My therapist would often ask 'How does this make sense?'. Asking and answering that question has become a way to pause and process when I feel frustrated, sad, or overwhelmed. As I worked through my emetophobia, I found it very helpful to understand how emetophobia evolved throughout my life. Below, I share the timeline of my emetophobia as I understand it.
- 7 Years Old - My earliest memory of emetophobia was laying awake at night, imagining myself throwing up over and over on repeat. This caused significant distress. To try to stop it, I invented a scene to think of instead. I pictured a boat traveling along a canal, its wake bouncing and rippling. I imagined the sound, the smell, how the boat would slow for turns in the canal and accelerate along the straight. Specifically, I imagined this boat making a right turn, resetting, repeat, over and over. This was my first 'clean thought' that I used to try to drown out emetophobia thoughts for nearly 20 years.
My theory is something was making me chronically nauseous. Whatever the cause, chronic nausea led to obsession of vomiting - I always felt sick, so I thought about it, planned for it. This kicked off the vicious cycle. Nausea triggered anxiety, anxiety made me nauseous.
- 11 Years Old - I dreaded the dentist. I didn't understand how anyone could sit through it. I understand now, my dread of the dentist was rooted in the fear of them gagging me. This is how emetophobia impacted me as a kid. The dentist was harder (what if they gag me and I vomit?), going to the movie theater was harder (what if I have to vomit but can't get to the bathroom in time?), car rides and planes (what if I get car/air sick?), test day at school (what if I have to vomit in the middle of the test?). Everything was harder. I was good at thinking of the worst case scenario.
- 14 Years Old - I quit soccer. At the time I thought I wasn't good enough, but reflecting on this decision, I know now it was completely driven by emetophobia. Our coach would threaten to run us until we puked, and the nervousness before a big game triggered nausea and anxiety. Quitting soccer brought the familiar feeling of instant massive relief, but long term reinforced the avoidance cycle and increased my anxiety response.
- 16 Years Old - I had my first panic attack at a school assembly. I specifically remember imagining myself throwing up in front of the entire school, triggering a wave of anxiety. I thought I was having a heart attack and made it to the hallway where a very kind teacher helped me through it. I did see a doctor, and they suggested it was anxiety and prescribed me xanax, although I still didn't know (or admit) I had emetophobia. I knew throwing up bothered me much more than it bothered my friends, but I still didn't understand what was going on. Emetophobia really had a hold on me from this point on.
- 17 Years Old - I finally googled 'Why am I so afraid of throwing up' and discovered emetophobia. I found a list, something like 20 signs of emetophobia, and almost coming to tears as I read down the list and related to each one. It felt amazing to have a word to describe what I was feeling, and for a while, that was enough. I treated emetophobia as a part of my identity, I embraced the idea that I would not be a world traveler, an adventurous eater, an athlete. I settled with living with emetophobia.
- 19 Years Old - I saw a few doctors on and off for occasional panic attacks and anxiety. I avoided telling anyone I had emetophobia, including doctors.
- 22 Years Old - Tired of chronic nausea, I saw a therapist with the goal of taming my anxiety. I remember in my first appointment, trying not to reveal that I had emetophobia and focus on anxiety. I had convinced myself that I would always have emetophobia, and I didn't want to talk about that. Immediately, the therapist recognized my phobia and encouraged me to try exposure therapy. He taught me the concept of 'clean and dirty discomfort' which was a very helpful lens for me. However, he moved too fast through exposure and I lost trust in him. I stopped therapy before making any recovery. This is also when I made the first version of Bia, in an attempt to continue my exposure sessions at home without my therapist.
- 26 Years Old - I buried myself in work as a distraction from emetophobia. It was my excuse. I didn't have to say 'I don't want to go out tonight because I am terrified I will get sick and not find a bathroom'. I could just say 'I have to work'. But, over time, emetophobia was taking more and more away from me. I would have intrusive thoughts about the food I had just purchased, surfing was no longer a relaxing activity but a trigger (what if there is bacteria in the water that makes me sick?). I started to skip meals. I thought that being hungry was better than eating and potentially feeling sick. One morning, hungry but deciding to skip breakfast, it clicked, and I knew I needed to fight. Emetophobia had taken enough of my life for long enough, I was ready to face it head on.
I found a therapist near me. He listened, and when I was mad or frustrated with emetophobia he helped me make sense of it. He introduced me to Dr. Claire Weekes and the Ironic Process Theory. Slowly, I started to take my life back. I revived the Bia project that I had set aside 4 years ago and continued to build it out. It was a therapeutic exercise for me, I wasn't just doing exposure, I was thinking about exposure, how it works, why it works, treating it like learning a language. This was when I realized Bia might be able to help other people.
- 27 Years Old - After another 8 months of therapy, I had a breakthrough. One day, I felt zero fear. It was a completely new feeling for me, and I just wanted to go for walks, listen to the birds, and enjoy eating and drinking. Since then, emetophobia has made its attempts to return. I'm not confident emetophobia will ever be gone, but, I am 100% confident that I have the tools and ability to conquer whatever comes my way. Therapy and exposure saved my life. I do what I want when I want now. I decided to quit my job and focus on Bia, with the goal of helping people along their emetophobia journey. I know recovery is hard, but I know it is possible. My therapist would say, "Life lives on the other side of fear."
Thank you for reading about my journey with emetophobia.