My Emetophobia
Trigger warning: Description of treatment of emetophobia by exposure and response prevention therapy, descriptions of times I have seen vomit. There are no images of vomit in this post.
Emetophobia is the fear of throwing up. I have that! Until some time in my late 20s, I didn’t quite realize I felt differently about throwing up than most people. I remember a friend mentioning they had emetophobia and having to look up what that was. How surprising to find people who feel the same way about throwing up as me and do all the same stuff I do to avoid it at all costs. It was a few more years after learning emetophobia was “a thing” that I heard first hand accounts from friends that, yes, you can go to therapy to treat it.
For me, emetophobia looks like avoiding a wide variety of things that I think could make me throw up (e.g., seeing or talking about vomit, foods I deem “unsafe", alcohol and bars, roller coasters, boats, planes, and so on). The result of all this avoidance is that my world shrinks, there are fewer things I feel I can do in my everyday life. I will get sent into an anxiety spiral thinking about whether I’m going to throw up if I’m not able to avoid these things, which often involves me acting on compulsions which help reassure me that I won’t throw up. Rather, what I just described is how I felt about all this before starting therapy! I’ve since made some progress toward managing these thoughts and feelings.
Taylor and me in Lexginton in the fall
A few years ago, Taylor and I were in Lexington for Thanksgiving. One morning during that trip, we were walking to get breakfast, and passed some vomit on the sidewalk. This made me feel very anxious, and without even verbally acknowledging why, I conveyed to Taylor that I was not going to be able to walk down this street for the rest of the trip. A very on the nose example of how emetophobia was shrinking my world.
In the summer of 2025, we were in Vegas for my birthday with some friends. This was before I started therapy, but I had been planning to start looking for a therapist after getting home from that trip, although not specifically for emetophobia. At one point, we were walking through the hotel and passed a spot where someone had thrown up on the floor. I don’t think anyone but me even noticed. For the rest of the trip, I wanted so badly to suggest we walk a different route so we could avoid that spot, but I didn’t! In that instance, it was very difficult, but I didn’t let my emetophobia shrink my world. This is the overarching goal I’m working toward in therapy: to not let emetophobia make me avoid things that would otherwise be part of a normal and full life.
Last year, during the premiere of Survivor 49, a contestant threw up very suddenly and in full camera view right near the end of the episode. This was the first time in years I had even seen a depiction of throwing up. This was really difficult for me to handle, I felt panicked and numb for the rest of the episode. I went and sat at my computer when it was done and disassociated for about an hour until I felt kind of normal. I described the feeling to my therapist as “feeling like everything is wrong and bad in the world”. the scene replayed over and over in my head for days. This happened only a couple months into therapy before I had made much progress in handling these feelings.
An excerpt from my therapy notes doc about the Survivor 49 premiere
I had a very different experience when, a couple weeks ago, Survivor 51 premiered. Almost exactly one year since the 49 premiere, and a little over one year in therapy. In a strangely poetic way, someone threw up in this episode too. It feels so crazy to say, but it barely had an effect on me! I thought it was gross, had some of the same thoughts and feelings that I’ve always had, but ultimately I was so much more well equipped to handle it. It didn’t affect my enjoyment of the episode at all! More generally, the way I consume media has changed in that I no longer need to look up timestamps of when or if someone throws up in a movie or show before watching. I’m watching and enjoying entire genres that I avoided in the past (e.g., horror). A year ago, I wouldn’t have thought this was possible. I can’t overstate how crazy this feels! It’s so awesome to see the work I’ve put in pay off in such a tangible way.
So how did I get here? If you’re familiar with OCD, my description of emetophobia from earlier in my post might sound familiar. The way I’m tackling my emetophobia is with ERP therapy, which stands for exposure and response prevention, which I understand is often used in treatment for general OCD as well. What this means is that I expose myself to a trigger in a controlled and repeatable way (like seeing someone throw up in an episode of Survivor), which will make me feel anxious. I then sit with that anxiety without acting on my compulsions, like reaching for a piece of gum or medicine that I feel would settle my stomach (this is the “response prevention” part). Eventually, after doing these controlled exposures daily (see my post on discipline and my “daily mental exercises”) and working up a hierarchy of triggers that I rate as more and more anxiety inducing, I habituate to the feeling of anxiety and it becomes easier to deal with. Ultimately, I’m working toward accepting the idea that “I might throw up”. In this first year of therapy, I’ve done a lot of work specifically around seeing depictions of vomit in media and how I respond to that. I don’t want to get too in the weeds about this process here, but I plan to make a separate post about it in the future.
Something that has helped motivate me a lot is celebrating my progress and allowing myself to feel proud of myself. There is a part of me that would minimize my progress and my milestones, but I’ve gotten a lot better at ignoring that and letting myself feel proud. I’m proud that I’ve walked down that street in Lexington on subsequent trips there. I feel so proud that I didn’t ask Taylor and my friends to walk some weird route in the Vegas hotel to avoid the puke on the floor. I feel proud that I was able to finish watching the Survivor 49 premiere, despite being extremely anxious. I feel proud that I didn’t avoid watching Survivor after that exposure, and more so that I still enjoy watching Survivor as much as ever. Most of all, I feel so proud of myself for putting in this work and making the progress that I have toward taking control of my life back from my emetophobia. I still struggle with things and there is plenty of work left for me to do, but it does feel great to achieve what I have over the past year. Just because there is still work to do doesn’t mean I can’t celebrate my progress so far!