Overcoming Emetophobia (Vomit Phobia) with a CBT Therapist
Updated on April 24, 2024
What is Emetophobia?
Emetophobia is also known as the fear of vomiting or throwing up (or vomit or barf phobia). People with emetophobia experience intense and persistent anxiety and fear around the possibility of vomiting or seeing others throwing up.
If you struggle with the act of vomiting or seeing other people barf, you could be struggling with emetophobia. If you worry about others judging you if you vomit, then you might be struggling with social anxiety. If you worry about becoming contaminated from vomit, then you could be struggling with obsessive-compulsive disorder (OCD).
You will need to determine what your “core fears” are to determine if it is truly emetophobia. You can ask yourself: what I am worried will happen if I vomit? Or, what I am worried will happen if someone else vomits?
Meet Celissa & Melissa, Clinical Directors of Virtual CBT Clinic
We will meet with you and match you with a therapist who is experienced in treating anxiety disorders including phobias. We receive quite a few referrals for vomit (barf) phobia. Book your free 15-minute call by clicking the tab below.
We have a variety of counsellors to choose from and are covered by most benefit providers. Call your benefits to see if you are covered for counselling or psychotherapy (also called psychological services).
Prevalence of Vomit Phobia
If you struggle with emetophobia - you are not alone! According to the American Psychiatric Association (APA), specific phobias, including emetophobia, are among the most prevalent anxiety disorders in the United States, affecting an estimated 7-9% of the population at some point in their lives.
This phobia can significantly impact your daily life and make it difficult for you to engage in normal activities, such as going to school, work, or social events. You may even avoid a lot of things like certain foods, young children, or social settings.
Causes of Emetophobia
The exact causes of emetophobia are not well understood. However, researchers believe that it is likely caused by a combination of genetic, environmental, and psychological factors. Traumatic experiences, such as a severe illness or a bad experience with vomiting, can also contribute to the development of emetophobia. Overall, there are probably several reasons why you developed a fear of vomiting. If you can’t identify any causes - no worries - sometimes we develop phobias for no particular reason.
"Courage is not the absence of fear, but the triumph over it." - Nelson Mandela
Symptoms of Emetophobia
The far of barfing can cause a variety of physical and psychological symptoms. These may include:
Intense emotions like anxiety, disgust or shame. You may even be struggling with symptoms of depression because you feel hopeless and different.
Avoidance of situations, places or activities that may trigger anxiety or vomiting. For example, you might avoid: certain foods like chicken or sushi, young children, groups of people, avoiding sick people and children, public washrooms, alcohol, etc.
Obsessive thoughts and rituals (or safety behaviours) around cleanliness or avoiding germs. Some examples of safety behaviours with people who have a fear of vomit: are overcooking meat like chicken, excessive hand washing, tossing food items before their expiry or best-before date, overusing hand sanitizer, excessive cleaning routines, and distracting yourself from anxiety.
Physical symptoms when thinking about vomit, such as nausea, sweating, and rapid heartbeat.
Catastrophic thoughts about vomiting, like “I will never stop vomiting”, “people will judge me”, “I won’t be able to cope”, I could choke on my vomit and die”, and “I could lose control”.
Treatment Options for Fear of Barf
Cognitive-behavioural therapy (CBT) is a type of counselling that is particularly effective for treating emetophobia. CBT involves identifying and challenging the thoughts and behaviours that contribute to anxiety and fear.
Exposure therapy, a type of CBT treatment that gradually exposes the person to the feared object or situation in a controlled and safe manner, is also used to help people overcome their fear of vomiting. Learn more about exposure therapy for anxiety.
Examples of exposures for emetophobia:
Writing trigger words (e.g. vomit, barf, puke, hurl, gag)
Write trigger sentences (e.g. I will vomit)
Looking at images of vomit or people vomiting
Watching videos of people vomiting
Imaginal exposure is also very effective for emetophobia because it is a hypothetical situation (in other words, it’s in the future)
On occasion, interoceptive exposure should also be integrated into treatment (e.g. purposely feeling dizzy or like you could gag or vomit)
Eliminating Safety Behaviours
An effective treatment plan will also include eliminating safety behaviours - something that is often overlooked by therapists. If you struggle with emetophobia, you may have quite a few of these. Although these behaviours make you feel better in the short-term they could be worsening your symptoms in the long-term. To learn more about safety behaviours.
If you struggle with severe emetophobia and are not willing to try counselling, you may want to meet with your doctor or a psychiatrist and discuss the possibility of starting medication. Some people will need a combination of mental health counselling and medication.
Tips for Managing Vomit Phobia
In addition to seeking professional help, there are also several things that people with emetophobia can do to manage their anxiety and fear. These may include:
Practicing relaxation techniques, such as deep breathing or meditation. It’s best to schedule a time to practice relaxation techniques so that it does not become a “safety behaviour” (which helps you to feel better in the short-term but will maintain your symptoms in the long term).
Consider gradually cutting back your avoidant behaviours and eliminating your safety behaviours.
Challenging negative thoughts and beliefs that contribute to anxiety and fear using a thought record.
Learn how to practice mindfulness.
The fear of barf can be a debilitating anxiety disorder, but it is also highly treatable. With the right support and treatment, people with emetophobia can learn to manage their anxiety and overcome their fear of vomiting. If you or someone you know is struggling with emetophobia, it's important to seek professional help and support. Remember that you are not alone and there is hope for recovery.
Vomit Phobia Resources
Books
Free Yourself from Emetophobia: A CBT Self-Help Guide for a Fear of Vomiting
The Emetophobia Manual: Free Yourself from the Fear of Vomit and Reclaim Your Life
Websites
We also like this website on emetophobia for exposure and treatment ideas for vomit phobia (although, you may want to meet with a therapist who can show you how to do exposures, create a fear hierarchy and help you to identify your safety behaviours).
Getting Started with a CBT Therapist
Most of the therapists at our mental health clinic are trained in providing exposure therapy for emetophobia and have had several clients overcome their anxiety symptoms related to their vomit phobia. Treating emetophobia has become one of our specialties.
You can book a free consultation with a CBT therapist by clicking the tab below. Check your benefits to see if you are covered for psychotherapy by a social worker, psychotherapist, psychologist or RN psychotherapist and get started on your path to wellness today. Learn more about our therapy fees.
*The psychotherapists at Virtual CBT Psychotherapy are registered to provide services to Ontario residents (adults, teens and children).
References:American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). 