How Vomit Phobia Works

is a specific phobia, a fear of throwing up. And we'll get way more into um all of that and what it means, but we're talking about vomiting. It's basically tied for first as the subject of this episode. So we're gonna be talking about vomiting a lot. And I found from researching this reading and I imagine hearing about vomiting for a good thirty minute forty minute stretch, it

can make one queasy. So just fair warning. I don't think it's actually going to make you queasy, but it's possible if it starts to happen, just plow through it. To just say, Josh and Chuck would want me to plow through it, and your queaziness will magically go away. Oh yeah, all right. Uh So, like you said, it is a specific phobia and it is actually listed in the d s M. Now, I'm not sure how long it's been in there, but it is, well a meta phobia, isn't. Well,

I thought the specific phobia vomiting. Now, I guess I think specific phobias are. I don't. I don't know if it's if it's a specifically listed chuck. So when this says it is a specific phobia a current according to the d s M, what does that mean? I think it means that it falls under the umbrella of a specific phobia. Okay, you see what I mean. Not really, but that's okay. Um. This means, well, you're afraid you

might vomit. You're afraid someone else might vomit around you. Um, you're afraid what people will think of you if you do vomit. Yeah. It's just uh, and it's not this article where'd you get this stuff? Anyway? Was just sort of cobbled. It was cobbled together from some pretty good sources, including Psychology Today, the American Association of Anxiety Disorders UM, the National Institutes of Health Library, the BBC Vice and I want to give a shout out to the listener

who wrote in to share her a metaphobia story. I had never heard of it before, and she had a very harrowing experience and overcame it just through sheer grit and willpower, um, and came through the other side of this very serious phobia. Yeah, which you know, we'll to the how to do that later. But um, these articles

and make great pains to point out that it is. Uh. I think all people think it's gross and are very much repulsed and turned off by the sound or the smell or the look or anything that deals with somebody getting sick like this. Um. But this is different than that. This is a debilitating fear that can overtake your life. Yeah,

that would specifically be a metaphobia. There's actually it seems like a spectrum where you can also suffer from what's called fear of vomiting, which is much less um overwhelming, but still you're preoccupied with the idea of vomiting. With the metaphobia, your life does not resemble what your life would be if you if you weren't afraid. Yeah, it's a it's a real impairment to your life in a lot of different ways, which will go over It seems

like there's not a lot of study about it. I mean I ran across a few studies, but even in the studies I found, they specifically say not a lot of studies about us. So a lot of the guests is about the prevalence are guesses. But um, one thing I saw was that UM in the general population eight point eight percent. I think that's actually fear of vomiting.

I think a metaphobia is more like less than one percent of the population has actual a metaphobia, but that it tends to be UM about four to one ratio of women to men. Women suffer from it. They have a tendency to suffer from it more. Yeah, and I certainly do not have it. But um, like I said, like almost everyone in the world probably it is a trigger for most folks. Yeah, nobody wants to throw up.

But if you have a metaphobia, just seeing the title of this come through your podcast feed could have set off an anxiety attack. And like I feel very guilty about that. There nothing we could do because even if we warned everybody in the episode before this that this was coming that would set off a panic attack. Just the mere mention of the word vomit can can set the the anxiety disorder into UM full gear. Yeah. This

one article you sent. One of the clinicians they interviewed UM, who treats anxiety disorder, said it is, in her practice, the most common fear among children that they see. Yeah. Uh, And that's typically how it starts. So it's a chronic disease, meaning that if you don't treat this, it's going to persist basically every day of your life, and it tends

to get worse over time. UM. And it usually starts with a traumatic experience of vomiting, most frequently of all in childhood, So it's it's more common I think, among kids, but it can survive into adulthood and it can start

in adults. But what seems to happen is you have a traumatic experience from vomiting, and just like with any other true attic experience, whether it's surviving UM, a violent crime or being in war, UM, vomiting can have that same effect on the brain apparently, and you developed something pretty closely akin to PTSD at the thought of vomiting, and it overwhelmed the life as a result. I had

a traumatic experience with this when I was a kid. Um. I might have told the story before for another reason, but um, I was on the bus going to elementary school and there was a scary kid. Remember an elementary school. They were just the scary kids. I remember my scary kids first and last name. Yeah, right, And they're scary for various reasons, whether they were bullies or I mean, you could probably diagnose something that was wrong as an adult,

but as a kid, they were just scary kids. And I'm not talking about like I mean, I'm talking about like sociopathic behavior, not something that you know, like some They weren't, yeah, exactly. They had like real issues that

were affecting other people around exactly. So this one kid, I remember his name was Tony something, but he on the way to school one day would or many days, he would make himself throw up outside of the uh with his face out of the window, and it would, you know, the school bus was going down the road and it would fly down and land on the windows all the way down and other windows, and he would make himself vomit, and it just it's scared the crap out of me. Man, and it wasn't like I was

scared scared, scared scared of this dude. Yeah, well that's really bizarre, yeah behavior, especially if he was doing it to like intimidate, to freak other people out. Yeah, and I think I might remember a story because it's you know how sometimes a certain event can tie something else in your brain. You know. My dad was my elementary school principal. I don't know why I was riding the bus because he usually just went to work with him.

He wanted to normalize things maybe, but um, I ran to my dad's office right when I got to school crying. He wasn't in there, and the secretary, Dot Jones let me in the office, and Dot let me stay in his office because I was sad. And he had one of those big um cabinet stereos record so the stereo was already on. But the song that was on, weirdly was the BGS How Deep Is Your Love? And to this day I hear that song and it makes me

want to cry. Yeah, it's just a trigger from that day with that guy, you know what, and that weird that's a sad story because that's a good song. I know, it makes me want to weep. It makes me want to thinking about Tony making himself throw up, And I always wonder what happened that guy. He's in Jim Rose's side show right now. Maybe is that still around. I don't know, Puky Tony, but yeah that was him, Yukiitonian,

hippie robber and like a little jug band together. But anyway, that's a long way of saying that that was not enough. Even the traumatize me to the point where I have a metaphobia. No, but I mean it could have been. It just it seems to be like and it's not even necessarily like a type of person or um. It's it's the brain can just the synapsies can fuse in a certain way, and all of a sudden you have this phobia. And the problem is this is it starts

from a traumatic experience. So let's say that that had had this impact on your chuck, right, what would have come next if you were on the road to a metaphobia would have been to um, start to fear throwing up, seeing somebody throw up, probably is how it would have started. And then that would have spread to throwing up yourself, and then you would have become hyper vigilant. You would you would want to protect yourself from seeing somebody throw up or from throwing up. Well, how do you do that?

To prevent yourself from throwing up? You're gonna monitor every single weird feeling you have to say it would mind about to throw up, I need to like tamp this down, or I can't eat that food it might make me throw up. Or I can't read in the car, it might make me car sick and I'll throw up, Or that person looks kind of sick. I'm going to avoid them, and then let's just take it a little further and avoid everybody altogether, because anybody could really throw up at

any given time. And you start to become preoccupied with this, and you adjust your life and alter it, and then you're constantly worried about throwing up. And once that happens, it's the phobia is complete. Your life has changed, you're

constantly worried about it. And then the cherry on top of the whole thing is that when you finally are confronted with the word vomit actually seeing somebody something like that, you enter a panic attack, an actual panic attack, and um, the only way to overcome that is to get away, to run, to get out of there, to um, I'm not sure all the ways you can handle a panic attack, but then it calms down and your anxiety returns to normal levels, which is to say hi for the average person. Yeah.

So in my case an elementary school, how that could have gone was, um, I had another ride to school. But if I hadn't, I might have stopped taking the school bus and started skipping class and not going to school at all because I was afraid to get on the school bus because of puky tony and gone weeks in a row. And then my parents get a call saying, Chuck hasn't been in school for weeks, what's going on?

And that's exactly what's going on. Like it can get that severe, and it all boils down to the at least in most cases, the anticipation of this more so than the actual act in every case, because the the people that are struck with this, by all accounts, are less vomitous than the general population, so much so because they've tried to avoid it, so much so that this one article said that most of these people can even name like the three or four times in their life

they have ever puked and what they ate that day, and what they had on television and what they wore, because it stands out that singularly to them. And then so that's horribly ironic that the people who are the most worried about throwing up are the people who are actually, statistically speaking, at least likely to throw up. Right. Um, But there's an even greater irony to the whole thing, and we'll talk about that after this break. How about that it's a chuck where you're on the irony train

and I want to keep going. Okay, Yes, the the irony of paying attention and being hyper vigilant about vomiting, especially when you are, um, worried that you're going to vomit, because again, there there's a number of things that you're you're worried about. You're going to be worried that you won't be able to find a bathroom in time to go throw up. You're worried about throwing up in front of other people, um, and embarrassing yourself for being teased

for throwing up. Um. You're worried about just the experience of throwing up, this horrible experience. But once you start to get a metaphobia, you you lose perspective completely, Like it becomes like I've seen multiple they call them a metaphobes, people with a metaphobia. I have seen multiple people say you would prefer to die than to throw up. That's how much they fear throwing up, and the rest of us it's like, God, that would suck to throw up, but I know I'll be fine on the other end

of it, not to a person with a metaphobia. So the irony of all this is the more you start to focus on this and you start to uh think about every gurgle in your stomach or every weird twist or turn um, it actually produces more anxiety. And here's the ironic part. Anxiety can actually make you queasy when you're thinking about throwing up, that's right, So it makes the whole thing worse and it becomes this vicious cycle. Yeah, and they recommend trying to tell yourself, like, I might

feel queasy, but I'm not going to throw up. My anxiety might be making me feel nauseous, but I am not going to throw up. Yeah, Because there's a confusion of queasiness equals nausea equals throwing up and that's just not the case. Like, you can make yourself sick with anxiety, but you can't make yourself throw up from being anxious, so the whole thing is just wasted. Worry. Yeah, some of the other things you might do because of the spear.

You might not shake hands with anyone ever again you Well, I think a lot of people avoid looking at television puke scenes. Yeah, you cannot watch. You really can't watch those at all. You can't watch Stand by Me or The Meaning of Life. Those are so funny looking though, but still probably not. Uh. You might throw away food in your fridge that uh is not even past this

expiration date. You might have a trigger there. Um. You might overcook your food on purpose, and then before you eat it, you will lift the bread a bunch of times called checking behavior. Sure. Um, you might not eat on vacation as readily because you only trust your trusted food sources. You might go into a place and like you know, when some people go into a music venue, like they check for the exits, like you're checking for the bathrooms. You you may not even make it to

the music venue. You A lot of them. A lot of people with the metaphobia end up being agoraphobic and just don't leave their house really developing it's it's often confused for agaphobia by by UM counselors. Yeah, shrinks, I've got another one, all right. Apparently a lot of people who have a metaphobia walk around with a plastic bag on them at all times, something to throw up into,

an emergency throw up bag. They walk around with this because they're so afraid of throwing up that they never need to use because they probably don't ever throw up, I know. And some of them will actually carry a change of clothes around with them as well, for the same reason. If they throw up on themselves, they can change their clothes. Yeah, And of course, air travel, drinking alcohol um, any of those things are, or car travel

even like any kind of travel is probably avoided. Definitely don't booze it up or Yeah, they probably don't drink at all, and subsist on things like pasta and bananas and very very safe um digestively speaking foods, although banana could gag you. Yeah, you know, God, that would be a nightmare if you had a metaphobia. I wonder if they mash them up and eat it like like mashed up with a fork. Maybe maybe you could see it. Yeah, and I could see cutting your food up into you know,

the tiniest pieces, because you feel if you're choking. And that's one of the fears too. I don't think we mentioned like they're not just afraid of the vomiting, but they sometimes can fear choking on vomit and dying and affixiating and or going to the hospital or starting to vomit and the vomiting never ending. That's another fear of a metaphobia. One other thing that I saw people do, um is prevent getting pregnant because of a fear of mourning sickness. Um. So yeah, so your life is is

altered and curtailed because you're afraid of vomiting. Everywhere you look there's some potential trigger out there. So it just be easier to stay home and eat your pasta and not watch movies basically, and it just lie there and monitor your stomach for signs that you're about to throw up. That's what they do. That's what you do when you have a metaphobia. That's your life. It's no way to live. So,

like this is not all just academic and stuff. We're grasping at shows and pulling together from different cases like this is. There's actually a case study we found, UM that was of an eight year old girl who had a terrible experience throwing up and really kind of encapsulates the experience of a metaphobia. She had full blown to metaphobia. She had appendicitis and had been throwing up before the doctors figured out she had a pendicitis and had her

appendix removed. And that experience throwing up was um while it triggered a metaphobia in her. She when she came to and Um was recovering from her surgery, about ten days later, she started getting really worried she was going to start throwing up like that again. Yeah. It was a really sad case and uh pretty much covered everything we've said and and even then some to the point where her father traveled for business and she didn't want

him to travel anymore. Her father to travel anymore for fear that he would uh get some sickness and then bring it back to the house. Uh, I mean that's pretty extensive, you know. Yeah, Like she didn't want to eat herself. She she didn't want to eat any outside food. She had her safe food, but she also didn't want her parents to eat any outside food either because she didn't want them throwing up. She stopped um playing with other kids because she was worried about throwing up in

front of him and being teased. That was her big thing. Um And as as one of the clinicians who we came across in this research said, it's not the vomiting that's really the problem, Like that's the focus, that's the obsession, But the real problem is the worry, the constant worry. It's the worry that's altering your life, and it altered

this little girl's life, you know, very sad. So let's let's take another break and then we'll come back and put a silver lining on this thing and talk about treatment. All right, So we've talked a lot on the show over the years about CBT cognitive behavioral therapy or exposure and response prevention e r P, basically exposure therapy, and this is definitely probably the way to go when it

comes to a metaphobia. So depending on who you go see, you might undergo various kinds of treatments, ranging from starting out by literally saying the words vomit out loud or throw up or puke or just all the words um, because that's literally the first step sometimes into getting over this is just being able to speak the word yeah. And you may have to start out by writing it down first before you can say it out loud for real.

And so once you move past that, um. The the therapies range from um, they're kind of all over the board, from looking at fake vomit that your therapist has made in a toilet. Yeah, now you're starting to move into exposure therapy, right, Yeah, I mean this is all of this stuff, uh E r P and CBT, but um, you know, they'll make up some fake vomit, put it in the toilet, make you go look at it. They themselves, the therapists might make the noises in front of you,

just out of nowhere. Well I imagine they probably prep them or maybe not. Uh may may go in the bathroom and jump up and say I gotta go get sick. And all of this is just exposing this patient over and over to the point where they can handle hearing the sound, seeing the thing, saying the word. Hearing the

smell is another one too. One of the recommendations for exposure therapy is you make your own throw up, like in the toilet, a little bit of um, cold soup something like that, maybe mixed in some oatmeal with it, and then pour a little vinegar in there to like make it pungent, and sit around and think about that being vomit. Maybe try to make the sound of throwing up yourself, um, try to make yourself gag and and all this is to show you, when you have a

metaphobia that this is, first of all, it's manageable. That's the first part. Is what you're trying to do is get to this point without having a panic attack. But then also um that if you gag, it doesn't mean you're automatically going to throw up. And if you do throw up, it doesn't mean you're never going to stop throwing up, or that everyone's going to ridicule you for

throwing up. And and that's you know, the point of any cognitive behavioral therapy is just kind of change your perspective and give you a more realistic view of the thing you're worried about. Um. There's also a website called

rate my Vomit. Have you heard of it? Yeah? I wouldn't get to mention that, But go ahead, you have heard of it before, No, no, no, I read about it, but I just it just sounds like, I mean, that's like classic internet stuff, right, Somebody's like, oh, let's put pictures of throw up on there, and you guys tell me how gross it is. Well, it's actually used by people with a metaphobia too, as exposure therapy at home to just go look at this stuff and see it.

There's also videos of people throwing up. There's a lot of stuff the internet like unintentionally is this great place for people with a metaphobia to go get over their fears? And I'm sure, like if you have a fear of snakes, it's good for that too, But so is like a time life book. You're not gonna find a time life book that's nothing but pictures of vomit. You're gonna find it on the internet, Yes you will. That's not in

the Old West series. And then I found this other um to other type of therapy Chuck called eye movement desensitization and reprocessing e m d R, and it's used for post traumatic stress disorder. And it's the most bizarre treatment I've ever heard of in my life. But apparently it really really works. Are you ready for this? So say I was your therapist and you were you have PTSD, uh, and it's been used to treat a metaphobia a couple of times. But you're talking about the thing that gave

you PTSD. You're focusing on the worst aspect of this traumatic experience, and you're talking about it out loud. But while you're doing it, I'm moving my finger back and forth and up and down and maybe in a slow circle, and I've instructed you to follow my finger wherever I move it while you're recounting this horrible traumatic experience. Supposedly just doing this over multiple sessions, but sometimes just in

one long session, PTSD can be treated. And the way that this they think this happens, if it actually does work, it just sounds like such, just like totally made up that in fifty years are going to be like they actually thought this worked. But if it does work, they think that it works because it it taxes your working memory to follow the finger, and your recall then is not aided fully by your working memory, So the vividness of this horrible memory isn't as as robust as it

would be if your full working memory. Was was working on it, and so it when it when you reprocess it, when you file it away again, this memory it's lost its luster, it's lost a lot of its um bite because you've gotten it out there and reprocessed it in a way that's not nearly as traumatic because you're working memory was being used in part to follow your therapist finger. Supposedly it works, Yeah, and that nuts it's pretty neat. Yeah, I think so too. I wonder if it really does work.

You should try it. Anybody, anyone who has ever undergone eye movement, desensitization and reprocessing. I would love to hear your story if it actually helped you or not. And if you have a metaphobia, godspeed, We hope you get well soon. And to take this on or any phobia really has so much courage and grit that just taking a first step towards treatment, My hat is off to you for life. Yes, and chances argued probably didn't even listen to this episode. Yeah, but if you have a

different phobia, yeah, you know, any phobia. Uh And since I said phobia a couple of times, that means it's time for listener mail. I'm gonna call this our second p s A in as many weeks. If this releases the same week, okay, but this one's about dogs. It's very sad. Hey, guys, take a while to write this because it's been very difficult to talk about your animal lovers. Oh so, probably a good majority of your listeners are, and I thought sharing our tragic story would help prevent

others from experiencing the same thing. We lost our our dog River about two months ago because I left the bag up chips out. We were at work while she got her head stuck in the bag, and we came home to find our dogs stiff and lifeless from suffocation. We've always been careful about plastic bags and stuff like that and kept them stored away for recycling, but never occurred to us said a chips bag on the counter would something would need to be concerned about. No one

ever would ever think about that. Everyone we've also told said it was something they never thought about either. So now we keep all of our bag foods in the cupboard and cut the bottoms off of anything that goes into the recycling and waist pins. It's a good idea too. I started doing that since these guys wrote it in. Yeah, we were and still are extremely heartbroken. I hope no one else will have to go through experience. Um, it was the worst and if I can help save just

one other dog's life, it's been worthwhile. So thanks for being you guys. Thanks for being you guys. There's a comment, there's not, but I think that's how I'm supposed to read it. I hope you make it into your next Seattle show. That's Jackie W from Seattle. Jackie, thank you for writing in. I'm so sorry about River. Um, but I hope you guys are doing okay. Yeah, that sounds like a guest list. Yeah, I agreed action to me. Yeah, right back in and uh we'll guest Yeah, we're coming

in January. So yes, so just right back in. We'll throw you on there. And she sent a picture of River, beautiful dog, very very sad, River look very sweet. Um, if you have a p s A that happened to you that you think we should share to warn everybody else about, we want to do that. UM. You can tweet to us at s Y s K podcast. I met Josh ump Clark. You can also check out my website. Are you see is clark dot com Chuck's on Facebook at Charles W. Chuck Bryant, and there's the official Stuff

you Should Know Facebook. Two. You can send all of us and Jerry an email to Stuff Podcast at how stuff Works dot com and has always joined us at our home on the web, Stuff you Should Know dot com. For more on this and thousands of other topics, is that how Stuff Works dot com