Ever heard of emetophobia? The oddly common phobia often misdiagnosed as anxiety or anorexia
My daughter's emetophobia diagnosis changed everything.

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.
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There's a reason why some people can perfectly copy accents, and others can't
Turns out, there's a neurodivergent link.
A woman in black long sleeve shirt stands in front of mirror.
Have you ever had that friend who goes on vacation for four days to London and comes back with a full-on Queen's English posh accent? "Oooh I left my brolly in the loo," they say, and you respond, "But you're from Colorado!" Well, there are reasons they (and many of us) do that, and usually it's on a pretty subconscious level.
It's called "accent mirroring," and it's actually quite common with people who are neurodivergent, particularly those with ADHD (Attention Deficit Hyperactivity Disorder). According Neurolaunch, the self-described "Free Mental Health Library," "Accent mirroring, also known as accent adaptation or phonetic convergence, is the tendency to unconsciously adopt the accent or speech patterns of those around us. This linguistic chameleon effect is not unique to individuals with ADHD, but it appears to be more pronounced and frequent in this population."
Essentially, when people have conversations, we're constantly "scanning" for information—not just the words we're absorbing, but the inflection and tone. "When we hear an accent, our brains automatically analyze and categorize the phonetic features, prosody, and intonation patterns," writes Neurolaunch. For most, this does result in copying the accent of the person with whom we're speaking. But those with ADHD might be more sensitive to auditory cues. This, "coupled with a reduced ability to filter out or inhibit the impulse to mimic…could potentially explain the increased tendency for accent mirroring."
While the article explains further research is needed, they distinctly state that, "Accent mirroring in individuals with ADHD often manifests as an unconscious mimicry of accents in social situations. This can range from subtle shifts in pronunciation to more noticeable changes in intonation and speech rhythm. For example, a person with ADHD might find themselves unconsciously adopting a Southern drawl when conversing with someone from Texas, even if they’ve never lived in the South themselves."
People are having their say online. On the subreddit r/ADHDWomen, a thread began: "Taking on accents is an ADHD thing?" The OP shares, "My whole life, I've picked up accents. I, myself, never noticed, but everyone around me would be like, 'Why are you talking like that??' It could be after I watched a show or movie with an accent or after I've traveled somewhere with a different accent than my 'normal.'
They continue, "Apparently, I pick it up fast, but it fades out slowly. Today... I'm scrolling Instagram, I watch a reel from a comedian couple (Darcy and Jeremy. IYKYK) about how Darcy (ADHD) picks up accents everywhere they go. It's called ADHD Mirroring??? And it's another way of masking."
(The OP is referring to Darcy Michaels and his husband Jeremy Baer, who are both touring comedians based in Canada.)
Hundreds of people on the Reddit thread alone seem to relate. One comments, "Omfg I've done this my whole life; I'll even pick up on the pauses/spaces when I'm talking to someone who is ESL—but English is my first language lol."
Sometimes, it can be a real issue for those around the chameleon. "I accidentally mimicked a waitress's weird laugh one time. As soon as she was out of earshot, my family started to reprimand me, but I was already like 'oh my god I don’t know why I did that, I feel so bad.'"
Many commenters on TikTok were shocked to find out this can be a sign of ADHD. One jokes, "Omg, yes, at a store the cashier was talking to me and she was French. She's like 'Oh are you French too? No, I'm not lol. I'm very east coast Canada."
And some people just embrace it and make it work for them. "I mirror their words or phrase! I’m 30. I realized I start calling everyone sweetie cause my manager does & I work at coffee shop."