I had to apologize to three of my emetophobia clients this past week for a photo I posted on my Resource Page of some vomit (no people in the picture). I had found a photo which I thought would be good to put between another photo of vomit and the final photo on Level 8 of two people in a parking garage. Long story short: I posted the phot in HUGE format without realizing it! I had printed it out for my binder in the thumbnail version, and didn't realize the clients were looking at this ginormous zoomed-in view! Anyway, the clients all did extremely well in looking at it and I was very proud of them. But I have indeed made that photo smaller now!

The photo, as well as many others I show clients to have them gradually desensitize to vomit, brings up an interesting topic which is the title of this week's blog. How much of our inability to cope with vomit is anxiety and how much is disgust?

With anxiety, therapists use a standard "SUD" scale of 0-10 which stands for "Subjective Units of Distress." We ask clients (constantly, to the point we're annoying) to "give us a number." But the emotion of disgust is one of those interesting emotions that, at least at higher levels, is tied to anxiety. It's why some people faint if they see somebody with horrible injuries: the anxiety goes too high and all the blood drains from their head. The way I like to describe it is this: "When disgust goes too high, it pulls anxiety up with it."

What does this mean for emetophobics? Well, is the glass half-full or half-empty for you? If you're the half-empty kind of person it means that you will have to learn how to cope with some pretty disgusting stuff in order to get better. Sorry. If you're the half-full sort of person you can look at it this way: the perk of desensitizing your anxiety to vomit is that you also desensitize to disgusting things! So like...you could become a nurse in the end or one of those TV CSI people who examines bones and severed heads and such. (Can you tell which sort of person I am? haha)

If you think you're the kind of person who gets disgusted easily or gets squeamish then it will be an important part of your recovery to desensitize to disgusting things in general. The more you can handle looking at awful things, the less your phobia will be triggered in your everyday life.

For over ten years now I've been a member and moderator of an emetophobia discussion forum. I've probably read posts and corresponded with literally thousands of emetophobes. One thing I've found that the majority have in common is the need for reassurance from others that they won't vomit. On the forum, phobics describe their stomach symptoms and, often in a panic, ask the community for reassurance that they won't vomit. Inevitably the community responds with reassurance that they won't be sick and that they're just anxious.

Children with emetophobia (or any other phobia for that matter) often ask their parent(s) for reassurance that they won't vomit, or won't see a spider, etc. I've talked with some pretty exhausted parents who day in and day out are peppered with questions from their anxious child.

Getting reassurance from someone else brings temporary relief to one's anxiety. But it is temporary, and in the long-run will make your phobia worse. What every emetophobic can benefit from is the knowledge that seeking reassurance is a symptom of anxiety disorders. It's part of the problem, not any sort of solution - temporary or not. It's one way in which emetophobia is related to Obsessive-Compulsive Disorder ("OCD"). The obsessive thought is "what if I'm sick? what if I'm sick?..." or "is it norovirus? is it norovirus?"

In seeking reassurance you may calm down a bit if someone tells you that you're not going to be sick and it's just gas, or just some discomfort, or you're just full, etc. etc. The problem comes in when a) you don't really believe them - because after all, they're not you, and how could they know what your stomach is going to do? and b) them reassuring you that you won't be sick is like them saying that if you were to vomit you would somehow be in some kind of danger or harm's way, when in reality vomiting is not dangerous or harmful at all.

So if you're emetophobic, try to think clearly when you are tempted to ask for reassurance. Practice breathing more slowly and evenly, and relaxing all your muscles from head to toe. Say to yourself, "vomiting is not dangerous or harmful in any way, so I don't need to be afraid of it." If you're the emetophobic's loved one do not give them reassurance. It's tempting to do so because it may calm them down, but it will make their phobia worse in the long run because it's a way of avoiding what they're afraid of. Instead, help your loved one out by helping them to get professional help for their phobia. If you can't afford that, check out the "Resources" page on this website's menu and then click "Self-Help." Meanwhile, calmly say to them something like this: "I don't know if you're sick or not, but I do know that even if you are, you will be ok. Vomiting isn't harmful, it just feels like it is. I will be right here with you, no matter what.