2. Those who primarily fear OTHER PEOPLE vomiting.

Generally the phobia starts in childhood and when a parent is uneasy about vomiting, this sometimes leads to the child also developing the phobia. There doesn't appear to be any single cause for developing emetophobia although tentative links have been made with childhood abuse and bad experiences of vomiting e.g. due to food poisoning. However, in the vast majority of cases, the emetophobe has no idea why they have the phobia.

Emetophobes can further be divided into two groups:-

How do You Spot an Emetophobia Sufferer?

You probably won't spot one directly as emetophobia tends to be a very closely-guarded secret. Many emetophobes are highly skilled in the art of making excuses to avoid potentially difficult situations that might induce nausea, such as travelling.

Emetophobia can manifest itself in very many different ways, but there is often a pattern of avoidance behaviours that indicate there might be a problem. Typically, some of the following will apply: -

1. Many emetophobes avoid using public transport and, if travelling, often insist that travel by car and that they are the driver. Where this isn't possible, emetophobes have been known to travel in their own car while the rest of a group will travel by rail, or even trail behind a mini-bus in their own car. Few emetophobes will travel by boat and fairground rides, particularly those that rotate, are most unpopular.
2. Most emetophobes adopt meticulous food hygiene standards and are very careful about the types of food they will eat, especially when eating out. Some will insist upon inspecting kitchens before ordering a meal.  Sandwiches and similar packaged foods might be eaten direct from their wrapping without being touched at all.  Fries can be held between fingertips and the touched end of the fry discarded.
3. Often, emetophobes will avoid having necessary medical treatment or investigations, including surgery, anaesthesia or even taking prescribed medication without first checking potential drug side-effects.
4. Many emetophobic women will avoid pregnancy due to the risks of 'morning sickness'.
5. When a member of their household, or a close acquaintance, suffers a stomach infection - they will be extremely anxious that they might contract it themselves. Many will virtually starve themselves for the following few days until the likely incubation period has passed without them becoming ill. Some emetophobes are misdiagnosed as suffering from anorexia nervosa or another eating disorder (click link button for further information relating to eating disorders)
6. In more extreme cases, emetophobes become socially isolated in order to minimise the risk of catching any infection and will adopt a 'safe' diet to minimise the chances of contracting food poisoning.
7. Emetophobes often have a morbid obsession regarding their fear. For example, an emetophobe who fears others vomiting will constantly be on the lookout for others who may be vomiting or about to vomit. This can include closely watching people in social situations to ensure they look well and healthy - e.g. while in a theatre or cinema, such an emetophobe will be checking those in the neighbouring seats are laughing at appropriate moments, ordering refreshments at the interval and, when travelling by road, will strain to look at the car pulled off the road with the nearside door wide open - just incase somebody should be ill. Although they strongly dislike seeing others vomit, there is a strange compulsion to actually look and observe briefly their worst fear being confirmed! This morbid obsession can even lead to a smaller number of emetophobes monitoring the progress of a 'stain' on the pavement being washed away over the following few weeks!
8. Emetophobes will normally sit far away from other patients in hospitals and medical centres (and will only even attend when absolutely necessary), often beside a door or open window, and hardly dare to lick their lips or pick up a well-thumbed magazine, to minimise any risk of contracting any infection from other patients.
9. Emetophobes can adopt most unusual behaviour (which can be quite amusing to the observer) ranging from making bizarre excuses to avoid situations potentially associated with vomiting to those emetophobes who save a small amount of food on their plate or spit into the toilet after using it - as their 'offering' to the 'God of Vomit'.
10. On the (often rare) occasions that emetophobes eat out at restaurants, you may spot them dissecting their meal, especially fish and meat, to ensure they are adequately cooked through.  Similarly, salads may be inspected for any insects.  At fast-food eateries where food is cooked to order, e.g. chicken, the cooking times might be discreetly checked via frequent glances at a wristwatch.
11. Many emetophobes develop an unusual range of skills including: opening doors using their elbows or hands dug deep into pockets or retracted into sleeves and can flush public toilets with their feet demonstrating a range of balancing techniques.

Despite the (sometimes) daily fear of vomiting, emetophobes rarely actually vomit - some even proudly boast their personal records of over 50 years having passed since they were last sick. Although vomiting is thought to be an involuntary act controlled by the brain, many emetophobes have survived pregnancy, childbirth, appendicitis, renal or biliary colic and other vomiting-inducing medical conditions without actually vomiting themselves. Also, more than one emetophobe, in an attempt to deliberately 'confront' the phobia has consumed double-doses of a normally effective emetic (ipecacuanha) together with water, tea, coffee, soup and a light meal and still not vomited. (Sarah, a Gut Reaction member, tried this approach and her experience is included on this web site at emetic-method).  

It seems emetophobes have a high level of 'vomit continence' and are able to fight the urge to vomit for long periods - until the overwhelming nausea eventually subsides.

Due to the fear of eating - or, rather, a fear that eating may lead to food-poisoning or vomiting, many emetophobes are under-weight and some have even been mistakenly treated for anorexia nervosa (see serotonin for further information). Most emetophobes with a low body weight, however, would dearly love to gain weight. It is possible some emetophobes will have eating disorders but these are usually a symptom of emetophobia.

NeuroPhysiological Psychologists have suggested that some phobias, including agoraphobia and emetophobia, may not be purely psychological disorders. For further information, go to the  neuro-physiology page.

Alternatively, do you believe your nausea symptoms could be a physical expression of psychological problems?  For further information, go to somatisation page.

Generally, it is always advisable to seek advice from your GP if you are suffering from any health-related problem.  However, it has been the experience of several emetophobes that - admitting to emetophobia or other 'psychological' conditions can lead to labeling.  An unfortunate consequence of this is that future (genuine) medical problems and conditions can similarly be perceived to be purely 'psychological' and investigations are not undertaken, treatment is not prescribed and, thus, the emetophobe can endure years of unnecessary suffering from legitimate illnesses.