Hi Jon,
Andee's right on-- your pcp is a great place to start. Sometimes a med can help control the anxiety so that you can deal with the other problems. I've had great luck with Lexapro--it knocks out the bad stuff but doesn't make me groggy. I'm still me...
Here are some thoughts you may find helpful, or at least encouraging. I speak only from my own experience and don't claim that other people agree or feel the same, but it's usually good to get perspectives from many people then see what you think..

You're not alone and please don't give up--your life doesn't have to be like this. I've had emetophobia since I was six and I'm now 35, so I understand what a long and scary road it is. You're absolutely not paranoid. You're not crazy or weak, and it's certainly not your fault. My guess is that your phobia began with a childhood illness? (Like many cases, mine began after a particularly bad stomach bug when I was 6, though it's taken me years identify the source.) Phobias often begin with a traumatic or frightening event. In the course of that event, your brain learns to respond to the offending trigger with an exaggerated fear response. What you have to do is retrain it. There is nothing mysterious, mystical, or magical about it. There is no fantastic miracle cure and no fabulous pill. Retraining your brain takes work and time, it's not always easy, and sometimes it seems like you take a step back for every step forward. But the only way out is through, and you will feel so proud of yourself every time you do something you never thought you could, even if it's just getting up in the morning. Your quality of life can absolutely improve.

After years of trying to deal with my emetophobia, I finally feel like I'm on a good, progressive path. I'm not "cured" at this point. I'm not sure if I'd use the word "cure" anyway. But I am healing. My thinking patterns are changing, my confidence is growing, and I am learning a new way to be. I have worked very hard, and I still have a lot of work to do, but my quality of life, my outlook, and my sense of everyday joy are vastly improved. For the first time in my life I actually believe that I will gain the upper hand over this terrible phobia. I have felt so much pain and fear over the past 30 years that I want more than anything to share what I've worked so hard to learn with people like you. Please don't give up hope.

I'd imagine everyone's path to understanding and healing their emetophobia will be different depending on personality, circumstances, age, degree, etc. Here are some things I've found particularly helpful that you may want to consider or look into:
- It helped me to learn more about the physiology of the human brain and how it works, especially concerning anxiety and anxiety-related disorders. Research has been done fairly recently on the role of the amygdala in anxiety, as well as how the brain reacts to fearful situations. PBS aired an interesting show about the emotional brain on 3/29/10 in which they addressed phobias. Dr Joseph Ledoux also wrote a book called The Emotional Brain. I'm sure if you start googling some of these keywords, lots of info will come up.
- Recent studies have shown parallels between phobias and post traumatic stress disorder. This information led me to research PTSD treatments in hopes that something might work on my phobia. As it turns out, a therapy called EMDR (eye movement desensitization and reprocessing) has had measurable and encouraging success in treating PTSD, and is starting to be used on phobias and other trauma-related disorders. Doctors are exactly sure what about EMDR is working, but reliable, respected studies have shown that it has a good success rate. It is also endorsed by the US Dept of Veterans Affairs and the Dept of Defense, the UK Dept of Health, and other upstanding bodies. Check out emdria.org I've been undergoing EMDR treatment since last spring and I've found it to be absolutely the most helpful method so far. And best of all, it's not scary at all--it's fairly relaxing for the most part. But please, please--if you pursue EMDR--find a well-respected, certified, professional psychologist or psychiatrist. There are a lot of schemes out there. EMDR is real and helpful, but not everyone who says they practice it has had the appropriate training. EMDR--in combination with cognitive behavioral therapy--have been very helpful for me.
- Find yourself a therapist who is knowledgeable and experienced in treating anxiety disorders, and specifically phobias, if you can. Many take insurance, some don't. The most important factor is to find someone who you feel comfortable and who "gets" you. I've worked with a few psychologists over time, and I've finally found one who gets my problem, gets the way I think, and who has been brilliant at working through my phobia with me within the context of my own personality--my own strengths, weaknesses, abilities, and experiences. He believes in me even when I don't believe in myself, which has been a tremendous help in itself.
-Learn about Cognitive Behavioral Therapy (CBT). Working with a therapist who can help you make your thinking and behaviors healthier is a must.
- Look into meditation. Much to my surprise, it's not a new-wavey, hippie, mystical thing at all. It's simply a way of becoming familiar with your self, your mind, your body, and what's going on with all of them. It's relaxing, and practicing it helps you gain more awareness and control over what your mind is doing, which helps when you feel it start to race off into that terrifying darkness we've all felt when the phobia kicks in. The more you get comfortable with and familiar with your mind and body, the more attention you pay to it, and the more you can influence what you're doing. I've learned to stop panic attacks mid-way through, which I never thought I could do. It takes a lifetime of practice though, and I've a lot way to go.

Sorry this is so long, but I hope it's somewhat helpful. DO NOT GIVE UP. Your quality of life will improve if you are willing to work at it. And "working at it" isn't necessarily scary--it's just not a miracle cure. Connect yourself with professionals you trust, and don't listen to anyone who tells you you're paranoid or overreacting. Emetophobia can be debilitating, but there are ways to heal. Hang in there. You're not alone.
Best of luck!