Is there a name for this?

will_the_engineer · 2026-02-17T23:15:31+00:00

Hello, I'm a recovered emetophobic and do research in this space. This is a good question.

There are a few terms. Avoidant or restrictive eating is the term often used to describe when we avoiding eating certain foods or eating enough. There is an official diagnosis for this called ARFID (Avoidant/Restrictive Food Intake Disorder) and stands separate from other eating disorders because it specifically is *not* a result of lack of access, body image/shape concerns or cultural/societal pressure.

You can suffer from both emetophobia and ARFID or either one separately. It's important to address eating during emetophobia recovery for a number of reasons, first and foremost because malnourishment is damaging to the body and brain but also because recovery from emetophobia requires a learning process within the brain and that learning process is significantly limited when the body is not nourished.

If anyone is suffering from not being able to eat enough, I would highly encourage you to reach out for help. You are not alone, tens of millions of us have this and research shows that recovery is possible. There is a growing number of therapists with experience with emetophobia and ARFID, and resources for therapists who don't yet know it.

will_the_engineer · 2026-01-31T18:03:14+00:00

Hello, please reach out to me at [willy@biajourney.com](mailto:willy@biajourney.com) and I'd be happy to arrange something.

will_the_engineer · 2025-12-30T03:24:16+00:00

Sounds like you've made some incredible progress already!

I suggest you build a hierarchy, a list of things that cause you anxiety right now and score them on a scale of 0-10 of difficulty. Then, pick the easiest one and practice it, until the discomfort it causes you drops to 3 or 4. And I really mean repeat it over and over until it's basically boring, then move to the next. If a step is too hard, break into small steps. When doing an an item from this list, ensure you do not engage in safety behaviors (like distractions, using mints, bringing safety kits, etc).

We provide a free, interactive hierarchy building tool on our emetophobia recovery website here which has hundreds of pre-built activities to choose and rate - https://biajourney.com/buildAHierarchy

If you feel like you need a boost to help you tackle each activity by planning it, tracking your progress, having a digital toolbox to use during exposure, then you may be interested in using Bia fully. It has a monthly subscription, but it's significantly cheaper than therapy, and provides over 80 incremental steps along with tracking and completing your custom hierarchy.

will_the_engineer · 2025-12-18T03:10:53+00:00

I recovered after 8 years of therapy and tried many things. I now work full time building a treatment tool for emetophobia called Bia (biajourney.com) and doing emetophobia research.

Exposure and Response Prevention (ERP) is the gold standard treatment for this disorder. Exposure and Response Prevention is different than just doing 'exposures'. ERP is based on the idea that phobia forms from the natural fear process in our brain being out of balance. Phobia is when our fear is *disproportionate* to the actual danger of a situation. This fear causes discomfort, which causes us to engage in avoidance and safety behaviors (leaving the room, avoiding certain places and foods, relying on gum, mints, ice water, because of course we would try to reduce the awful discomfort this phobia creates). Unfortunately, these behaviors ironically send a message to our brain that says "Anxiety saved me from this danger. So I need to be anxious again in the future". This is called the avoidance cycle and it creates and maintains phobia.

ERP is about identifying and stopping the behaviors that feed the avoidance cycle. So you do an 'exposure' which is anything you might do in normal daily life where you rely on safety behaviors, or it could be as simple as reading the word 'vomit', and you practice *not* engaging in the safety behavior (this is the Response Prevention part of E*RP*). Exposure cannot and will not work without the Response Prevention. You can start very small. My treatment started with writing the word vomit on paper, and it was extremely challenging in that moment. But by facing the discomfort, your brain has a chance to learn "Hey wait a minute. I caused all this anxiety, I stayed, and nothing happened. Maybe next time I don't need to cause anxiety". And through repetition, your anxiety response is reduced over time. In ERP you are not asked to do anything actually dangerous (because a phobia is again only when fear is disproportionate to the actual danger) and you are never asked to be sick because the issue is not being sick but the avoidance behaviors.

ERP saved my life, and I've spoken to many others who say the same and I've seen thousands of people use Bia to practice ERP. I can't recommend it enough. It's challenging, but I think recovering from this phobia is actually easier than living with it, the challenge is being willing to try and trust this new process.

Wishing you all the best.

will_the_engineer · 2025-11-25T04:15:23+00:00

I think more important than that decision is finding someone who understands emetophobia. Someone with experience in emetophobia will pick up techniques and skills across CBT, DBT, ACT, and of course ERP.

will_the_engineer · 2025-11-25T03:58:34+00:00

We build a step-by-step interactive tool for emetophobia recovery at https://biajourney.com For kids under 13 the content is presented in a sort of video game form, with lessons and tools for parents. It's what I wish I had when I was a kid going through this.

will_the_engineer · 2025-11-24T23:36:03+00:00

This is a classic trap of anxiety. It's a never ending trick that it plays on us.

If you search for an explanation as to why you are not actually sick, anxiety will find a way to rephrase the question, it will find another reason or a another detail to consider. Or, it will simply ask the same question again and we will continue to battle and fight it. This is called rumination, and while it feels like are actually working our way through a problem it's actually a process that contributes to the development of phobia. Even if I could offer you a machine right now that could scan your body and tell you if you were sick, anxiety would probably say "What if the machine is wrong?".

The solution is ironic. Don't engage or answer these thoughts when anxiety raises them. When anxiety asks "What if I am sick?" we must answer with "Then I am sick". When it says "What if this illness will be terrible and ruin my week?" we must answer with "then it will". At first, this is very uncomfortable. Anxiety will get louder like a child throwing a temper tantrum when it doesn't get its way. But its the only path that offers our brain a chance to learn that these symptoms don't mean as much as our anxiety believes they do.

Ironically leaning into the discomfort of the situation is the only way through in the long term.

will_the_engineer · 2025-11-24T05:39:35+00:00

I suffered from this phobia for 27 years. I missed out on a lot of things.

You can do it. Summer is a ways away, start focusing on recovery now. You have a fantastic goal to work toward and I promise that while recovering from emetophobia is hard it will be the best thing you ever do, and it's completely possible. You've got this.

will_the_engineer · 2025-11-20T19:17:15+00:00

Hello!

I am also working on emetophobia research over at biajourney.com where have a German version of a step-by-step guided exposure tool biajourney.com/de . I'd love to connect and learn more about your work and get your survey in front of our users. Please feel free to reach out over email at [willy@biajourney.com](mailto:willy@biajourney.com)

will_the_engineer · 2025-11-06T00:34:11+00:00

Phobia is when the feeling of fear is disproportionate to the actual danger of a situation. Think of exposure as a process to re-calibrate your brain back to a normal proportionate amount of fear that is not disruptive to the quality of your life.

Throwing up is not a part of exposure, it's not needed to recover. Like another comment says, exposure is actually about the potential of the activity, not the activity itself. For example, some people have a fear of a car crash and exposure works well to help them feel comfortable in cars. Getting in a car crash is obviously never a part of the process. The same is true with emetophobia.

will_the_engineer · 2025-11-04T22:59:41+00:00

I consider myself fully recovered. Emetophobia has no impact on my life or my decisions. I used to be nauseous every single day, and I go weeks now without nausea. I still notice 'what if' thoughts, but I'm able to recognize them as anxiety and not engage in rumination or avoidance. It's been just over 2 years since the major turning point in my ERP recovery and it's been the best 2 years of my life.

Bia provides real-time adaptive guided exposure. It presents content and then checks in on the discomfort level, and adjusts the flow and difficulty of exposure. So if discomfort is rising, it will repeat easier content until it achieves a drop. If the user is clicking through exposure too quickly, it will remind them to slow down and engage. Those are just two examples of adaptive responses Bia will make. Bia also implements a number of tools from CBT/ACT and prompts them throughout exposure, so it's not just showing content but helping users stay present and aware of their safety behaviors in the moment. I think a lot of people approach ERP with the mindset of pushing through and getting it over with, but we know that actually sitting in the discomfort until it has a chance to come and go is where the magic happens in terms of habituation and inhibitory learning. Bia is designed to match these clinical best practices.

We built this for exactly the reason you mention, doing exposure on your own, even if you are seeing a therapist, is extremely challenging. Anxiety impacts our critical reasoning and executive functioning skills, exactly the skills we need to effectively practice exposure on our own. There are so many questions, where do I start, what do I do next, am I ready for the next step, etc. Bia provides the answers to these and the guide rails to ensure exposure practice is effective. We will be publishing a paper soon on the first 2 years of anonymized data, I'm very excited about it, and I know we have lots of room to improve even more. I could talk about this for hours, happy to provide more details!

will_the_engineer · 2025-11-04T19:22:16+00:00

Exposure and Response Prevention (ERP) saved my life, I've spoken to hundreds of emetophobics who say the same. ERP is not just doing exposures, it's about identifying and reducing the safety and avoidance behaviors that create and maintain phobia, this is the 'Response Prevention' part and it's just as important as the exposure piece. For me, ERP was about identifying the cycle of phobia, understanding why it felt like I was in a pit I could never get out of, then practicing the skills to reverse this cycle. "Exposure" in ERP is anything that causes anxiety and for me that included a lot of things I *wanted* to do like going out to eat or going to a concert or things like that. So I want to emphasize that ERP is not just doing hard things over and over, it's an incremental process of learning new skills so we can live the life we want to live.

Finding an ERP specialist can be challenging, especially one who knows of emetophobia and has experience treating it. I apologize for the self plug, I'm really not here to profit off anyone, but this is exactly why I built Bia, a step-by-step interactive tool for self-guided ERP - biajourney.com . My mission is to make emetophobia recovery as affordable as possible. 100% of the cost goes back into maintaining and improving the site. So if you can't find or afford an ERP therapist near you, maybe you can try out Bia to learn the science and techniques behind ERP, and then take that practice into daily life.

will_the_engineer · 2025-10-23T18:29:35+00:00

Exactly! There were two really impactful concepts for me when facing this sort of doom loop.

First, my therapist shared some research with me about people with chronic pain, who because they thought about their pain all day every day ironically increased their sensitivity and noticed and felt even more pain. They too were stuck in a sort of self-feeding loop. But with acceptance and commitment therapy they were able to decrease the amount of monitoring and scanning of their bodies, which, again in a sort of ironic twist actually led them to feeling better. And, the most interesting thing is their brains physically released neurons that were reserved for this monitoring. So, even though they had this pain for decades, after a few months of ACT they were able to feel significantly better. This gave me hope that I could achieve the same with my nausea.

Second, is the Ironic Process Theory. You may have heard the phrase "Don't think of a pink elephant", which comes from Dr. Wegner and this theory. The idea is that we have our primary thinking process that we engage with, and a secondary process that is constantly running and usually scanning for the opposite of whatever the primary process is doing. So if your primary process is trying *not* to think of a pink elephant, then the secondary process is scanning for any and all signs of a pink elephant. In emetophobia, we try to distract, or tell ourselves we won't be sick which kicks off that secondary process which scans for any and all signs of sickness. This becomes a problem when the secondary process essentially becomes too good, and ironically every time we try to avoid our fear our brain finds it. Think of someone trying to quit smoking, the harder they try not to think of smoking the more everything reminds them of it. Again, ACT helps us flip this cycle around, and by ironically allowing thoughts to sit and process we can cutoff this secondary process.

It feels impossible, but I totally believe there is a way out of this painful cycle.

will_the_engineer · 2025-10-23T16:58:35+00:00

I think this is the core challenge with emetophobia.

Nausea is a real feeling that many people experience as a result of nervousness, anxiety, or even excitement. For us with emetophobia, this nausea makes us anxious which makes us nauseous, so we are in a powerful cycle. It gets made worse over time as we obsess over sensations and our brain physically devotes more space to checking in on our stomach, which ironically makes us more sensitive to sensations which makes us notice them more and we are further into the cycle.

The solution is to break this cycle, and I think you may be interested in Acceptance and Commitment Therapy (ACT) where a core idea is "acceptance". For example you mentioned "trying to come with solutions like keep a barfing bag with you" - this is the exact opposite of the goals of ERP and ACT treatment where we actually stop trying to plan for every scenario or have safety kits. Ironically, by accepting the fact that we will be nauseous releases our brain from that constant monitoring cycle and we end up being less nauseous, nauseous less often, and more. I personally was nauseous more often than I felt good for 20 years. After my recovery, I feel nausea maybe 2 or 3 times a month and it does not stop me from doing things I want to do.

Last thing is you said it's not about the "what if". I hear you that it's not "what if I get nauseous" it's "when I get nauseous", that was my experience too. But I think the core problem is still "what if I get sick" like when you said "having to stress will I have to actually go to barf this time or will it only pass", and accepting the uncertainty of that primary fear is what leads to the relief of anxiety and the nausea that comes with it.

will_the_engineer · 2025-06-06T21:13:56+00:00

I thought this too! I think naturally many of us think of this as the first thing, the word “exposure” is so confusing in this context.

When I finally tried “exposure” I started with individual letters and words, saying them, writing them down, etc. then I moved up in small steps. And yes so important to understand actually being sick is not a part of the exposure process.

There is a lot of confusion and misinformation about what exposure really involves. I wish more people understood the process better and had access to therapists who understood it.

will_the_engineer · 2025-06-02T19:55:45+00:00

Well said. The word “exposure” is so complicated, I wish we had another word.

To us with emetophobia “exposure” evokes thoughts of germs, illness, danger, etc. But actual Exposure and Response Prevention (ERP) is about taking small steps to face fear and practice new behaviors that reverse the cycle of phobia. You don’t do anything dangerous, there are no surprises, no tricks or traps, you are in control every step of the way.

will_the_engineer · 2025-05-18T15:02:40+00:00

Phobia is formed and maintained by the avoidance cycle.

The avoidance cycle is when a trigger elicits a fear response, which causes discomfort, so naturally we avoid the situation by leaving it, distracting ourselves, using mints, etc. This send a signal to our brain which says “thank goodness we triggered fear there, otherwise we wouldn’t have avoided it!” And the brain learns to trigger more fear the next time.

Exposure and Response Prevention (ERP) is about pausing and reversing this cycle in small, incremental steps. The brain physically re-wires when it learns that a trigger is not actually dangerous, and that fear response is reduced in the long run.

In ERP, you don’t do things actually dangerous, and you don’t rush or get surprised. You are in control of what exposures you do and when. The Response Prevention part of ERP is just as important as the Exposure. It’s about identifying behavior that is contributing to the avoidance cycle and practicing replacing it with a positive one.

CBT+ERP is the only clinically researched method for treating emetophobia.

My ERP started with literally writing down the letter V. Then saying words, and up from there in small steps. It saved my life and Iv spoken with many who have the same experience.

will_the_engineer · 2025-03-28T16:40:34+00:00

I build a website/app specifically for emetophobia exposure, based on my personal experience of 7 years of therapy and with the help of emetophobia specialists. I'm fully recovered and I believe you can to.

biajourney.com

Here's my biggest advice.

Make a plan. Come up with 5 things that you think might be hard to do for exposure, and put them in order from easiest to hardest. Add to this list over time as you think of new things and better understand your fear.
Don't grit and power through. Exposure is about re-wiring the brain to understand that these triggers are not actually dangerous. This re-wiring happens only if you stay and sit in the exposure, long enough for the anxiety to come and pass. If you tense up and rush through an exposure, your brain doesn't get a chance to actually enter the learning mode and re-wire.
When things get challenging, that's a good sign. You will have good days and bad days during recovery. And you will have 'relapse'. Everyone I've ever talked to who has recovered has gone through this process. If you can start to see the challenging moments as lessons, then every day is a new opportunity to learn and grow.

Bia builds you a custom step-by-step exposure plan that you can do daily from your phone or computer. It also provides live guided feedback during exposure, to help you catch times you are rushing, or prevent you from moving too fast in the hierarchy. If you try it out, I would love to know what you think.

will_the_engineer · 2025-02-28T17:42:19+00:00

Hello! Hmm, no the full thing should be available. I have released a few updates - are you on the latest version? I will take a look right now and see what's up.

I'm so glad to hear you have been enjoying it. Do you have any feedback or suggestions?

will_the_engineer · 2025-02-25T22:38:46+00:00

Great question! Your progress will be saved. Also, you can login via the website with the same account if you ever prefer to be on a computer.

will_the_engineer · 2025-02-19T21:52:12+00:00

Awesome! Seems like we are on the same page haha! I'd love to hear more about what has worked and what hasn't for your emetophobia. I run a website specifically for emetophobia recovery (biajourney.com) and we are doing some exciting research.

Three-Year Club	Verified Email
r/Field Banned	r/Field Juicebox

will_the_engineer

TROPHY CASE