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Mental Health

Ever heard of emetophobia? The oddly common phobia often misdiagnosed as anxiety or anorexia

My daughter's emetophobia diagnosis changed everything.

Ever heard of emetophobia? The oddly common phobia often misdiagnosed as anxiety or anorexia
Canva

Emetophobia is a pathological fear of vomiting and can be incredibly debilitating.

Something was wrong with our daughter. We'd seen the signs brewing for a while, but couldn't pinpoint their exact nature. She'd always been an easy-going kid, but sometimes she'd flat-out refuse to do certain things or go certain places, and she would panic if we tried to coax her.

She had frequent dizzy spells and stomachaches with no apparent physical cause. If she heard someone we knew was sick, she'd immediately ask with a worried tone, "What kind of sick?" Those last two things should have been bigger clues, but we didn't have the clarity of hindsight. And as adolescence approached, she started experiencing more anxiety in general. She would back out of plans with friends more frequently.

She spent more and more time in her bedroom. When I took her to orchestra practice—something she enjoyed—she couldn't make herself get out of the car to go in. We could see her trying to do things, but more and more she was paralyzed by a fear she couldn't name. It was clear she was struggling with anxiety and we tried a couple of different therapists. They each helped a little, at least to keep the spiral from getting worse. But we seemed to be missing something.

It began dawning on me how often she talked about feeling nauseous. I took note of how many times she'd ask us if food was OK to eat and how frequently she'd refuse to eat certain things. She obsessively checked every bite of meat to make sure it looked cooked enough, and if her stomach felt the slightest bit off, she wouldn't eat at all. If a character in a movie or TV show gave any indication that they were about to vomit, she'd hop up and leave the room. If she found out someone had a stomach bug, she'd hole herself up in her bedroom. And so we started piecing it together.

"I've noticed that most of your anxiety seems to be centered around you worrying about throwing up," I said to her one day. "Does that sound accurate?" She flinched when I said, "throwing up," but nodded "yes."

As a shot in the dark, I googled "intense fear of throwing up," and found the clinical term that would change everything: emetophobia.

Emetophobia (also called specific phobia of vomiting, or SPOV) is a pathological fear of throwing up. In scientific literature, it is often referred to as an "understudied" or "underresearched" disorder, but there is a growing consensus that it is surprisingly common. One study found that up to 3% of men and 7% of women are affected by it. No one loves throwing up, of course, but when it becomes an actual phobia it can be incredibly debilitating.

For our daughter and other emetophobes, throwing up is the most terrifying thing that could happen to them. My daughter has said if she were given the choice between throwing up and dying, she's not sure which she'd choose. Totally irrational, but that's what makes it a disorder. Sometimes emetophobia is a PTSD response to a traumatic vomiting episode, but often—as in our daughter's case—there's no clear cause. But the why is less important than the what and the how to treat it.

People with emetophobia are basically afraid of their own bodies. Many phobias are situational—people don't generally freak out about heights or spiders or small spaces unless they're in or around those situations—but a person can't avoid or escape their own body. There are no breaks, no periods of relief from the fear. And the biggest triggers for emetophobia—food and other people—are also unavoidable, which makes it a particularly challenging disorder.

We all know that anything we eat has the possibility of giving us food poisoning—we know it's rare, so we take reasonable precautions and don't worry about it. Emetophobes do worry about it. All the time. They check expiration dates obsessively. They ask for reassurance that food is safe to eat. (I can't count how many times our daughter has asked us to smell or taste something that is not the least bit old.) Obviously, they can't not eat, but they often start limiting their diets to things they deem "safe."

Additionally, in an emetophobe's brain, pretty much every normal stomach sensation—hunger, digestion, gas—gets interpreted as nausea. And if they think they're nauseous, they won't eat. Such disordered eating can easily be misdiagnosed as anorexia nervosa, though it's a totally different illness.

People are another big trigger. Any person we interact with could have a stomach bug and not know it yet, which they could pass along to us. Again, we all know this, but we understand the chance is small, so we don't worry about it. Emetophobes do worry about it, incessantly, to the point of avoiding people and places where people will be, which is basically everywhere except their own personal living space. Hence the spiral into reclusiveness, which can easily be mistaken for agoraphobia.

The compulsive food checking, the frequent hand washing and the avoidance of certain things that go along with emetophobia also look a lot like OCD. (And indeed, as my daughter's therapist explained, emetophobia is a form of obsession.) All of these things make diagnosis tricky, especially since emetophobes won't usually walk into a therapist's office and say, "Hey, I'm deathly afraid of throwing up." They often avoid all words related to vomit and won't talk about it, so they speak in vague terms about their fear, which can lead to an initial diagnosis of generalized anxiety.

Getting the correct diagnosis is vital, however, to getting the right kind of treatment.

Before we found a therapist who knew how to treat emetophobia, we utilized a website called emetophobiahelp.org. It's run by therapist Anna Christie, who suffered from emetophobia herself, and it's an excellent starting place for self-help.

One of the first things the website suggested was to have my daughter look at this:

V * * * *

Not the word "vomit," just the first letter with the rest of the letters as stars. That's how avoidant many emetophobes are about anything involving the idea of throwing up. We added one letter at a time—just looking at them, not even saying the word—until she worked up to reading the whole word, then saying it out loud until she could do it with minimal discomfort, then saying synonyms—puke, barf, upchuck, and so on. The day my daughter could say "vomit" and "puke" without hesitation was a huge milestone.

Incremental exposure like that, eventually leading up to watching videos of people vomiting and pretending to throw up yourself, is one part of treatment. (Successful treatment doesn't require actually throwing up, by the way. Nor is vomiting a cure for the phobia. It's common for people to think, "Oh, if they just throw up and see it's not that bad, then they'll get over it," but that's not how it works. Generally speaking, an emetophobe vomiting without undergoing the mental changes needed to process it will not resolve the phobia.)

The other part of treatment is cognitive behavioral therapy (CBT). This is the retraining of the brain to manage the fearful thoughts. There are various elements of this part of treatment, including learning how the amygdala—the fear center in your brain—works and how to purposefully interact with it. Through various thought-feeling-behavior exercises, you learn how to diffuse the fear and stop inadvertently reinforcing it. (There's some evidence that EMDR can also be helpful for people with emetophobia.)

As her parents, we had to learn how the behaviors we thought were helping our daughter actually weren't. Telling her over and over again that food was fine seemed like the logical counter to her repeated requests for reassurance, but really, we were reinforcing her need for reassurance, which then reinforced the anxiety. We had to learn to tell her once, and only once, that something smelled or tasted fine and then stop responding. We had become avoidant of talking about vomit in front of her because it seemed so traumatizing—that wasn't helpful either.

So much of what we've learned in treating emetophobia is counterintuitive. That's true of treating most anxiety disorders, but with emetophobia, the behaviors are so specific it's important to find a therapist who understands how to treat it. It also can be hard to find a therapist who is familiar with it. Most we have called have never heard of it or never treated it.

Anna Christie's website is a good place to start your search. It has a list of therapists who specialize in treating emetophobia. She also has recommendations for finding a therapist if there aren't any on her list near you. We're in a rough time for finding therapists right now, though, as so many are booked out for months and aren't accepting new patients.

For self-help, an incredibly helpful book also came out last year. It has been a lifeline for my daughter, as her therapist moved out of state and we have struggled to find another to complete her treatment. "The Emetophobia Manual" by Ken Goodman, L.C.S.W. is basically a whole course of therapy in book form, complete with exercises and exposures. It's so good, I can't recommend it highly enough.

The good news is, emetophobia is treatable and there are more and more resources available for people who suffer from it. But it starts with getting the correct diagnosis, which is often the hardest part of the process.


This article originally appeared two years ago.

Mel Robbins making a TED Talk.

Towards the end of The Beatles’ illustrious but brief career, Paul McCartney wrote “Let it Be,” a song about finding peace by letting events take their natural course. It was a sentiment that seemed to mirror the feeling of resignation the band had with its imminent demise.

The bittersweet song has had an appeal that has lasted generations, and that may be because it reflects an essential psychological concept: the locus of control. “It’s about understanding where our influence ends and accepting that some things are beyond our control,” Jennifer Chappell Marsh, a marriage and family therapist, told The Huffington Post. “We can’t control others, so instead, we should focus on our own actions and responses.”

This idea of giving up control (or the illusion of it) when it does us no good was perfectly distilled into two words that everyone can understand: "Let Them." This is officially known as the “Let Them” theory. Podcast host, author, motivational speaker and former lawyer Mel Robbins explained this theory perfectly in a vial Instagram video posted in May 2023.

“I just heard about this thing called the ‘Let Them Theory,’ I freaking love this,” Robbins starts the video.

“If your friends are not inviting you out to brunch this weekend, let them. If the person that you're really attracted to is not interested in a commitment, let them. If your kids do not want to get up and go to that thing with you this week, let them.” Robbins says in the clip. “So much time and energy is wasted on forcing other people to match our expectations.”

“If they’re not showing up how you want them to show up, do not try to force them to change; let them be themselves because they are revealing who they are to you. Just let them – and then you get to choose what you do next,” she continued.

The phrase is a great one to keep in your mental health tool kit because it’s a reminder that, for the most part, we can’t control other people. And if we can, is it worth wasting the emotional energy? Especially when we can allow people to behave as they wish and then we can react to them however we choose?

@melrobbins

Stop wasting energy on trying to get other people to meet YOUR expectations. Instead, try using the “Let Them Theory.” 💥 Listen now on the #melrobbinspodcast!! “The “Let Them Theory”: A Life Changing Mindset Hack That 15 Million People Can’t Stop Talking About” 🔗 in bio #melrobbins #letthemtheory #letgo #lettinggo #podcast #podcastepisode

How you respond to their behavior can significantly impact how they treat you in the future.

It’s also incredibly freeing to relieve yourself of the responsibility of changing people or feeling responsible for their actions. As the old Polish proverb goes, “Not my circus, not my monkeys.”

“Yes! It’s much like a concept propelled by the book ‘The Subtle Art of Not Giving a F**k.’ Save your energy and set your boundaries accordingly. It’s realizing that we only have “control” over ourselves and it’s so freeing,” one viewer wrote.

“Let It Be” brought Paul McCartney solace as he dealt with losing his band in a very public breakup. The same state of mind can help all of us, whether it’s dealing with parents living in the past, friends who change and you don’t feel like you know them anymore, or someone who cuts you off in traffic because they’re in a huge rush to go who knows where.

The moment someone gets on your nerves and you feel a jolt of anxiety run up your back, take a big breath and say, “Let them.”

let them theory, let it be, paul mccartney, the beatles, exhalethe beatles wave GIFGiphy

This article originally appeared last year.

@ilonamaher/Instagram

“BMI doesn’t tell you what I can do.”

It seems like at least once a year, the topic of “BMI,” or “body mass index,” being a flawed measuring system for fat mass and health comes up in conversation. Experts will explain how BMI leads to an incomplete perspective at best—since it doesn't take into consideration several key factors that influence a person’s body composition—and at worst, actual health risks, affecting eligibility for things like weight loss medications, insurance rates, joint-replacement surgery and fertility treatment. And then life moves forward.

And yet, despite the constant debunking, the belief in BMI still marches on. And this time, it was hurled at the USA rugby star and Olympian Ilona Maher. More specifically, someone commented “I bet that person has a 30% BMI” on one of Maher’s TikTok videos.

ilona maher, olympics, team usa, rugby, bmi, body weightBMI is not always an accurate measure of health.

Could this person have simply been pointing out the inherent flaw of BMI? Saying that Maher, an elite athlete, would be considered “overweight” using this system? Perhaps. But this is the internet we’re dealing with, so Maher (and others) interpreted it to be an insult.

And under that context, Maher wasn’t having it, and chose "not to just ignore the haters."

“Hi, thank you for this comment. I think you were trying to roast me, but this is actually a fact. I do have a BMI of 30. Well, 29.3 to be exact,” Maher said in response video…which became something of a roast itself.

Maher talked about how she had been considered “overweight” her entire life, and even recalled being “so embarrassed” to turn in a physical form to the office which had “overweight” written on it.

“I chatted with my dietician, because I go off facts, and not just what pops up here. You know, like you do.” she quipped while tapping her temples.

Maher is 5-ft.-10-in. and 200 lbs, which is considered “overweight” by BMI standards. But as she explained, about 170 of those 200 pounds are “lean muscle mass.”

“Do that math in your head…you probably can’t,” Maher said sarcastically.

It’s easy to see through this example how bogus BMI really is, especially for athletes.

Essentially, “BMI doesn’t tell you what I can do.”

“It doesn’t tell you what I can do on the field. How fit I am. It’s just a couple of numbers put together,” she said. “It doesn’t tell you how much muscle I have, or anything like that.”

Maher concluded by faux lamenting, “I do have a BMI of 30. I am considered overweight. But alas, I am going to the Olympics, and you’re not.”

u.s. women's rugby, jill biden, 2024 olympics ilona maherThe U.S. women's rugby team with First Lady Jill Biden and members of the U.S. delegation to the 2024 Summer Olympic GamesThe White House/Public Domain

While Maher’s clapback was certainly satisfying, it also provided some much needed reassurance to folks. So many commented on how this outdated concept has affected (or still effects) their own body image of that of a loved one.

How can I get my teenage daughter with a high BMI (but fit!) to understand this?! She feels shamed even at the doctor for her BMI.”

“Dancer here, I'll never forget at 13 being told I had the BMI of 24 of ‘overweight.’ I broke down and the nurse said it didn’t mean anything and all I could think was then WHY are you making me do this?!”


body weight, scale, BMIWeight and BMI can't say what we can do.Giphy

“I had to ask the doctor’s office to put a note on my child’s file to not bring up/talk about BMI in her check ups. It isn't an accurate representation of health!”

“Thank you for sharing your weight, bc seeing lbs numbers in different bodies has been so helpful in me loving mine. I’m nowhere near an athlete's body but damn, the numbers really do us in.”

Until a more affordable solution pops up, BMI will continue to rear its ugly head in doctor’s offices and in our psyches. Maybe this is a reminder that our bodies are so much more than height and weight every now and again is a good thing. And if it comes from an Olympian…even better.

Maher also shut down any notions that her BMI was high due to anything other than muscle with a Sports Illustrated cover shoot in August of 2024. Um, yeah.

Thin and fit are not the same thing. Thank you, Ilona Maher, for the powerful reminder.

This article originally appeared last year.

The Gardiner Brothers stepping in time to Beyoncé's "Texas Hold 'Em."

In early February 2024, Beyoncé rocked the music world by releasing a surprise new album of country tunes. The album, Renaissance: Act II, includes a song called "Texas Hold 'Em," which shot up the country charts—with a few bumps along the way—and landed Queen Bey at the No.1 spot.

As the first Black female artist to have a song hit No. 1 on Billboard's country music charts, Beyoncé once again proved her popularity, versatility, and ability to break barriers without missing a beat. In one fell swoop, she got people who had zero interest in country music to give it a second look, forced country music fans to broaden their own ideas about what country music looks like, prompted conversations about bending and blending musical genres and styles, and gave the Internet a crash course on the Black roots of country music.

And she inspired the Gardiner Brothers to add yet another element to the mix—Irish step dance.

In a TikTok that's been viewed over 42 million times, the Gardiner Brothers don cowboy hats while they step in time to "Texas Hold 'Em," much to the delight of viewers everywhere.

Watch:

@gardinerbrothers

Beyoncé 🤝 Irish dancing #beyonce #countrymusic

Michael and Matthew Gardiner are professional Irish-American step dancers and choreographers who have gained international fame with their award-winning performances. They've also built a following of millions on social media with videos like this one, where they dance to popular songs, usually in an outdoor environment.

The melding of Irish dance with country music sung by a Black American female artist may seem unlikely, but it could be viewed merely as country music coming back to its roots. As mentioned, country music has roots in Black culture and tradition. One major staple of the country music genre, the banjo, was created by enslaved Africans and their descendants during the colonial era, according to The Smithsonian. The genre also has deep roots in the ballad tradition of the Irish, English and Scottish settlers in the Appalachian region of the U.S. Despite modern country music's struggle to break free from "music for white people" stereotypes, it's much more diverse than many realize or care to admit, and Queen Bey is simply following tradition.

banjo, country music, country, roots, genreMan playing banjo.Canva Photos

People are loving the blending of genres and culture that the TikTok exemplifies.

"Never thought I’d see Irish step dancing while Beyoncé sings country," wrote on commenter. "My life is complete. ♥️"

"So happy Beyoncé dropped this song and exposed my timeline to diversified talent 👏🏽👏🏽," wrote another.

"Beyoncé brought the world together with this song 😭," offered another person.

"Ayeeee Irish Dancing has entered the BeyHive chatroom… WELCOME!! 🔥🔥🔥" exclaimed another.

"I don’t think I can explain how many of my interests are intersecting here," wrote one commenter, reflecting what several others shared as well.

The Beyoncé/Gardiner Brothers combo and the reactions to it are a good reminder that none of us fit into one box of interest or identity. We're all an eclectic mix of tastes and styles, so we can almost always find a way to connect with others over something we enjoy. What better way to be reminded of that fact than through an unexpected mashup that blends the magic of music with the delight of dance? Truly, the arts are a powerful uniting force we should utilize more often.

And for an extra bit of fun, the Gardiner Brothers also shared their bloopers from filming the video. Turns out stepping in the rain isn't as easy as they make it look.

@gardinerbrothers

Beyoncé Bloopers #texasholdem #gardinerbrothers

This article originally appeared last year.

Humor

A guy revealed the 12 simple things that make men happy and it's 100% accurate

If it's not a dog, a buddy, a beer, and a cool stick, we don't want it.

Nolan Reid / TikTok
A guy definitively listed the 12 things that make men happy and it's 100% accurate

Minimalism is on the rise, not just in design and architecture, but in the way people live their lives. Having fewer things, sporting simpler styles, and enjoying the fundamental good things in life is cool now. Regular people who aren't influencers post fewer updates to social media. The world is just so loud and chaotic, more people are getting satisfaction out of just... chilling out and existing.

There's an old joke/meme that goes something like this: "Guys literally only want one thing and it's disgusting." Its used to imply, obviously, that men are shallow and crude creatures. TikTok creator and simple-life advocate Nolan Reid, however, has a different idea of what men really want.

Nolan recently made a video about "Little things in life that make men happy."

The hilarious list includes:

  • A fridge full of beer.
  • Drinking said beer in the garage. With your dog. And a good buddy.
  • Finding a cool stick.
  • Kicking a rock.
  • Staring at water.
  • Dropping rocks into said water.

As a fellow man, I would say: Yeah. That pretty much covers it.

It really doesn't take much! Watch Nolan's full video to see the rest, and just appreciate how much joy and satisfaction he gets from these simple things.


@nolanreid7

It’s that simple #beer #mustache #muzzymade



People loved Nolan's list—so much so that they began adding their own ideas of "simple things men love." The video racked up hundreds of thousands of views across TikTok and Instagram.

One commenter wrote, "He just described my whole personality." Another added, "This guy gets it."

Others chimed in with their own additions to the list, like staring at a fire for hours or just peace and quiet.

But most of the nearly 200 comments were just people chiming in to say one thing:

"Hell yeah."

Finally, someone who understands us! The video was such a hit that Reid put out two sequels where he added things like skipping rocks, throwing a thumbs up in a photo, or making something from scratch. "A dog" seems to make an appearance in every single video, and for good reason: Dogs make guys happy!

Nolan's ultra-relaxed vision of "masculinity" is honestly so refreshing.

@nolanreid7

And many more #littlethings #muzzymade

Men on social media are usually bombarded with the Andrew Tates and Jordan Petersons of the world—influencers who constantly berate us to make more money, lose weight and add muscle, sleep with more women, take charge, and relentlessly self-improve.

I like Nolan's much chiller idea of masculinity. It reminds me of being a kid: taking pleasure in the simple things, not racing to be anywhere, not trying to impress anyone or prove anything. And I love that all the things listed are timeless. They were enjoyed by men, and all people, in the 50s, in the 90s, and they'll be enjoyed by people 50 years from now, too.

Nolan's entire account is a breath of fresh air, an antidote to hustle culture. His videos find joy in:

  • Breaking down cardboard boxes
  • Driving at sunset
  • Going fishing
  • Throwing a frisbee
  • Wearing t-shirts

A daily visit to his page is almost like a meditation. I highly recommend giving him a follow to add a little counterprogramming to your social media feed.

Nolan says in another recent video that he started making TikToks and Instagram reels just for fun, but discovered along the way that he was really passionate about the message.

@nolanreid7

And many more #littlethings #men #happy #muzzymade

"I never thought that my simple living and love for little things would resonate with so many of you."

He said he hopes to inspire people to "take a step back and enjoy the good simple things in life." And now, I suddenly have the urge to go chuck a rock into a river, so I would say: Mission Accomplished!

This article originally appeared last year. It has been updated.

Family

'Would you let your child wear this?': Is this mom 'overreacting' to a Target dress?

"I know I’m a little bit more conservative. I don’t usually even let my girls wear bikinis, but maybe I’m overreacting."

via Target and Mike Mozart/Flickr

A controversial dress being sold at Target.

There seems to be a constant war between children’s clothing retailers who want to push the boundaries of modesty and parents who push back, saying they are sexualizing children. On top of that, when young girls believe they are supposed to wear clothes that are tight-fitting and revealing, it's very damaging to their self-esteem and body image. So what is a parent to do?

“I think it’s one thing that the girls’ clothes are very fitted and small, and it’s another that they’re in such direct contrast to what you find on the boys’ side, and those two things send a pretty strong message about what they’re supposed to look like, dressed to be slim and to be fit,” Sharon Choksi, a mom of two and founder of the clothing line, Girls Will Be, told CNN.

The topic came up again recently when Meghan Mayer, a mother of 2 and a 7th-grade school teacher, posted a video on TikTok about a dress she saw at Target that received over 1.6 million views. Meghan was reacting to a smock-style patterned dress with balloon sleeves that appeared modest at first glance. But after closer examination, it has holes on the waist on both sides, revealing the girl’s midriff and possibly more.


“My oldest daughter and I are at Target, and there’s some cute spring stuff,” Mayer started the video. "I am a little bit more conservative when it comes to my kids’ clothing, so maybe I’m overreacting, but let me know what you think of these dresses.”

She added that the dress may be okay for a 12-year-old but was inappropriate for a 6- or 7-year-old. Mayer asked her followers what they thought of the dress. “Like I said, I know I’m a little bit more conservative. I don’t usually even let my girls wear bikinis, but maybe I’m overreacting, I don’t know. Thoughts?”

For reference, she then showed the sizes of the dresses to show they were for kids, and then revealed the holes in the sides. “Look at these little slits on the sides of these dresses, right at the hips on all these dresses,” she said.

Most people commenting on the video thought the dress was a bit much for such a young girl to wear and that it was inappropriate for someone that age to expose themselves.

target, target aisle, big box retail, target pov, shoppingWalking down the aisle in a target.via Mike Mozart/Flickr

"You're not overreacting. You're parenting properly," Paper Bound Greetings wrote. "No, no. There is no reason for those holes to be there. They should have pockets! Not holes!" Anna wrote. "I think retailers are trying to mature our kids too fast. I agree with mom!" HollyMoore730 commented.

But some people thought that that dress was acceptable and Mayer was overreacting.

"Unpopular opinion, I think they’re cute," Dr. Robinson wrote. "When I was a kid in the ‘70s I wore halter tops and tube tops; they were not seen as big deals. I don’t think this is scandalous," Kimberly Falkowsi added. "Overreacting. Both my girls have the blue and white, you can’t even tell much. It’s not that big of a hole. The dresses are so cute," LolitaKHalessi commented.

"Fun fact… you don’t have to buy it, Bethany wrote. "Idk I think it’s cute and that everyone just making it weird when it really isn’t," Wisdomdeals added. "Nothing wrong with the dress. It’s sold out in my area. Luckily if you don’t like it or think it’s inappropriate, you don’t buy it for your child," Maddison commented.


target, retail store, target front, target doors, target locationThe front of a Target.via Mike Mozart/Flickr

Some commenters told Mayer that she should buy the dress and have her daughter wear a shirt beneath it so it doesn’t show skin. However, Mayer believes that it would support Target in making questionable kids' clothing.

"No, I'm not going to buy it and have them wear a tank top with it, because then that's showing Target that it's OK," she told Today.com. "And over time, the cutout will get bigger and bigger."

This article originally appeared last year.