Emetophobia Awareness Day is officially May 1st, 2012. I say "official" rather tongue-in-cheek. It's only official because I thought it up and said so! But the point is, we emetophobes need to come out of the closet for the good of all.

Emetophobia is so common yet most doctors, therapists and researchers have never heard of it. It's been featured on the TV show "My Strange Phobia" as though the woman featured was some kind of fluke of nature. As a result people suffer in isolation, are looked down upon by their partners and families and cannot find any help or hope from the medical community. This is wrong. Part of it is our fault.

For some reason emetophobic people (myself included, in the past) are horribly ashamed and embarrassed to admit that they are afraid of vomiting. Sometimes we try it, tentatively. "I'm deathly afraid of vomiting" we say. To which they reply "Well nobody likes it." As if we would then go, "Oh ok" and we'd get our lives back. But the problem is, these sorts of belittling comments silence us. This can go on no longer.

What I've noticed by listening to literally thousands of emetophobics online and after spending the past two years treating exclusively emetophobics is that we are not specific enough when we talk about our phobia. Some people use the word "phobia" loosely, meaning they squeal and jump up on a chair when they see a spider. This is not a phobia, it's just a fear. A true phobia of spiders would mean your life is completely ruined and you are debilitated by the fear. You can never sleep at night in case there's a spider in the house. You spend every waking hour vacuuming and cleaning and spraying with Raid. You can't work, socialize or even go out of your house because other places are not as "safe" from spiders. That's a phobia.

So we need to not only come out of the closet, but we need to say more. Explain more. I find in consulting with other therapists that most of them have no idea how scared an emetophobic is of vomiting. Some therapists have tried ludicrous ways of treatment such as suggesting that the emetophobic vomit in order to "see how it can't hurt you." Imagine having a fear of spiders and being forced to be covered with them for an afternoon. Now imagine having a phobia and doing the same thing. This is not "treatment" it's cruelty.

We have to speak out, and we have to be more explicit. We can't back down when our families or our doctor or therapist tries to brush the phobia off as not very significant and believes it can be overcome by just "getting over it."

Stay tuned to this blog (or subscribe) for ideas, press releases, tips and more as we get closer to May 1st. Meanwhile, think about what media outlets you might have access to or what PR/marketing folks you could approach for some help.

Living with emetophobia is not really about the fear of vomiting. In one sense, vomiting has nothing to do with your fear or phobia. I tell all my clients: your problem isn't vomiting. Your problem is anxiety.

It's just that things to do with vomit trigger the anxiety or panic attack. So getting over emetophobia is more simple than you think. Because it doesn't matter who is vomiting, who has norovirus, whether you feel nauseous or sick, how often you've washed your hands or anything else "out there in the world." None of those things matter. All that matters is your ability to control your anxiety. Because right now, your anxiety probably controls you.

Therapists measure anxiety on an 11-point scale called an "SUD" scale which stands for Subjective Units of Distress (or Disturbance). There are 11 points because zero is one of the numbers: 0-10. Zero represents no distress (anxiety) at all. 10 is the worst possible panic you could ever imagine.

As I am working through gradual exposure with clients I am constantly asking them for an SUD number. (It probably annoys the hell out of them!) But the numbers are important because they're your numbers. Hence the term "subjective." 7 is 7/10 for you. Perhaps that's when you start to feel your heart racing, but for someone else it's when they have sweaty palms and tingling feet. Everyone's numbers are different, but the numbers help us to get an idea of whether your anxiety is rising, lowering or staying the same.

But the numbers also serve another important purpose. They let you know how scared you are. Often phobics think of themselves as either "freaked out" or calm, but there are a lot of numbers in between those two and learning to recognize each one of them is key to overcoming your anxiety.

Let's say that you are feeling 1/10 for a baseline. A little stressed perhaps, but no noticeable symptoms. If your anxiety rises to 3 or 4/10 you can probably lower it again just by taking a deep, cleansing breath and then concentrating on slowing your breathing right down and dropping your shoulders to a more relaxed position.

If your anxiety rises above 6/10 being able to control it is more difficult. Up at 8 or 9 you're not even able to think straight. But often it is those numbers between 4 and 7 that give phobics the most trouble. It's there that you can feel a lot of body symptoms such as increased heart rate and breathing, tingly hands or feet, dizziness, nausea, etc. So if you notice your anxiety that high, it's time to try to relax. Breathe slowly. More slowly! Don't hold your breath at the top or bottom of the air - keep it moving. Relax shoulders, stomach, face and jaw. Then take a numerical reading again. Are you at 3 or 4 now? Great. Because it's much easier to lower it from there. More concentrated breaths, more relaxed muscles.

Just the act of "taking a number" can help calm you down. Whatever the number is, you can lower it! Just practice, practice, practice. If you need some help click on the "Resources" section and then "Relaxation Recordings." Good luck! Before you know it your fear of vomiting (or fear of norovirus) will be much better.

One of the reasons I have information on this site about norovirus is so that people with emetophobia can find it, and find the help they need to overcome their fear of vomiting. And this time of year I get more emails asking for help than all the other seasons combined. All because it's winter (at least in the northern hemisphere) and norovirus seems to be running rampant through the schools and nursing homes.

So why the title of this post? Because researching norovirus is not going to help you with your emetophobia. In fact, it may only make it worse. If you are emetophobic you probably think your biggest problem is avoiding or preventing vomiting. But that's not true. In fact, vomiting isn't any problem at all. It's not dangerous. It's not harmful. It can't hurt you in any way. Your biggest problem is anxiety or the fact that you fear something that can't hurt you.

Focusing on norovirus and ways to avoid or prevent vomiting is what will make your phobia even worse. It will trick you into believing that vomiting is some sort of big scary monster to be avoided at all costs. But norovirus isn't Ebola or AIDS - it's a harmless virus that makes you feel quite lousy for 24 hours and then you're fine.

I understand how scared emetophobics are of norovirus - I used to be that scared. Luckily for me, I was emetophobic before there was an internet. I really think that if I had researched all this stuff and gone online talking to other emetophobics my life would have been completely destroyed.

Spend your energy researching ways to get over anxiety disorders. There's lots of that on the internet! There are relaxation recordings, tips for panic attacks, and of course lists of therapists in your area that deal with anxiety disorders and phobias. If they've never heard of emetophobia just get them to email or call me!

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.

Finally all my schoolwork is completed, resume updated, forms filled out, supervised hours all done, references and transcripts arranged for and criminal records check sent in and back. The whole package has been sent off to the registering body for consideration this October, and God-willing and the creeks don't rise I'll be a registered clinical counsellor before 2012. It takes such a long time! But I have a friend who's about to be licensed as a psychologist in California and she needed to complete 1000 hours of supervision first so I can't complain.

This summer I've been taking it easy with a fair bit of time off to relax and enjoy my garden, Vancouver and the little fishing village I live in called Steveston. I also bought a used bicycle and have taken up riding for exercise. Other than a nasty spill on Thursday and a skinned knee, it's proved to be very beneficial.

One of the things I've been working on in my time off is an update and minor re-organization of the Resources page. Instead of just 8 categories of gradual exposure I now have 10 plus four more in the "miscellaneous" sections. After working with over 30 clients the past year I noticed what was in the wrong order and what was missing. I now have a level called "sentences" which comes in after "words" and before "drawings." I also added a level of pictures of people around toilets - something that many emetophobes have a problem with. In the miscellaneous section is a page about animals, hospitals, a simple picture of a water fountain and a "is it soup" quiz that demonstrates how we assign the property "disgusting" to some things which look exactly like other things that we don't deem disgusting at all.

I haven't finished the "sentences" section yet, and I also hope to add another level soon called "in vivo" which means "in reality" - things that people can gradually begin to do in real life such as not washing hands so much, not disinfecting everything, not throwing out food, etc.

I really hope that the new resource page helps a lot of therapists in treating emetophobia and also understanding it so that as many people as possible can overcome this phobia!  Stay tuned for my fall newsletter!

Emetophobia doesn't get a lot of press. In fact, most doctors and therapists don't even know what it is. So I'm doing my best to spread the word and you can help. If you're on Facebook go to www.facebook.com/emetophobiahelp and click "like." Then, when the wall posts go through your news stream click "share" on those so that the word gets out to your whole network. This way the word will grow exponentially.  

I've also posted an "Event" for April 1, 2011 that I'm calling "Fools for Emetophobia." It will be an international emetophobia day. Emetophobics everywhere will be encouraged to "get some press" on that day. The more people know the more therapists will inquire about how to treat it and then millions of sufferers will finally get the help they deserve.  Yes, I dream big!

Thanks to the beautiful template I used for this website, I've chosen the sunflower as a "brand" symbol. Keep your eyes peeled for it everywhere!

Emetophobia can be difficult to deal with at the best of times, but during the holidays it is even worse. Most people suffering from anxiety, panic and the fear of vomiting try to stay indoors if they can. They don't want to go out where they will encounter people who might have a norovirus. They don't like to eat out because they fear the food may be contaminated if they don't prepare it themselves. Most emetophobia sufferers also try to stay away from children because they believe that they carry a lot of germs.

At Thanksgiving, Christmas and New Year's there are traditionally family gatherings and often not at the emetophobic person's home. So all of their fears can be present at one time: going out, not preparing the meal, being around other people, especially children.


I remember those days and I only wish that I could have had some wise advice in those days. Yes, it will be stressful, but there will be much joy in it too and don't forget that. Here are some tips for helping you get through the holidays when you fear vomiting.

1. Remember that being "around" people will not make you sick, even if they are sick. You have to ingest the virus. So always wash your hands before eating or putting them in your mouth. If you do that, you are just as safe as if you were attending the festivities in a bubble.
2. Trust your relatives to cook the food properly. Don't ask questions about it. Continually questioning is an anxious behavior, not a calming one.
3. If there's something you don't want to eat, just don't eat it and don't feel bad/guilty/obliging. You are a grown-up and you can eat whatever you want. Hold your head high and just say "no thank you."
4. Don't continually question people if they talk about not feeling well or having been sick recently. Again, this is anxious behavior. You can't possibly hear an answer that's going to calm you down.
5. Enjoy yourself! LISTEN to conversations, play games, catch up with relatives, smile at babies and children's happiness. Savor every delicious morsel of food. Avoid sitting in a corner freaking out - get out into the conversation instead. Keep busy.
   
6. When you hear the voice in your head freaking out and being anxious try just saying "stop" and going on to distract yourself with something else. Even if you say "stop" five thousand times over the holiday, it's better than saying five thousand terrifying things to yourself and nothing else.
7. As a Christmas gift to yourself, or a New Year's resolution, get some counseling and get over this phobia once and for all. My website will tell you how. You deserve this!
8. Finally, these are religious holidays. If you are a person of faith, pray and ask God to help you conquer this phobia. Note that God needs soil to grow seeds - they won't grow on your coffee table, no matter how much you pray. Emetophobia counselors and therapists and emetophobia treatment programs are the soil you need!
   

All the best to everyone this holiday season!