Sufferers of emetophobia often describe being able to prevent sickness, and in some cases, an apparent inability to vomit. What does this mean for those seeking CBT?
Currently, there is research being undertaken in the UK that will specifically look at how CBT (cognitive behavioral therapy) can help sufferers of emetophobia, the extreme fear of vomiting (hereafter referred to as v* for the benefit of sufferers). Although I think CBT may be a promising treatment, I’d like to see more research into this phobia, in particular, the mechanisms associated with v*.
My concern is that many sufferers report being able to prevent themselves from v* , and in some cases report not being able to v* even when they want to. These themes have recurred so often in research (what little there is), and the topic is often discussed on phobia forums. Some sufferers report being dismissed and even being laughed at when they describe being able to stop themselves from v*. However, should this be dismissed? What if, as odd as it may sound, there is some validity to these concerns?
Some researchers did look into this idea, suggesting that sufferers may actually be able to train themselves not to v*. The neural hypothesis suggests that the v* center in the brain may respond to inhibitory stimulation from the limbic system, learning that v* is completely unacceptable. There is also physical hypothesis that suggests breathing and stomach muscles may also be controlled to prevent v*. These ideas are understandably difficult to put to the test, both scientifically and ethically.
CBT aims to modify thoughts, feelings and behaviors. A possible thought challenge might be, “If I’m going to v*, there’s nothing I can do about it”. But what of those who believe they can keep it down – will this challenge work? Surely we should explore these possible ideas further, in case some chronic sufferers are really unable to v*?
