Vomiting isn’t the most pleasant or graceful experience, but it’s an inevitable fact of life. We all have to do it at some point. However, this natural act can cause anxiety in a lot of people, especially in children. If your child doesn’t want to go to school out of fear of getting sick and throwing up, or gets hysterical when she sees another person vomit or gag, you are not alone.
Puke panic, seasick scaries, dryheave dread—whatever you want to call it— vomit phobia is real. In fact, as an anxiety specialist, emetophobia (the excessive fear of vomiting) is the most common child phobia I treat. According to research, my experience with patients reflects a bigger trend.
Is Emetophobia Really a Big Deal?
Sources suggest that vomiting phobia is a pretty significant issue. One study of 547 young adults found that vomiting was the sixteenth highest rated fear from a selection of 88, beating out fear of heights or spiders.1 Furthermore, studies indicate that this fear of throwing up is likely to start at a young age and persist well into adulthood.2,3 For instance, adult participants in one study reported that the average age their vomit phobia started was just a little over nine years old. Participants also reported that, on average, they had suffered from vomit phobia for 22 years by the time they were surveyed, with over 90 percent experiencing distress from the phobia every week of the year, and over 70 percent experiencing phobia-related distress during six-to-seven days each week.4
The Phobia Formula
So how does a fear of vomiting develop into full-blown emetophobia? It really boils down to the “phobia formula,” which involves two things: an out-of-proportion fear of a specific object or situation AND frantic efforts to avoid the said object or situation. Just as people who are terrified of dogs will avoid any situation where they might encounter one, my patients who deal with vomit phobia arrange their lives to avoid anything that they think might trigger vomiting or even simply remind them of it.5
The problem with avoidance is that it actually makes phobias worse. Individuals begin to think that their unnecessary precautions are what is preventing their fears from happening. In reality, running away from the problem creates a cycle, causing vomit phobia in children to continue into their adult lives.
5 Ways to Throw Away Throw Up Fear
How can you break the cycle and stop your child’s fear of vomiting from controlling his/her life? Here are some tips I share with my clients.
- Don’t mirror their stress. Always stay calm and upbeat in the face of your child’s escalating hysteria about the possibility of vomiting. Parents worry that if they don’t mirror their child’s emotional distress, their child will learn not to trust them. But, what if his distress concerns something safe, or even healthy, as vomiting most certainly is? Mirroring that distress sends a confusing message.
- Hide your own disgust or irritation. Vomiting feels and looks weird to children and they will look to adults to gauge how they should think and feel when they do throw-up. Please do not react with irritation or horror when your child vomits. Even if it is projectile. Even if your child doesn’t make it to the toilet. Even if it happens in public.
- Avoid constant reassurance. Repeated requests for reassurance are a form of avoidance. Any version of the question “Will this make me throw up?” should be answered enthusiastically and honestly with: “I don’t know!” Thereafter, “already asked, already answered” can suffice as your response.
- Don’t let your child avoid based on fear. Refuse to let your children avoid safe things that they fear will make them vomit. Remember, avoidance behaviors are the means by which ordinary fears mushroom into full-blown phobias.
- Be a Hurl Hero yourself. Grown-ups who whine about twinges of nausea or freak out every time they throw up send a clear message to their children that BARFING IS BAD. It isn’t–vomiting is the body’s way of expelling something it doesn’t want or need. What could be healthier? Viva la vomit!
Of course, the best way to handle vomit fears is to prevent them. You can’t stop your child from vomiting, of course, but you can make sure that getting sick isn’t a stressful ordeal in your household. Strive to make your home a place where throwing up doesn’t come with anxiety, disgust, and shame. Might I suggest regular visits from The Vomit Fairy, who leaves treats under your children’s pillow each time they barf? Call me crazy, but wouldn’t you rather a visit from the Vomit Fairy instead of the Vomit Phobia Monster?
1Kartsounis, L., Mervyn-Smith, J., & Pickersgill, M. (1983). Factor analysis of the responses of British university students to the Fear Survey Schedule III (FSS-III). Personality and Individual Differences, 4, 157-163.
2Van Hout, W., & Bouman, T. (2012). Clinical features, prevalence and psychiatric complaints in subjects with fear of vomiting. Clinical Psychology and Psychiatry, 19, 531-539.
3Veale, D., Murphy, P., Ellison, N., Kanakam, N., & Costa, Ana. (2013). Autobiographical memories of vomiting in people with a specific phobia of vomiting (emetophobia). Journal of Behavior Therapy and Experimental Psychiatry, 44, 14-20.
4Lipsitz, J., Fyer, A., Paterniti, A., & Klein, D. (2001). Emetophobia: Preliminary results of an internet study. Depression and Anxiety, 14, 149-152.
5Boschen, M. (2007). Reconceptualizing emetophobia: A cognitive-behavioral formulation and research agenda. Journal of Anxiety Disorders, 21, 407-419.
Katherine K. Dahlsgaard, Ph.D., is a licensed clinical psychologist specializing in Cognitive Behavioral Therapy for children, adolescents, and young adults. She focuses on anxiety disorders, including selective mutism, social anxiety disorder, and OCD, among others. Dr. Dahlsgaard is an accomplished lecturer, published author on child development and mental health, and holds prominent positions at the Anxiety Behaviors Clinic and the Picky Eaters Clinic in The Children’s Hospital of Philadelphia.