Emetophobia: Redrawing the Border
It is embarrassing to admit, but I have emetophobia (fear of vomiting). It is embarrassing because I think it makes me seem neurotic. I don’t want to be neurotic. Who wants to be some worry wart who frets over their food? I sure don’t.
It began in the second grade. I had a stomach bug and puked all over my pillow and bed. My mother was upset over the mess and told me that if I puked again, I would have to clean it up. I don’t know why, but this planted a dark seed of anxiety in my mind. Any frustrated mother would say the same thing. Until then, I hadn’t feared puking…but for some reason, after that incident, I began to fear vomiting.
I started sleeping with water by my bed in case I had to puke in the night. The water, in my imagination, would help me not vomit. I also started having panic attacks. I felt my chest and throat tighten. In my young brain, I mistook this for nausea or that I would soon throw up. So, bus trips and car trips were a nightmare. I feared that I would throw up, uncontrollably, in a confined space…making a huge mess. I am a messy person? Why does this matter? I don’t know. There is no logic to phobias. This is also a source of shame, as I try to be a logical person. The phobia is like a demon that possesses me, drawing out the worst traits of paranoia and irrationality. I don’t believe in gods or ghosts, but I believe that vomiting is worse than death!
Anyway, for many years I suffered with this phobia. I had panic attacks, feared road trips, feared carnival rides, feared unfamiliar food, feared restaurants, etc. For many years, it was nameless. I never knew that people could actually fear vomiting. I thought I was a solidary weirdo with a bizarre fear. But, I found that there are entire websites dedicated to it and that it is one of the more common 500 or so phobias that have been identified.
It is hard to explain what it is like having it. It has shaded my life. Whenever a new situation arises, I immediately think…”will this make me throw up?” As such, in years past, I had anxiety flying… or going on boat rides or trying new foods. In recent years, I have made some headway fighting this phobia. The biggest breakthrough was realizing a.) I have a phobia. b.) the phobia has a name. c.) other people have this phobia. To use the demon metaphor, perhaps having a name for it gave me some control over it…as I could research it and learn more about it. Another boon for overcoming the phobia has been life experience. The more I experience life, the more evidence I have against the irrationality of the phobia and the more exposure to the things that make me afraid.
Exposure. Yikes. When I was young, I feared seeing vomit on television and became afraid someone else vomited. I feared new things, such as dissecting in biology class or unfamiliar smells. However, I have learned that not all things cause vomiting. I stopped fearing flying after not becoming ill during my first international flights. The flying itself did not make me sick. I have never become sick from being on a boat or sick from a new smell. Vomit on television or on a sidewalk will not make me vomit. So, slowly the phobia has shrunk down from its original form in my childhood.
I have also faced stomach bugs in recent years. This has been a mixed experience. Between the years of 1989-2010, I never vomited. Not once. This is quite a record. It seems almost impossible. I even forgot what nausea was like- so I often mistook anxiety for nausea. Then, in 2010, I caught a stomach bug. I very quickly learned what nausea was (after missing out all those years). I had a very unpleasant day. I didn’t throw up, by a dry heaved for the first time since….second grade. I cried. I begged for anti-emetics. I took Nausene and survived. After surviving, I felt a little less afraid.
Then, things were calm again until I worked at the Boys and Girls Club. Working with 80 kids that don’t often wash their hands is a recipe for all kinds of illnesses. The year that I worked there, I got sick with stomach bugs three times. Again, I never puked…but there were miserable bouts of dry heaving (which I suppose is close enough?).
I think that the worst nightmare was my trip to Eastern Europe. Throughout the trip, I had a few bouts of diarrhea, nausea, and upset stomach. It was unpleasant, but survivable. However, on the morning of my flight back home…I was hit by something awful. I used the bathroom six times in an hour…with a lot of watery diarrhea. This was coupled with severe nausea. To prevent myself from puking on the flight from Prague to Amsterdam, I could not move my body. The slightest jostling upset the delicate balance in my stomach. When I arrived in Amsterdam, I bought a Gatorade and had to wait in a long security line…feeling like I would explode from either end at any moment. I had to throw out the Gatorade of course, passed through security, went to my gate, and dry heaved in the gate’s bathroom until my flight to the U.S. was announced. Then, I spent 8 miserable hours in my seat with a blanket over my head…counting the minutes and hours. I could not watch the movie or move one bit, as again, any movement triggered the extreme nausea that I was facing. Never in my life have I been that nauseated and for THAT long. I couldn’t drink water as even this upset my stomach. Being trapped in a confined space with limited ability to vomit was hellish.
The past year, working at a shelter for women, has also exposed me to many germs. Again, I have had stomach bugs a few times. I even think I had food poisoning this summer when I went out for Thai food. Each time I survive. It isn’t pleasant. But, I survive. I suppose, in a small way, the phobia shrinks a little each time I survive a stomach bug.
Now, I am actually far less afraid. I think the phobia is a skeleton of what it once was. In the end, I am only truly afraid of puking in limited situations. My main nightmare is becoming sick at work, with no one to cover my shift. So, this is the fear of vomiting at work with an inability to escape my duties to be sick. Another nightmare is becoming sick on a bus or vehicle with no place to vomit. In the end, with my phobia far smaller, I see it’s naked ugliness.
The phobia is about control. I fear vomiting because I can’t control it. I can’t control how long it will last and where it will happen. I can accept, to some degree, that I will get sick- and provided that I am near a bathroom or comfortable place- I can live with that. But, what I really fear is lack of control over vomiting.
For example, I work at a shelter for domestic abuse. There are sometimes fifty five people in the shelter. The individuals live in closed quarters and many are children. Add stress to the situation (which compromises the immune system), some lack of hygiene and lack of medical care…and there is really a hot bed for disease. As such, we have many bouts of stomach bugs through the shelter over the year. In fact, I really don’t think Norovirus ever actually leaves the shelter as we have stomach bug outbreaks every month or two.
As a rational person who doesn’t want to get sick, it is reasonable that I would want to CONTROL norovirus. I can’t. We use hand sanitizer in the office, but alcohol based sanitizers don’t really work against norovirus. Hand washing is effective, but once I touch a door knob, keyboard, counter, or one of the hundreds of other things, my hands are infected again. Worse, norovirus can travel through the air. So, if you enter a room where someone has been ill, you can become sick from vomit or fecal particles in the air. Worse still, it only takes 10-100 viral particles to make you sick. A pin head sized piece of feces has millions of viral particles. As such, a sick resident can carry just the tiniest droplet on their clothes or hands and make everyone sick. And, even if a person becomes ill with norovirus, the immunity tends to be rather short. I can’t think of any way to win against norovirus. For all practical purposes, it cannot be controlled. I bleach counters and surfaces…many things…at night with bleach and water. Bleach kills it. But, only until the shelter becomes dirty again when residents touch things. I can see how this phobia might lend itself to OCD behavior as the habits to control it would require such behaviors (a lot of hand washing and cleaning).
When I go to work and know that people have been ill, it causes me anxiety. It causes me anxiety because I fear that I will get sick and be at work, trying to take care of the shelter…with no reprieve to vomit. I can’t control becoming sick. As I have mentioned, norovirus is quite difficult to control. The best I can do is control myself, by washing my hands and avoiding eating or touching my face. However, even if I do my best to avoid putting anything near my mouth, this only prevents the oral-fecal route of contamination. Airborne viral particles from vomit or feces cannot be controlled, lest I put on a mask. So I worry. This is where my phobia is the worst.
I could seek professional help. I might benefit from counseling or an anti-anxiety drug. However, perhaps because of the stigma of mental illness, I prefer to plod along on my own. Already, I have brought my phobia down to a skeleton of its original form. In the end, there are certainly times that I skip meals, avoid going places, or have panic attacks. It makes life harder. At the same time, I take pride in facing my fear. Imagine if you once afraid of spiders. You panicked when they were on television or at the zoo. Then, through enduring spiders and facing life, the fear becomes smaller. Maybe you travelled to the desert and saw a tarantula. Maybe a spider fell on your shoulder when you went through the Amazon. It was horrific. But, you didn’t die. At this point, the only spiders you fear might be in just a few places or situations (maybe you fear going into the basement or the garden shed). That is how it has been with my phobia. I have had the shits and hellish nausea from Prague to Minneapolis! But, I still saw Prague and all of Eastern Europe.
I once heard a quote that life begins where fear ends. I didn’t learn until later that the quote is rather New Age-y and from Osho Rajneesh. Although spirituality isn’t my thing, I found that the quote was a good sentiment. Fear fences out many wonderful experiences. If I had let the phobia truly rule my life, I would have never gone on a flight or travelled. I would avoid working with children or domestic violence victims at the shelter. My life would be very fenced in. I don’t want that. So, I hope that one day the phobia shrinks down to nothing, so I can live without being fenced in by this fear. I am optimistic that it will. I think it will as long as I push back against the fence and face the things that I fear.