Severe emetophobia. Need help.
September 16, 2011 7:21 PM Subscribe
I am posting this for my partner, who has severe emetophobia. Details inside.
My girlfriend of three and a bit years has a major psychological problem, which is emetophobia: an intense fear of vomiting, either her own or other people's.
At first I was like "Yeah, nobody really enjoys puking" but it's gotten to a point lately where it has become an intense and damaging issue, and isn't doing wonders for our relationship.
It manifests itself in many different ways, but a few of the more common examples are: severe obsessive compulsiveness when it comes to cleaning (she sweeps and mops and wipes pretty much the whole house a couple of times a day), extensive use of pharmaceuticals (such as Pramin, Buscopan and Somac) to combat the intense fear she feels whenever anything happens with her stomach, and an intense reluctance to attend gatherings where children might be present (because children are disgusting and covered in germs).
Sometimes I actually witness her worrying herself about being sick to the point that she is almost sick. She is afraid that just about every food is going to poison her and make her throw up (and I sometimes, though rarely, like to try and make something a little different, and get irrationally pissed off when she refuses to try any).
Nobody takes it seriously, and I fully admit that at first I didn't either. Whenever she tells anybody about her problem, the first thing they give her is their Great Vomit Story. Thankfully I've never done that. But my point is that I recognise that it is a very serious issue, and it is causing her health to deteriorate mightily. She has very low iron levels as well, as in dangerously low, but supplements aren't doing anything (the doc theorises that it may not be being absorbed through her stomach) and we are having difficulty getting IV/injection treatments. Her "movements", if we can call them that, are sporadic and basically Maltesers, and she gets a lot of constipation and bloating. She is always incredibly anxious about seeing puke (and I've watched her obsessively looking at the ground whenever we are out and about, looking for evidence of where people might have thrown up). Whenever we're watching a movie or a show I've got to keep one finger on the 'mute' button in case a character starts to look a bit queasy.
She was seeing a therapist for it some years ago but that fizzled out. Basically her only forms of self-medication at the moment are the cleaning and drugs listed above, and working the phobia forums and chatting to other sufferers. It's left her convinced that nothing will ever fix her ever, that nothing can ever be done, and has in fact told me that the only way she will ever be free of the problem is by killing herself.
I've tried to tell her that while I recognise it is a serious problem with no easy fix, and will require all sorts of different therapies and treatments, and that we need to try as many things as we possibly can, she is steadfast in her belief that nothing can ever be done.
So to that end...I have to say I don't really know what my question is. I guess I wanted to canvass Metafilter and hopefully get the advice of anybody else who has or had the same problem, or a similar problem (psychological which manifests as physiological), or anybody who has done any research into the matter, or any doctors or scientists or therapists, who might be able to give us some ideas. None of the MDs or psychiatrists she has been to have had any familiarity with the subject, and have more often than not taken it about as seriously as a lay person. One suggested exposure therapy. I think not.
Money is difficult for us at the moment as my girlfriend is out of work and I don't earn a great deal, but things can be done on that front. I just wanted to hear about things that we can try.
Does anybody have any ideas?
My girlfriend of three and a bit years has a major psychological problem, which is emetophobia: an intense fear of vomiting, either her own or other people's.
At first I was like "Yeah, nobody really enjoys puking" but it's gotten to a point lately where it has become an intense and damaging issue, and isn't doing wonders for our relationship.
It manifests itself in many different ways, but a few of the more common examples are: severe obsessive compulsiveness when it comes to cleaning (she sweeps and mops and wipes pretty much the whole house a couple of times a day), extensive use of pharmaceuticals (such as Pramin, Buscopan and Somac) to combat the intense fear she feels whenever anything happens with her stomach, and an intense reluctance to attend gatherings where children might be present (because children are disgusting and covered in germs).
Sometimes I actually witness her worrying herself about being sick to the point that she is almost sick. She is afraid that just about every food is going to poison her and make her throw up (and I sometimes, though rarely, like to try and make something a little different, and get irrationally pissed off when she refuses to try any).
Nobody takes it seriously, and I fully admit that at first I didn't either. Whenever she tells anybody about her problem, the first thing they give her is their Great Vomit Story. Thankfully I've never done that. But my point is that I recognise that it is a very serious issue, and it is causing her health to deteriorate mightily. She has very low iron levels as well, as in dangerously low, but supplements aren't doing anything (the doc theorises that it may not be being absorbed through her stomach) and we are having difficulty getting IV/injection treatments. Her "movements", if we can call them that, are sporadic and basically Maltesers, and she gets a lot of constipation and bloating. She is always incredibly anxious about seeing puke (and I've watched her obsessively looking at the ground whenever we are out and about, looking for evidence of where people might have thrown up). Whenever we're watching a movie or a show I've got to keep one finger on the 'mute' button in case a character starts to look a bit queasy.
She was seeing a therapist for it some years ago but that fizzled out. Basically her only forms of self-medication at the moment are the cleaning and drugs listed above, and working the phobia forums and chatting to other sufferers. It's left her convinced that nothing will ever fix her ever, that nothing can ever be done, and has in fact told me that the only way she will ever be free of the problem is by killing herself.
I've tried to tell her that while I recognise it is a serious problem with no easy fix, and will require all sorts of different therapies and treatments, and that we need to try as many things as we possibly can, she is steadfast in her belief that nothing can ever be done.
So to that end...I have to say I don't really know what my question is. I guess I wanted to canvass Metafilter and hopefully get the advice of anybody else who has or had the same problem, or a similar problem (psychological which manifests as physiological), or anybody who has done any research into the matter, or any doctors or scientists or therapists, who might be able to give us some ideas. None of the MDs or psychiatrists she has been to have had any familiarity with the subject, and have more often than not taken it about as seriously as a lay person. One suggested exposure therapy. I think not.
Money is difficult for us at the moment as my girlfriend is out of work and I don't earn a great deal, but things can be done on that front. I just wanted to hear about things that we can try.
Does anybody have any ideas?
Strangely enough, two friends of mine that have this to varying degrees. One is generally fearful of vomit in general, the other is generally only afraid of herself vomiting. The latter was helped considerably by going on anti-depressants (I think she was on Zoloft, but I'm not sure).
As much as you don't want to rely on medication, if she is at the point where she feels nothing can ever be done, it might be an avenue worth going down, at least temporarily anyway.
posted by ryanbryan at 7:35 PM on September 16, 2011
As much as you don't want to rely on medication, if she is at the point where she feels nothing can ever be done, it might be an avenue worth going down, at least temporarily anyway.
posted by ryanbryan at 7:35 PM on September 16, 2011
what tau said:
@ first glance my intital thought maybe just try to explain this is just your body telling you something is wrong and doing you a favour by getting rid of what needs to go, but it seems way beyond that.
While barfing is pretty much foul whether you are the er, or ee, this seems a lot deeper.
Does she have any sort of eating disorder this may be tied into? Just the digestive problems you described made me think maybe there is something she might be hiding from you in that area.
posted by timsteil at 7:37 PM on September 16, 2011
@ first glance my intital thought maybe just try to explain this is just your body telling you something is wrong and doing you a favour by getting rid of what needs to go, but it seems way beyond that.
While barfing is pretty much foul whether you are the er, or ee, this seems a lot deeper.
Does she have any sort of eating disorder this may be tied into? Just the digestive problems you described made me think maybe there is something she might be hiding from you in that area.
posted by timsteil at 7:37 PM on September 16, 2011
and has in fact told me that the only way she will ever be free of the problem is by killing herself.
I am nt a professional, but this does not sound like something a person who has good overall mental health says, even someone with a chronic, incurable condition. She needs to get some serious psychiatric help, but she must be willing to put in a good deal of work herself. It doesn't sound like she is ready to do that yet.
posted by Rock Steady at 7:53 PM on September 16, 2011
I am nt a professional, but this does not sound like something a person who has good overall mental health says, even someone with a chronic, incurable condition. She needs to get some serious psychiatric help, but she must be willing to put in a good deal of work herself. It doesn't sound like she is ready to do that yet.
posted by Rock Steady at 7:53 PM on September 16, 2011
Anxiety and OCD go hand in hand. The phobia is just an outlet for the same thing that's torturing her with the obsessive cleaning. Some therapy, maybe some meds if the therapist thinks it would be helpful... these feelings won't go away, but they can be managed.
The phobia is a symptom, not the disease, if I'm reading you right.
posted by Slap*Happy at 7:57 PM on September 16, 2011
The phobia is a symptom, not the disease, if I'm reading you right.
posted by Slap*Happy at 7:57 PM on September 16, 2011
I have mild emetophobic tendencies, so I sympathize with both you and her. But this is a profound quality of life issue. She needs serious professional help from a therapist who knows what they're doing.
And for the love of god, don't watch Bridesmaids.
posted by gnutron at 8:04 PM on September 16, 2011
And for the love of god, don't watch Bridesmaids.
posted by gnutron at 8:04 PM on September 16, 2011
She is afraid that just about every food is going to poison her and make her throw up (and I sometimes, though rarely, like to try and make something a little different, and get irrationally pissed off when she refuses to try any). [ . . . ] She has very low iron levels as well, as in dangerously low, but supplements aren't doing anything (the doc theorises that it may not be being absorbed through her stomach) and we are having difficulty getting IV/injection treatments. Her "movements", if we can call them that, are sporadic and basically Maltesers, and she gets a lot of constipation and bloating.
IANAP. It sounds like her phobia might have crossed the line into the territory of eating disorder, and all the stuff about low iron levels and how food is going to poison her and her weird bowel movements really remind me of this account of ortho/anorexia. I think you need to get her serious professional help, regardless.
posted by PhoBWanKenobi at 8:23 PM on September 16, 2011
IANAP. It sounds like her phobia might have crossed the line into the territory of eating disorder, and all the stuff about low iron levels and how food is going to poison her and her weird bowel movements really remind me of this account of ortho/anorexia. I think you need to get her serious professional help, regardless.
posted by PhoBWanKenobi at 8:23 PM on September 16, 2011
I had a severe fear of vomiting as well as pooping (I think you describe this above) and other compulsions when I was younger. I got over the vomiting thing specifically but I've still got many of the other issues.
I think she needs to try therapy again. I do not agree that it cannot be solved if she wants it to be solved. Even though I am agreeing with therapy chorus, in my case, the "solution" was not therapy but an unrelated surgery that changed my intestines/digestive tract enough to both increase the likelihood of vomiting, and also my bowel habits. When you vomit all the time it becomes no big deal. Not that I am suggesting that, of course. If she's anything like me then the solution is accepting that not everything can be controlled.
posted by cabingirl at 8:24 PM on September 16, 2011
I think she needs to try therapy again. I do not agree that it cannot be solved if she wants it to be solved. Even though I am agreeing with therapy chorus, in my case, the "solution" was not therapy but an unrelated surgery that changed my intestines/digestive tract enough to both increase the likelihood of vomiting, and also my bowel habits. When you vomit all the time it becomes no big deal. Not that I am suggesting that, of course. If she's anything like me then the solution is accepting that not everything can be controlled.
posted by cabingirl at 8:24 PM on September 16, 2011
I know a little about emetophobia (when I was a student therapist I was in a small supervision group with another student treating an emetophobic patient, so we talked a lot about the presenting issues and treatment options). The obsessive behaviors are typical and secondary to the phobia. A lot of people with emetophobia develop severely restricted eating patterns and some can become agoraphobic in an effort to avoid germs and illness. It can be a really debilitating and difficult to treat.
No one with a phobia wants to do exposure (i.e. desensitization) therapy. Most therapists would start with relaxation and imagined exposure and trying to get the person comfortable just thinking about vomit, then eating new foods, then something else that's more challenging and so on and so on. It's hard work and the person has to be really motivated and committed to treatment. What you need is a creative, experienced CBT therapist. Don't try to do this stuff on your own.
posted by Mrs.Spiffy at 8:24 PM on September 16, 2011 [4 favorites]
No one with a phobia wants to do exposure (i.e. desensitization) therapy. Most therapists would start with relaxation and imagined exposure and trying to get the person comfortable just thinking about vomit, then eating new foods, then something else that's more challenging and so on and so on. It's hard work and the person has to be really motivated and committed to treatment. What you need is a creative, experienced CBT therapist. Don't try to do this stuff on your own.
posted by Mrs.Spiffy at 8:24 PM on September 16, 2011 [4 favorites]
I agree with others that serious professional help seems critical here -- not just psychological, but also medical. Perhaps starting with an intuitive gastroenterologist to discuss her diet and GI problems would be a more "doable" first step toward getting her into a more comprehensive treatment plan.
I have to say that your description reads as if this has actually become an addiction for her, with many of the classic signs of addictive behavior. I don't mean to use clinical terms out of context, but I imagine that there may be some resources available for spouses etc. related to addiction that could prove useful to you, even tangentially.
Also, I am not in any way qualified to vouch for this, but FYI this online study is referenced on the Wikipedia page for emetophobia, and may at least warrant a look.
I wish you both the best of luck.
posted by argonauta at 8:59 PM on September 16, 2011
I have to say that your description reads as if this has actually become an addiction for her, with many of the classic signs of addictive behavior. I don't mean to use clinical terms out of context, but I imagine that there may be some resources available for spouses etc. related to addiction that could prove useful to you, even tangentially.
Also, I am not in any way qualified to vouch for this, but FYI this online study is referenced on the Wikipedia page for emetophobia, and may at least warrant a look.
I wish you both the best of luck.
posted by argonauta at 8:59 PM on September 16, 2011
Wow, yeah, I very much agree with those above who say that this seems to have gone beyond a standard phobia. I am an emetophobe myself, though thank heavens it seems to be diminishing. I also used to have a phobia of dogs. And yes, I would freak out and have to cross the street and try really hard not to panic when a chihuahua on a leash went by; and yes, I kind of want to run away and cry in a corner when someone tells one of those Great Vomit Stories, even now that it's not so bad anymore. (By the way, NEVER make her watch Monty Python's "The Meaning of Life". *I'm* never going to get over that. It would be much worse, I think, for her.)
*Takes a moment, squares mental shoulders, forges on*
At any rate, much as these things did and do upset me, I never panicked about them *constantly*. If there was no dog around, I didn't worry about one somehow getting into my house. And I certainly don't look for vomit. While I could be wrong here, I think your girlfriend's problem has moved well beyond a standard phobia. I can't diagnose her, obviously, but I would definitely suggest that she get diagnosed. This is, as someone said above, far too big a quality-of-life issue to be ignored. One can have a phobia which is not aggravated as long as one avoids the trigger, but it doesn't sound like that's the case with your girlfriend.
This sounds bad. Poor girl needs some help. Good luck. And I'd like to add that you are awesome for being willing to support her through this.
posted by Because at 9:15 PM on September 16, 2011
*Takes a moment, squares mental shoulders, forges on*
At any rate, much as these things did and do upset me, I never panicked about them *constantly*. If there was no dog around, I didn't worry about one somehow getting into my house. And I certainly don't look for vomit. While I could be wrong here, I think your girlfriend's problem has moved well beyond a standard phobia. I can't diagnose her, obviously, but I would definitely suggest that she get diagnosed. This is, as someone said above, far too big a quality-of-life issue to be ignored. One can have a phobia which is not aggravated as long as one avoids the trigger, but it doesn't sound like that's the case with your girlfriend.
This sounds bad. Poor girl needs some help. Good luck. And I'd like to add that you are awesome for being willing to support her through this.
posted by Because at 9:15 PM on September 16, 2011
I'm sorry that GPs and psychiatrists have failed you.
I think the first step is to find a GP who will take your girlfriend's problems seriously. There are some very good GPs out there, but there are also some terrible ones, and in my experience a lot of doctors who bulk bill are so in demand that they barely spend any time with the patient. I would consider asking your friends or co-workers for GP recommendations. You'll probably have to pay out of pocket for it (mine charges about $35 on top of the Medicare rebate) but the quality of care is so much better.
If your girlfriend is okay with it, I would go with her to her GP appointments. I do this sometimes for an older relative, and having somebody who is slightly removed from the situation to advocate can really be beneficial. When the doctor is dismissive, or doesn't think something is a big deal, it's much easier for me to politely say, "Well, we'd like to get this checked out anyway, just in case. Can you recommend us a specialist?"
You might like to give Beyond Blue a call. Despite their name, they deal with anxiety-related conditions as well, and they should be able to give you advice on how to best get your girlfriend the treatment she needs. They also keep a database of practitioners that may be useful to you.
Lastly, regarding money, a lot of mental health professionals work on a sliding scale. Ask about it when you make the first appointment.
Best wishes to you both.
posted by Georgina at 9:41 PM on September 16, 2011
I think the first step is to find a GP who will take your girlfriend's problems seriously. There are some very good GPs out there, but there are also some terrible ones, and in my experience a lot of doctors who bulk bill are so in demand that they barely spend any time with the patient. I would consider asking your friends or co-workers for GP recommendations. You'll probably have to pay out of pocket for it (mine charges about $35 on top of the Medicare rebate) but the quality of care is so much better.
If your girlfriend is okay with it, I would go with her to her GP appointments. I do this sometimes for an older relative, and having somebody who is slightly removed from the situation to advocate can really be beneficial. When the doctor is dismissive, or doesn't think something is a big deal, it's much easier for me to politely say, "Well, we'd like to get this checked out anyway, just in case. Can you recommend us a specialist?"
You might like to give Beyond Blue a call. Despite their name, they deal with anxiety-related conditions as well, and they should be able to give you advice on how to best get your girlfriend the treatment she needs. They also keep a database of practitioners that may be useful to you.
Lastly, regarding money, a lot of mental health professionals work on a sliding scale. Ask about it when you make the first appointment.
Best wishes to you both.
posted by Georgina at 9:41 PM on September 16, 2011
Hi. I'm emetophobic myself, though nowhere near as severely as your partner at this point in my life. I can definitely at least relate to living in that mindset, though -- as a child I remember once my little brother barfed in the car and when we got home I went and made myself a mask out of paper towels and insisted (until my parents stopped me) on wearing plastic bags over my hands in order to prevent any contact with the "barf germs".
Nowadays (in my early 30s) I still tend to freak out/run away if any actual person vomits in my vicinity (the noise and the smell literally do make me feel horribly sick and panicky in the OMG THE WORLD IS ABOUT TO EXPLODE IN A FIERY MASS OF PUKE sense) but I *am* at least capable of handling (and even being vaguely amused by, in some cases) the various Great Vomit Stories I encounter. Also, for whatever reason, I *can* handle cat puke -- it seems to mainly just be human vomit that sets off my fight-or-flight response.
All that said, it definitely sounds like your partner has a massive amount of primary anxiety going on, and the emetophobia is just one specific manifestation of that. If it wasn't barf it would likely be something else, so definitely getting to the point (via therapy or otherwise) to where she's not constantly scanning the horizon for something to panic about (anxious brains do this A LOT, it has a "centering" effect, weirdly enough) should be a priority.
And all THAT said, the main thing that has helped me tone down my own emetophobia over the years (as in, it's still there but not to life-limiting levels) is realizing that if as many things I *thought* would result in vomiting actually did, I'd have been doing it a heck of a lot more throughout my life. E.g., even though I instinctively recoil if I hear or see someone else barfing, I no longer sit there for hours afterward CONVINCED that if I so much as *move* I will puke myself. And I think that I could *probably* handle cleaning duty if someone I loved got sick.
Not sure how old your partner is but frankly (while I *have* had a fair amount of therapy) it's not been therapy that's helped me the most, but just time, mindful observation (along the lines of "how many times do I or others ACTUALLY puke vs. how many times I feel terrified about vomit?"), and life experience. Best of luck at any rate, this IS a very real phobia and pretty awful to experience at the levels you describe your partner as having.
posted by aecorwin at 10:57 PM on September 16, 2011 [1 favorite]
Nowadays (in my early 30s) I still tend to freak out/run away if any actual person vomits in my vicinity (the noise and the smell literally do make me feel horribly sick and panicky in the OMG THE WORLD IS ABOUT TO EXPLODE IN A FIERY MASS OF PUKE sense) but I *am* at least capable of handling (and even being vaguely amused by, in some cases) the various Great Vomit Stories I encounter. Also, for whatever reason, I *can* handle cat puke -- it seems to mainly just be human vomit that sets off my fight-or-flight response.
All that said, it definitely sounds like your partner has a massive amount of primary anxiety going on, and the emetophobia is just one specific manifestation of that. If it wasn't barf it would likely be something else, so definitely getting to the point (via therapy or otherwise) to where she's not constantly scanning the horizon for something to panic about (anxious brains do this A LOT, it has a "centering" effect, weirdly enough) should be a priority.
And all THAT said, the main thing that has helped me tone down my own emetophobia over the years (as in, it's still there but not to life-limiting levels) is realizing that if as many things I *thought* would result in vomiting actually did, I'd have been doing it a heck of a lot more throughout my life. E.g., even though I instinctively recoil if I hear or see someone else barfing, I no longer sit there for hours afterward CONVINCED that if I so much as *move* I will puke myself. And I think that I could *probably* handle cleaning duty if someone I loved got sick.
Not sure how old your partner is but frankly (while I *have* had a fair amount of therapy) it's not been therapy that's helped me the most, but just time, mindful observation (along the lines of "how many times do I or others ACTUALLY puke vs. how many times I feel terrified about vomit?"), and life experience. Best of luck at any rate, this IS a very real phobia and pretty awful to experience at the levels you describe your partner as having.
posted by aecorwin at 10:57 PM on September 16, 2011 [1 favorite]
Hey ya'll!
I'm the girlfriend in question. Thanks so much for all your advice. There's quite a bit more to it than the original post let on, a lot of explanations for certain behaviors. My mother has extreme OCD. She herself, and no one else in my family ever seemed to have any kind of issue with vomit. But I was raised in an environment where if I got a spec of dirt on my body, I'd be stripped down and put in the bath. So I feel that explains why I need to clean. And I also feel extreme solace in cleaning. I just can't wait to feel that amazing feeling of being in a clean environment. Because if it's not clean, or is messy, my throat tightens up and my mouth dries out and my heart beats fast and I MUST eliminate the mess or face doom...or something!
I've had the emetophobia as far back as I can ever remember. I even have a full HD archive of videos of every time I've seen someone vomit in front of me in my head. And when I am faced with seeing someone vomit (which hasn't happened in about 5 years), or if I see it on the sidewalk in the street, no matter how good my mood was, I just turn sour and angry and choked up, then I obsess over the image for the rest of the day. I play over in my mind how it might look and feel if I vomit, what the quickest way will be to kill myself if I vomit and things like that. There is so very many little things (keeping a hairband around my wrist at all times in case I need to tie my hair back to get sick, pretending to vomit with water in front of the mirror at the sink to prepare myself for the actual occasion, actually praying to god when I have nausea even though I'm an atheist, keeping a bag inside my purse to get sick into if I need it, worrying about my boyfriend walking through vomit when I'm not with him, washing my body with bleach if someone gets sick at my house etc). So many tiny little obsessive things to break out of. One very funny, curious thing about it is that I am only scared of men and children vomiting, women only worry me if i have to hear/see/smell it or if it's viral. It's just the men and children and viruses that make me snap.
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it. And there is no way in the world that I would ever consider exposure therapy. It feels pretty much like emetophobia is my whole life, everything else is secondary, and the emet will be the end of my life too. Some people say emetophobia is sort of a fear of losing control, and most emets like to be in control of EVERYTHING EVER, but we can't be in control of our stomachs, and that is some scary ass shit right there!
I really appreciate all your advice. I am very very interested especially to hear from other emets, and would be even more over the moon to hear from one who shares this phobia to the same degree as me and have overcome it and are perfectly happy to leave their house and drink too much booze, and go on public transport and go to pubs and hospitals and theme parks and all those other places we avoid like Chernobyl.
posted by foxy at 12:19 AM on September 17, 2011
I'm the girlfriend in question. Thanks so much for all your advice. There's quite a bit more to it than the original post let on, a lot of explanations for certain behaviors. My mother has extreme OCD. She herself, and no one else in my family ever seemed to have any kind of issue with vomit. But I was raised in an environment where if I got a spec of dirt on my body, I'd be stripped down and put in the bath. So I feel that explains why I need to clean. And I also feel extreme solace in cleaning. I just can't wait to feel that amazing feeling of being in a clean environment. Because if it's not clean, or is messy, my throat tightens up and my mouth dries out and my heart beats fast and I MUST eliminate the mess or face doom...or something!
I've had the emetophobia as far back as I can ever remember. I even have a full HD archive of videos of every time I've seen someone vomit in front of me in my head. And when I am faced with seeing someone vomit (which hasn't happened in about 5 years), or if I see it on the sidewalk in the street, no matter how good my mood was, I just turn sour and angry and choked up, then I obsess over the image for the rest of the day. I play over in my mind how it might look and feel if I vomit, what the quickest way will be to kill myself if I vomit and things like that. There is so very many little things (keeping a hairband around my wrist at all times in case I need to tie my hair back to get sick, pretending to vomit with water in front of the mirror at the sink to prepare myself for the actual occasion, actually praying to god when I have nausea even though I'm an atheist, keeping a bag inside my purse to get sick into if I need it, worrying about my boyfriend walking through vomit when I'm not with him, washing my body with bleach if someone gets sick at my house etc). So many tiny little obsessive things to break out of. One very funny, curious thing about it is that I am only scared of men and children vomiting, women only worry me if i have to hear/see/smell it or if it's viral. It's just the men and children and viruses that make me snap.
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it. And there is no way in the world that I would ever consider exposure therapy. It feels pretty much like emetophobia is my whole life, everything else is secondary, and the emet will be the end of my life too. Some people say emetophobia is sort of a fear of losing control, and most emets like to be in control of EVERYTHING EVER, but we can't be in control of our stomachs, and that is some scary ass shit right there!
I really appreciate all your advice. I am very very interested especially to hear from other emets, and would be even more over the moon to hear from one who shares this phobia to the same degree as me and have overcome it and are perfectly happy to leave their house and drink too much booze, and go on public transport and go to pubs and hospitals and theme parks and all those other places we avoid like Chernobyl.
posted by foxy at 12:19 AM on September 17, 2011
I even consider the colour and content of my food, and wonder how disturbing it will look if I throw it up later...crazy!
posted by foxy at 12:22 AM on September 17, 2011 [1 favorite]
posted by foxy at 12:22 AM on September 17, 2011 [1 favorite]
Going by your description, I'd say that this does have notions of extreme OCD (IANAP, IANAD etc), but it's worrying that you don't think that this can be treated and that makes me wonder whether you actually want to face up to this (I'm sure that's not the case though). With the right therapist/GP/approach, great strides can be made, but it requires an active desire to change your mindset and all the advice in the world can only go so far to help you with that, the change has to come from within. A good therapist won't just try to 'talk you out of it', but rather give you tools and techniques to be able to deal with these debilitating thoughts and actions which are having a really detrimental affect on your life.
posted by Scottie_Bob at 12:41 AM on September 17, 2011 [2 favorites]
posted by Scottie_Bob at 12:41 AM on September 17, 2011 [2 favorites]
That's a lot of "we" there foxy. If you've built some of your identity around this, then there's going to be some attraction to being "uncureable". I am sure though that your friends in the emet community would not kick you out for feeling better if and when that time comes. If you have some extra status by ring the most extreme member of your community, I don't think that would change either by being willing to do work on the issue.
Don't get me wrong, I sympathize, having been for many years in a similar situation as your boyf, with a partner who might leave a dinner party if another guest mentioned they'd had a busy week because a coworker had been home sick. These days she's pretty much ok, we throw out food on it's best before date, and go through a lot of hand-disenfectant in the winter months, but that is doable, we live well. Give yourself some credit, get some cbt, and choose life. Good luck!
posted by Iteki at 1:18 AM on September 17, 2011
Don't get me wrong, I sympathize, having been for many years in a similar situation as your boyf, with a partner who might leave a dinner party if another guest mentioned they'd had a busy week because a coworker had been home sick. These days she's pretty much ok, we throw out food on it's best before date, and go through a lot of hand-disenfectant in the winter months, but that is doable, we live well. Give yourself some credit, get some cbt, and choose life. Good luck!
posted by Iteki at 1:18 AM on September 17, 2011
Therapy won't be "just talking you out of it." Therapy for severe phobias and anxiety involves direct action on the fear response. Exposure therapy doesn't start with "hey let's look at some puke and force you to touch it"--it starts a lot more gently than that, and exposure therapy also happens to be **extremely** well-documented in terms of efficacy on phobias and related anxiety. The fear is irrational, and therapy can help your brain and body to learn the difference between rational and justified fears and irrational, consuming-your-life-for-no-reason fears.
I went through therapy for emetophobia and panic disorder when I was 15-16 (and had lost around 30 pounds in 2 months from refusing to eat because I JUST KNEW I would throw up... my pediatrician thought I had anorexia, because she had no idea what this was, so luckily she referred me to counseling and I was able to take advantage of it), and now I am a therapist and I have actually had the opportunity to treat a few people with emetophobia!
foxy, please don't discount the possibility of therapy helping. I used to carry around the plastic sandwich bag, constantly needed to sit near doorways, always monitored where the trash cans were in any building, washed my hands constantly to rid myself of the germs that I was certain would make me sick even if I didn't touch my face. You are not too far gone for therapy to help you. I understand that it's very scary to think about confronting it instead of doing all of the safe-feeling anxiety management things you do now (like avoiding your fearful stimulus at all costs--including the cost of your happiness and potential to live a full and enjoyable life), but ultimately? The freedom from that anxiety is the best thing that ever happened to me, and it opened my life up so much.
P.S. AskMe, when did armchair-diagnosis become ok again? Because it's not. It's not appropriate for an actual trained mental health professional to offer this person a diagnosis over the internet, so why would it be ok for a totally untrained person with zero professional credentials or experience but Stuff S/He Read on the Internet?
posted by so_gracefully at 1:35 AM on September 17, 2011 [13 favorites]
I went through therapy for emetophobia and panic disorder when I was 15-16 (and had lost around 30 pounds in 2 months from refusing to eat because I JUST KNEW I would throw up... my pediatrician thought I had anorexia, because she had no idea what this was, so luckily she referred me to counseling and I was able to take advantage of it), and now I am a therapist and I have actually had the opportunity to treat a few people with emetophobia!
foxy, please don't discount the possibility of therapy helping. I used to carry around the plastic sandwich bag, constantly needed to sit near doorways, always monitored where the trash cans were in any building, washed my hands constantly to rid myself of the germs that I was certain would make me sick even if I didn't touch my face. You are not too far gone for therapy to help you. I understand that it's very scary to think about confronting it instead of doing all of the safe-feeling anxiety management things you do now (like avoiding your fearful stimulus at all costs--including the cost of your happiness and potential to live a full and enjoyable life), but ultimately? The freedom from that anxiety is the best thing that ever happened to me, and it opened my life up so much.
P.S. AskMe, when did armchair-diagnosis become ok again? Because it's not. It's not appropriate for an actual trained mental health professional to offer this person a diagnosis over the internet, so why would it be ok for a totally untrained person with zero professional credentials or experience but Stuff S/He Read on the Internet?
posted by so_gracefully at 1:35 AM on September 17, 2011 [13 favorites]
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it.
I understand why you have this intuition, but I don't think it's empirically right. Specific phobias are one of the problems talk therapy (in this case, exposure therapy) has the best record of addressing. I'm not the person who posts "get therapy" in every "I have a problem" thread, but this problem is basically why we have CBT therapists who do exposure.
And there is no way in the world that I would ever consider exposure therapy.
Please know that this is the way the phobia protects itself.
Exposure therapy will be unpleasant and difficult for you. I think that continuing to live as you have been will be, in the long run, more unpleasant and difficult, nor just for you but -- does this help? -- for the person you love.
posted by escabeche at 4:51 AM on September 17, 2011
I understand why you have this intuition, but I don't think it's empirically right. Specific phobias are one of the problems talk therapy (in this case, exposure therapy) has the best record of addressing. I'm not the person who posts "get therapy" in every "I have a problem" thread, but this problem is basically why we have CBT therapists who do exposure.
And there is no way in the world that I would ever consider exposure therapy.
Please know that this is the way the phobia protects itself.
Exposure therapy will be unpleasant and difficult for you. I think that continuing to live as you have been will be, in the long run, more unpleasant and difficult, nor just for you but -- does this help? -- for the person you love.
posted by escabeche at 4:51 AM on September 17, 2011
Hi. My name is cygnet, and I am an emetophobic.
The symptoms you are describing are, sadly, within the bounds of standard emetophobia. It is a very difficult condition to deal with. The number one reason it's a difficult condition to deal with is this: the response of almost everybody who hears about it will be either:
a) to tell you the Great Vomit Story (as you point out), which is the worst possible response
b) to explain to you that vomiting is a natural process of the body and won't hurt you
c) to suggest that you just should make yourself throw up and then you'll realize it's no big deal
or,
d) to tell you there's clearly something more wrong with you than you think.
It can be especially difficult to get people to understand that emetophobia is NOT the same thing is hypochondria, which, in the US anyway, is often considered the result of moral failing or poor education, not an anxiety disorder. They may be coincident in some but I think that's rare. You sneezed all over my face? I don't care. I'm feeling like I've got a cold? Whatever. You have a terrible disease? PLEASE KNOW that I am not afraid of you. It's just throwing up. That's IT.
It's also very, very hard to be an emetophobic child. My own parents - truly wonderful parents who bent over backwards for their children - did not understand my fear. It was so irrational, so unexplained, and so incredibly intense that they resorted to screaming at me to "get a grip", calm down, and left me alone in the middle of the night while I had panic attacks. To many adults, it will look like some kind of defiance or a behavioral problem or "general neediness". It's not, but the kid won't know how to articulate that.
Like your girlfriend, I have an incredibly extensive mental video record of every single episode of vomiting that I've ever observed. No, I'm not exaggerating. EVERY. SINGLE. TIME. Including in films, whether it's explicit, only the sound, or even just suggested. Times I was sick myself? The surrounding days are BURNED in to my memory. I know what I wore, what I ate, who called on the phone... everything. As a neuroscientist I find this really fascinating. Everybody knows where they were when they heard about 9/11, right? That's because everybody's amygdala (that's a brain structure) helped them categorize that news as "extremely significant" and place it in to special high-security memory storage reserved for life-changing events. For emetophobics, every encounter with vomiting triggers this response. Maybe that can help people who really don't understand the condition get a sense of how Truly Catastrophic it feels.
Again, like your girlfriend, I have also noticed many small ways in which I "prepare myself" for the possibility of becoming ill. For example, in large lecture rooms, I have a tendency to want to sit on the ends of rows. This is so that, should I become ill during the lecture, I will be able to get up and run out of the room before throwing up. There are many more examples. As a child I was terrified to go to sleep because I might wake up sick - and I wouldn't have felt it coming and had time to prepare.
I just want you to know that you're not alone. It's hard for others to imagine the level of planning and complexity that is the result of this fear.
I am so grateful that I've been able to work with my emetophobia and that it does NOT rule my life. I can be around children (I even volunteer with large groups of babies), I can go where I please, I eat almost anything (but not that questionable leftover), and it does not dominate my days. I can't know what precisely will help you, but here are the things that have helped me.
1. Therapy. No, I did not walk out cured, but I think it would actually be foolish not to try, and here's why: it seems, from the perspective of an emetophobic, that the fear is instantaneous, 100% irrational, and utterly baseless. In my case, it felt to me as though encountering vomiting turned a switch in my brain that changed me from a normal, empathetic, easy-going person into a selfish, fearful person. There did not appear to be ANY middle ground: any reasons, any intermediate feelings, nothing. Therapy helped me delve in to my past and figure out what about vomiting I found so terrifying, and why that might be. In my case, the thought of vomiting in my own bathroom, without having to run there in front of my husband, when nobody can hear, and when I know it's coming is still very very unpleasant, but it's not my nightmare. My nightmare is developing a virus suddenly, in a crowded public space, where I will create a disgusting other mess that somebody else will have to clean up. I will lose control. I will become a helpless infant-like creature in front of people who are supposed to see me as a functional adult. Now that, I find terrifying. I didn't use to think this kind of distinction existed in my fear, because the adrenaline begins to flow and the obsessive thoughts start up the second an "incident" occurs. But there is a finer grain to the fear, and seeing that has helped me to handle it.
I have also managed to pinpoint the incident that caused the fear. This is a bad (and to the non emetophobics, yes, disgusting) story; do not read if you aren't ready. I was 5 years old. Woke up in the middle of the night propped up on my elbows, having just thrown up (before I was awake) all over my pillow, myself, and my special blankie. I *wasn't even awake* to realize it was going to happen, lean over, or go to the bathroom. Throughout that night, I was barely awake, but I remember my parents putting towels under me because I had diarrhea. I have a crystal clear memory of trying to tell them that I totally did NOT need that towel because I was a big girl. It was incredibly traumatic for me at that particular age. I was in the process of defining myself as a being who was responsible for herself and who didn't need help taking care of her body, like an infant.
The number one thing my therapist said that helped me was this: "If that had happened to me at that age, and I cared as much as you did about becoming independent and responsible, I would probably have the same fear as you. It's not so irrational, under the circumstances." Obviously it's impossible to know if this is totally true.
2. Meditation. I've written about this a LOT elsewhere on metafilter, so I'll keep this short. It helped me the quickest, the most, it has provided the most lasting help for my condition, and as a bonus it has helped me in every other area of life. Just "calming down" is not what it's about. It's about learning to be OK, somewhere deep inside yourself, when the way you feel is (superficially at least) totally NOT OK AT ALL. I can't recommend meditation enough and if you want any more information, especially if you are in the Boston area, feel free to memail me.
3. Medication. On two occasions, when my fears were starting to limit my behavior, I took Prozac (10 mg, the dose for anxiety, which is lower than the dose for depression). It helped ENORMOUSLY. It does wonders for cutting the obsessive anxious thinking and the sheer terror that can develop.
4. Having an understanding partner. It sounds like this is already the case. This has been very important to me.
5. NEVER, EVER reading those forums for other people with emetophobia. I promise it's not because I think they're all "crazy" or "crazier than me".
Emetophobia tells you: "this stomach sensation means I will vomit", "this food will make me vomit", "this situation means I will surely observe somebody else vomiting", and, WORST OF ALL, "if I'm not utterly vigilant about this situation or sensation it will cause me to vomit, and vigilance will help prevent this from happening". There is nothing worse for this fear than listening to other people say the same. It's an echo chamber for phobic beliefs about reality and they just amplify themselves.
This is not to say that discussing emetophobia in the abstract with other emetophobics is bad. I'm doing it right now. HOWEVER, I have never seen a forum that isn't full of people posting in the midst of an anxiety attack, CONVINCED that they will be vomiting in minutes. The other posters aren't able to reassure them that they will be OK, because they are also afraid. They do not tend to be places to share the difficulties of living with the phobia, they tend to be places to share immediate fears, and that's just not helpful.
Good luck, girlfriend of the OP. Things can - and will, I trust - be more comfortable and easier for you. This fear does not have to run your life, and there is help out there.
posted by Cygnet at 5:09 AM on September 17, 2011 [16 favorites]
The symptoms you are describing are, sadly, within the bounds of standard emetophobia. It is a very difficult condition to deal with. The number one reason it's a difficult condition to deal with is this: the response of almost everybody who hears about it will be either:
a) to tell you the Great Vomit Story (as you point out), which is the worst possible response
b) to explain to you that vomiting is a natural process of the body and won't hurt you
c) to suggest that you just should make yourself throw up and then you'll realize it's no big deal
or,
d) to tell you there's clearly something more wrong with you than you think.
It can be especially difficult to get people to understand that emetophobia is NOT the same thing is hypochondria, which, in the US anyway, is often considered the result of moral failing or poor education, not an anxiety disorder. They may be coincident in some but I think that's rare. You sneezed all over my face? I don't care. I'm feeling like I've got a cold? Whatever. You have a terrible disease? PLEASE KNOW that I am not afraid of you. It's just throwing up. That's IT.
It's also very, very hard to be an emetophobic child. My own parents - truly wonderful parents who bent over backwards for their children - did not understand my fear. It was so irrational, so unexplained, and so incredibly intense that they resorted to screaming at me to "get a grip", calm down, and left me alone in the middle of the night while I had panic attacks. To many adults, it will look like some kind of defiance or a behavioral problem or "general neediness". It's not, but the kid won't know how to articulate that.
Like your girlfriend, I have an incredibly extensive mental video record of every single episode of vomiting that I've ever observed. No, I'm not exaggerating. EVERY. SINGLE. TIME. Including in films, whether it's explicit, only the sound, or even just suggested. Times I was sick myself? The surrounding days are BURNED in to my memory. I know what I wore, what I ate, who called on the phone... everything. As a neuroscientist I find this really fascinating. Everybody knows where they were when they heard about 9/11, right? That's because everybody's amygdala (that's a brain structure) helped them categorize that news as "extremely significant" and place it in to special high-security memory storage reserved for life-changing events. For emetophobics, every encounter with vomiting triggers this response. Maybe that can help people who really don't understand the condition get a sense of how Truly Catastrophic it feels.
Again, like your girlfriend, I have also noticed many small ways in which I "prepare myself" for the possibility of becoming ill. For example, in large lecture rooms, I have a tendency to want to sit on the ends of rows. This is so that, should I become ill during the lecture, I will be able to get up and run out of the room before throwing up. There are many more examples. As a child I was terrified to go to sleep because I might wake up sick - and I wouldn't have felt it coming and had time to prepare.
I just want you to know that you're not alone. It's hard for others to imagine the level of planning and complexity that is the result of this fear.
I am so grateful that I've been able to work with my emetophobia and that it does NOT rule my life. I can be around children (I even volunteer with large groups of babies), I can go where I please, I eat almost anything (but not that questionable leftover), and it does not dominate my days. I can't know what precisely will help you, but here are the things that have helped me.
1. Therapy. No, I did not walk out cured, but I think it would actually be foolish not to try, and here's why: it seems, from the perspective of an emetophobic, that the fear is instantaneous, 100% irrational, and utterly baseless. In my case, it felt to me as though encountering vomiting turned a switch in my brain that changed me from a normal, empathetic, easy-going person into a selfish, fearful person. There did not appear to be ANY middle ground: any reasons, any intermediate feelings, nothing. Therapy helped me delve in to my past and figure out what about vomiting I found so terrifying, and why that might be. In my case, the thought of vomiting in my own bathroom, without having to run there in front of my husband, when nobody can hear, and when I know it's coming is still very very unpleasant, but it's not my nightmare. My nightmare is developing a virus suddenly, in a crowded public space, where I will create a disgusting other mess that somebody else will have to clean up. I will lose control. I will become a helpless infant-like creature in front of people who are supposed to see me as a functional adult. Now that, I find terrifying. I didn't use to think this kind of distinction existed in my fear, because the adrenaline begins to flow and the obsessive thoughts start up the second an "incident" occurs. But there is a finer grain to the fear, and seeing that has helped me to handle it.
I have also managed to pinpoint the incident that caused the fear. This is a bad (and to the non emetophobics, yes, disgusting) story; do not read if you aren't ready. I was 5 years old. Woke up in the middle of the night propped up on my elbows, having just thrown up (before I was awake) all over my pillow, myself, and my special blankie. I *wasn't even awake* to realize it was going to happen, lean over, or go to the bathroom. Throughout that night, I was barely awake, but I remember my parents putting towels under me because I had diarrhea. I have a crystal clear memory of trying to tell them that I totally did NOT need that towel because I was a big girl. It was incredibly traumatic for me at that particular age. I was in the process of defining myself as a being who was responsible for herself and who didn't need help taking care of her body, like an infant.
The number one thing my therapist said that helped me was this: "If that had happened to me at that age, and I cared as much as you did about becoming independent and responsible, I would probably have the same fear as you. It's not so irrational, under the circumstances." Obviously it's impossible to know if this is totally true.
2. Meditation. I've written about this a LOT elsewhere on metafilter, so I'll keep this short. It helped me the quickest, the most, it has provided the most lasting help for my condition, and as a bonus it has helped me in every other area of life. Just "calming down" is not what it's about. It's about learning to be OK, somewhere deep inside yourself, when the way you feel is (superficially at least) totally NOT OK AT ALL. I can't recommend meditation enough and if you want any more information, especially if you are in the Boston area, feel free to memail me.
3. Medication. On two occasions, when my fears were starting to limit my behavior, I took Prozac (10 mg, the dose for anxiety, which is lower than the dose for depression). It helped ENORMOUSLY. It does wonders for cutting the obsessive anxious thinking and the sheer terror that can develop.
4. Having an understanding partner. It sounds like this is already the case. This has been very important to me.
5. NEVER, EVER reading those forums for other people with emetophobia. I promise it's not because I think they're all "crazy" or "crazier than me".
Emetophobia tells you: "this stomach sensation means I will vomit", "this food will make me vomit", "this situation means I will surely observe somebody else vomiting", and, WORST OF ALL, "if I'm not utterly vigilant about this situation or sensation it will cause me to vomit, and vigilance will help prevent this from happening". There is nothing worse for this fear than listening to other people say the same. It's an echo chamber for phobic beliefs about reality and they just amplify themselves.
This is not to say that discussing emetophobia in the abstract with other emetophobics is bad. I'm doing it right now. HOWEVER, I have never seen a forum that isn't full of people posting in the midst of an anxiety attack, CONVINCED that they will be vomiting in minutes. The other posters aren't able to reassure them that they will be OK, because they are also afraid. They do not tend to be places to share the difficulties of living with the phobia, they tend to be places to share immediate fears, and that's just not helpful.
Good luck, girlfriend of the OP. Things can - and will, I trust - be more comfortable and easier for you. This fear does not have to run your life, and there is help out there.
posted by Cygnet at 5:09 AM on September 17, 2011 [16 favorites]
I am also apparently an emetophobe (never knew it had a name until now!) but I'm not particularly severe, so I guess I don't really have anything to contribute on that score. I did want to address this, however:
My mother has extreme OCD. She herself, and no one else in my family ever seemed to have any kind of issue with vomit. But I was raised in an environment where if I got a spec of dirt on my body, I'd be stripped down and put in the bath. So I feel that explains why I need to clean.
There is a strong hereditary component to OCD. So don't be too quick to dismiss your cleaning issues as "the way you were brought up." That may have helped to shape the form of some of your obsessions/compulsions but it's quite possible that you have your very own case of OCD which is causing or contributing to a lot of your issues.
I have OCD and so does my daughter, and the first thought that went through my mind when reading your BF's description was "that's not a plain old phobia, that sounds like OCD."
posted by Serene Empress Dork at 6:05 AM on September 17, 2011
My mother has extreme OCD. She herself, and no one else in my family ever seemed to have any kind of issue with vomit. But I was raised in an environment where if I got a spec of dirt on my body, I'd be stripped down and put in the bath. So I feel that explains why I need to clean.
There is a strong hereditary component to OCD. So don't be too quick to dismiss your cleaning issues as "the way you were brought up." That may have helped to shape the form of some of your obsessions/compulsions but it's quite possible that you have your very own case of OCD which is causing or contributing to a lot of your issues.
I have OCD and so does my daughter, and the first thought that went through my mind when reading your BF's description was "that's not a plain old phobia, that sounds like OCD."
posted by Serene Empress Dork at 6:05 AM on September 17, 2011
You may find my past question helpful. Feel free to contact me about it. Not that I have the solution, but I have the same issue
posted by KogeLiz at 7:03 AM on September 17, 2011
posted by KogeLiz at 7:03 AM on September 17, 2011
Also, its excellent you recognize her phobia. A lot of people in my life think im just being dramatic. The worst is when some tries to be "funny" and pretend they're throwing up.
posted by KogeLiz at 7:05 AM on September 17, 2011
posted by KogeLiz at 7:05 AM on September 17, 2011
P.S. AskMe, when did armchair-diagnosis become ok again? Because it's not. It's not appropriate for an actual trained mental health professional to offer this person a diagnosis over the internet, so why would it be ok for a totally untrained person with zero professional credentials or experience but Stuff S/He Read on the Internet?
I'm not sure if this is directed at me, but I both stated that I'm not a psychiatrist and that I thought foxy needed professional help regardless. I'm glad to have been set straight on the account that emetophobia often mimics an eating disorder, and that foxy has connected with other people here who have suffered from the same. Best of luck to you regardless, and good for you for beginning to recognize the impact this is having on your life.
posted by PhoBWanKenobi at 7:58 AM on September 17, 2011
I'm not sure if this is directed at me, but I both stated that I'm not a psychiatrist and that I thought foxy needed professional help regardless. I'm glad to have been set straight on the account that emetophobia often mimics an eating disorder, and that foxy has connected with other people here who have suffered from the same. Best of luck to you regardless, and good for you for beginning to recognize the impact this is having on your life.
posted by PhoBWanKenobi at 7:58 AM on September 17, 2011
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it.
Oh, hello, fellow emetophobe! Nice to hear from you. (I could tell you all sorts of stories about how I used to be, and the little trigger responses I still get to this day, but let's just skip the boring qualifications. :) Besides, I often consider that kind of talk to be wallowing; indulging my anxieties is not a useful way for me to live my life. I treasure my freedom, and you can too. Cygnet had some very good things to say on this topic.)
Yes, you are in one way correct with this statement above. My shrink did not "talk me out" of my worldview. That's not how real therapy works. We're not talking about you laying on a couch and blathering on about your mother and what you (didn't) eat for lunch. We're talking about you doing some real work. Are you ready to do that? And I do mean work: it's going to be labor.
You have really started to base your identity around your compulsions. I say this with affection, and as someone who gets it (and someone with a fun complicated array of OCD and anxiety issues, who also didn't get on planes or in elevators for years): You think you're special and different. Oh, no one can help you! You're just such a bad case!
Well, that's some garbage-at-the-center-of-the-world baloney. You're trying to talk yourself into being incurable. So you think you're worse than everyone else. And in a way you actually like what you've become, because you can only get relief now through your rituals, and so you're identifying with this community of sufferers (in a way that reminds me of the girls with the pro-ana blogs). But guess what? Your world view sounds like pretty much everyone else who's walked through the doors of an alcohol rehab or an eating disorder clinic.
Do you want to be a damaged victim for the rest of your life? Do you want to drive everyone away from you? Or do you want to be free of anxiety and ritual and fear?
Find yourself an exceptionally well-recommended CBT practitioner who gets it. You've got some choices to make, and you could use the help. It also doesn't happen overnight, and part of the journey to wellness SUCKS. (Not gonna sugarcoat it.)
Take it from me. I actually ate RAW SHELLFISH the other night, something I WOULD NEVER, EVER have done. (And I liked it!) I'm curable, you're curable, and everyone's curable. There's no point in victimizing ourselves. Life is short, we're grown-up adults now, and what we do is all up to us. I'll be rooting for you.
posted by RJ Reynolds at 8:53 AM on September 17, 2011 [8 favorites]
Oh, hello, fellow emetophobe! Nice to hear from you. (I could tell you all sorts of stories about how I used to be, and the little trigger responses I still get to this day, but let's just skip the boring qualifications. :) Besides, I often consider that kind of talk to be wallowing; indulging my anxieties is not a useful way for me to live my life. I treasure my freedom, and you can too. Cygnet had some very good things to say on this topic.)
Yes, you are in one way correct with this statement above. My shrink did not "talk me out" of my worldview. That's not how real therapy works. We're not talking about you laying on a couch and blathering on about your mother and what you (didn't) eat for lunch. We're talking about you doing some real work. Are you ready to do that? And I do mean work: it's going to be labor.
You have really started to base your identity around your compulsions. I say this with affection, and as someone who gets it (and someone with a fun complicated array of OCD and anxiety issues, who also didn't get on planes or in elevators for years): You think you're special and different. Oh, no one can help you! You're just such a bad case!
Well, that's some garbage-at-the-center-of-the-world baloney. You're trying to talk yourself into being incurable. So you think you're worse than everyone else. And in a way you actually like what you've become, because you can only get relief now through your rituals, and so you're identifying with this community of sufferers (in a way that reminds me of the girls with the pro-ana blogs). But guess what? Your world view sounds like pretty much everyone else who's walked through the doors of an alcohol rehab or an eating disorder clinic.
Do you want to be a damaged victim for the rest of your life? Do you want to drive everyone away from you? Or do you want to be free of anxiety and ritual and fear?
Find yourself an exceptionally well-recommended CBT practitioner who gets it. You've got some choices to make, and you could use the help. It also doesn't happen overnight, and part of the journey to wellness SUCKS. (Not gonna sugarcoat it.)
Take it from me. I actually ate RAW SHELLFISH the other night, something I WOULD NEVER, EVER have done. (And I liked it!) I'm curable, you're curable, and everyone's curable. There's no point in victimizing ourselves. Life is short, we're grown-up adults now, and what we do is all up to us. I'll be rooting for you.
posted by RJ Reynolds at 8:53 AM on September 17, 2011 [8 favorites]
I would like to address the OP: Please look after yourself. While your concern and the intense focus on your girlfriend's mighty challenge are well-founded, it's an awful lot for you to be managing. This qualifies as serious stress, and can compromise your immune system, distract you from keeping your self safe, and cause you to neglect your own health. I hope you have family, friends, job, interests etc in which you can find refuge! Take care and good luck. ... By the way, not being flippant -- is there really that much vomit around? I don't think I've ever run across random stranger vomit, and I live in Manhattan.
posted by thinkpiece at 9:14 AM on September 17, 2011
posted by thinkpiece at 9:14 AM on September 17, 2011
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it.
I have personally seen intensive therapy help a close friend of mine whose severe depression led to several serious suicide attempts. He is now happy, healthy, employed, married, and generally enjoying life. When he was struggling with depression, he was so sad, for such a long time, that he gave up on himself, and so did many of his friends. I can tell you candidly that after I had seen how many different treatments had failed him and how sincere he was in trying to end his own life, I came to believe that there was no help on earth for him and he would never be well. I began to wait for him to finally succeed in killing himself.
Luckily for my friend, his parents never gave up and pushed him to keep trying different therapies/drugs/programs and after years, they found one that worked. And now he is better. And no longer lost in misery and suffering. And he is happy.
If there was help for my friend, there is help for you. Psychiatry doesn't just hand-hold bored housewives with first-world problems. Psychiatry helps people with overwhelming and severe mental illnesses.
Keep trying different things until you find what works for you. It might be medication, or the right therapeutic approach (there are many) or a combination of those things.
The descriptions of your struggle with emetophobia in this thread are heartbreaking. Any competent mental health professional will take your problem very, very seriously. Keep trying.
posted by prefpara at 9:16 AM on September 17, 2011
I have personally seen intensive therapy help a close friend of mine whose severe depression led to several serious suicide attempts. He is now happy, healthy, employed, married, and generally enjoying life. When he was struggling with depression, he was so sad, for such a long time, that he gave up on himself, and so did many of his friends. I can tell you candidly that after I had seen how many different treatments had failed him and how sincere he was in trying to end his own life, I came to believe that there was no help on earth for him and he would never be well. I began to wait for him to finally succeed in killing himself.
Luckily for my friend, his parents never gave up and pushed him to keep trying different therapies/drugs/programs and after years, they found one that worked. And now he is better. And no longer lost in misery and suffering. And he is happy.
If there was help for my friend, there is help for you. Psychiatry doesn't just hand-hold bored housewives with first-world problems. Psychiatry helps people with overwhelming and severe mental illnesses.
Keep trying different things until you find what works for you. It might be medication, or the right therapeutic approach (there are many) or a combination of those things.
The descriptions of your struggle with emetophobia in this thread are heartbreaking. Any competent mental health professional will take your problem very, very seriously. Keep trying.
posted by prefpara at 9:16 AM on September 17, 2011
Yes, a really competent therapist is needed. More likely a PhD with experience treating obsessive behavior. Also a reference to a good psychiatrist for correct medication review.
I hate throwing up a lot, though not to the point of phobia. If I am in danger of throwing up, small sips of ginger ale or water really help. While sipping, the action of swallowing helps suppress the muscles that cause throwing up. Ginger helps settle the stomach. And, if I end up throwing up anyway, ginger ale is the least nasty thing. (sorry) Last time I puked was because of bad salmon, so throwing up was my body's way of taking care of me. Learning how to not throw up, settle my stomach, and understanding that sometimes it's a benefit has helped me calm down about it. I recognize that your sweetie needs much more serious help, but perhaps it will be a small help to some readers of this thread.
She's lucky to have you; good luck to you both.
posted by theora55 at 9:29 AM on September 17, 2011
I hate throwing up a lot, though not to the point of phobia. If I am in danger of throwing up, small sips of ginger ale or water really help. While sipping, the action of swallowing helps suppress the muscles that cause throwing up. Ginger helps settle the stomach. And, if I end up throwing up anyway, ginger ale is the least nasty thing. (sorry) Last time I puked was because of bad salmon, so throwing up was my body's way of taking care of me. Learning how to not throw up, settle my stomach, and understanding that sometimes it's a benefit has helped me calm down about it. I recognize that your sweetie needs much more serious help, but perhaps it will be a small help to some readers of this thread.
She's lucky to have you; good luck to you both.
posted by theora55 at 9:29 AM on September 17, 2011
A lot of people think of therapy as generalized talking and it's easy to see why that doesn't seem like it would be useful. But think of CBT (and DBT) more like physical therapy without a body part involved. If you jacked up your knee really badly, for example, you might go to a physical therapist. They're not going to do surgery, they can't make the problem go away, but they're going to work very specifically on how to move, how to strengthen the good muscles to help take over for the damaged ones, they're going to teach you how to ice/rest/brace and generally care for your knee so that you have more functional movement, less pain, and are less likely to re-damage the healing tissues.
That is what good therapy does. It will help you strengthen your coping mechanisms, teach you strategies for managing your anxiety, and give you tools for dealing with this. Unfortunately, when you have anxiety or obsessive issues, one symptom of those issues is often fear of working on the issue. A good therapist will help you with that part too, but nobody but you can make you walk through that door every time.
People who get better don't hang out on the forums. That's like an alcoholic hanging out in a bar every day to talk about their recovery. Those places can be useful for someone who's still at the information-seeking phase of their efforts, but you just can't recover from an obsessive disorder by obsessing all day.
posted by Lyn Never at 10:02 AM on September 17, 2011 [3 favorites]
That is what good therapy does. It will help you strengthen your coping mechanisms, teach you strategies for managing your anxiety, and give you tools for dealing with this. Unfortunately, when you have anxiety or obsessive issues, one symptom of those issues is often fear of working on the issue. A good therapist will help you with that part too, but nobody but you can make you walk through that door every time.
People who get better don't hang out on the forums. That's like an alcoholic hanging out in a bar every day to talk about their recovery. Those places can be useful for someone who's still at the information-seeking phase of their efforts, but you just can't recover from an obsessive disorder by obsessing all day.
posted by Lyn Never at 10:02 AM on September 17, 2011 [3 favorites]
That's why I feel therapy is of no use whatsoever to me. It's too far gone, too out of control and too complex for me to just be TALKED out of it. And there is no way in the world that I would ever consider exposure therapy. It feels pretty much like emetophobia is my whole life, everything else is secondary, and the emet will be the end of my life too.
Hi, I'm also emetophobic, though not as severely. I don't feel like it is my whole life or that it will be the end of my life. It is my hope you can get to this place. For me, some exposure has actually helped - I still find it horrific when I see/hear/think about people vomiting, but it is no longer traumatic with the sort of post-traumatic holdover you describe. I know you are not ready to consider this course of action, but I do really think a skilled therapist can help you, along with the support of your loved ones (who obviously want the best for you). Folks above are right - you have to want to make this change, and believe that it is possible to heal. I don't hear that you're there yet, but I hope that hearing from others in this thread who have recovered (partially or fully) from this will help convince you that it is possible.
posted by judith at 12:22 PM on September 17, 2011
Hi, I'm also emetophobic, though not as severely. I don't feel like it is my whole life or that it will be the end of my life. It is my hope you can get to this place. For me, some exposure has actually helped - I still find it horrific when I see/hear/think about people vomiting, but it is no longer traumatic with the sort of post-traumatic holdover you describe. I know you are not ready to consider this course of action, but I do really think a skilled therapist can help you, along with the support of your loved ones (who obviously want the best for you). Folks above are right - you have to want to make this change, and believe that it is possible to heal. I don't hear that you're there yet, but I hope that hearing from others in this thread who have recovered (partially or fully) from this will help convince you that it is possible.
posted by judith at 12:22 PM on September 17, 2011
Hi. My name is stagewhisper, and I am an emetophobic.
I only admitted this once before in my life, when I was still a very young child, but it was never taken very seriously and since then I just tell people I don't ever vomit (true- I haven't vomited since 1983 and it's part of the mental illness that I remember the date so well) because vomiting or being around the act freaks me out (also true). I don't let on how debilitating this once was or how deeply it affected my ability to live anything approximating a normal life. I was, and still am, completely ashamed by it.
For anyone who is reading this thread primarily out of curiosity, please be sure to read Cygnet's excellent explanation about what kinds of thoughts and bodily sensations are accompanied by this phobia. It's something I developed sometime in middle school and it's certainly linked to the fear of losing control of one's own body, disease, death, and to some degree fears of drawing extreme negative attention/public disgust to oneself (I guess this qualifies as social anxiety).
Although at the time it felt as though as though constant reaction of extreme horror and panic every time I encountered thoughts or situations related to vomiting (something as innocuous as reading or misreading a word in the newspaper related to the act could set me off), being able to now trace the phobia back to specific childhood events has helped my manage the phobia in a way that allows me to live a normal life. Foxy, Cygnet offers excellent advice about being able to start to get a handle on the phobia by making sense of what past experiences may have led to a panic disorder manifesting itself in such a specific form.
For myself I can trace it back to the following:
1. As a child I was very close to my grandparents and when my grandmother got breast cancer I spent a lot of time at her house while my mother was caring for her during chemotherapy treatments. It was very traumatic because my grandmother had a horrific time with the treatments and didn't want to get sick in front of me. I can distinctly remember a few times when my grandmother would be crying and retching and screaming to my mother to get me out of the room because she was going to throw up. It's little wonder I associate the act with despair, violence, loss, and death.
2. At the same time my mother's sister was struggling with alcoholism. Many family fights at my grandparent's house would end with my out of control aunt in the bathroom vomiting.
3. Around the same time I had a vomiting episode induced by stress and related to an earlier molestation (the perpetrator was present). It was kind of the last straw in a terrible day for my father, who was, to put it mildly, an incredibly un-empathetic person.
etc.
By recognizing the *whys* of the phobia and making some rational sense out of helps strip it of its power.
Foxy, as a child all the way up through high school I would go to sleep hoping I would never wake up. Almost every moment of every day a would be plagued by obsessive thoughts. I'd tested with a very high IQ in middle school and had been tracked into a gifted program, but I couldn't pay attention in Junior High and High School because of the constant intruding thoughts, hyper-vigilance, and daily panic attacks. Constantly drawing on any surface I could find was the only thing that kept me calm and distracted enough to stop me from bolting from my seat most days.
I was addicted to rolaids, which only made the problem worse. I tried to worm my way out of any event that someone (or worse, myself!) might vomit at (school field trips, birthday parties, pretty much anything social and fun) and would hide check-up reminders from the doctor and dentist. I would plot highly detailed suicides before appointments and events I was sure I'd be forced to attend.
I'm sure these childhood stories must sound terribly histrionic or embellished to anyone who never had the full-blown version of this phobia, but they aren't. I'm telling my tale not because I enjoying reliving it (oh god no) but because I am no longer crippled by any of these impulses or thoughts. Foxy, if I could get better, you can get better too.
I did not have therapy for this disorder, and when I was in intensive therapy in my early 20s for something else, I was too ashamed of the phobia to tell any psychiatrists or other mental health workers about it. Also, and I'm sure you can relate, Foxy, I was afraid that just speaking about it aloud would trigger spiraling panic I'd never claw my way back out from.
This is what helped me:
1. I have read people's descriptions of general anxiety disorder and agoraphobia, and this particular phobia manifests itself in a lot of the same ways, and so similar self-treatments work. Both share hyper-vigilance surrounding physical sensations. A big part of shutting down panic became recognizing when I was focussing on, say, my throat feeling tight or my tongue feeling strange and allowing myself to acknowledge the feeling and *then let it pass* rather than fight it.
2. I'd been a competitive figure skater when I was younger, and over time I became at least a little desensitized to feeling butterflies in my stomach, to feeling dizzy, and to being out of breath. Later in life I started competing as a long distance runner, which was the turing point in helping manage the phobia. I was regularly training to the point of oxygen debt, I was learning to deal with extended periods of physical discomfort *that I could control*, and I was putting myself into situations all the time where I was riding a pretty thin line between keeping my breakfast down and not. Competitive runners for the most part are pretty nonchalant about the whole vomiting thing, which was a healthy attitude for me to be around.
3. I moved to NYC where I was forced to be in very close contact with lots of people, in enclosed areas (especially subways- and my job for a long time included 7-10 subway rides a day to source materials and props) and lots of vomit on the street and subway platforms. NYC, particularly the Times Square area = exposure therapy. Guess what? The more I was forced to deal with it on my own terms, the less traumatic dealing with it was.
Foxy, I am not going to lie- I still make sure I have a plastic bag available on long train or bus rides, I still worry on planes that the person next to me might vomit and I'll be trapped, and I still dislike going to movie theaters and will try and get an aisle seat at every theatrical production I attend; every meeting and lecture I'm in; etc. *However* notice I said "worry". That's all it is. It does not control my life, it does not stop me from doing anything I want to do and going wherever I want to go. If I encounter some barf unexpectedly on the sidewalk (even if I almost step in it, which happens with alarming regularity) I simply register my disgust- exclaim "eww" and then mindlessly go about the rest of my day. I've learned to not play back the experience- just experience it and move on to experience the next unexpected thing I encounter on the sidewalk.
You can get better. You can get to a point where this not only no longer controls your life, but it barely registers at all in your day to day existence. Let me put it this way: I now teach regularly in a prison, where I am locked in and getting between rooms (or to a bathroom) requires all sorts of security clearance and people talking on walkie-talkies. Students do get sick sometimes. That hasn't happened in my workshops there yet, although recently a student urinated on the floor.
I also occasionally teach an urban adult daycare population (and one of my students emptied his colostomy bag on the floor during an onsite gallery workshop) as well as a group of developmentally disabled adults who don't always have full control of their bodily functions. These situations would have been *impossible* for me to suffer through at one time, but instead I look forward to all of these workshops.
Please talk to a therapist. You really, really can get better. I am *positive* you can. Here's a little secret- life is awesome without the phobia. It really is. I look back at all those years and feel like they happened to someone else, because I am not that person anymore.
p.s. I can also clean up kitty vomit! Go me!
posted by stagewhisper at 1:58 PM on September 17, 2011 [3 favorites]
I only admitted this once before in my life, when I was still a very young child, but it was never taken very seriously and since then I just tell people I don't ever vomit (true- I haven't vomited since 1983 and it's part of the mental illness that I remember the date so well) because vomiting or being around the act freaks me out (also true). I don't let on how debilitating this once was or how deeply it affected my ability to live anything approximating a normal life. I was, and still am, completely ashamed by it.
For anyone who is reading this thread primarily out of curiosity, please be sure to read Cygnet's excellent explanation about what kinds of thoughts and bodily sensations are accompanied by this phobia. It's something I developed sometime in middle school and it's certainly linked to the fear of losing control of one's own body, disease, death, and to some degree fears of drawing extreme negative attention/public disgust to oneself (I guess this qualifies as social anxiety).
Although at the time it felt as though as though constant reaction of extreme horror and panic every time I encountered thoughts or situations related to vomiting (something as innocuous as reading or misreading a word in the newspaper related to the act could set me off), being able to now trace the phobia back to specific childhood events has helped my manage the phobia in a way that allows me to live a normal life. Foxy, Cygnet offers excellent advice about being able to start to get a handle on the phobia by making sense of what past experiences may have led to a panic disorder manifesting itself in such a specific form.
For myself I can trace it back to the following:
1. As a child I was very close to my grandparents and when my grandmother got breast cancer I spent a lot of time at her house while my mother was caring for her during chemotherapy treatments. It was very traumatic because my grandmother had a horrific time with the treatments and didn't want to get sick in front of me. I can distinctly remember a few times when my grandmother would be crying and retching and screaming to my mother to get me out of the room because she was going to throw up. It's little wonder I associate the act with despair, violence, loss, and death.
2. At the same time my mother's sister was struggling with alcoholism. Many family fights at my grandparent's house would end with my out of control aunt in the bathroom vomiting.
3. Around the same time I had a vomiting episode induced by stress and related to an earlier molestation (the perpetrator was present). It was kind of the last straw in a terrible day for my father, who was, to put it mildly, an incredibly un-empathetic person.
etc.
By recognizing the *whys* of the phobia and making some rational sense out of helps strip it of its power.
Foxy, as a child all the way up through high school I would go to sleep hoping I would never wake up. Almost every moment of every day a would be plagued by obsessive thoughts. I'd tested with a very high IQ in middle school and had been tracked into a gifted program, but I couldn't pay attention in Junior High and High School because of the constant intruding thoughts, hyper-vigilance, and daily panic attacks. Constantly drawing on any surface I could find was the only thing that kept me calm and distracted enough to stop me from bolting from my seat most days.
I was addicted to rolaids, which only made the problem worse. I tried to worm my way out of any event that someone (or worse, myself!) might vomit at (school field trips, birthday parties, pretty much anything social and fun) and would hide check-up reminders from the doctor and dentist. I would plot highly detailed suicides before appointments and events I was sure I'd be forced to attend.
I'm sure these childhood stories must sound terribly histrionic or embellished to anyone who never had the full-blown version of this phobia, but they aren't. I'm telling my tale not because I enjoying reliving it (oh god no) but because I am no longer crippled by any of these impulses or thoughts. Foxy, if I could get better, you can get better too.
I did not have therapy for this disorder, and when I was in intensive therapy in my early 20s for something else, I was too ashamed of the phobia to tell any psychiatrists or other mental health workers about it. Also, and I'm sure you can relate, Foxy, I was afraid that just speaking about it aloud would trigger spiraling panic I'd never claw my way back out from.
This is what helped me:
1. I have read people's descriptions of general anxiety disorder and agoraphobia, and this particular phobia manifests itself in a lot of the same ways, and so similar self-treatments work. Both share hyper-vigilance surrounding physical sensations. A big part of shutting down panic became recognizing when I was focussing on, say, my throat feeling tight or my tongue feeling strange and allowing myself to acknowledge the feeling and *then let it pass* rather than fight it.
2. I'd been a competitive figure skater when I was younger, and over time I became at least a little desensitized to feeling butterflies in my stomach, to feeling dizzy, and to being out of breath. Later in life I started competing as a long distance runner, which was the turing point in helping manage the phobia. I was regularly training to the point of oxygen debt, I was learning to deal with extended periods of physical discomfort *that I could control*, and I was putting myself into situations all the time where I was riding a pretty thin line between keeping my breakfast down and not. Competitive runners for the most part are pretty nonchalant about the whole vomiting thing, which was a healthy attitude for me to be around.
3. I moved to NYC where I was forced to be in very close contact with lots of people, in enclosed areas (especially subways- and my job for a long time included 7-10 subway rides a day to source materials and props) and lots of vomit on the street and subway platforms. NYC, particularly the Times Square area = exposure therapy. Guess what? The more I was forced to deal with it on my own terms, the less traumatic dealing with it was.
Foxy, I am not going to lie- I still make sure I have a plastic bag available on long train or bus rides, I still worry on planes that the person next to me might vomit and I'll be trapped, and I still dislike going to movie theaters and will try and get an aisle seat at every theatrical production I attend; every meeting and lecture I'm in; etc. *However* notice I said "worry". That's all it is. It does not control my life, it does not stop me from doing anything I want to do and going wherever I want to go. If I encounter some barf unexpectedly on the sidewalk (even if I almost step in it, which happens with alarming regularity) I simply register my disgust- exclaim "eww" and then mindlessly go about the rest of my day. I've learned to not play back the experience- just experience it and move on to experience the next unexpected thing I encounter on the sidewalk.
You can get better. You can get to a point where this not only no longer controls your life, but it barely registers at all in your day to day existence. Let me put it this way: I now teach regularly in a prison, where I am locked in and getting between rooms (or to a bathroom) requires all sorts of security clearance and people talking on walkie-talkies. Students do get sick sometimes. That hasn't happened in my workshops there yet, although recently a student urinated on the floor.
I also occasionally teach an urban adult daycare population (and one of my students emptied his colostomy bag on the floor during an onsite gallery workshop) as well as a group of developmentally disabled adults who don't always have full control of their bodily functions. These situations would have been *impossible* for me to suffer through at one time, but instead I look forward to all of these workshops.
Please talk to a therapist. You really, really can get better. I am *positive* you can. Here's a little secret- life is awesome without the phobia. It really is. I look back at all those years and feel like they happened to someone else, because I am not that person anymore.
p.s. I can also clean up kitty vomit! Go me!
posted by stagewhisper at 1:58 PM on September 17, 2011 [3 favorites]
Response by poster: Thank you all so much for your stories and advice. I won't 'best answer' any particular one because a) the question isn't for me, exactly, so I have no way of knowing, but b) all the answers so far have been fantastic.
One thing: medication. Foxy has done a lot of internet research into the various medications that might be of use. But the problem with internet research is that it isn't quite real, and can be misinforming. And one of the things that is more often misinforming than not is the possible side effects of medication. And one of the possible side effects of every single medication ever in the world is, you guessed it, nausea. So that's a big problem here.
And for the love of god, don't watch Bridesmaids.
I actually toyed around with the idea of putting together a sort of IMDB of vomiting, designed for emetophobes, much like that (I think religious?) site where the precise incidents of sex, violence and swearing are catalogued. Except in this case it would be vomiting. "005:45 - main character makes gagging noises", "106:22-110:15 - girl vomits continuously into a toilet" etc. Unfortunately I wouldn't even know where to start and I don't remember the precise incidents of sickiness in all the movies I've ever seen.
posted by tumid dahlia at 2:58 PM on September 17, 2011
One thing: medication. Foxy has done a lot of internet research into the various medications that might be of use. But the problem with internet research is that it isn't quite real, and can be misinforming. And one of the things that is more often misinforming than not is the possible side effects of medication. And one of the possible side effects of every single medication ever in the world is, you guessed it, nausea. So that's a big problem here.
And for the love of god, don't watch Bridesmaids.
I actually toyed around with the idea of putting together a sort of IMDB of vomiting, designed for emetophobes, much like that (I think religious?) site where the precise incidents of sex, violence and swearing are catalogued. Except in this case it would be vomiting. "005:45 - main character makes gagging noises", "106:22-110:15 - girl vomits continuously into a toilet" etc. Unfortunately I wouldn't even know where to start and I don't remember the precise incidents of sickiness in all the movies I've ever seen.
posted by tumid dahlia at 2:58 PM on September 17, 2011
Brilliant thread, and surely helpful/illuminating in some way for everyone following it.
I didn't realise how common and how severe emetophobia can be. As an anaesthetist (anesthesiologist), postoperative nausea and vomiting (PONV) is a common professional concern for me. FWIW I have found that in my practice, stimulation of the P6 acupuncture point (in the midline of the wrist where the palpable tendon(s) and intersect with the proximal skin crease) is as effective as any single antiemetic drug, and a Cochrane library review confirms this. Commercially available "SeaBands" stimulate this point. Although I am not aware of proof of long-term chronic effectiveness in the prevention of nausea, you might want to try this out and see if you gain reassurance from it. SeaBands don't look particularly attractive, so in view of your habit of carrying hairbands you can look for (colourful) hairbands that come with a built-in metallic knob (they exist) which should do the same job.
Otherwise I can only second what cygnet, KogeLiz, PhoBWanKenobi, RJ Reynolds, stagewhisper and many others have said. tumid dahlia, well done for putting it out there as a problem that needs some sort of solution (if only alleviation). And foxy, your mental health and well-being do need a helping hand from experts (therapists and/or psychiatrists) familiar with this complex problem. Wishing both of you the best of success with this and your relationship - which going by the posting appears to be strong at present but nonetheless imperilled by the strain emetophobia will put on any couple.
posted by kairab at 3:18 PM on September 17, 2011
I didn't realise how common and how severe emetophobia can be. As an anaesthetist (anesthesiologist), postoperative nausea and vomiting (PONV) is a common professional concern for me. FWIW I have found that in my practice, stimulation of the P6 acupuncture point (in the midline of the wrist where the palpable tendon(s) and intersect with the proximal skin crease) is as effective as any single antiemetic drug, and a Cochrane library review confirms this. Commercially available "SeaBands" stimulate this point. Although I am not aware of proof of long-term chronic effectiveness in the prevention of nausea, you might want to try this out and see if you gain reassurance from it. SeaBands don't look particularly attractive, so in view of your habit of carrying hairbands you can look for (colourful) hairbands that come with a built-in metallic knob (they exist) which should do the same job.
Otherwise I can only second what cygnet, KogeLiz, PhoBWanKenobi, RJ Reynolds, stagewhisper and many others have said. tumid dahlia, well done for putting it out there as a problem that needs some sort of solution (if only alleviation). And foxy, your mental health and well-being do need a helping hand from experts (therapists and/or psychiatrists) familiar with this complex problem. Wishing both of you the best of success with this and your relationship - which going by the posting appears to be strong at present but nonetheless imperilled by the strain emetophobia will put on any couple.
posted by kairab at 3:18 PM on September 17, 2011
Just wanted to pop in and say a few more small things.
1. Nausea as a side effect of medication: yeah, it can cause a lot of anxiety. I think the best way to deal with this is to start taking the medication at a low dose and ramp up, and to take the first dose on a weekend day when you feel good and don't have to do anything or go anywhere and somebody can take care of you if you feel poorly. Personally, I often worry about a medication upsetting my stomach, but honestly, not a single one of them has.
2. Although I have met very few emetophobics in real life (we tend to be ashamed of ourselves...), the few I have met have some commonalities which I find interesting. I don't know if this is a trend or simply "sampling error", but I and many others are people who tend to get stomach aches frequently for non-contagious-illness-related reasons (in my case it's acid reflux, others have IBS, "sensitive stomachs", etc), and yet never seem to catch contagious stomach-related illnesses and just don't throw up (I haven't since I was a little kid, and even then, only a few times). This is kind of weird, and it's hard to tell whether the vigilance caused by anxiety results in rarely getting ill, or whether this kind of thing is more likely in people who didn't get accustomed to nausea or vomiting as children. I know I sure didn't. It drives me crazy when people suggest I just should try to get sick and then I'd get over it all, and that's not at all what I'm saying, but it's an interesting thing to think about (but only when you're not feeling anxious!).
Also, everybody I know of with emetophobia is a smart, highly-empathetic woman. That could be sampling error too.
posted by Cygnet at 3:22 PM on September 17, 2011
1. Nausea as a side effect of medication: yeah, it can cause a lot of anxiety. I think the best way to deal with this is to start taking the medication at a low dose and ramp up, and to take the first dose on a weekend day when you feel good and don't have to do anything or go anywhere and somebody can take care of you if you feel poorly. Personally, I often worry about a medication upsetting my stomach, but honestly, not a single one of them has.
2. Although I have met very few emetophobics in real life (we tend to be ashamed of ourselves...), the few I have met have some commonalities which I find interesting. I don't know if this is a trend or simply "sampling error", but I and many others are people who tend to get stomach aches frequently for non-contagious-illness-related reasons (in my case it's acid reflux, others have IBS, "sensitive stomachs", etc), and yet never seem to catch contagious stomach-related illnesses and just don't throw up (I haven't since I was a little kid, and even then, only a few times). This is kind of weird, and it's hard to tell whether the vigilance caused by anxiety results in rarely getting ill, or whether this kind of thing is more likely in people who didn't get accustomed to nausea or vomiting as children. I know I sure didn't. It drives me crazy when people suggest I just should try to get sick and then I'd get over it all, and that's not at all what I'm saying, but it's an interesting thing to think about (but only when you're not feeling anxious!).
Also, everybody I know of with emetophobia is a smart, highly-empathetic woman. That could be sampling error too.
posted by Cygnet at 3:22 PM on September 17, 2011
Response by poster: I can confirm that foxy has pretty bad acid reflux and feels "crook" more often than not, but the last time she vomited was a couple of years ago after getting an infected tooth ripped out and that was likely a side-effect of the anaesthetic they put her on. Before that she hadn't been sick for something like ten years. It's interesting that in the lead up to finally having the tooth removed she was on quite a few courses of antibiotics (as in, she took the course prescribed by the GP, then neglected to make the appointment with the dentist or couldn't afford it, then when the pain got unbearable again she would go back to the GP for another course of antibiotics, and this little dance went on a few times), and subsequent to all of that her stomach and intestinal problems appear to have amplified severely, which leads to her being more and more anxious about throwing up. So chances are her insides have been blasted by all those antibiotics, and she is currently on the public waiting list for the various cameras they shove up/down both ends.
posted by tumid dahlia at 3:33 PM on September 17, 2011
posted by tumid dahlia at 3:33 PM on September 17, 2011
Response by poster: One other thing, and I'm kind of ashamed to admit it, but my reasons for wanting to try and fix this are quite selfish. Obviously I want her to be better, but I also want to feel less stressed by her stress. And things have gotten pretty bad lately and I think I just figured out why. I've only been properly researching the issue for the past couple of days but I've already accumulated a good deal of information. Emetophobia is, after everything, basically a problem of extreme anxiety. From what I can ascertain about extreme anxiety (and I've had it myself in the past, with periods of akathisia, which is nightmarish), it can make a person extremely self-absorbed. Self-absorbed to the extent that, to quote a blog post, they are "indifferent towards others and their needs and feelings", which, rightly or wrongly, is how I have felt. That is, that she is indifferent to things I might want, and even though I am, generally speaking, pretty easy going, I still have my own wishes and desires. So I wanted to put that out there, for the people telling me I'm sweet and so forth for caring about her problem. Obviously I do care, finally, to the extent that I actually want to help her fix the problem, but at least 50% of my reasoning for it is because it is also a problem for me.
posted by tumid dahlia at 3:51 PM on September 17, 2011
posted by tumid dahlia at 3:51 PM on September 17, 2011
Hugs to you, tumid dahlia, from somebody in a similar boat (partner to a person with anxiety and depression, not, in my case, OCD and emetophobia issues). I just wanted to say that I understand this:
That is, that she is indifferent to things I might want, and even though I am, generally speaking, pretty easy going, I still have my own wishes and desires. So I wanted to put that out there, for the people telling me I'm sweet and so forth for caring about her problem. Obviously I do care, finally, to the extent that I actually want to help her fix the problem, but at least 50% of my reasoning for it is because it is also a problem for me.
very well and it's all part of how it goes.
posted by PussKillian at 5:58 PM on September 17, 2011
That is, that she is indifferent to things I might want, and even though I am, generally speaking, pretty easy going, I still have my own wishes and desires. So I wanted to put that out there, for the people telling me I'm sweet and so forth for caring about her problem. Obviously I do care, finally, to the extent that I actually want to help her fix the problem, but at least 50% of my reasoning for it is because it is also a problem for me.
very well and it's all part of how it goes.
posted by PussKillian at 5:58 PM on September 17, 2011
Please don't feel guilty about wanting your girlfriend to be well for "selfish reasons". I am personally incredibly aware of the way my difficulties impact others and THE biggest motivator I had to begin the process of getting well was so that I could be freed of the selfishness anxiety causes. So - being around somebody with a severe anxiety disorder CAN be really hard. Being the person with the anxiety disorder is also hard, not just because of the disorder but because we know it hurts others. Your feelings and your girlfriends' are equally legitimate.
(Actually, I spent a year in therapy because I was becoming nervous to do anything with anybody, because I had become terrified of "ruining other peoples' days" by having to stop a hike because of feeling poorly, not eating dinner with a group, etc. Having what feels like an "outside force" seemingly prevent me from being generous and sensitive to others is one of the most miserable parts of this mess. I am SO THANKFUL it very rarely happens nowadays.)
posted by Cygnet at 6:19 PM on September 17, 2011
(Actually, I spent a year in therapy because I was becoming nervous to do anything with anybody, because I had become terrified of "ruining other peoples' days" by having to stop a hike because of feeling poorly, not eating dinner with a group, etc. Having what feels like an "outside force" seemingly prevent me from being generous and sensitive to others is one of the most miserable parts of this mess. I am SO THANKFUL it very rarely happens nowadays.)
posted by Cygnet at 6:19 PM on September 17, 2011
Heck, if therapy helped even 10%, it'd be worth it. The all or nothing of judging therapy by whether it can "cure" is the ilness talking.
posted by vitabellosi at 11:47 PM on September 17, 2011
posted by vitabellosi at 11:47 PM on September 17, 2011
My wife obsesses about cleanliness, though not for the emetophobic reasons your girlfriend has. The cupboards get scrubbed at least once a week, along with washing the floors in the kitchen and bathroom by hand with a rag. Hangars in the the closet have to be arrange by color, and my shirts have to be arranged by some function of style, function, and country of origin.
I used to try to "fix" her. I thought I was helping her by trying to stop her from doing these things. Then I realized, if she wasn't doing these things, she was really nervous and uncomfortable. If these things aren't done, she can't focus on anything else while these things aren't done. Even though it is more "work", she is much more happy doing these things than not doing them. Who am I to tell her she can't do these things that make her happy?
Think about it. If foxy really would be more happy by not overcleaning, she already would not be doing it. Every time she does it, she has already weighed the happiness utility of not overcleaning against the happiness utility of cleaning, and she has already decided she'll be happier with the overcleaning. I understand that she wants to seize control of herself, to be okay with her surroundings (re: this specific aspect of her surroundings). When her desire to be okay with her surroundings surpasses her desire to control her surroundings, she'll decide that way. Let her do what she needs to do to be happy. She isn't hurting anyone else, and if it is having a negative impact on her, the impact isn't as negative as what happens to her when she doesn't do it.
So sorry, I don't have an answer for her, but I do have an answer for you, tumid dahlia. Let her. Hell, help her sometimes. Grab a broom once in a while when she actually isn't cleaning. When I help my wife on these things, she immediately sees how silly it is. She can tell how weird the behavior is when someone else demonstrates it, and I think it has slowly helped let go of the behavior. She'll still take it over from me, because there's still a chance that I'll put a long-sleeve-predominately-red-Japanese-T-shirt-on-a-white-hanger next to my short-sleeve-button-up-predominately-orange-American-dress-shirt-on-a-black-hangar. But now she has gotten to the point where she doesn't immediately need to correct it, she can wait a couple weeks now until she defrags my closet.
(and regarding if this is normal behavior for a phobe: Yes it is. If it doesn't dramatically and negatively impact your life, it isn't a mental illness, it's just a personality trait. Once that trait dominates and controls your life, it falls into the mental illness category. And if you don't reserve that umbrella just for mental illnesses, then those with actual problems don't have any useful descriptors to fall under. Saying that everyone is an emetophobe just devalues the term. )
posted by BurnChao at 1:04 AM on September 18, 2011
I used to try to "fix" her. I thought I was helping her by trying to stop her from doing these things. Then I realized, if she wasn't doing these things, she was really nervous and uncomfortable. If these things aren't done, she can't focus on anything else while these things aren't done. Even though it is more "work", she is much more happy doing these things than not doing them. Who am I to tell her she can't do these things that make her happy?
Think about it. If foxy really would be more happy by not overcleaning, she already would not be doing it. Every time she does it, she has already weighed the happiness utility of not overcleaning against the happiness utility of cleaning, and she has already decided she'll be happier with the overcleaning. I understand that she wants to seize control of herself, to be okay with her surroundings (re: this specific aspect of her surroundings). When her desire to be okay with her surroundings surpasses her desire to control her surroundings, she'll decide that way. Let her do what she needs to do to be happy. She isn't hurting anyone else, and if it is having a negative impact on her, the impact isn't as negative as what happens to her when she doesn't do it.
So sorry, I don't have an answer for her, but I do have an answer for you, tumid dahlia. Let her. Hell, help her sometimes. Grab a broom once in a while when she actually isn't cleaning. When I help my wife on these things, she immediately sees how silly it is. She can tell how weird the behavior is when someone else demonstrates it, and I think it has slowly helped let go of the behavior. She'll still take it over from me, because there's still a chance that I'll put a long-sleeve-predominately-red-Japanese-T-shirt-on-a-white-hanger next to my short-sleeve-button-up-predominately-orange-American-dress-shirt-on-a-black-hangar. But now she has gotten to the point where she doesn't immediately need to correct it, she can wait a couple weeks now until she defrags my closet.
(and regarding if this is normal behavior for a phobe: Yes it is. If it doesn't dramatically and negatively impact your life, it isn't a mental illness, it's just a personality trait. Once that trait dominates and controls your life, it falls into the mental illness category. And if you don't reserve that umbrella just for mental illnesses, then those with actual problems don't have any useful descriptors to fall under. Saying that everyone is an emetophobe just devalues the term. )
posted by BurnChao at 1:04 AM on September 18, 2011
Just wanted to pop in and say that
a) listen to so_graceful for the experience of both sides
b) I am emetophobic and also have a debilitating fear of needles. Even though I am also afraid or losing control, I visited an excellent hypnotherapist (who explained I was still in control and let me have the chair how I wanted it, etc: no lying flat for me!) who let me have my partner in with me and gave me lots of positive affirmations and tools to cope with it. And now, instead of 2 x 45 minute sessions with OH holding my arm down and the nurse trying to persuade me and all that, I now go in, on my own, OK, cry a little, have it done, go out. No obsessing before or after.
So, I can promise that hypnotherapy worked well in my case and might be worth exploring, with a kind and recommended practitioner.
There is some other stuff I'm not that confident about sharing out loud (as is about someone close to me) but might help, re medication helping getting on towards therapy and therapy really helping.
Take care and hang on in there (oh and please do the index to all films - I would pay for that!)
posted by LyzzyBee at 3:30 PM on September 22, 2011
a) listen to so_graceful for the experience of both sides
b) I am emetophobic and also have a debilitating fear of needles. Even though I am also afraid or losing control, I visited an excellent hypnotherapist (who explained I was still in control and let me have the chair how I wanted it, etc: no lying flat for me!) who let me have my partner in with me and gave me lots of positive affirmations and tools to cope with it. And now, instead of 2 x 45 minute sessions with OH holding my arm down and the nurse trying to persuade me and all that, I now go in, on my own, OK, cry a little, have it done, go out. No obsessing before or after.
So, I can promise that hypnotherapy worked well in my case and might be worth exploring, with a kind and recommended practitioner.
There is some other stuff I'm not that confident about sharing out loud (as is about someone close to me) but might help, re medication helping getting on towards therapy and therapy really helping.
Take care and hang on in there (oh and please do the index to all films - I would pay for that!)
posted by LyzzyBee at 3:30 PM on September 22, 2011
This thread is closed to new comments.
posted by tau_ceti at 7:33 PM on September 16, 2011 [2 favorites]