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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.

@cosmo_andtheoddparents/TikTok

He wuvs his vet.

Not every dog might jump with joy after seeing their vet out in public. But for Cosmo the Golden Retriever, it was practically Christmas all over again when he spotted his own vet, Dr. Jones, at a brewery.

In an adorable clip posted to TikTok, we see Cosmo in pure, unadulterated bliss as he snuggles with an equally happy Dr. Jones, who, considering he’s still in his scrubs, might have just gotten out of work to grab a quick pint.

Watch:

Ugh, the cuteness is too much to handle! People in the comments could barely contain their secondhand joy.

“He looked over like, “Mom, do you see who this is?” one person wrote, while another said, “What in the Hallmark movie? Adorable!!”

One person even joked, “Did we all check the vet’s hand for a wedding ring? (Said as a married woman. Looking out for you all, or something.)”

According to Hannah Dweikat, Cosmo’s owner, the two actually share quite a history. She tells Upworthy that when Cosmo was but a wee pup, he “gave a scare” after eating a Sago Palm seed, which are highly toxic to dogs, from a plant in their backyard, which of course resulted in him being rushed to the animal hospital and staying there over the weekend.

While that’s every pet owner’s worst nightmare, and certainly a scary situation for the poor fur baby, Dweikat says that “the calm and patient demeanor” of Dr. Jones and his staff put Cosmo at ease. And because of this, “Cosmo has always loved going to see his friends—especially because they give him lots of treats and snuggles.”

Cosmo and Dr. Jones’ buddyship has also blossomed thanks to proximity, as Dweikat only lives down the street from the clinic. “Which means we get to see Dr. Jones and his staff out in public at times and Cosmo takes every chance he can get to say hi,” she explains. This time, however, she was able to capture it all on video. Yay for us!

What makes a good vet?

While not every vet, however gifted, will be able to elicit this type of reaction from their patients, having a calming presence like Dr. Jones is certainly a good sign for pet owners to be on the lookout for when shopping around for their own vet. But that’s not the only quality a good vet needs. According to Saint Matthews University, a vet also needs to have high stamina (both physically and mentally), as well as an ability to tolerate unpleasant situations (you can’t faint at the sight of blood or vomit), a high level of emotional intelligence (maybe all doctors should possess this skill, but especially those who work with animals), adaptability, a sense of enthusiasm, and finally, excellent communication skills.

Dr. Jones seems to have these attributes in spades, and his patients clearly love him for it. None so much as Cosmo, obviously.

By the way, if you’re in need of even more content featuring this precious pup, you can follow Cosmo on both TikTok and Instagram.

Health

Philosopher shares the subtle giveaway that someone is 'not very smart'

When you see this trait, it's time to rethink your relationship.

A man pointing at someone.

Individuals and groups have used scapegoating to blame their problems on others since the term was first coined in The Old Testament and probably long before. We see it all the time in politics, where leaders blame specific groups or ideologies for their country’s failures. We also see it in personal relationships where families blame one person for everyone’s problems or workplaces make an employee the fall guy for a failed project.

In a viral TikTok video, philosopher Julian de Medeiros explains why scapegoating is a sign that someone is unintelligent. He begins by quoting one of the most powerful British union leaders in the first half of the 20th century, Ernest Bevin, who once said: “An unintelligent person is always looking for a scapegoat.”

What's a sign that someone is unintelligent?

“What he meant is that a sign that somebody is not very intelligent is that they always have to blame their problems on other people. Like, it's never something they've done; it's always somebody else's fault,” de Medeiros says in a video with over 230,000 views. “They can avoid accountability; they can avoid introspection and self-reflection, which means that they can avoid growth because it's always somebody else's fault. A smart person is introspective, self-critical, and wants to grow, but an unintelligent person blames other people.”

@julianphilosophy

Intelligent vs. unintelligent #quotes #life #intelligent #wisdom


It can be hard to come to grips with our failures in life, whether they are financial problems, relationship issues or fear of losing control. “There are things that we cannot bear to see about ourselves. ‘I really don’t want to be seen as vulnerable or stupid or weak or greedy,’” Deborah Stewart, a Jungian psychoanalyst, told The Washington Post. “I don’t have to deal with myself if I scapegoat if I blame. That’s the part that most people don’t really know — that they are trying to expel some of their very own feelings by putting them on others.”

People and groups that are made into scapegoats can be put into incredible danger or subject to public disgrace, whether it is the Jewish people during the Holocaust or Anne Boleyn during the reign of King Henry VIII, or Yoko Ono for the breakup of The Beatles.

The big problem with scapegoating.

Those who scapegoat others for their failures can be seen as unintelligent because they refuse to take responsibility for their actions or even recognize where they may have been wrong. When people point their fingers at others, they also ensure that they never learn from their problems and are bound to repeat them. Intelligent people have a growth mindset, and scapegoating is the exact opposite.

Further, when societies refuse to look at the real causes of their problems and instead blame them on scapegoats, they will fail to progress. However, it’s very easy for leaders to fall into the scapegoat trap because it prevents them from being responsible and appears to solve problems when they are actually taking the easy way out.

Ultimately, it comes down to a core question: do you want to deflect blame for your problems by scapegoating someone else, or do you want to accept responsibility and grow from your difficulties? Ironically, those who scapegoat may think it makes their lives easier. However, living a life making the same mistakes repeatedly is a lot harder than accepting responsibility.

Peter Dinklage on "Game of Thrones?

When it comes to actors doing accents across the pond, some Americans are known for their great British accents, such as Natalie Portman ("The Other Boleyn Girl"), Robert Downey, Jr. ("Sherlock Homes"), and Meryl Streep ("The Iron Lady").

Some have taken a lot of heat for their cartoonish or just plain weird-sounding British accents, Dick Van Dyke ("Mary Poppins"), Kevin Costner ("Robin Hood: Prince of Thieves") and Keanu Reeves ("Bram Stoker's Dracula").

Some actors, such as Tom Hardy (“The Drop”) and Hugh Laurie (“House”), have American accents so good that people have no idea they are British.

Benedict Townsend, a London-based comedian and host of the “Scroll Deep” podcast, says there is one word that American actors playing characters with a British accent never get right. And no, it’s not the word “Schedule,” which British people pronounce the entire first 3 letters, and Americans boil down to 2. And it’s not “aluminum,” which British and American people seem to pronounce every stinking letter differently.

@benedicttown

The one word American actors aways get wrong when doing an English accent

What word do American actors always get wrong when they do British accents?

“There is one word that is a dead giveaway that an English character in a movie or a TV show is being played by an American. One word that always trips them up. And once you notice it, you can't stop noticing it,” Townsend says. “You would see this lot in ‘Game of Thrones’ and the word that would always trip them up was ‘daughter.’”

Townsend adds that when British people say “daughter,” they pronounce it like the word “door” or “door-tah.” Meanwhile, Americans, even when they are putting on a British accent, say it like “dah-ter.”

“So top tip if you are an actor trying to do an English accent, daughter like a door. Like you're opening a door,” Townsend says.



What word do British actors always get wrong when doing American accents?

Some American commenters returned the favor by sharing the word that British actors never get right when using American accents: “Anything.”

"I can always tell a Brit playing an American by the word anything. An American would say en-ee-thing. Brits say it ena-thing,” Dreaming_of_Gaea wrote. "The dead giveaway for English people playing Americans: ‘Anything.’ Brits always say ‘EH-nuh-thin,’” marliemagill added.

"I can always tell an actor is English playing an American when they say ‘anything.’ English people always say it like ‘enny-thin,’” mkmason wrote.



What is the cot-caught merger?

One commenter noted that the problem goes back to the cot-caught merger, when Americans in the western US and Canadians began to merge different sounds into one. People on the East Coast and in Britain pronounce them as different sounds.

“Depending on where you live, you might be thinking one of two things right now: Of course, ‘cot’ and ‘caught’ sound exactly the same! or There’s no way that ‘cot’ and ‘caught’ sound the same!” Laura McGrath writes at DoYouReadMe. “As a result, although the different spellings remain, the vowel sounds in the words cot/caught, nod/gnawed, stock/stalk are identical for some English speakers and not for others.”

American actors owe Townsend a debt of gratitude for pointing out the one thing that even the best can’t seem to get right. He should also give the commenters a tip of the cap for sharing the big word that British people have trouble with when doing an American accent. Now, if we could just get through to Ewan McGregor and tell him that even though he is fantastic in so many films, his American accent still needs a lot of work.

This article originally appeared last year.

@oldmansrock/Instagram

Truly a once in a lifetime talent.

When we think of badass, alt rock icons of the 90s, few are as singular and unique as Dolores O’Riordan, who gave The Cranberries its signature sound, and who was once described as having"the voice of a saint trapped in a glass harp.”

It wasn’t just that O’Riordan flawlessly blended traditional Celtic singing techniques like lilting and keening into rock music (which in itself is an amazing feat) but that her performances never compromised emotional authenticity for the sake of aesthetics. The result, as any fan will tell you, was something both ethereal and raw all at the same time.

So it should probably be of no surprise that in this resurfaced clip, presumably from the late 90s, O’Riordan’s stunning cover of Fleetwood Mac’s “Go Your Own Way” is every bit as magical. As @oldmansrock, the account that posted the video, wrote, “the way that Dolores could challenge the pitch but still stay on key, that is the mark of an accomplished singer.

It sounds dissonant compared to the manufactured material of today, where every tone is perfect, but hers is oh so human, and so very Irish! It is beautiful!”

But don’t just take their word for it. Watch:

If this had you wanting to pull up a Cranberries playlist on your Spotify to listen to for the rest of the day, you're not alone. Down in the comments, the renewed love for O’’Riordan was palpable.

“What sits deep with me is that no one sounds like her. Her voice is unmistakable. Whatever her take on a song/lyric? It was authentically, soul-touching Dolores.

“She was unbelievably talented and the cranberries are criminally underrated.”

“Her Irish vocal sweep ups are amazing.”

“She was just brilliant!!! Incredibly talented as well as a lovely and kind human being. I love and miss her. I don't know how anyone can have a bad word to say about this. I thought it was brilliant, both her live cover and studio cover. I wish people weren't so stubborn. I can accept covers no problem if the singer is talented enough, and she most certainly is. ❤️”

“A keening Irish queen. Her voice will always stir me.”

“An actual once in a generation talent”

“Also a master of the microphone. She knows exactly where the sweet spot is for every note.”

“She could melt your heart with that voice, or completely blow you away. Missed dearly, but never forgotten ❤️”

This cover would go on to be a part to the Cranberries’ third album, To The Faithful Departed, which was released in 1996 and became the band’s highest-charting album on the US Billboard 200, and was praised for its darker tone as well as its themes of grief and loss.

After O’Riordan died from drowning due to alcohol intoxication in January 2018, the Cranberries would disband in 2019, but they released their final album, In the End, that year. It was comprised of some of O'Riordan's unfinished demo tapes.

While O’Riordan met the same tragic fate that befalls many artists, especially those in the music industry, her spirit lives on in her art. Because she put so much of herself into her craft, even bite-sized clips of her performances, many years later, inspire those who listen to it. That’s something worth celebrating.

By the way, you can catch a full video of the cover below.

- YouTubewww.youtube.com

Joy

A poet wrote about meeting her younger self for coffee and launched cathartic viral trend

Women are creating healing "I met my younger self for coffee" poems as they reflect on how far they've come.

If you could meet your younger self for coffee, what would you say?

Life is complex and our feelings about our lives even moreso, which is why we humans so often turn to art as a means of processing it all. Poetry in particular has the power to distill complexity into a beautifully simple form, allowing us to succinctly express feelings that are difficult to describe. As Robert Frost wrote, "Poetry is when an emotion has found its thought and the thought has found words," and a skilled poet can help us all find words for our own thoughts and emotions.

A poem by Jennae Cecelia from her upcoming book "Deep in My Feels" has kicked off a viral wave of poetic expression as women reflect on how they've grown and changed since they were younger. Cecelia's poem begins, "i met my younger self for coffee at 10:15," and goes on to describe a lovely, compassionate interaction with her younger self, all while contrasting that younger self with the woman she has become.

People loved the poem so much they used it as inspiration for their own "meeting my younger self for coffee" writing exercises, and the various iterations, at once so personal yet universal, have taken TikTok and Instagram by storm. Some are just written on blank backgrounds as images. Others are videos with the poem overlaid and music in the background.

But what they share in common is the sentiment of wanting to let our younger selves know it was going to be okay. That life is hard but there are good things coming around the corner. That whatever she's feeling or going through now will someday just be a memory.

Some poems have come from women who are still young but fully adult now, speaking to their teen selves.

@jasbethany_

I’d do anything to talk to my 15 year old self 🥲 #nostalgia #coffee #youngerself

Others come from moms in the thick of parenting, reassuring their younger selves that their dreams of having a family have come true, while others show that they took a different path than they planned and it turned out fine.

@katrice_taylor

🤎 #imetmyoungerselfforcoffee #momtok #momsoftiktok #blackmomsoftiktok

The trend is moving people to tears, offering hope to people who are still in those uncertain younger self years, when the possibilities of life seem endless and yet so much feels impossible. Many are finding solace in seeing people's before and after stories, as they serve as a reminder that life is malleable, that the future isn't set in stone, that people can endure and overcome.

@puffy817

Why did this trend heal a little bit in me while I wrote it IB: @Jennae Cecelia Poetry #coffeewithmyyoungerself #parati

Many resonate with the message that whatever struggles we're dealing with now we likely won't be in the future. And, of course, there will always be new struggles we're dealing with but with age and experience we hopefully learn about our own strength to endure. We also hopefully still have dreams to catch.

Cecelia says she is glad that her poem has inspired so many people to create their own versions of it, adding a rightful request to be credited for her work. She shares that the poem is part of a new collection of poetry that she describes as "a dream come true." Her previous poetry books have been self-published, but for this book she landed a deal with a publisher and is thrilled by the idea of having her book available in bookstores and not just online.

"This book is personal" Cecelia says. "It’s a reflection of love, loss, growth, and all the emotions we’re sometimes afraid to name. It’s a reminder that vulnerability isn’t just okay—it’s necessary. Inside, you’ll find poems that sit with you in life’s highs and lows, including the one about, 'meeting your younger self for coffee'—a favorite in the collection."

You can find "Deep in My Feels" for pre-order on Amazon and you can learn more about Cecelia and her work at jennaececelia.com.