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Does CBT Work for Emetophobia?

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Emetophobia, an extreme fear of vomiting, can take a heavy toll on your life. If untreated, it can become all-encompassing, leading you to take drastic measures to avoid coming into contact with the object of your fear. If you need to get help, you might be considering CBT for emetophobia.

CBT, or cognitive behavioural therapy, is one of the most common forms of talking therapy. Here, we’ll explore how it is used to help emetophobia sufferers, how effective it is, and whether you should choose it over other treatments.

Emetophobia: definition

The term emetophobia refers to a specific phobia of vomiting. People with this condition may fear a variety of related scenarios, such as vomiting oneself, seeing others vomit, feeling nauseous or being in a situation where someone is likely to vomit. It is not simply a dislike of vomit.

It’s difficult to know exactly how common emetophobia is. Estimates suggest that as many as 8.8% of the population has some fear of vomiting, though only 0.1%–0.2% have a phobia. It is more common amongst women, as well as those with existing anxiety disorders, particularly OCD and health anxiety. The causes of a fear of vomiting are varied: it can arise as a result of trauma, while for others it is learned behaviour, or is linked to other mental health conditions.

Symptoms can be physical, such as nausea, a raised heart rate, shaking and sweating. Emotional symptoms, meanwhile, may include panic, dread and anger. In addition, emetophobia can lead to long-lasting behavioural changes, which may include obsessively checking food, avoiding social gatherings, and even avoiding saying the word ‘vomit’ altogether.

For a full overview of the causes and symptoms of a fear of vomiting, read our What Is Emetophobia? article.

What is CBT?

Cognitive behavioural therapy, or CBT, is a type of therapy that focuses on the connection between our thoughts, feelings and actions. It works by prompting the patient to reevaluate the way they think about a certain situation. The idea is that by changing how you think about something, you can influence how you feel about it and the way you act as a result.

According to the American Psychological Association, a key principle of CBT is that people can learn to cope with psychological problems, “thereby relieving their symptoms and becoming more effective in their lives”. This is achieved by breaking one’s problems down into smaller, more manageable parts, and talking through them.

CBT is thought of as a short-term therapy; according to NHS guidelines, patients usually take between five and twenty sessions, each lasting between half an hour and an hour. In contrast to other forms of therapy, CBT does not focus on addressing a patient’s past, and is instead centred on the present.

The key aim of CBT is to help individuals to deal with their own problems in a practical way. Through this therapy, you can learn coping techniques that allow you to counter harmful or unhelpful thoughts, manage your symptoms, and deal with challenges or stressful situations in your life.

CBT for emetophobia patients

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Cognitive behavioural therapy is used to treat a wide range of mental health conditions, including specific phobias. As such, CBT is an option that may be worth considering if you have emetophobia. You may, for example, be referred to a therapist by your GP. However, with long waiting lists for CBT on the NHS, you may also decide to pursue this option privately.

An initial CBT session for emetophobia may begin with the therapist asking the patient to give some background information regarding how their phobia first came about, as well as exploring how it affects them in their daily life. Some therapists may explore the patient’s childhood, as well as any family history of mental illness.

Once the therapist has a good idea of how your phobia is affecting you, they’ll begin helping you to reshape your thoughts. The aim here is to allow you to experience a particular situation without triggering any symptoms. This can take different forms, including:

  • Teaching you how to replace a negative thought with a more rational one. Your therapist will help you to understand your negative thought patterns and use this newfound awareness to restructure your thinking.
  • Exposure therapy, in which you will slowly be introduced to the things that trigger your phobia. This will help you to understand that they don’t pose you any real danger and can help you not to fall into avoidant behaviours.
  • Tackling your preconceptions by asking you to provide evidence for and against your existing beliefs. For example, you can challenge the idea that you are likely to vomit after eating out by reminding yourself that people go to restaurants all the time without experiencing any negative consequences.

These are just a handful of the ways in which CBT sessions can take place. As a short-term treatment, they can provide emetophobia sufferers with relief from their symptoms within weeks.

How effective is CBT at treating emetophobia?

While we know that CBT is a popular option for treating emetophobia, the question remains: how effective is it?

One study conducted by Riddle-Walker et al found that, after twelve sessions of CBT, 50% of patients with a specific phobia of vomiting “achieved clinically significant change”. Meanwhile, amongst patients in the control group, who were placed on a wait list, only 16% achieved the same degree of change.

Building on this research, a further study in 2020 focused on time-intensive CBT, with patients attending six weekly sessions as well as two intensive days of treatment, each with four-hour sessions. Its results were positive, with seven out of eight participants achieving “reliable improvement”, with “clinically significant change” for five of them.

Meanwhile, another study by Graziano, Callueng and Geffken saw an 11-year-old boy undergo 22 sessions of CBT for his emetophobia. This included graduated exposure and psychoeducation, as well as training for his parents. The therapy proved successful and long-lasting; at a six-month follow-up session, the boy’s parents “reported that he had encountered several situations related to vomit and handled it extremely well”.

It’s clear that CBT can prove effective for emetophobia sufferers. The main drawback, however, is that it requires the patient to be willing and motivated to commit to therapy. Many of those with a phobia of vomiting are particularly resistant to any form of exposure, which can limit the effectiveness of CBT.

Other treatment options

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Unsure whether CBT is right for you, or still weighing up your options? There are a number of different forms of treatment for emetophobia, so it’s worth taking the time to research each of them fully to determine the best path forward for you. Here are some other common treatments for a phobia of vomiting:

  • Other forms of therapy, including:
    • Eye movement desensitisation and reprocessing therapy (EMDR), in which patients receive bilateral stimulation as they recount past traumas, helping them to experience these memories less vividly and react to them in a less emotional way.
    • Hypnotherapy, which sees your therapist guide you into a relaxed mental state before offering you suggestions on how to overcome your phobia and confront stressful situations.
  • Self-help techniques, including practising mindfulness, prioritising self-care, and reaching out to those around you for support.
  • Medications, such as antidepressants to reduce feelings of anxiety and depression, beta blockers to ease physical symptoms, and gastrointestinal medications to prevent nausea.

To learn more about each of these options, visit our guide to the best treatments for emetophobia.

Does CBT work for emetophobia? The verdict

While research into the treatment of emetophobia is still in its infancy, studies to date show that many people with a phobia of vomiting could benefit from CBT, with as many as 88% of patients showing improvement after a complete course of therapy.

CBT can help patients to achieve noticeable change quickly, and sessions can be carried out as a complement to other forms of treatment, including medication. As a result, it’s the most commonly recommended form of therapy for emetophobia.

Through CBT, you can change the way you think, opening up new possibilities and giving you the chance at a more fulfilling life. If you think it could help you, speak to your GP, or explore the range of therapy packages available through EmetoGo.