Thanks to everyone for your replies. Stefanie, it's such a relief to know someone else with lupus and emet...when I was diagnosed I thought I would go completely insane with the combination of the two. Thinking back, I realised that lupus caused many incidents of unexplained n* and panic in the past 5 years which in turn kept making my emet worse. Ironically, I assumed it was because I was catching germs and would go crazy with the hand sanitisers/food hygiene without realising it was all coming from inside my own body :P.

A little update, in the three months since this post I've made a lot of progress. I'm almost shocked at the effectiveness of exposure therapy...and wonder why I spent so many years imprisoned by the fear when all it took was the resolve to force myself to persist with exposure. Basically I've been using Sage's "Exposure to Vomit" resource in combination with the "Muscle Relaxation" and "Candle Visualisation" Emetophobia Recovery Tape.

For each session I look at an image and listen to one of the two recordings until my anxiety decreases. Over time, I work through the heirarchy always beginning from level one and 'recapping' all the images until reaching the place I'm currently at (level 7). When starting the exposure, even the cartoon drawing of the man holding his stomach made me anxious so I would have never dreamed that the desensitization works so well as long as you stick to it.

The recovery is supported by real life progress as well, as I feel a palpable decrease in anxiety to certain situations that would have freaked me out before. On a holiday recently, my bf drank too much and got up in the middle of the night to v* in the bathroom. I heard everything but amazingly, didn't panic and have emet flashbacks of that night. Last week, he caught a stomach bug and I was able to kiss & interact completely normally (I was so used to emet, that I reflexively waited for the anxiety to hit, and the urge to disinfect and wash hands...but it wasn't there!) In contrast, several times last year I had panic attacks when he mentioned having a stomachache and had to come up with excuses to leave the house.

I still have a while to go before I can not panic at the thought of myself v* but I already feel so much better than I have for years. I can only recommend the exposure system, it takes motivation but it actually works.