The extreme morning sickness that has forced the Duchess of Cambridge to cancel several engagements has prompted a rash of sympathetic articles about commoners suffering similar symptoms of hyperemesis gravidarum, in some cases so severe they have vowed never to get pregnant again.
But just imagine living in constant fear of being sick, not just in the morning or during pregnancy, but every waking hour. It's called Emetophobia and it affects millions in Britain, women more than men, but has remained under the radar, unlike hyperemesis gravidarum which now has an unofficial royal patron.
I'd just turned seventeen when I discovered that I was emetophobic. Sitting, bored, at the GP's, flicking through a magazine when all of a sudden there it was - a phobia I'd been suffering from for as long as I could remember but had never found the words, or the courage, to articulate. This was back in the pre-Wikipedia/Social Media era so I'd never had the luxury - or curse - of mining the internet, enlisting Dr Google's help or self-diagnosing on countless forums and blogs. I just knew that since early childhood I'd been inexplicably and debilitatingly terrified of being sick or seeing others being sick.
Emetophobia, I read on, is an 'intense irrational fear or anxiety of, or pertaining to, vomiting.' Each sentence of that article felt like coming home. All the paranoid behaviour I thought was unique to me, all the bizarre thought patterns I would never have dared utter to another living soul were suddenly being given a name. And not only a name, but a bonafide explanation, in black and white, from a medical professional. I could finally relax. I wasn't a freak after all, just a person suffering from a chronic and very real phobia.
Slowly the discovery began to sink in. The relief was almost too intense. I felt so safe, so comforted and oddly, so justified. No one had ever listened to me when I'd tried to verbalise my fear - not really. At five, sitting up all night too scared to go to sleep in case I was sick in bed they thought I was scared of the dark. At eleven, when I became cripplingly anxious before long journeys for fear of car sickness (which triggered months of agonizing acid reflux), they took me to hospital for a scan and when they found nothing wrong sent me away with a three months' supply of Gaviscon. At seventeen, when I told friends I didn't want to stay out late drinking they thought I was being 'lame'. How could I explain to them that I was afraid of throwing up in public and having nowhere to hide?
Now I know my fear isn't unique. But the ignorance shrouding Emetophobia more than a decade after my discovery at the GPs that day still persists. A key reason is the lack of research into the phobia, probably stemming from sufferers' reluctance to 'come out'. My research located just a handful of websites, the majority of which lacked reliable statistics, though I did stumble on a list of celebs with the condition - it seems Cameron Diaz and I are more alike than I thought. The fact Emetophobia is such a little known condition is baffling given that 9% of the UK population, or some 5.5 million people of whom 90-95% are women, suffer from it according to the National Emetophobia Society. It's reckoned to be the fifth most common phobia and is linked to a wide range of conditions such as Obsessive Compulsive Disorder, Agoraphobia and Social Anxiety.
Whatever the reason, people seem to have great difficulty stomaching Emetophobia. It's a curious thing: tell someone you're scared of heights, the dark or even people dressed clowns and it's taken as a given, almost normal. But tell them you're scared of someone being sick on a night bus and they'll probably say something like 'Well, yeah it's gross isn't it? I mean no one likes being sick.' This type of response at once belittles you and trivialises your phobia. It's a surprising attitude in our ever more accepting society with the self-help industry burgeoning, alternative medicine part of the mainstream and therapy becoming increasingly commonplace.
The precise causes of Emetophobia, like those of the equally embarrassing but the massively more documented IBS, are unknown, but it's widely thought to be brought on by a traumatic childhood event involving vomiting; not the act of being sick itself but an irritated or disgusted reaction to the sickness from a parent or older sibling which induces feelings of shame or guilt that persist through adolescence into adulthood. It's also linked to feelings of powerlessness, insecurity and low self-esteem. As with other phobias, sufferers tend to develop what's known as 'safe behaviour', part of the fight or flight routine when facing danger. For Emetophobes this will range from routine precautions to extreme behaviour to avoid encounters of the bilious kind. These include:
- Carrying a bottle of water, plastic bag or anti-emetics (anti-sickness pills) at all times.
- Getting off tubes or night buses at the slightest hint someone could be ill or even avoiding public transport altogether
- Insisting on having aisle seats on planes and at the theatre and cinema to easily escape potential sick episodes
- Avoiding people who have recently been sick or had a stomach bug
- Obsessive hand washing to combat the spread of bacteria and germs
In the most severe cases sufferers will develop full-blown agoraphobia and women may even avoid pregnancy for fear of experiencing morning sickness.
Happily my anxiety has become less acute over the years thanks to learning how to control my thought patterns supported by two years of weekly therapy sessions. But the effects never completely disappear. On a recent cinema date I couldn't relax until I was comfortably secured in my aisle seat. My companion noticed this and of course I had to explain, which somewhat blunted the cool, feminine allure I was aiming for.
Securing an aisle seat isn't enough. I truly believe that as well as parental advisories and age ratings films should have an 'E' warning: 'May contain violent and unexpected sick scenes likely to scar emetophobes for the foreseeable future' (something tells me Hollywood won't buy this).
I hope this article will encourage fellow emetophobes to voice their fears. De-mystifying the disorder and promoting its understanding are crucial to accelerate the awareness of the condition. The first National Emetophobia Day in the UK on March 5th received some media play and Thrive, a pro-active cognitive therapy course spanning a range of disorders and destructive thought patterns related to anxiety, is also fast winning adherents.
Social media is also playing a vital role in giving sufferers a voice and creating a community of peers, particularly on Twitter. Emetophobia Problems -@EmetoProblems- (one woman's description of her ongoing battle with the condition) is rapidly building a following. There's even a website, www.phobiasatthemovies.com, alerting emetophobes to films that contain vomit scenes.
If you suffer from this phobia or you recognise the symptoms described in this article in someone you know, these websites provide useful information and advice: