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How to stop emetophobia from controlling your life

Many of our reactions to the world are learned.  We aren’t born with a fear of needles; we learned from experience that needles are painful.  After doing so, some of us developed some level of fear towards needles/syringes.  However, we can also unlearn our fears.  Throughout our lives, we commonly unlearn fears such as the fear of riding roller coasters, dealing with the opposite sex, sleeping without our parents in the same room/bed (as a little child), etc. etc.

What you don’t need to do

  • Don’t do anything stupid such as inducing v*ing for no reason, eating unsafe food, etc.
  • Don’t do anything that you would find extremely traumatizing such as watching videos of v*ing.

v* = the thing that emetophobes are afraid of.  Read the Wikipedia page on v*ing if you still can’t figure it out.

Exposure therapy

Exposure therapy is a scientifically-proven method of treating phobias.  You can read relevant research for yourself if you’d like.

  • Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of clinical psychiatry. 2008 Apr;69(4):621.  (full paper)
    This review looks at the effectiveness of CBT therapies on various adult anxiety disorders: social anxiety, OCD, PTSD, panic disorder / panic attacks, acute stress, and generalized anxiety.  Note that CBT (cognitive behavioural therapy) and exposure therapy are considered to be variations of each other.
  • Ahlen J, Edberg E, Di Schiena M, Bergström J. Cognitive behavioural group therapy for emetophobia: An open study in a psychiatric setting. Clinical Psychologist. 2015 Jul;19(2):96-104.  (abstract, full paper)
    This study looked at the use of group CBT for emetophobia.  3 months after treatment, 14 out of 21 participants (two thirds) were clinically significantly improved or recovered.
  • Maack DJ, Deacon BJ, Zhao M. Exposure therapy for emetophobia: A case study with three-year follow-up. Journal of Anxiety Disorders. 2013 Jun 1;27(5):527-34.  (full paper)
    Emetophobia case study using a exposure-based behavioral treatment.

To understand what exposure therapy is, we can look at what people do to get over their fear of riding roller coasters.  Early on in our lives, we learn to be afraid of falling so that we don’t seriously hurt ourselves.  Logically, we know that roller coasters are safe.  As we learn that the falling sensation isn’t a sign of extreme danger, we can work up the courage to go on even more intense and scarier rides.  We start with the least intense rides and work our way up.  We do not start with the most intense rides first as the experience may be overly traumatic and make us afraid of all roller coasters.  Gradual exposure to fear can teach our brain that our fears were exaggerated.

In the case of emetophobia, it is not necessary to induce v*ing to solve the fear problem.  What you presumably want is to live a normal life without the fear and anxiety from the phobia.  The end goal in exposure therapy is to live life without the avoidance behaviours and coping mechanisms caused by emetophobia, such as not eating “unsafe” foods that are actually safe.

How to re-program your brain

Step 1 is to make a brief list of things you find uncomfortable and rank them based on how uncomfortable you are with them.  It might look like this:

  1. Reading articles that mention v*ing (or infectious conditions that cause v*ing).
  2. Watching Youtube videos of people v*ing.
  3. Not using a safety behaviour (e.g. distracting yourself) when you feel stressed out about v*ing.
  4. Drinking alcohol.
  5. Cooking and eating “unsafe” foods that are actually safe.
  6. Watching/hearing other people v*.

Step 2 is to slowly work on being comfortable with those activities, starting with the activities that you can tolerate.  Play through the scenario in your head.  Then, use the logical part of your brain.  Actively tell the rest of your brain what the appropriate emotional reaction is.

Be confident in the correct logic.  Form your own convictions about the actual dangers of the following:

  • V*ing:  Yes, v*ing is unpleasant.  However, it is not the end of the world.  We will all experience unpleasant bodily events in our lifetime: paper cuts, rashes, bruises, broken bones, headaches, a visit to the hospital, etc.  You can talk to a doctor about how dangerous it is or isn’t as your v*ing likely isn’t a concern at all.  Your past v*ing likely has not caused any long-term damage or noticeable health effects.
  • Feeling of not being in control:  Paper cuts and getting struck by lightning are often outside of your control.  However, you don’t worry about such events.
  • Fear:  Fear stands for False Evidence Appearing Real.  When your body is telling you that there will be massive danger if you v*, you can logically understand that those fears don’t make sense.
  • Emotions such as anxiety:  While your feelings may be scary, you can understand that they can’t hurt you.

Once you’re confident that your fears are exaggerated, you can have a conversation with your brain whenever it is erroneously generating fear.  Tell your brain what you should be feeling and how you should be acting.  After doing this a few times, your brain will eventually ‘get it’ and stop generating the various feelings that make it more difficult to live your life.

Once you’re comfortable with a scenario in your head, you can make the leap to doing it in real life.  (Obviously, don’t harm yourself or do anything stupid such as getting wasted with alcohol.)

If it helps, you can think of it like driving.  Once you master driving, you operate a car without having to think much about it.  However, suppose that you move to a new country where you have to drive on the opposite side of the road.  While your brain might tell you that there is something very disturbing with driving on the “wrong” side of the road, you can actively ignore that feeling.  If you actively think about driving, you can reprogram all of your instincts and automatic responses to adapt to your new environment.  You can force yourself to think about what you should be doing instead of leaving your brain into autopilot mode.

What to do if you’re uncomfortable with all of the items on your list

Take a baby step then.  Train yourself not to laugh.  Go on Youtube and find funny videos such as a Try Not To Laugh Challenge, stand up comedy, funny shows such as Silent Library, etc. etc.  Re-program your learned reaction towards unexpected stimuli to something other than laughter.  Whenever something unexpected happens, you can instead try to spot a formulaic pattern to the comedy such as setup-setup-payoff.  (Or if you hate yourself, you can learn how to watch disturbing videos without being disgusted.  Go on Youtube and find videos of pimple popping, surgery, spider bites, mangoworms, etc.)

Once you’ve convinced yourself that you can re-program your brain, you should be less afraid of the uncomfortable stuff.

Don’t rely on coping mechanisms

Some ways of coping with anxiety is to use deep breathing, to relax your muscles, or to distract yourself so that you don’t think triggering thoughts.  While it is fine to use coping mechanisms occasionally, the goal is for your brain to learn that you don’t need to use coping mechanisms at all.  There is nothing to fear so there is no need to use coping mechanisms in the first place.  Using them reinforces the idea that there is something to fear.

Allow yourself to feel the anxiety.  Then, actively tell yourself that:

  1. Your feelings of anxiety can’t hurt you.
  2. There isn’t a logical reason to feel anxiety in the first place.

Similarly, keep track of your safety behaviours and avoidance behaviours.  For example, you may take excessive and possibly illogical precautions so that you don’t get sick.  Perhaps you avoid situations where people will be drinking alcohol and are more likely to v*.  These are fears that you should work on getting rid of once your fear is low enough.

Recap

Instead of running away from your fears, you can resolve emetophobia by facing your fears.  Look at them and realize that they are mirages that can’t harm you.  You are in control, not your emetophobia.

 

 


Resources

To see exposure therapy in action, you can find a video on Youtube where it is used to treat a phobia such as a fear of snakes (below) or confined spaces.

For zesty emetophobia memes, try the Subreddit r/emetophobia.

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