Your Fear of Vomit Might Run Deeper than You Think

When fear of vomit, illness, germs or contamination has taken over the command center (have you seen the movie Inside Out?!), clients often feel defeated, hopeless, and out of control.  If you have emetophobia or contamination OCD, your therapy should be laser focused on helping you with your fears (and related avoidance). 

However, there might be something else that needs your attention.  

Something else that exists quietly beneath the surface — stoking the flames that feed your biggest fears.  Left uncared for, this could negatively impact your recovery efforts. 

Here’s the thing I’ve noticed in my work with clients who seek therapy for fear of throwing up, getting sick, or somehow failing to protect their loved ones:

The vast majority of my clients are, at their core, deeply feeling people - they are intellectually sharp, emotionally attuned, and highly empathic.  But here’s the thing: they weren’t allowed to be who they were when they were growing up.  Most often, my clients describe one or more of the following:

• Chronic emotional invalidation by parents or caregivers 

• You were told your feelings were wrong, stupid, ridiculous, dramatic/exaggerated, inconvenient, and/or weak;

• Feelings that were dismissed, judged, ignored, or punished;

• Being rewarded, directly or indirectly, for being “the easy one” (i.e., the one who didn’t have outward emotions), the “independent” or “self-sufficient” one, the one who took care of those who should have been caring for her. 

• Living through something really scary/traumatic with no reliable or trusted grown up to help with emotional processing and safety.  

When you are not allowed to experience and express your feelings, you don’t learn how to have them safely, and feelings - especially for someone who feels things deeply - can be really scary when you are all alone with them at an early age (or any age, for that matter).  When you are told your feelings are wrong, you learn that you cannot rely on or trust your own instincts and reasoning.  When you live through something really scary without emotional support and comfort, you may have turned to some other capacity you had - a reliance on structure, reasoning, certainty, and rule following.  The world seems less terrifying to a young person if things can be distilled down into a series of if/then algorithms that promise safety and security.  

If I check this lock three x three times, nothing bad can come in.   

If I keep everything in here just so, no one else in my family will get cancer.  

To an adult without a phobia or OCD, it’s hard to understand how these algorithms can be so compelling.  To a child who came up under these circumstances, you didn’t choose it — it became your flotation device — and it was perhaps one of the smartest and most adaptive things that you could have done at the time.  

You might be seeing where I’m going with this. 

In order to help you feel better, effective therapy for fear of vomiting, germs, illness and contamination might involve:

• Helping you feel better; 

• Helping you learn that your feelings are not trivial, ridiculous, dramatic, harmful, or unworthy of your attention; 

• Helping you create space to be a more feeling person. Most of my clients are naturally sensitive, often deep-feeling people who had to learn to abandon this part of their identity in their family of origin.  

• Working on your relationship with yourself.  Learning to validate, trust, and respect your feelings.  Allowing for uncertainty and imperfection. 

There isn’t anything wrong with you. 

This vomit phobia that you have — these rituals and compulsions that you engage in — they don’t stem from a character problem.  Their roots likely connect to early unmet needs and your adaptive young self turning to something — anything — to feel a little less scared in an unpredictable world: rules, rituals, sequences, systems, and compulsions.  

In other words:

You did good, kid.  

And I want to help you learn to live — and feel — even better.  When we work together on your fear of throwing up, being sick, or coming in contact with things that feel scary, I want to teach you to better care for the feeling part of you.  

Will I teach you to use Exposure and Response Prevention (ERP; the gold standard treatment for phobias and OCD)?  You better believe it!  And the results of your ERP will be more robust and sustainable when we take this approach.   

If you are still reading and this feels relevant (and especially if your eyes are “leaking”), reach out to me to learn more about my approach and whether it’s right for you. 

I’d love to meet you and talk about what’s possible. 

The best way to get in touch: sara@bepsychotherapy.com