Selects: How Vomit Phobia Works | STUFF YOU SHOULD KNOW

hi everybody it's stuff you sh know. co-host Chuck Bryant here Charles W some. say uh I'm in charge of picking out the. Saturday select this week and we're. going back to. 2017 December 5th in fact it's a. Christmas episode It's called how vomit. phobia Works trigger warning there will. be talk of vomit r at. r welcome to stuff you should know a.

production of iHeart. [Music]. Radio hey and welcome to the podcast I'm. Josh Clark there's Charles W Chuck. Bryant and there's Jerry over there this. is Stephy Cho very special surprisingly. sad Edition oh yeah I think so yeah of. course it's. sad it's really gross it is gross.

I'm going to have a hard time getting. through this one so we should give. everybody fair warning we are talking. about emetophobia which 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. going to be talking about vomiting a lot. and I found from researching this y.

reading and I imagine hearing about. vomiting for a good 30 minute 40 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 just say Josh and chuck. would want me to plow through it and. your queasiness will magically go away. oh yeah mhm all right uh so like you. said it is a specific phobia and it is.

actually listed in the uh DSM now not. sure how long it's been in there but it. is well a metop phobia isn't oh well I. thought the specific phobia of vomiting. no I guess I think specific phobias are. I don't I don't know if it's if it's. specifically listed Chuck so when this. says it is a specific phobia occurrent. according to the. DSM 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 youh um you're afraid what people. will think of you if you do vomit yeah. it's just uh and and it's not this. article where'd you get this stuff. anyway was this sort of cobbled it was. cobbled together from some pretty good. sources including uh Psychology today. the American Association of anxiety.

disorders um the National Institutes of. Health Library the BBC. Vice and uh I want to give a shout out. to The Listener who wrote in to share. her a metaphoria story yeah 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 get to the how to do that later.

but um these articles 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 right um but this. is different than that this is a. debilitating fear that can overtake your. life yeah that would specifically be a. metaphoria 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 a metaphoria your life does not. resemble what your life would be if you. if you weren't afraid to of vom yeah. it's a it's a real impairment to your. life yeah in a lot of different ways. which we'll go over uh it seems like. there's not a lot of study about it uh I.

I mean I ran across a few studies but. even in the studies I found they. specifically say there's not a lot of. studies not a lot of studies about this. so a lot of the guesses about the. prevalence are guesses but um one thing. I saw was that um in the general. population. 88.8% I think that's actually fear of. vomiting I think aaph Bia is more like. less than 1% of the population has. actual theophobia yeah but that it tends. to be um about 4:1 ratio of women to men.

right 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 a trigger for most. folks yeah nobody wants to throw up but. if you have a metaph Bia 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's nothing we could do because. even 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 uh 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 treat. this it's going to persist basically.

every day of your life and it tends to. get worse over time yeah um and it. usually starts with a uh 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. traumatic experience whether whether. it's surviving a um a violent crime or.

being in war um vomiting can have that. same effect on the brain apparently and. you develop something pretty closely. akin to PTSD yeah at the thought of. vomiting and it overwhelms your life as. a result I had a 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 SCH school and there was a.

scary kid remember in 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. right but as a kid they were just scary. kids yeah and I'm not talking about like. uh I mean I'm talking about like. sociopathic Behavior not something that. you know like some they were weren't. goth you mean yeah exactly right they.

had like real issues that were affecting. other people around them exactly so this. one kid I remember his name was Tony. something but he on the way to school. one day would uh 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 oh. my God come in other windows and he. would make himself vomit and it just it. scared the crap out of me.

man and it wasn't like I bet it scared. the crap out of the bus driver 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 freak other people. out yeah and I think I might remember. you've never told that story before tell. 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 cuz. he usually just went to work with well. he wanted to normalize things yeah maybe.

but um I ran to my dad's office right. when I got to school crying he wasn't in. there and the the secretary do Jones let. me in the office and Dot let me stay in. his office uh cuz I was sad and uh he. had one of those big um cabinet stereos. you know you put on the rosie record so. the stereo was already on but the song. that was. on weirdly was uh the bgs how deep as. your love oh that's good and to this day.

I hear that song and it makes me want to. cry really yeah it's just a trigger from. that day with that guy you know what. isn't that weird that's a sad story cuz. that's a good song I know it makes me. want to weep it makes me want to weep. for you thinking about Tony making. himself throw up and I always wonder. what happened to that guy he's in Jim. Rose's side show right now maybe is that. still around I don't know pukey Tony but. yeah that was him pukey Tony and hippie. Rob or in like a little Jug Band.

together uh but anyway that's a long way. of saying that that was not enough even. the traumatizing me to the point where I. have a metaph bia no but I mean it could. have been it 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 synapses can fuse in a certain. way and all of a sudden you have this. phobia and the problem is this. it starts from a traumatic experience so.

let's say that that had had this impact. on You Chuck right what would have come. next if you were on the road to a. metaphoria 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 right and then. you would have become hypervigilant you. would you would want to protect yourself. from seeing somebody throw up or from. throwing up well how do you do that to. toe prevent yourself from throwing up.

you're going to monitor every single. weird feeling you have yeah to say am I. 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 altoe 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. the cherry on top of the whole thing is. that when you finally are confronted. yeah with the word vomit actually seeing. somebody vomit something like that you. enter a panic attack an actual panic. attack yeah you can for sure and um the. only way to overcome that is to get away. to run to get out 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 high for the average. person yeah so in my case in 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 pukey Tony right and gone.

weeks in a row and then my parents get a. call saying Chuck hasn't been in school. for weeks H what's going on and that's. exactly what's going on like it can get. that severe right 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 uh. the people that are struck with this by. all accounts are less vomitous than the. general population right so much so. because they've tried to avoid it so.

much so that uh 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 right 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 the. 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.

[Music]. that so Chuck we were on the irony train. and I want to keep going okay yes the. the iron. of paying attention and being.

hypervigilant 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 or being teased for throwing up. um you're worried about just the. experience of throwing up it's a. horrible experience but once you start.

to get a metaphoria you you lose. perspective completely like it becomes. like I've seen multiple they call them a. metaphores or people with a metaphoria. I've seen multiple people say you would. prefer to die than to throw up yeah. that's how much they fear throwing up. and to 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 metaphoria 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 well yeah and they. recommend trying to tell yourself like I. might feel Que e 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 uh because. of this fear 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 No or. the meaning of life those are so funny. looking though yeah but still probably. not uh you might throw away food in your. fridge that uh is not even past its. expiration date you might have a trigger. there MH um you might overcook your food. on purpose and then before you eat it. you will lift the bread a bunch of times.

it's called checking Behavior sure um. you might not eat on vacation as readily. because you only trust your trusted food. sources you might uh 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 a metaphoria end up. being a gorap phobic and just don't. leave their house really debilitating. often confused for a agoraphobia by by.

um counselors and shrinks I've got. another one all right uh apparently a. lot of people who have a metaphoria walk. around with a plastic bag on them at all. times something to throw up into yeah 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 uh some of them will. actually carry a change of clothes. around with them as well really mhm for. the same reason if they throw up on. themselves they can change their.

clothes yeah and of course air travel uh. drinking. alcohol um any of those things are or. car travel even yeah like any kind of. travel is probably avoided definitely. don't booze it up or yeah they probably. don't drink at all yeah and subsist on. things like pasta and bananas and very. very safe um digestively speaking. Foods although a banana could gag you. yeah you know God that would be a.

nightmare if you had a meop. phobia I wonder if they mash them up and. eat it like like mashed up with a fork. maybe maybe I could see it yeah and I. could see cutting your food up into you. know the tiniest pieces because you feel. fear 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 fixating and or. going to the hospital or starting to. vomit and the vomiting never ending.

that's another um fear of aaph one other. thing that I saw people do um is prevent. getting pregnant um because of a fear of. morning sickness yeah um so yeah so your. life is is altered and curtailed it. because you're afraid of vomiting. everywhere you look there's some a. potential trigger out there so it' just. be easier to stay home and eat your. pasta and not watch. movies basically and to 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 metaphoria that's your life yeah it's. no way to live it is not so like this is. not all just academic and stuff we. grasping at straws and pulling together. from different cases like this is. there's actually a case study we found. um that is was of an 8-year-old girl who. had a terrible experience throwing up. and really kind of encapsulates the. experience of a metaphoria she had. full-blown.

amaphisi and had her appendix removed. and that experience throwing up was um. well it triggered a metaphoria in her. she when she came to and um was. recovering from her surgery about 10. 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 right for fear that he. would uh get some sickness and then. bring it back to the house right uh and. 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 ate 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 cuz she was. worried about throwing up in front of.

them and being teased that was her big. thing yeah 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. uh let's take another break uh and then. we'll come back and and put a silver.

lining on this thing and talk about. [Music]. treatment all right so we've talked a. lot on the show over the years about CBT. cognitive behavioral therapy uh or.

exposure and response prevention Erp uh. basically exposure therapy and this is. definitely probably the way to go when. it comes to uh emetophobia 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 even 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 a 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. the stuff uh Erp and CBT okay 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 therapist might make. the noises in front of you right just. out of nowhere well I imagine they. probably prep them or maybe not uh it. may may go in the bathroom and jump up. and say I got to 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 word. 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 metaphoria 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 in in. having a panic attack yeah 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 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 going to mention that. but go ahead you have heard of it before. no no no I I read about it but I I just. yeah 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 metaphoria to 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 metaphoria to go get over. their fears and I'm sure like if you. have a fear of snakes it's good for that. too yeah but so is like a Time Life Book. you're not going to find a Time Life. Book that's nothing but pictures of. vomit no you're going to find it on the. internet though yes you will that's not. in the Old West series no uh and then I. found this other um this another type of. therapy Chu called eye movement.

desensitization and reprocessing EMDR. 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. yeah are you ready for this yep so say I. was your therapist and you were you had. PTSD uh and it's been used to treat. emetophobia a couple of times but you're. talking about the thing that gave you PT. SD 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 maybe in. a slow Circle and I've instructed you to. follow my finger wherever I move it yeah. 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 50 years they're going. to be like they actually thought this. worked right but if it does work they. think that it works because it 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 right because you've gotten it. out there and reprocessed it in a way. that's not nearly as traumatic because. your working memory was being used in. part to follow your therapist finger. supposedly it works wow yeah is that. nuts it's pretty neat yeah I think so.

too I wonder if it really does work you. should try it any anyone who has ever. undergone eye movement desensitization. and reprocessing I would love to hear. your story if it actually helped you or. not for sure and if you have a. metaphoria godspeed we hope you get well. soon and to take this on or any phobia. really has so much courage and grit that. that just taking a first step toward.

treatment my hat is off to you for life. yes and chances are you 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 uh I'm going to call this our. second. PSA in as many weeks if this releases. the same week okay uh but this one's. about dogs it's very sad uh hey guys. take me a a while to write this because.

it's been very difficult to talk about. now you're animal lover zo 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 uh we lost our our dog. River about two months ago because I. left a bag of chips out uh we were at. work while she got her head stuck in the. bag and we came home to find uh our dogs. stiff and lifeless from Suffocation. we've always been careful about plastic. bags and stuff like that and kept them. stored away uh for recycling but never.

occurred to us that a chips bag on the. counter would uh something would need to. be concerned about no no one ever would. ever think about that uh 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 cut the bottoms off of anything. that goes into the uh Recycling and. waistbands that's a good idea too I. started doing that since these guys. wrote in oh yeah uh we were and still. are extremely heartbroken I hope no one. else will have to go through this. 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 there's not but I think. that's how I'm supposed to read it uh. hope we 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 hope you guys are. doing okay yeah that sounds like a guest. list yeah agreed action to me yeah write. back in and uh we'll guest list you yeah.

so just ride back in we'll throw you on. there yeah and she sent a picture of. river beautiful dog very very sad the. river looked very sweet um if you have a. PSA 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 sysk podcast you can send. all of us and Jerry an email to stuff. podcast howstuffworks.com and as always. join us at our home on the web Stu stuff. you should know.com.

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