The Emetophobia Paradox
No one likes throwing up, but what happens when that aversion goes too far?
Listen to this story:
I was the adrenaline-obsessed kid who climbed the tallest trees, slid down the fastest waterslides, and ziplined across mountains. You most certainly would not find me stressing about spiders or snakes, nor would you find me too scared to speak or sing in front of hundreds of adults. “No regrets” was my biggest rule.
But while I came across as brave, the truth is that I was afraid of something much more embarrassing to admit: I had a phobia.
I watched Saving Private Ryan for the first time at eight years old — if you can really call experiencing the first five minutes watching.
The last thing most people remember about the movie is the scene before they hit the beach, but as it started playing, I couldn’t help but wonder aloud, “Are they really throwing up on the boat?”
“Well, yeah,” my dad responded as he watched the screen. “Many soldiers got seasick on those boats.”
His statement was simple and true, and I didn’t let on how deeply his reply perturbed me. I mean, many of these soldiers were about to die, and here I was, worried about the mess on the upper deck.
When they landed on the beach, my mother asked again if I wanted to watch a different movie. At the time, I knew she was asking me because of the gory violence, and I let her believe that was why I left the room. Admitting the sickness on the screen was the real reason I wanted to watch a different movie seemed pointless.
Many people go to extreme lengths to avoid the thing they’re afraid of — movies are no different. In fact, there are even websites that will list any phobia triggers in films. Unfortunately for me, I wouldn’t discover them until years later.
Instead, I spent my childhood grimacing away from disgusting scenes and panicking when random films like Pitch Perfect had a surprising amount of sickness involved. Even today, my heart skips when I’m exposed without warning.
Away from the World War II movie, my mother and I searched for something more age-appropriate, finally settling on Are We There Yet? a 2005 film set during a road trip.
I should’ve sensed that a children’s movie would use the motion sickness opportunity right in front of them, but when a child throws up all over the car halfway through the film, I was horrified. Seeing that mess up close was far worse to watch than any violence in Saving Private Ryan. The bright pink of that car interior windshield has been seared into my brain ever since.
So, while I wasn’t actually sick that day, I became terrified I would be.
When I told my parents I felt sick watching Are We There Yet?, they gave me a bucket, and its reassurance quelled my stomach problems. After that I became inseparable from that little pail. I knew that if the worst thing were to happen, then at least I would have a bucket nearby.
This is the earliest memory I can link to emetophobia (em·e·to·pho·bi·a). It’s clinically referred to as the Specific Phobia of Vomiting (SPOV) and is an intense and irrational fear of seeing someone throwing up or experiencing it yourself. I’ve carried this phobia for over a decade, and it has shaped virtually every aspect of my daily life.
Before you say, “Well, no one really likes throwing up,” I can assure you there is more to it than that. A fear is a rational reaction to a threat; a phobia is anything but.
To some, even using specific words can be extremely distressing. Personally, I refuse to use graphic terms to describe throwing up, and on online forums like r/emetophobia, users often censor themselves and one another.
A study from the Clinical Psychology Review found that 81 per cent of emetophobics report having intrusive imagery and memories about throwing up. Simply using or hearing graphic descriptions can trigger a response. In fact, the article says that 31 per cent of people with emetophobia have intrusive visions showing future worst-case scenarios of someone being sick.
For me and many others on these forums, even talking about the phobia creates an exposure, even when it is fully controlled by the mind.
After that day, I’d place a bucket at the side of my bed for the next few years just in case I’d wake up sick in the middle of the night. When friends would sleepover, I would tuck it into the closet — out of sight, but still within reach.
My parents would see it in my room, but they didn’t tell me to get rid of it. The square bucket, yellowed from old age, was not in particularly high demand by the rest of my family. It was, however, an eyesore in my bright red and purple room, and I would give excuses no one asked for to prove it made sense to keep it by my side.
This solution worked for a while — then it became a trap.
The idea of reaching for a bucket soon became paradoxical: if I had it near, I was safe, but it also meant I had accepted the possibility of throwing up, and accepting that made it inevitable. After learning that stress can cause nausea, I then worried about being too worried.
Eventually, looking at the bucket in my room became too overwhelming. I pushed it into my closet for good this time, leaving it close enough to quickly grab in a crisis. With or without the bucket, however, the paradox returned every time my emetophobia reappeared. Trying to soothe the panic meant I was taking the threat seriously enough that the panic would exponentially increase.
Without realizing it, I repeated this bucket-pattern throughout the years, trying to find new objects that would supply me with reassurance. Emetophobia showed up every time I was nervous or excited about anything. Nausea was waiting for me at every corner.
Overall, phobia symptoms in children can be hard to identify because they mimic regular developmental fears. In my case, I would freeze up — unable to move or speak. But an overview from Mayo Clinic shows how children might also cling or be inseparable from someone, or something, they feel is safe. When it comes to emetophobia specifically, there is very little data on children. A meta-analysis on emetophobia from the Journal of Anxiety Disorders found that while the phobia usually begins in childhood and mostly affects women, children have not generally participated in the studies, making it difficult to diagnose them.
I knew it wasn’t normal to be best friends with a bucket. At the same time, I could never find the words to explain what it was about throwing up that scared me so much. The risk of becoming an easy joke made it too hard to even try. For years, I didn’t tell anyone how deeply it was affecting me, but I was always vigilant, constantly looking for signs that someone was going to be sick.
It was like waiting for a bomb to go off. Except, with emetophobia, each person I met became the bomb. At any given time, someone could blow. So, I learned to read the faces and body language that meant someone was about to be sick. I’d search for signs the bomb might go off, so I could avoid the vicinity of the blast.
For me, school became a warehouse of bombs. At any given time, someone could explode in the hallway, in a classroom, or worse — near me.
One morning in grade five, I was putting books in my locker when I heard sounds I do not wish to describe, mixed with a few gasps and some hurried footsteps.
Innocent curiosity propelled me to look. Immediate panic brought my left hand to the side of my face. I almost sprinted into the classroom just to get away from the scene, finding friends in the corner of the room.
“Someone just threw up,” I told them, but if they had any reactions, I don’t remember them. I was paying too much attention to my breath hitching in my throat, my face heating up, and the ever-increasing urge to escape.
While I knew I should feel compassion, I instead felt morally outraged. I refused to look at the culprit when they walked back into the room, and for days afterwards, I could barely talk to them. It wasn’t their fault, but that didn’t matter.
I loathed being in the presence of someone who had committed such an innocent, dreadful crime.
To mostly everyone else around me, throwing up was a funny joke. It was so funny to them that, when my distress became too obvious to hide in later years, I became the easy target.
Some classmates thought it was hilarious to fake-gag around me. Others would joke about throwing up on me just to see my reaction. I knew it was teasing, but my body reacted as if the bomb was seconds away from exploding.
I still find it hard to grasp how anyone finds throwing up funny. I’ve read that people with emetophobia often have a higher sensitivity to disgust than others. The emetophobia meta-analysis from the Journal of Anxiety Disorders goes as far as saying that more severe symptoms of emetophobia can be moderately related to a higher tendency of disgust and anxiety.
This higher sensitivity to disgust, as the Clinical Psychology Review explains, can play a role in the belief system of someone with emetophobia, especially as they pertain to throwing up.
While disgust is a natural psychological reaction stemming from evolution that was meant to protect us from illness, it can also transfer to objects or other things that are not harmful. Disgust is a rejection of things we don’t like, true. But as David Gelman wrote in his Newsweek editorial “Developing the gift of gag,” disgust is much more judgmental than that.
With emetophobia, the judgement comes from a risk of illness. If I hear someone has recently been sick, I’ll have a hard time believing they are safe to be around. My mind swirls — don’t let them come close. Don’t touch them. Don’t talk to them. Don’t share anything with them. If I do, I’ll get sick.
I still struggle with separating these feelings and beliefs from reality. So you won’t find me holding a friend’s hair back or consoling them in the bathroom after a night out — I’ll be miles away trying to convince myself I shouldn’t be angry with them.
I had a conversation with Sonya Pop, registered hypnotherapist from the Canadian Association of Counselling Hypnotherapists and Educators (CACHE), about how powerful your brain can be. She told me how phobias show up somatically, and when exposed to a trigger, the critical thinking part of your brain doesn’t acknowledge it.
Most people with phobias probably know their thought processes are irrational, but knowing doesn’t mean it goes away. The daily battle between logic and feeling instead becomes such a familiar fight that you begin distrusting yourself.
How can I be sure I’m making the right decisions when my brain so often lies to me?
On random nights, I would stumble deliriously into the bathroom mere hours after I had gone to sleep. I wasn’t really sick, but I thought I would be. I never knew what woke me. Perhaps it was a dream, or an odd sensation in my stomach. While it started in my teens, it still occurs to this day — albeit not to the same extent.
Even in the safety of the bathroom, I would still find myself reaching for a garbage can to hold close. The cans varied throughout the years — different colours, sizes, and weights that I became far too familiar with.
I would plant myself on the floor before the sink with my back resting on the wall behind me. Shaking from fear, exhaustion, or the cold, I’d wrap myself in a hand towel and hold the garbage can firmly in my lap. The fan hummed as my stomach spun in circles.
This isn’t the part where I tell you I threw up.
After four years of repeating this nighttime ritual a couple of times a week, I was only ever sick once. The anticipation was the worst part of it all. The sleep deprivation didn’t even come close.
Over time, I began to feel relief at the sign of hunger. It had become the only feeling I could identify separately from nausea. It told me I was safe to leave the bathroom. It allowed me to reclaim my agency.
An unhealthy relationship with food isn’t an uncommon response for people with emetophobia. The European Eating Disorders Review found that people with this phobia frequently have abnormal eating behaviours to reduce the risk of throwing up. For many, the act of eating causes an enormous amount of stress.
These eating patterns are why emetophobia is often misdiagnosed by health professionals as anorexia nervosa or avoidant restrictive feeding disorder (ARFID). The Clinical Psychology Review says that 49 per cent of eating disorder clinicians encounter emetophobia in their patients.
On Reddit forums for emetophobia, you’ll find people talking about “safe foods,” “fear foods,” and everything about food safety. This paranoia surrounds everything around food — the cooking, cleaning, preparation, and especially expiry dates. If any food is considered at risk of contamination, it mustn’t be eaten.
To me, hunger is predictable — I can’t be sick if my body is wanting food. It’s the only piece of proof I have against my irrational thoughts.
At my worst, I wouldn’t go anywhere. I was too afraid to even leave the house. It wasn’t lying to say I felt too sick to leave — but it wasn’t the full truth either. Fear grabbed onto every opportunity with a tight grasp.
When I did leave the house, I would make notes on how long it would take me to get to the closest bathroom in any room or building I entered.
Public transportation became a bomb warehouse. So did shopping malls and restaurants.
I still have days like these, but I now understand how to push myself past the fear. I have to remind myself that avoiding everything means I’m living for nothing. A part of me was the kid who lived and breathed “no regrets.”
So, when I got to the age where friends started throwing parties with booze, I often wondered if it was worth the anxiety to attend. Many emetophobes refuse to be around alcohol at all for fear of exposure to people throwing up, but I wasn’t about to let my phobia cause regrets.
I got exposed to my fear many times at these parties. But when the effects of my drinks started kicking in, I slowly stopped seeing sick people as culprits. The panic at being close to them was still there, beneath the surface, but it wasn’t as overwhelming as it once was.
Eventually, I did drink too much. I did throw up.
But as long as I pinched my eyes shut and plugged my ears, I could pretend like it had never happened. This is what I still do today.
Even if it was only by a little bit, the alcohol overpowered the phobia. It gave me a chance to practice managing the fear. I’d find that later, when I’d throw up outside of the influence of alcohol, it wasn’t as harrowing as I thought it would be.
Over the years, I would see countless doctors and therapists to help me understand my fear. None of them would have an answer for me, and many would attribute it solely to social anxiety or depression.
There’s limited research on specific types of treatments for emetophobia. The Clinical Psychology Review found no reported studies on the effectiveness of personal exposure to throwing up. Although, this could be due to the lack of emetophobes willing to undergo this treatment.
To treat emetophobia, some practitioners recommend an approach that targets both disgust and anxiety symptoms, like hypnotherapy. But a lack of conclusive research makes it so hard for people with emetophobia to get the help they need.
It wasn’t until I spoke with a healthcare provider who had personal family ties to this phobia that I was able to receive the most important advice: ginger is your friend. Taking ginger pills would help relieve my nausea, and as the physical effects subsided, the anxiety got easier to manage.
A study from the University of Mississippi found that 51 per cent of emetophobes tend to be nauseous for at least an hour or more every day. It is something I’ve become so accustomed to navigating — the stomach pains and the resulting anxiety — that you might not even notice when I fade away from conversations to self-regulate.
I also discovered MindShift, a Canadian Cognitive Behavioural Therapy (CBT) meditation app, on my own, after too many nighttime bathroom rituals. These short, guided meditations would help calm my breathing, releasing the nausea caused by stress.
Together, these two methods have allowed me to regain normalcy in my life, but this story doesn’t end with a fix-all cure. The phobia isn’t as extreme anymore, but it has shaped me significantly.
A few months ago, I was at a Boston Pizza when I noticed a group of wait staff frantically wiping things down. They were barely in my line of sight, so I ignored the immediate urge to catastrophize. It wasn’t until my parents began a hushed conversation that I started putting things together.
I didn’t see nor hear anything, but I knew it had happened.
Rather than scanning exits and letting the pit in my stomach grow large enough to swallow me whole, I sat with the discomfort. I fixed myself to the pleather booth, ordered my food, and enjoyed my time with my family.
Today, I couldn’t tell you where any bucket in my house is. When I catch myself thinking of other people as bombs, I take a pause and carry on. Each day, with a little ginger in my pocket, I work on getting back to being that adrenaline-obsessed girl who takes risks and lives for adventure.
No regrets.
