I have emetophobia, an extreme fear of vomit. I kept this secret from almost everyone. When I tried to explain to close friends, they typically replied, "I hear you; I can't stand vomit," having no idea how fear ruled my life. It felt like I was the only person in the world with my disorder. For decades, I didn’t even know it had a name.
From the time I was a child, I would shake with panic whenever I felt nauseous. After I became a parent, emetophobia seeped into almost every thought. I analyzed my kids’ behaviors like a forensic scientist. Did they touch the grocery belt with bare hands? Was the child on the monkey bars sick with a stomach bug? Did anyone look pale? I became an expert contact tracer, symptom analyzer, and worrier, and it was exhausting.
Then the pandemic happened. Oddly, while my friends and family became more anxious, I began to relax for the first time in my life. My concern that someone would catch a stomach virus subsided. I let my kids sleep in the same bed. We shared bowls of popcorn. I forgot about vomit for days at a time. Was this how most people felt every day? I wondered. Then I started to research emetophobia in earnest. Until that point, my only effort to learn more involved Googling “fear of vomit” in college and discovering the word "emetophobia.” Back then, I read one terrifying account of a person whose therapist forced them to vomit as treatment, and I closed my laptop fast.
Now, I wanted to understand everything about my phobia. Most importantly, I wanted to find treatment so I could hang onto my sense of calm when the world eventually reopened. Through research, I discovered that millions of people have emetophobia, and clinically proven therapies exist. Though the thought of exposure therapy, a critical component of treatment, terrified me, I didn't rule it out. The problem was, there weren’t many therapists who specialize in emetophobia. Worse, the few I found weren’t local. One wasn’t taking new patients. Another told me I was number 53 on her waitlist. A third didn’t reply.
According to Imogen Rehm, a clinical psychologist and lecturer at Victoria University in Australia, it can be especially difficult for people with poorly understood disorders to find information and professional support. My own search confirmed this.
What I found instead: social media groups. In fact, online forums for mental illnesses are exploding in popularity.
Rehm coauthored a 2021 study on the use of social media for obsessive-compulsive and related disorders in which 90 percent of the admittedly few 54 participants reported having positive experiences. “These groups can be good for connection, reducing the sense of isolation or that you’re alone or abnormal in what you’re feeling,” says Rehm. That was certainly my experience.
While I waited to connect with a therapist, I found several forums catering to people with emetophobia: a 14,000-member active subreddit, a Twitter hashtag, and TikTok videos with more than 100 million views. To my surprise, I found thousands of other people like me in a private Facebook group. I scrolled happily, awestruck by my luck. How had I not known there were so many of us? When an administrator posted, “Tell me you have emetophobia without saying emetophobia,” I read replies for an hour.
As I read through the comments, I felt validated for the first time in my life. According to Michelle Colder Carras, a public mental health researcher at Johns Hopkins, my giddiness at feeling seen wasn’t unique. “It's vital for people not to feel alone,” she says.
One member confessed to overcooking food to prevent illness: “I literally burn the meat so I will be sure.” Another post made me laugh, not because it was funny but because I remembered thinking the same thing: “When a car pulls over, I think it’s someone getting sick.” Other not-weird-to-me comments kept me glued to the screen: “I’m more scared of catching Norovirus than Covid.” “I monitor stains on the pavement.” “My heart drops when I see the school is calling and I’m actually relieved to hear my kid got in trouble.”
All my secret thoughts and behaviors were there on the screen, written by strangers. It was like seeing the ocean for the first time: I felt blissfully minuscule, held by something larger than myself.
Colder Carras tells me these online communities can be remarkably healing because they cultivate a certain intimacy between users who will never see each other in real life. “Anonymity has been shown to foster more confiding, and discussion and connection ultimately help us reframe and heal from mental health problems,” she says.
In some cases, Colder Carras believes digital peer support on platforms allowing for synchronous communication, like those hosted by Discord, can be more than just a supplement to traditional therapy. “With phobias or PTSD, for example, evidence-based therapies like exposure therapy can be tough to tolerate,” she says. In those cases, having support online may be a better solution.
At their best, groups can be resource havens for members, providing a catalyst to find the right clinician or even pointing to clinical trials or resources for people who can’t afford specialists.
But experts warn that social media support also has drawbacks. While 90 percent of the participants in Rehm's study reported positive experiences, half also mentioned negative experiences, like becoming more preoccupied with a disorder after participating (or even lurking) in groups, harassment, and feeling hopeless about recovery. In some groups, misinformation regarding “miracle” cures can arise, leading to the spread of bad advice. Groups without rules and moderators are particularly risky. But even in groups with explicit rules, content flurries can sometimes be too much for a moderator to handle effectively.
My early visits to social media sites tailored to emetophobes were the most uplifting because I was riding the wave of first-time solidarity. But within a few weeks, I experienced camaraderie’s gloomy flipside: shared dread. People who weren’t feeling well or who were in close proximity to a sick person often “panic-posted.” Well-meaning members replied, sometimes with encouragement, but other times with advice like, “Get out, find a hotel” and even suggestions to take pharmaceutical or over-the-counter remedies, often without consulting a doctor. I began to see how the forum could devolve into an echo chamber.
“Sometimes, online groups become less helpful because a lot of highly anxious people are talking about how to avoid what they're highly anxious about. It becomes a space to become better at avoiding,” says Alexandra Keyes, a clinical psychologist in London and author of a new self-help book and website for people with emetophobia. “Once avoidance strategies become established, without proper help [the disorder] can sometimes be harder to treat.”
Once I finally started Zoom cognitive behavioral therapy sessions with a therapist specializing in phobias, I didn’t visit those sites as often. Perhaps the novelty of simply knowing I wasn’t alone had worn off, allowing my focus to shift to getting well.
“Recovery isn’t linear,” says Rehm. “We all have setbacks and great leaps.” But if we can find groups along the path to recovery, and be flexible in our approach to using them, they can help. Rehm advises her clients who are interested in joining groups to be picky.
“There are hundreds of groups. I encourage people to explore first rather than feel pressured to dive in and become an active member straight out of the gate,” she says.
Some groups, like the one I first joined, cater to individuals who need space to vent, fret, even panic. That kind of support is important when validation is missing in real life. But for someone seeking to recover, with or without professional help, inundation with those types of posts can trigger incremental worries.
I've become more selective with the groups I frequent. Currently, I’m part of a new private Facebook group created by Anna Christie, owner of an emetophobia website and a licensed therapist specializing in the disorder. Her group is for people focused on recovery.
At this stage in my journey, Christie’s group feels like the right fit. After all, I’m not hiding my disorder anymore. But now and then, when my deepest truths still feel too weird to share with my friends, I know I can always drop in on my online communities of people who #understand.
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