Recognizing Emetophobia in Kids and Teens
Emetophobia, or the fear of vomiting, is a common fear in kids. Nobody likes to throw up, but kids and teens with emetophobia are particularly nervous, and often experience significant distress and impairment in their life. Their anxiety may focus on the fear that they themselves may throw up, that others around them will do so, or both. Emetophobia can lead kids to quit favorite sports or activities, avoid friends or social situations, or even refuse to go to school entirely. Although effective treatment exists for emetophobia in children and teenagers, it can often go unrecognized for years if adults do not know what to look for.
What are some common signs of emetophobia in kids?
Anxiety when someone is sick. Kids and teens with emetophobia are always on high alert for a situation that might lead to vomit. As a result, they are particularly anxious when they or someone they know show signs of illness. For a child with emetophobia, simple colds and stomach bugs may become insurmountable obstacles. Since illness is an unavoidable part of childhood, a kid who is afraid of being sick may find their worries very difficult to manage.
Worry whenever they feel a stomach ache or other physical symptom. Stomach aches and nausea are common somatic symptoms of anxiety - a part of the body' s fight or flight response system. But kids with anxiety are often not very good at understanding their body’s reactions to stress. As a result, they may misinterpret these symptoms of anxiety as a sign they are about to throw up. For a child with a fear of vomiting, this misunderstanding will only lead to more anxiety - and more physical symptoms. This cycle is one of the most common symptoms of emetophobia in children.
Significant avoidance of anything that is connected to vomit. Kids and teenagers with emetophobia may avoid people who are recently ill, or places people have been or might be sick. For example, they may refuse to go on long bus rides or roller coasters, ask to move seats when their classmate has a cold, avoid a specific bathroom where someone threw up, refuse specific foods or restaurants associated with nausea, or avoid clothing or items from the last time they were ill. In more severe cases, avoidance can lead to school refusal or restricted eating.
Distress hearing sounds, pictures, or words that remind them about vomit or illness. People with emetophobia don’t limit themselves to avoiding places and things that are associated with real illness. They also have a tendency to avoid pictures, stories, and movies that have vomit. A child who is scared of vomiting may also be afraid of gifs, cartoons, and emojis that bring these topics to mind.
Lots of rituals or safety behaviors to feel less anxious. Kids and teens with emetophobia often develop certain rituals or rules to deal with their anxiety. In addition to avoidance, they might wash their hands more frequently, check expiration dates on food, sit in certain “safe” seats, scan their own body or the faces of others for signs of illness, and more.
Reassurance-seeking with parents or others. The most common ritual that exists in emetophobia is asking repetitive questions about illness and safety. Known as reassurance-seeking, these questions are ones that the child already knows the answer to, but their anxiety creates the need to ask them over and over. For a child afraid of throwing up, these may be questions about their physical health, the health of those around them, and the likelihood that they will be sick. In many families, reassurance-seeking is time consuming and a source of significant conflict.
What can help a child with emetophobia?
Like all anxiety, emetophobia is maintained through the cycle of avoidance. This is because the more we avoid stressful things, the less likely we are to learn skills to cope with them. This is particularly true for something like vomit, which is not actually dangerous. As a result, all of the avoiding, checking, and reassurance-seeking described above actually increases the anxiety, because it denies the kid the opportunity to learn how to manage their worry.
The good news is that there is a treatment that is very effective in treating emetophobia. Exposure and response prevention (ERP) is a kind of cognitive behavioral therapy (CBT) that is used to treat emetophobia in pediatric populations. ERP is an evidence-based treatment that can help kids overcome their fear of throwing up. ERP for emetophobia involves helping kids gradually face their fears to learn how to cope with situations that trigger the child’s anxiety about vomiting.
Ready to start your child’s recovery?
CABT's Emetophobia Institute and expert therapists specialize in ERP therapy for patients of all ages. Many of our clinicians are child psychologists with extensive experience treating emetophobia in kids. Book a free 15-minute intake call today.
