Most of us know a person who can’t stand to be around vomit. The one who can’t hold your hair back when you’re sick from too many drinks at the bar. The one who avoids your kids in case they decide to spit up everywhere.
I’ve been that person all of my life. And if I think I, myself, am going to throw up? I literally break out in shakes.
I have emetophobia, or a fear of all things puke. In its most severe form, emetophobia impacts 0.1% of the population ― about 10 million people in the U.S. struggle with it. However, anywhere from 3.1% to 8.8% of people have a general fear of vomiting, with women being four times more likely to experience it than men.
I’ve been living with emetophobia for as long as I can remember.
While I have no conscious memory of it, my mum battled Stage 3 breast cancer when I was a toddler. The lump in her breast was consistently ignored by doctors because at 36, she was “way too young” to have cancer. By the time she was 38, the lump had grown exponentially bigger and her doctors finally had to concede it was cancer.
They performed a mastectomy. Afterwards, the chemo treatment began, making her violently ill, throwing up regularly. Again, I have no memory of any of this, but I believe it became etched in my mind that vomiting represented the threat of losing my mum.
Today, mum is thankfully more vibrant than ever. At almost 70, she is hiking mountains, teaching people CPR and planning her 50th high school reunion. But emetophobia continued to impact me mentally, socially and physically.
When everyone at summer camp got the stomach flu, I cried in the woods and begged to go home. (My parents refused to pick me up, for which I still hold a grudge.)
As I got older, the impact of my phobia got worse. College was especially hard; I’m sure you can imagine why. Eventually, I had to carefully watch everywhere I stepped in case there was vomit on the street. I had panic attacks on planes and in cars. The thought of throwing up occupied a huge amount of my mental energy.
And then, as I inched closer to my 30s, came the biggest fear of all.
I went through most of my 20s saying that I didn’t want to become a mum. One big reason was my focus on my career – I wanted to get licensed as a psychologist and start my own practice before even considering children.
But then I met those goals, and I realised an even bigger factor influencing my decision was the fear of how my phobia would impact me during pregnancy and motherhood.
With my severe phobia of vomit, the idea of being pregnant and enduring morning sickness, and then raising a child who inevitably pukes ― likely on a regular basis ― was enough to make me want to call the whole thing off.
What if I had hyperemesis gravidarum (that thing Kate Middleton and my mother-in-law had where you vomit multiple times, DAILY?). What about when my future child vomits all over the car, all over their bed…or all over me? (The unpredictability of a surprise puke is especially scary for me.)
But ultimately, I didn’t want my anxiety to make such an important decision for me. I decided to seek treatment to face my fear.
Exposure and Response Prevention Therapy (or ERP) is considered the most evidence-based treatment for phobias, OCD, panic attacks, and the like. I worked with a therapist to build what’s called an “anxiety hierarchy” to gradually tackle my fear of vomit. This included everything from cleaning up my cat’s hairballs, looking at pictures of vomit, and watching videos of people throwing up.
It was really hard, and I’m thankful that my therapist guided me through the process. ERP is known to be one of the most effective, but also most difficult, treatments to undergo. By sticking with it though, I saw that throwing up is survivable. Unpleasant, sure, but tolerable.
After the therapy, I was able to watch movies where people threw up. My panic attacks in cars became less frequent. But there was still my biggest fear left to face. For so long I let my phobia run my life. It was the ultimate form of birth control because there was no way I was going to let myself get pregnant. But now I was ready to stare my phobia in the face and say “not anymore.”
I knew that I would likely get sick. I sure as hell knew that a future kid would get sick many times over. But the potential benefits finally outweighed the anxiety.
Still, four months later, when I saw a faint line on a stick, I started mentally preparing my personal disaster kit: electric acupressure band, Unisom, anti-nausea gummies, teas, crackers.
As my pregnancy progressed, I got more tired. Hungrier. But no vomiting. Until my husband made me scrambled eggs. That did it.
Bent over the toilet that morning, I closed my eyes (because I’m still not at the point where I can actually look at vomit), and kept saying aloud, “You’re OK, you’re OK.” My husband rubbed my back, totally unfazed.
Afterwards, I said to him: “That actually wasn’t so bad. I mean, I wouldn’t do it again if given the choice, but it was not as bad as I imagined.”
I got through it. I survived.
That turned out to be the only time during my pregnancy that I actually threw up. The heartburn during the third trimester was way worse, as well as the pubis symphysis pain where I could barely walk for a month.
In the end, all the physical discomfort brought me the best gift: my son. The fact that my husband and I created this incredible human life together blows my mind daily.
At 12 weeks, as I watch my baby learn how to smile and sing along to Dancing Queen and Party in the USA, I am so grateful that I didn’t let barf be the thing that kept me from the magic that was waiting for me.
Was it all worth it? Without a doubt, yes. Even when he throws up on me. (Yes, it’s already happened ― several times in fact.) I made a vow to my husband at the altar, and I now make the same vow to my child, in sickness and in health. I will be there.
Dr. Lauren Cook is a licensed Clinical Psychologist, company consultant, author, and speaker. Stay tuned for Dr. Lauren’s latest book, “Generation Anxiety” ― set to hit the shelves in Fall 2023.
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