Nothing to Fear but... Phobias
Jan/Feb 2008 - Erin Isings

For Eva*, the fear began one terrible night when she was six years old – a night she describes as one of her worst childhood memories. “I awoke and suddenly threw up into my hands as I sat in bed. I spent the rest of the night vomiting repeatedly.” Today, the 26-year-old woman believes this incident played a large role in the development of her emetophobia, an irrational fear of vomiting.

It’s a fear that has trapped her in a world where she’s unable to drink alcohol, go on midway rides, eat in most restaurants, touch doorknobs or put her hands on other public surfaces. What began as a common childhood occurrence led to this phobia that’s invisible to others, yet debilitating to her own life and her ability to function socially. She also believes that her phobia contributed to the onset of her clinical depression, which she’s been struggling to overcome for several years.

“My mother was always concerned about cleanliness and preventing food-borne illness. Her anxiety definitely rubbed off on me from a young age. It started (when I was) six with me cutting hamburgers in half to make sure they were cooked throughout and progressed over many years until I was no longer able to eat in restaurants and became a vegetarian.”

Eva says her fear became “manageable” as she grew, and although she convinced herself she was often nauseous, she’s positive that her nausea was emotional. “I built up nausea in my mind so that it was the single worst sensation I could feel,” she says, adding that she always carried a package of Gravol™ with her. The last time she actually vomited was when she was eight.

But in her fourth year of university, Eva’s emetophobia problems exploded again. She was living with a family whose housekeeping left much to be desired. With a messy dog in the house and mice running across the kitchen counter, Eva says she was unable to prepare food “without obsessively worrying about it becoming contaminated with bacteria.”

In an effort to improve the situation, she moved, but the situation worsened. Her new home included sharing the kitchen with four male roommates. “At one point, I was only able to consume granola bars, bananas and bottled juice ... maybe peanut butter. I read everything I could find about food-borne illness and food contamination, so I knew every possible avenue for illness. It was a nightmare. I simply could not convince myself that food was safe to eat for fear of vomiting after eating.”

“This phobia makes me feel powerless, afraid, terrorized, frustrated, angry, oppressed. Also extremely sad and depressed,” says Eva. “Emetophobia makes me feel like a sideline observer of life rather than a participant.”

While not being able to eat for psychological reasons is incomprehensible to many, suffering from such a phobia is a genuine condition and not the same as feeling fear, explains Dr. Guy Grenier, a London clinical psychologist and author.

“A phobia is a strong, persistent, irrational fear of a particular stimulus,” he says. “It differs from fear primarily in terms of intensity and degree of irrationality.”

Some of the more common phobias are agoraphobia (fear of open spaces but often mistakenly thought of as a fear of people or crowds), claustrophobia (fear of closed spaces), zoophobia (fear of animals), nyctophobia (fear of darkness), and hemophobia (fear of blood). “There are, however, countless phobias primarily because phobias have an irrational quality. Thus, someone could have a phobia associated with extremely specific objects, events or locations,” says Grenier.
People who have phobias and come into contact with their feared stimulus experience a reaction. A phobic response isn’t an overactive brain, but rather a misfiring of the “fight or flight” system in the brain, says Grenier. This system exists to help protect us from actual dangerous stimuli, so it’s unknown why some people develop phobias. “For some, one negative experience can bring on a lifetime of phobic response, while for others, repeated exposure or no exposure at all can bring on a phobic response,” he says.

Strong phobic reactions resemble panic attacks: a racing heart, rapid breathing and increased sweating. “Some people may also experience a change in vision (as a function of pupil dilation), numbness or tingling in hands, feet, arms or legs, nausea, dizziness, and fearful thoughts of losing one’s mind or going crazy,” says Grenier, explaining that these symptoms are simply a result of the fight or flight system kicking in.

“Actual heart attacks or psychotic episodes are practically unheard of in these situations. Of course, to the person experiencing this degree of fear, these seem like very real possibilities despite the fact that they never actually happen,” he says.
Because Eva has gone to great lengths to avoid being put in a position where she could be prone to vomiting, she hasn’t experienced a phobic reaction to her own vomit. But she admits that she’s extremely uncomfortable when she hears or sees someone throw up. “I feel uneasy when someone complains of nausea or anything related to a gastrointestinal illness and I quickly find a way to avoid that person,” she says.

Eva recalls periods where she felt trapped inside her own body because she could never escape the possibility of having to throw up. Struggling with her conditions made her realize the social significance of food and how her phobia limited her ability to live a full and happy life. “You can’t join people for dinner, you can’t eat at other people’s homes, you can’t travel. You are never sure what you will be able to eat in a day or whether you will eat at all.”

Most of her friends and family members have been extremely supportive, however, Eva says there’s still a lot of misunderstanding about phobias. “Some friends have tried to cajole me into situations that have made me uncomfortable, such as forcing me to eat certain foods, but most people are very kind. Professional help is absolutely imperative to fighting phobia, in my view,” she says.

Today her focus is on working abroad in the education sector. With the help of her therapist, who she’s been seeing for two years, Eva has been practicing exposure therapy which challenges her to confront fears in a concrete way.

“Right now, I am working at eliminating obstacles to freedom caused by emetophobia. I am challenging myself to eat at restaurants at least once a week. I am preparing foods, such as fish and green salads, that I haven’t been able to eat for a few years,” she says. “It’s about exposing yourself to different fears until they no longer exist or are at least manageable.”

Throughout her struggle, Eva has learned and grown. “It’s extremely difficult to be happy when you are always afraid,” she says. “Think about how much courage it takes for someone to confront their fears and live in this world like everyone else. Dealing with phobia has caused me to become a more empathetic person, I think, because I understand certain aspects of struggle.”

*Name changed to protect privacy.