Emetophobia, or the intense fear of vomiting, is more common than people realize. As a therapist who specializes in anxiety and Exposure and Response Prevention (ERP), I work with many clients who feel isolated, frustrated, and overwhelmed by fears. If you're struggling with emetophobia, know that you're not alone, and treatment is absolutely possible.
Below, I answer some of the most common questions about emetophobia, from symptoms and triggers to effective treatment strategies.
Emetophobia is a specific phobia marked by an intense or severe and persistent fear of vomiting. This fear can happen when the threat of throwing up is present, or even just a perceived threat. The fear produces discomfort and anxiety, and those with emetophobia tend to avoid things that trigger their fear, including certain foods, places, people, etc. Some people with emetophobia have a fear of hearing or seeing others vomit. These fears can be associated with a prior distressing experience such as a severe illness or even public embarrassment.
Studies on emetophobia estimate it to be present in about 5% of the population, with most individuals being women. This phobia generally begins in childhood.
Emetophobia is often not discussed due to shame or misunderstanding, and many people struggle with this fear in silence. You're not alone, and there's help.
Symptoms can include feelings of nausea, dizziness, obsessive worry about illnesses, avoidance of certain foods, places, or situations, and frequent “body checking” for signs of sickness. Individuals can also carry “safe” objects such as water bottles, mints, ginger, or nausea medication. Excessive cleaning can also be present.
Yes. Emetophobia is considered a specific phobia, which falls within the broader category of anxiety disorders. It can also overlap with conditions like OCD, panic disorder, or health anxiety.
Nope! Emetophobia can look a lot like OCD, for example the compulsive behaviors may look similar to those with someone who has OCD. With emetophobia, the fear that is present is of vomiting, as are the related obsessions and compulsive behaviors. With OCD, there is typically a broader range of obsessions and compulsive behaviors. In the book Emetophobia: Understanding and Treating Fear of Vomiting and Children and Adults (Keyes & Veal, as cited in Christie & Russ, 2023) have proposed that obsessive–compulsive disorder (OCD) and emetophobia may exist on a continuum; however, this remains a working hypothesis. Whether the diagnosis is OCD or emetophobia, treatments will look similar.
Triggers vary widely but often include:
Emetophobia can lead people to avoid restaurants, social events, intimacy, or even having children. It can interfere with work, relationships, and diet, creating a sense of isolation and shame. People make choices out of fear, or overestimation of the probability of their fear coming true, and their lives get smaller.
Evidence-based treatments like Exposure and Response Prevention (ERP), Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy (ACT) are highly effective. These therapies help you face the fear gradually, reframe anxious thinking, and build tolerance to discomfort. If there are any medical conditions present (such as ulcers, IBD, IBS, GERD, etc.), we want to make sure those are getting treated alongside the work we do in therapy.
A therapist provides support, structure, and a personalized treatment plan. You’ll learn skills to reduce compulsive behaviors, approach fear rather than avoid it, and connect with your values—like freedom, health, or connection. Many people also appreciate the accountability of a therapist in treating emetophobia. It's hard to hold ourselves accountable!
Therapists may also provide a referral to a Doctor or Psychiatric Nurse Practitioner for medication if symptoms are intense and greatly interfering with an individual’s life. Medications such as SSRIs can help manage anxiety and assist with the work we do in therapy.
ERP involves gradually and at your own pace exposing yourself to feared stimuli while resisting the urge to avoid, seek reassurance, neutralize, body check, or other behaviors done to alleviate anxiety. Over time, the fear lessens as your brain learns you can feel big feelings and not complete safety behaviors or avoidance.
ERP should ALWAYS be done collaboratively with clients, and at the client’s own pace. This isn’t Fear Factor!
Exposures for each person will look different and ERP is tailored to individual clients. Clients should expect to be doing exposures in session with their therapist, and at home for homework. Exposure and response prevention homework is essential. That’s where you will be doing most of your work.
Yes. Acceptance and Commitment Therapy focuses on helping you build a different relationship with your fears. Instead of trying to eliminate anxiety, you learn to accept its presence while committing to meaningful actions and living a full life, while recognizing you are not your fears. Anxiety can be a helpful emotion at times, like when preparing for an interview or exam. It motivates us and helps us care about the outcome of these events, so we don’t want to have the goal of getting rid of it completely- we cannot do this anyway!
I love ACT and use it with many of my clients, not just those with emetophobia. It helps to understand what is important and meaningful, what we are doing that is moving us away from those things, and helps us to make choices that instead are moving in the direction that we want to go in life.
Some people find relief on their own, but most benefit from targeted treatment. If it’s interfering with your life, seeing a therapist can help you move forward much faster and more confidently.
Before doing exposures with clients, I will spend time working on skills they can use to better understand anxiety and make it more manageable. We want to be able to respond to discomfort or anxiety differently, and learn that we can have big feelings AND be in situations that are important to us. Next, we make an exposure menu (including situations the client wants to be in that may also trigger emetophobia), and we start with manageable exposures and build up. Baby steps are still steps! I always encourage clients to track their progress, celebrate small wins, and remind them that avoidance feeds the fear.
Validate their experience without enabling avoidance. Avoid giving constant reassurance and instead encourage small steps toward facing fears. Patience and compassion are key. Encourage them to make decisions that go toward freedom, not fear. “Just stop worrying about it” will not help.
If you live with emetophobia, please know you don’t have to keep suffering in silence. Emetophobia is highly treatable, and people can go from avoiding life to living it fully. The fear may feel overwhelming, but it doesn't have to define your life. Therapy works—and you're capable of change.
Interested in working together? Reach out for a free consultation or learn more about how therapy for emetophobia can help.
Emetophobia: Understanding and Treating Fear of Vomiting and Children and Adults (Christie & Russ, 2023)
The Emetophobia Manual: Free Yourself From the Fear of Vomit and Reclaim Your Life (Goodman, 2020)