Interview transcript
Firstly, can you explain what emetophobia is?
Certainly, the main thing about emetophobia you need to know about is that it is an irrational fear or phobia linked to vomiting. Different people suffer with slightly different symptoms and outcomes. So for example, some people are terrified of being sick themselves especially in public places, some people have a phobia of seeing others being sick or watching the action of vomiting and some people fear just seeing the substance vomit. The medical community has deemed it one of the most common phobias in the world however there has, so far, been very little medical research into it.
Who is likely to suffer?
Absolutely anybody has the potential to have a phobia or fear of being sick, particularly if an individual has had a traumatic experience which centred around the action of vomiting or seeing the substance. For many people, physically vomitting or feeling sick is a manifestation of stress or fear, so the root of the phobia can sometimes be traced back to a particularly scary or upsetting experience earlier on in. As I said earlier, there has been very little research done so far, but some doctors do believe that there is a chance that if an individual already suffers with OCD they are more likely to suffer with emetophobia as well. OCD is generally picked up on a lot earlier in life than emetophobia because there are more obvious signs that lead to a clear diagnosis.
What are its causes?
Clinical research conducted in the 1980’s suggested that humans can have one of two perceptions regarding where control is located, this is known as the locus of control. Some people believe that control is conducted from within oneself and therefore is known as an internal locus of control; whereas other people believe that control is out of their grasp and therefore referred to as an external locus of control. The research goes on to suggest that individuals suffering from emetophobia tend to fall into the category of having an internal locus of control, preferring to be on top of any situation and controlling the outcome. When they are then sick, this is out of their control as you cannot dictate to your body when you want to be sick as it is a natural reaction. This alteration in control location makes it harder for them to relinquish control during any act of feeling sick or physically vomiting.
What effect does it have on daily life?
It has been noted that, especially in females, anorexia can develop as a result of suffering from emetophobia. This is because when one suffers from a fear of being sick, one rationale is that sickness can be caused by eating too much or by eating certain foods, therefore some individuals will monitor their food intake to extreme and therefore leading the anorexia nervosa.
Obviously it depends on the severity of the phobia and what element of sick or the action of being sick each individual has a fear of; to give you an idea though I have had female patients who have not felt they could go through pregnancy and adopted instead due to the presence of morning sickness during pregnancy. Other patients have very little social life as they feel they cannot go out to pubs or clubs due to other people in society drinking to excess on a night out, resulting in sick being present in toilets and other public places. Any serious phobia often has a high level of anxiety attached to it which can often have an effect on whether a job in a professional fast-paced environment can be maintained. Some individuals who suffer with emetophobia often develop very specific methods or obsessive routines for food preparation at meal times, for example washing food repeatedly.
Are there any cures?
As I have previously explained, very little research has been conducted in order to find out how best to help people deal with and tackle emetophobia. However, what we can suggest is that sufferers of the phobia perhaps try treatments or therapies that have been known to help people with alternative phobias. Unfortunately a large percentage of people who suffer with emetophobia feel they cannot be persuaded to try taking anti-depressants, gastrointestinal medications or benzodiazepines for fear the medication itself will cause them to be sick in the process of taking it. Psychological treatment can be beneficial for some patients while others are slightly more dubious that the method will be successful in the long-term.
Such treatments can include the exposure treatment where a patient is subjected to video footage of somebody in the act of being sick to slowly, in an controlled environment the emetophobia sufferer can slowly build up their confidence and for some it has been an extremely beneficial emetophobia treatment.