Emetophobia is the severe fear of vomiting, or seeing others vomit, and is surprisingly common.
We all have some degree of fear about vomiting or being in close proximity to someone who is. However, there are individuals panic-stricken by even the thought of vomiting. In fact, this phobia is particularly common in children. On average, 6% – 7% of females and 1.7% – 3.1% of males experience Emetophobia.
Kids who already tend to be anxious are more likely to develop it. It leads to fear of things they associate with vomiting. Often it starts with avoiding places where they (or someone else), threw up, or places that remind them of it. They may refuse to wear the clothes they were in when they vomited or go into the room where it happened. They may stop eating a lot of foods to try and avoid being sick again. The fear of vomiting may mean they can’t go on school trips or even get to school.
When parents try to get help for Emetophobia, some professionals may say the kid is being defiant or looking for attention. This is not true, and when the child’s fear isn’t taken seriously, they can develop terrible shame, which if left unaddressed, can continue into adulthood. They may try to hide their fear while in school and fall apart when they get home. The child’s fears may keep growing and growing until they are afraid of lots of things. Like a lot of phobias, it can start small and then keep growing bigger and bigger.
Almost 50% of kids with fear of vomiting also have symptoms of OCD, a disorder in which the child develops rituals to quiet their overwhelming fears. There are a lot of different ways in which OCD can present itself including a fear of harming other children or family members and being afraid of germs and bad luck.
What causes Emetophobia?
It is hard to pinpoint what exactly causes Emetophobia. It can be a combination of factors including genetics and if the child is already extremely anxious. However, Emetophobia is commonly triggered by a traumatic experience involving vomiting. The phobia is not restricted to a specific age. Emetophobia is typically triggered at a young age and can persist into adulthood if not appropriately supported.
Sometimes the anxiety can start from an early age when the child is fearful of being separated from their parent/s. This can lead to the development of various behaviours including vocal tics such as persistent coughs or clearing of the throat, and other compulsive behaviours such as asking questions repetitively.
How will I know if my child might have Emetophobia?
As a parent, it can be difficult to find out what is bothering your child. At a young age, they will struggle to express their worries and thoughts to you. If you are concerned about your child’s health or suspect they might have this condition talk to your GP first. They will advise on the most appropriate treatment and support for your child. However, if your child suffers from Emetophobia there are some practical techniques you can put into place to support them.
What can I do if my child has Emetophobia?
- Don’t dismiss the issue. Consider this as a phobia until you have a medical diagnosis, and be there to support your child.
- Try to avoid making make false promises. For example, ‘if you wear this necklace it will stop you feeling sick.’
- Find out as much as you can about your child’s relationship with this issue. Getting a clear understanding of the phobia can help you consider what can be done to support your child. So consider the following: When did it start? When does it affect them? How does it make them feel?
- Encourage them to have a focus for the day or the week. For example, to pick 3 things they are looking forward to this week. The more they focus on this, the less they will focus on their phobia. Suggest that they write or draw these things and then put it on the fridge or somewhere they can see it every day.
- Remind them they have power over their body and how they feel. Give them simple physical examples like drinking some water or rubbing their tummy.
- Empower them by helping to draw a picture of something that makes them feel powerful and put it somewhere they can see it regularly. For example, it could be them dressed as their favourite superhero or it could be a strong animal like a tiger or lion.
- Help them come up with some ways they can help themselves if they are starting to feel sick, like asking for a drink of water or for a window to be opened.
- Create a ‘Comfort Box’ and encourage them to use it when they start to worry about being sick.
A Comfort Box is a physical or imaginary box used to distract a child from negative thoughts and encourage more positive, soothing ones. It is to be used when a child is experiencing periods of anxiety. The key is to fill it with items that create happy memories, soothing sensations or pleasant feelings through stimulating the five senses – sight, smell, taste, touch and hearing e.g.
Smell: bathtime soap or your body spray/aftershave
Taste: their favourite sweet or snack
Sight: a picture of a fun, family experience
Touch: a comfort blanket or favourite cuddly toy
Sound: an audiobook, piece of music or sound of a loved one talking
It is important that these items create only happy, joyful memories. They should not have any association or connection with difficult memories or experiences. Ideally, they should not be too stimulating either. This is particularly the case with the audio item so try to avoid music with a high tempo or that is particularly loud.
When a child is feeling anxious the comfort box can be used to change the negative thought patterns. As the child goes through the items in their own box encourage them to say outwardly or inwardly what they are thinking or feeling as they taste, touch, listen, smell or see each item.
Here are some examples:
‘I like the feeling of this pillow because it is soft and fluffy’
‘This smell reminds me of mummy’
‘I collected this shell the day we all went to the beach and had ice cream’
‘This blanket makes me feel warm and cosy’.
As the child moves through their comfort box and talks about each item, the positive thoughts should gradually replace the negative ones and ultimately ease their anxiety.
There may of course be some situations where it is not possible for the child to have their comfort box to hand, for example when they are at school. Here it may be helpful to practice an imaginary version with them. In their virtual version of the box, support them to say what they think when they imagine holding, touching, smelling, seeing or hearing each item.
Useful Resources
Overview – Phobias – NHS (www.nhs.uk)
International Emetophobia Society | The Web’s Largest Meeting Place for People With Emetophobia