Fear of Vomiting

Does your child experience extreme anxiety at the mere thought of throwing up?  Does he or she experience adverse reactions, such as intense nausea or panic, when seeing or smelling vomit? Most people don’t enjoy being around vomit, but some adults and children actually experience panic at the thought of vomiting or coming in contact with vomit. If your child reacts in this way, it is possible that he or she is suffering from emetophobia: an extreme and pervasive fear related to vomiting.

Normal vs. Clinical Fear of Vomiting
Emetophobia is an extreme anxiety reaction to vomiting, way beyond the normal queasiness and disgust that people generally feel. The reaction can be so intense that kids can have unmanageable fears regarding illness or nausea because both of these are associated with the possibility of vomiting. In other words, if the child hears that a classmate has the flu, she might begin to obsess and panic about the chances that she herself will fall ill (having been exposed to the sick child in class). The child will worry that if she gets the flu, then she might have to vomit. The thought of the possible illness may keep her awake for nights on end until it seems that she has escaped the illness after all.

Parental reassurance and support does little to comfort the child. In fact, reassurance can actually prolong the panic reaction (see below).  Children with emetophobia may begin to panic even when hearing that someone in the neighborhood has been vomiting. They may fear eating at restaurants or friends’ houses because of the fear of getting food poisoning that may lead to vomiting. Or they may fear visiting people in hospitals because “that’s where sick people are.” They may fear going on school trips because someone may experience travel sickness and end up vomiting. In short, the fear of vomiting can affect a child’s entire life as the child tries valiantly to avoid all instances of vomiting in herself or others.

What Causes Emetophobia?
Like many clinical fears and phobias, fear of vomiting occurs without a known reason. Although some people develop this fear after having an unpleasant gagging experience, most people cannot trace the fear to a bad experience. In fact, if panic of vomiting is triggered through a very bad experience it is most likely a trauma reaction rather than emetophobia (a true phobia). Don’t bother asking your child what she is afraid of because she won’t be able to explain her strong reactions beyond saying she doesn’t like vomit. What she knows is that her heart beats rapidly, she feels nauseous, dizzy and/or overwhelmed and she can’t turn the feelings off.

How can Parents Help?
What can parents do to help a child with a fear of vomiting?

Firstly, it’s important that parents respond with compassion and empathy when children experience anxiety attacks. Clinical phobias are already difficult and debilitating on their own – getting reprimanded and punished for them will just add to the stress. Seeing a parent upset over something that can’t be helped will just shame a child for being ill.

Gradual de-sensitization to vomiting behavior or vomit can do a lot in helping a child with emetophobia. There are different therapeutic interventions that result in desensitization such as CBT (cognitive-behavioral therapy), EMDR (Eye Movement Desensitization and Reprocessing) and EFT (Emotional Freedom Technique). Home treatment of emetophobia is not recommended. Instead, take your child to an anxiety disorders clinic (where they treat phobias) or a child psychologist who treats fears and phobias. Treatment is normally brief with long-lasting effects.

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