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  1. #1
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    Hey guys: I seem to get asked a lot of questions over and over, and keep composing answers that are similar as weeks, months or years go by. So I'm going to start this thread and then refer to it later, or you can refer people here for my "Sage advice" (for whatever that's worth). Of course, you don't have to agree to any of my advice!


    For more info about emetophobia and treatment:

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  2. #2
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    WHAT TO SAY TO YOUR THERAPIST WHEN THEY ASK WHAT EXACTLY YOU'RE AFRAID OF


    Hey guys - here's something I wrote today that seems worth saving cuz people ask this question a lot. If it's helpful, print it out and take it to your therapist and read it to him or her:


    "I thought about what you asked me in reference to what exactly I'm afraid of if I vomit, and it's like this:


    I don't have any thought in my head at all...it's a pure fear response. For some reason vomiting, or even the thought of it, triggers absolute terror and horror for me. It's like a fate worse than death. I panic like I'm dying.


    I know that's not logical, but...it's obviously not the logical part of my brain at work, then, is it? Tell my amygdala that it's not logical. All I know is that the thought of vomiting is so terrifying for me that I obsess over it day and night, and it is ruining my life. The number of situations I have to avoid to cope with this fear are mind-bogglingly numerous. Although there may be other aspects to my state of anxiety, what I really want to do is to address this horrible and debilitating phobia first, and deal with whatever else comes up later. Do you think you can help me with it, or should I look for someone else?"Edited by: sage
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  3. #3
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    ON BEING AFRAID TO BE CURED, LEST YOU GET SICK MORE


    QUESTION: I was thinking about why it is so hard to cure emetophobia...and I realized there is a huge part of me afrai do fbeing cured, because if I am cured and not so aware of my phobi all th etime, then that could mean I could V* because I wouldn't be so careful...does that make sense to anyone?

    ANSWER:


    Yes, this sort of thinking "makes sense" in the phobic way of making sense - lol! Let me put to rest for everyone that I've been cured of the fear of vomiting myself for about 20 years, and have only vomited once in that time, when VERY VERY ILL with chemotherapy, and the experience was a big fat nothing that didn't matter to me in the least. In fact, I wondered why the hell I had given up so many billions of hours of my life to worrying about it! Even in the past 4 years of being totally completely anxiety-free...I don't lead some sort of filthy disease-ridden lifestyle. I'm still clean and I don't eat chili that's been out on the counter all night or anything. I don't get sick any more or less than when I was phobic.


    But others have alluded to the real point: your worst problem is NOT the fact that you might vomit one day. Your worst problem is ANXIETY - the fear of it! THIS is what you want to stop...(honestly, you do - you just don't know that you do - lol) You don't realy want to stop vomiting. Vomiting is just normal and natural and slightly unpleasant but over in 10 seconds anyway.


    The thing is, to help yourself from having your whole life ruined by this phobia, it's important to keep telling your brain the real truth. That is, that it's NOT logical to think you need to have a debilitating phobia forever in order not to get sick, and that somehow you're better off in this life with a horrible anxiety disorder. That makes no sense. One part of your brain (the fear part) is fighting like hell to tell another part of your brain (the logical part) that you MUST STAY AFRAID in order to protect yourself. In order to be cured of the phobia, the logical part of your brain has to learn to "speak louder" than the fear part. [for those of you interested in the science, the fear part = the amygdala and the logical part = the neocortex] Edited by: sage
    For more info about emetophobia and treatment:

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  4. #4
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    HOW DID WE GET THIS PHOBIA?


    QUESTION: I am sorry if this has been asked before but I really would like to know why and how we develop phobias? I know it sounds a silly question but I would just like to know why some people are deeply affected by things and others not. I mean, I really hate spiders but my fear of them is nothing compared to the way I feel about v*!


    ANSWER: It is different with everyone, to a degree. What we have in common is that phobias are the result of a "perfect storm" of things coming together. Every psychologist out there who study anxiety disorders agrees that there is no one single cause. Whatever "trauma" we had in childhood with vomiting (such as having food poisoning, or someone getting sick on/near you) does not cause emetophobia in every child. That is because there are other factors at play.


    Things like the family's stress level, and how our families handle stress is very influential. Grief and loss, abuse, trauma and anxious parents (particularly mothers) are factors as well. Heredity could play a part, but it's not everything. No gene has ever been found for anxiety/phobia


    No matter what led to our phobias, the "cure" is the same...good, solid therapy over a long term which usually involvesgradual exposure to the stimulus ina safe environment and avoids re-traumatization (such as saying that the client has to vomit himself to get over it). If it's very very serious then medication might be helpful as well. In any case, there's no need to spend a lot of energy worrying about the cause. Spend your energy on your treatment instead.Edited by: sage
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  5. #5
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    DO I NEED TO VOMIT IN ORDER TO BE CURED OF THIS PHOBIA?


    This is such a ridiculous notion that I can't believe some therapists actually still suggest it. My advice is to ask THEM the following question in response: "Do you think it's also necessary for victims of sexual abuse to have a goal of experiencing non-consentual sex again in order to get over their anxiety?" In my opinion, it's about the same thing. So is saying that those afraid of heights need to try jumping off a building, or those with flying phobias need to be in a plane crash.


    Now let me give your therapist a break for a mnute: therapists get this idea because they do not fully understand just HOW AFRAID of vomiting you are. To them, don't forget, vomiting is a big fat nothing...so why not give it a try with ipecac or something and see what happens. But to YOU, it's akin to death, a plane crash, or rape. It really is. You need to get your therapist to LISTEN TO YOU. Keep trying that. If, after a while, they don't listen then FIND ANOTHER ONE WHO DOES. Listening is #1.


    NEVER agree to a course of treatment that terrifies you. It will NOT WORK, and it may make your phobia worse. You are in the 'driver's seat' in your therapy. You call all the shots.
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  6. #6
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    AM I SUPPOSED TO TYPE THE WORD 'VOMIT'LIKE THIS: "V*"?


    The general rule around here, which we've discussed over and over, is that if you are afraid to type out the whole word, then feel free to shorten it. But you are also welcome to type it out if it doesn't bother you. Although some people seem to be afraid of seeing the word in full, it is generally thought that those folks are unlikely to even come to this website (where you have to see it at least once to get here), and if they do there is a lot more scary stuff around here than just the word typed out in full.


    It is the most basic, simplest form of gradual exposure: just seeing the word.


    We also realized that if we went down that road, that some people are afraid to see all sorts of words like N*, S*, D*, SV, etc. We can't protect everyone from everything, and avoidance only leads to more fear.


    If your post is GRAPHIC then please post a warning.
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  7. #7
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    WHY IS ANTICIPATORY ANXIETY SO MUCH WORSE THAN ACTUALLY VOMITING? (WHEN I VOMIT, I SEEM TO BE ACTUALLY CALM...BUT THEN THE PHOBIA COMES BACK LATER.)


    it's the anticipatory anxiety that is the killer. It's a strange phenomenon, and not "logical" which drives most human beings nuts. We think our logic is the only part of our brain operating, but the brain is just so complicated. The "danger" system in the brain (amygdala)will respond to logic, but 1) not quickly [i.e., over only a long period of time] and 2) not when continually stimulated. So if you're IN a situation where you're terrified, logic just shuts down. You can agree to it and hear it, but it won't stop the fear response. That's why you need to "play with it" /practice gradually...very VERY slowly...i.e., gradual desensitization.


    Once you're actually DOING the thing you fear, then all the parts of the brain agree: hey - this isn't dangerous! However a day later, that silly amygdala [fear centre] will start right up again playing tricks on the neo-cortex [logic centre].


    Maybe if folks read this post like,a hundred timesa day, then it would start to sink in...but maybe not! That's where setting up a treatment program with a therapist really helps.
    For more info about emetophobia and treatment:

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  8. #8
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    ARE THESE SCAMS? CUREEMETOPHOBIA.COM AND CHANGETHATSRIGHT.COM AND ANYONE ELSE WHO CLAIMS TO CURE EVERY PHOBIA OVER THE PHONE, OR IN 24 HOURS, OR IN 10 SESSIONS.


    Yes, these are absolute scams. You can plug into Google ANY phobia, and that website will come up - as though it's written specifically for that phobia. They also claim to treat you until you're better or your money back. But they never give anyone their money back - they just claim you didn't do your homework (which is always something impossible in the end).


    The main thing to remember when assessing treatments is that phobias are not genetic. No gene has ever been found that is a "phobia" gene. This means that although there are multiple factors contributing to an onset of a phobia, they are ALL formed, somehow in relationship. That means they can only be cured, ultimately, in relationship. Milder phobias can be treated quite well with the person working on gradual exposure by himself, but the underlying anxiety doesn't generally go away - it resurfaces somewhere else. But severe phobias cannot be treated with a book or a set of videos or by talking to someone on the phone. And they REALLY can't be treated in 24 hours or even 10 sessions....they took far too long to form to be "fixed" quickly.


    Sorry, I'm ranting about this. I hate those guys....!
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  9. #9
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    WHAT ABOUT HYPNOSIS? OR TFT (THOUGHT-FIELD-THERAPY....TAPPING)?


    There is nothing about either of these that is a "scam"...what you have to watch out for is people who claim they can "fix you quickly" - like with ONE session of hypnosis or whatever. Hypnosis can be an important part of an overall treatment program - and it is not harmful. Qualified therapists will do it, so you're not being scammed for money or anything. I never underwent hypnosis in my treatment, although my therapist wanted to try it...simply because I was afraid of it. I got successfully treated anyway.


    We did do TFT, and it was helpful for many things, but didn't make a dent in the phobia. Others may have a different experience.


    The reason I caution about these things is that I don't want folks to become "victims" of insecure therapists (and there are some) who try to blame YOU if one of these quick-fixes doesn't work. Slow and steady wins the race. Keep plugging away in therapy at the underlying relationship issues (i.e., family, childhood) and working on changing cognitions and gradually exposing yourself (VERY gradually) to the stimulus. Talk about emotions, and try to re-experience them in a safe, helpful relationship with the therapist. Work on this over a good long period of time and you'll get results. There are no "quick fixes" in life.
    For more info about emetophobia and treatment:

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  10. #10
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    WHAT ARE WE ACTUALLY THINKING (WILL HAPPEN)?WHAT IS REALLY GOING ON IN OUR BRAINS?


    For me, I finally figured out that my thought was "if they vomit, then I will too, and then I will die". And when I say thought, I mean that quite loosely. Not even a thought...more of an instantaneous association inmy brain.


    One of the problems with cbt people who are big on the "c" (cognitive) is that they think that if you think differently that it will change your fear response. And while that is an important part of it, and works very well with milder phobias, it can be pretty useless information to an extreme phobia. I have said this to a psych theorist: "you're telling this information to my neocortex (the "thinking"/logic part of the brain), but now figure out a way to tell it to my amygdala (the fear centre)."


    You see, they are quite separate and distinct in the brain. And yes, the neocortex can send a message to the amygdala, but the problem is that the amygdala works faster sending the info the other way. So by the time the "logic" message gets to the amygdala, it has already fired off another "oh my God I'm in terrible danger and I'm going to die" message to the neocortex. I really think this is the problem with emetophobia and other very severe phobias.


    For me, I worked away with the 'b' part of cbt - "behavior" - gradual exposure - until I was able to slow down that fear response enough to insert a cognition. The cognition was "I'm not in any danger". Also things like "nothing is happening to me; I'm fine. I'm perfectly safe; I'm afraid, but I'm ok; This is just a body response; It doesn't matter. This is not a big deal." ..........these worked quite well for me over time.
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  11. #11
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    WHAT ABOUT CHILDHOOD "TRUAMA"? ...AND WHAT EFFECT COULD A TRAUMA POSSIBLY HAVE THAT I CAN'T EVEN REMEMBER??


    I know there are lots of ideologies out there on phobia, so I'll just give you mine and you can do what you want with it.


    I believe that "trauma" is a word that is more encompassing than most people think. We often think of something horribly heinous when we use the word trauma. Yet to child development psychologists and those who study the effects of trauma on the brain, this is not so. Birth itself is a trauma. Most people can overcome this trauma with a secure attachment to their mother. In your case, you didn't have this secure attachment at a young age. So you were further "traumatized" as an infant. And while you can't remember it with the logic/language part of your brain your body remembers it. The oldest part of our brains, from an evolutionary perspective, is the amygdala which is responsible for creating "wiring" to respond to danger. An infant with no mother is the biggest danger there is - think about it. If you are an infant and have no mother, you will die very quickly...especially in ancient times, when this part of our brains was "created". Once you reach 3 years of age, you can link together events in "memory", but before this age you cannot. However, the WIRING is still there connecting the fear response to certain triggers. With phobia, some other thing gets associated with that neuro-pathway (like vomiting). Don't ask me why. Nobody knows. For you it's vomiting, for someone else it's another anxiety of some type. In ideal conditions from 3 months on, you might have had no effect whatsoever of the early trauma. But other factors (which you may or may not ever discover) added up to a bouncing baby phobia for you.


    Think about it: if a baby were beaten and raped every day from birth to age 3, then "rescued",do you really think that kid would be ok just because they can't remember it? I promise you, even in the most loving home afterward, the child/adult would be permanently damaged beyond belief. In fact, the odds are about 99% that they would become some sort of murderer, completely incapable of forming attachments with anyone or having any kind of conscience. Now granted, this is nothing like what happened to you, but the idea that the body remembers what the "mind" can't is still true.


    I don't believe that this is Freudian, by the way. Freud's beliefs are complicated and mainly rest in the unconscious...the idea that you hate your mother, compete for your father, need sexual comfort and avoid death. This has nothing to do with what your therapist is talking about. Although ALL therapy relates, one way or another, to Freud's discoveries about our early experience influencing our lives somehow. Your therapist's beliefs are based on solid research that is pretty standard and universal these days. Rather than Freud, look to the universally accepted work of John Bowlby on attachment, and also Victor Janov. Ask your therapist about these great thinkers of our time. I would also recommend Leslie Greenburg's work. That's if you feel like reading up on trauma, anxiety and emotion.





    I always say that the good news is that it doesn't matter WHAT factors contributed to your phobia - adoption, anxious families, sexual abuse, etc...because the cure is the same. And the cure begins with feeling safe with your therapist, and then gradually (either through imagination, talking, or visually) being exposed to that which you fear, and re-writing the outcome [i.e., you're safe]. The idea is to create new synaptic connections in the brain that spell this: VOMIT DOES NOT = DANGER. Right now you've got VOMIT = DANGER going on.


    It's true that sometimes therapists go down roads that are out to lunch
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  12. #12
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    THE 5TH MOST COMMON PHOBIA? REALLY? THEN WHY HASN'T ANYONE HEARD OF IT?


    I did a fair bit of research myself a couple of years ago about emetophobia, although I wasn't all that interested in its statistical incidence.So here goes:


    According to the National Institute of Mental Health (USA) approximately 6.3% of Americans suffer from some kind of phobia. "Fearing vomiting" is absoultely NOT a phobia...it's just what a lot of people think, but they never think about vomiting until an hour or less before they do it...when they may be nervous. This has nothing to do with emetophobia.


    Phobias in order of "most common" according to the DSM-IV (Diagnostic and Statistical Manual - the "handbook" of diagnosing all psychiatric disorders)
    1. <LI>Animals (snakes, dogs, spiders, bugs, etc. etc.)
      <LI>Nature (heights, tornadoes, thunder, water, germs, etc. etc. etc.)
      <LI>Blood-injection-injury (blood, needles, surgery, etc. etc.)
      <LI>Situational (flying, bridges, driving, elevators, shopping, etc. etc. )
      <LI>Other (choking, vomiting, loud sounds orcostumed characters+ approximately 3 THOUSAND other misc. things)</LI>



    The italics are mine. So although emetophobia is listed under the 5th most common, there are actually dozens of phobias MORE COMMON than emetophobia.


    We all know that most phobias fall under the first four types - as they certainly get the most "press". They probably represent about 95% of all phobias. That only leaves about 1/2M people will all "other" phobias. I suggest that since vomiting is actually listed in the DSM-IV TR along with 3 other subtypesthenwe can safely say thatthe incidence ishigher than the several thousand phobias that are not listed. My guess would be that about 20,000 people in the USA suffer from emetophobia....(and it's only a guess) This site has seen about 2-3,000 members, which is 10-15% which is consistent with other statistics of people who seek information or help on the internet. (Many more people would have come here, but not joined).


    The other thing to consider is just common sense. This phobia is rare! Most doctors, therapists and the average Joe have NEVER HEARD OF IT.


    THE GOOD NEWS


    1) Although emetophobia is rare, many MANY people have it. Many people also fear clowns, choking, and several other things that folks think are ridiculous or rare. You are not a "freak" if you have emetophobia. It's something that can happen, and in your life it "made sense" somehow.


    2) Emetophobia, and ALL phobias are treatable. It doesn't matter if your therapist has never heard of it, because phobic brains are all the same - it's just the stimulus that's different. The thing to remember when you talk to your therapist about it is that it can be a very SEVERE phobia. And they may not realize this when they design a treatment plan. But they can learn about it, and you can help them. Although it can be tricky to treat, it's possible. Think about it - how easy is it to gradually expose oneself to flying? (not!) But people get treated every day for both kinds.


    For more info about emetophobia and treatment:

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