By Susan Elliott Brown
You’re not going to throw up. You’re not going to throw up. You’re not going to throw up…
I can’t tell you how much time I’ve spent repeating that strange little mantra to myself in the past twenty-some years. I’ve been terrified of vomiting since I can remember. Usually, if I ever have the courage to admit that to someone, it’s met with one of a few set responses: “Yeah, I hate it too,” or “Well, no one likes vomiting.”
But it’s different for me. I don’t just hate it. I don’t just find it unpleasant. I’m deathly afraid of it to my very core. I’m more afraid of vomiting than I am of anything else on the planet.
It sounds unreasonable and irrational for a few reasons. One reason is that it’s just “part of life,” and it happens to everyone. Another reason is that vomiting might actually be good for your body in certain situations of illness. None of these reasons matters to me. My brain cannot see vomiting as a natural part of life or a thing that just happens sometimes. I never learned that about vomiting.
Here are some things this phobia has caused me to do:
· In second grade, I saw another student vomit into the trashcan, and I ran—and I do mean ran—from the classroom without permission and waited in the bathroom (panicking) for several minutes until knew he and the vomit had been removed from the room.
· If a family member had a stomach bug, I pretty much stayed in my room, and I would use whichever of the two bathrooms they weren’t using. If I had to walk past them, I’d hold my breath so I didn’t breathe in their germs.
· When I was in elementary school, I became afraid of going to school at all for fear that I or another student would be sick. I would cry and throw a fit every single morning, and my mother had to get help from a teacher I trusted to walk me in the building sometimes.
· I would constantly ask my mother for reassurance that I wasn’t going to be sick, and I wouldn’t be satisfied until she basically promised me that I was okay.
· I became afraid of going to sleep at night because I might wake up sick, so I would have to keep a TV on so I could listen to something else besides my own thoughts until I eventually drifted off. (I still do this sometimes, except now I used podcasts.)
· I had panic attacks. At school, at work, in the car, in public, anywhere.
· I carried Tums or Pepto-Bismol with me everywhere just in case I felt ill.
· If anyone mentioned throwing up in relation to me, I made them knock on wood for fear they had jinxed me.
· I developed rituals that I felt helped control the phobia and kept it at bay.
I did not seek help for this or admit my phobia to a medical professional until I was twenty-two. By that point, I’d spent at least fifteen years living in fear, having panic attacks, and meticulously counting the number of times I touched something or blinked or made a certain movement, all because of this phobia. I was twenty-two when a doctor first told me I had Obsessive-Compulsive Disorder that stemmed from emetophobia. Sometimes hearing a diagnosis can be a scary thing, but for me, I felt a sense of relief. This monster had a name. And if it had a name, I could face it for the first time in my life.
I had concealed this from nearly everyone I knew until I sought help. I even hid it from my now-husband, who I’d been dating off-and-on for over two years at the time I was diagnosed. I think I probably seemed fairly well adjusted to most people who knew me. My ritualistic behaviors that turned out to be part of OCD were mostly well concealed from years of practice. And during college, I’d gotten somewhat better for a period of time. I was still terrified of vomiting, but the compulsions and rituals weren’t always at the foreground of my mind like they had been before. I don’t know what it was about this time in my life that allowed me some temporary peace, but I’m happy I had those years because it was about to get much, much worse.
When I began graduate school in the fall of 2010, I moved to a new city and began a journey that was much more difficult and demanding than I realized it would be. Before I knew it, the rituals were back. The panic attacks were back, and they were happening without warning. This frightened me enough that I finally asked for help, despite my fear of talking to someone about my mental state. It’s a shame that there’s still a stigma around mental illness and even seeking treatment (a stigma that I had internalized), especially because I feel like taking that step and confronting my own mental illness with a professional was the most helpful thing I’ve ever done for myself.
After getting diagnosed, I went to counseling regularly and practiced natural methods to calm down in the event of a panic attack, and we talked about ways to help combat the compulsions, like trying to do the opposite thing once and seeing that I was okay afterward. For example, if I had a compulsion to make sure the volume on my television was set to a multiple of three (three was my big number), I should try to instead set it a multiple of two and just see how it felt and notice that the world did not come crashing down around me because I didn’t listen to the compulsion. These things did help for a while.
Things got worse again when I started round two of graduate school for my PhD. Even after that counseling, I felt like I had a huge backslide when I realized I was maybe more afraid of vomiting than I had ever been. I practically ran out of a classroom when someone read a poem with the word “vomit” in it (until 2013, I couldn’t even type the word myself without inducing panic, if that tells you anything about how intense my fear was). I was in second grade all over again. I stood in the bathroom looking in the mirror and shaking under the fluorescent lights. It’s not real. It’s just a poem. The rituals were back, and I couldn’t ignore them. I was back to counting, back to tapping, back to OCD making all my decisions for me. I was back to being powerless, and somehow I still needed to function in school and live up to the high standards of a PhD program. I sought help again.
This is when I met Melanie*. Melanie, a counselor at the university I attended, and another mental health professional worked in tandem to create a plan for me to confront this phobia head-on, not just to stop the rituals. We began working with meditation methods and did guided-imagery exposure therapy to help me re-learn how to cope with situations that made me panic, but from a safe and relaxed environment. I took medication for my OCD for the first time, something I was afraid of doing for so long (partially because medications have the potential for nausea as a side effect). Besides my fear of side effects, I wrongly believed that taking medication somehow made me weak.
Once I was taking medication to help me tolerate the repeated exposure to my phobia in therapy, we confronted the phobic situations one by one, building up from least to most threatening. I won’t go into too much detail about my phobia hierarchy, but I can tell you the smallest one was just seeing the word “vomit” in print, like in a book or magazine. That’s how small I had to start, and even getting past that one was a challenge. Getting through all of the hierarchy—about ten steps—took over a year.
I’ve since moved away from that state and haven’t seen Melanie in over a year. I’m not “cured.” I function much better than I did at my worst, but I still need help. I still see a professional on a semi-regular basis to help keep things in check. I still have panic attacks sometimes, and I am still very afraid of the possibility of vomiting. I will still go out of my way to avoid putting myself in a situation where vomiting could become more likely. I’m fairly terrified of getting pregnant because morning sickness sounds like a living nightmare to me. But one thing Melanie always told me was that I have to remind myself of my “wins” and not just focus on the things that still feel debilitating.
I can type the word “vomit” over and over, as evidenced by this essay you’re reading. I can say the word out loud, along with other trigger words, like retch, puke, throw up, stomach virus, etc. I can stand in the kitchen when my husband prepares raw meat for cooking without thinking about food poisoning and having to run from the room in panic. I can see someone vomit on television and not think about it for the next several hours, replaying it over and over in my head until I’m afraid I might vomit myself. I can be near a person who says he or she was recently sick. I can tell people about my experience.
To be honest, I’ve been a little worried about sharing this publicly. Some people who have known me since I was a kid have no idea this is a part of my life and a part of who I am. Some people still judge mental illness harshly, and I might get some of that judgment from people who don’t know me well. And—let’s just say it—this is personal. It’s super personal. It’s my deepest fear on display for everyone to see, but I feel compelled to share this now that I’m able to talk about it.
Maybe someone reading this sees himself or herself in my experience and finally asks for help. Maybe someone will just feel that sense of relief I felt when I knew my phobia had a name and that I was not alone. Maybe it won’t help anyone else, but I think writing it down helped me. (Seriously, I wrote the word “vomit” so many times!) And maybe helping me is enough.
If you or someone you know needs help with mental illness, please speak to your family doctor for a referral, or visit Psychology Today’s website to search therapists in your area. If you are a student, check your school’s website for counseling options for students. Many universities offer counseling as a free service to students. You don’t have to deal with your mental illness alone. Don’t be afraid to ask for help.
*Name has been changed.