Emetophobia — why it’s NOT about being sick

Please don’t be put off by the title! Emetophobia is NOT about being sick — it’s actually a phobia of feeling out of control and vulnerable. Joe and Rob discuss it in detail in today’s episode.

Most people don’t really understand how and why phobias are formed — and this certainly includes most psychiatrists, doctors, psychologists and therapists. We’re not saying that to disrespect those professions, rather just to make it clear to you that WE DO UNDERSTAND. You need to know that we know, in order for you to take us seriously and to recognise both the depth and the insights contained within our programme.

Every phobia is the same

Every single phobia that anyone could suffer from is actually the same thing. Someone who has a fear of spiders actually has the same phobia as someone with a fear of lifts, or death, or heights, or driving on the motorway, or being sick. That’s because people don’t have phobias of something outside of themselves — what they fear is something inside. People unknowingly create a phobia in order to avoid a situation in which they don’t believe they could cope.

Imagine you don’t like spiders. You don’t like them, but you can tolerate them. You are able to manage your emotional response, to keep yourself from panicking, to stop your stress levels going into the ‘red zone’. If there’s one in the kitchen and there’s no one home but you, you could get a glass, pick it up and put it outside. You wouldn’t like it, but you’d do it. Some people have taken their dislike of spiders and gradually, over time, built up more and more negative thoughts and feelings about them, to the point where they now work themselves up so much when they see or think about one that they have created a phobia.

The stressometer

Imagine you have a ‘stressometer’ which goes from 1 to 10. Up to number 3 there’s really no stress at all, just some surface emotions. 4 and 5 are quite stressful, 6 and 7 very stressful, and 8 is awful. You can’t go to 9 or 10 — they have to be avoided at all costs, because you wouldn’t be able to cope. Basically, if that’s you, you’d create a phobia about any situation where your emotions would hit 9 or 10 on your stressometer. For you it’s 9 or 10, for others it’s 7, for some it’s 4.

There are lots of cognitive components involved in creating and maintaining a phobia as well — it’s not just your emotions. Most phobias involve some ‘unhelpful thinking styles’ like brooding, black and white thinking, or catastrophising. It’s the over-use of these thinking styles that can turn a dislike into a phobia. Emetophobes have nine or ten unhelpful thinking styles, as well as things like disgust propensity, perfectionism and social anxiety — and that’s the main reason why their phobia is so bad, so all-encompassing, so stressful.

So there you have it: a fear of being sick isn’t a fear of being sick at all, it’s a fear of your emotional response to being sick — and your emotional response is something you can change relatively easily.

This episode featured discussion between Joe Manuel and Rob Kelly.