What causes emetophobia ?
What causes emetophobia is likely to be diverse. However, most models seem appear to put the majority of causation down to a combination of a predisposition to anxiety and traumatic experience of vomiting. However, even this may not be straightforward.
What causes emetophobia – Traumatic vomiting
Veale et al (2013a) found that many sufferers had memories of especially bad vomiting, be this due to its intensity or because it was public. However, they also observed that many sufferers displayed a loss of time and context perspective. This leads to the question of which came first. If the Emetophobia arose it may lead to enhanced recall of bad experience?
This question may in part be answered by De Jongh’s 2012 study. De Jongh used Eye Movement Desensitisation and Repossessing (EMDR) to treat traumatic memories of events which were believed to be causal to the development of the phobia. In four sessions a 46-year-old woman was successfully treated by working through vomit related memories. This is intriguing evidence as it point to the role of memory in emetophobia. However, it cannot be declared conclusive because it is a single case. In addition, there is the possibility that a confidently delivered treatment which fits the patient’s belief system may be sufficient to cure them but may not having anything to do with the actual causation.
What causes Emetophobia – Predisposition to anxiety
Sykes, Boschen, & Conlon (2016) identified that sufferers have high levels of comorbid anxiety disorders. This suggests that a predisposition to anxiety may be a factor. However, this may be something of a chicken and egg situation as the most common conditions, panic attack, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD) and hypochondriasis are just as likely to be secondary symptoms of the emetophobia as causes or from an underlying condition.
Van Overveld et al (2008) found in a survey of Dutch people with Emetophobia that people with Emetophobia have an increased sensitively to the feeling of disgust. They experience disgust both more often and to a higher level than people without the condition. Again, we have the problem of which came first? Is the heightened disgust a cause or a symptom? We don’t currently have sufficient information to say.
Boschen (2007) offers a cognitive model of the development of Emetophobia. In this model Emetophobia starts with broad anxiety and crystallises down to fear of the operations of the upper digestion. A process referred to a ‘cataphoric misappropriation’. This leads to hypervigilance of the gastro-intestinal functioning which then sets up a reciprocal cycle of vigilance. In this cycle triggers are spotted, which lead to stress and further vigilance. The whole thing becomes a self-reinforcing nightmare in which the sufferer is trapped.
What causes Emetophobia – Conclusion
It is currently difficult to say exactly what causes Emetophobia. The best working theory we have is that the twin forces or possible predisposing factors, such as anxiety and heightened disgust, provide the foothold for traumatic experience of vomiting to set up a recurring cycle of fear.