I have a debilitating fear of vomit – and it affects every part of my life

The morning after Halloween 2019, I was on the London Underground on my way to work when a young woman stepped onto my train carriage. She was clearly on her way home after a night out, with her mascara smeared and hair dishevelled. There was a faint but distinctly sour odour lingering around her. I knew immediately she smelt of sick. My hands became clammy and I held my breath as I inched towards the train door. I needed to escape. It only took a few minutes to get to the next stop, but it felt like an eternity, trapped with this person who had recently vomited. I could not bear to be near her. I felt sick myself.

For as long as I can remember, I’ve been afraid of vomit. You may roll your eyes and say, “Nobody likes puking”. Of course not – nausea is horrible and debilitating, and the act of vomiting is something most people don’t want to do unless they really have to. But my feelings about it go far beyond mere dislike. It’s not just that I am afraid of throwing up, I am also afraid when other people throw up near me. Even if they look like they’re about to be sick, my body responds viscerally with panic; my hands shake; my throat closes. It’s a full-on flight-or-fight response.

This fear of vomiting and anything associated with it is called emetophobia. There aren’t any solid figures on how prevalent it is, with one study suggesting it affects up to 3.1 per cent of men and 7 per cent of women, while another estimates it only affects 0.1 per cent of people. The rarity of emetophobia explains why I haven’t found – until very recently – a single other person who can relate to my fear.

None of this is an exaggeration, by the way. I am constantly on high alert that someone around me might throw up. Sometimes I don’t even realise the extent of my fear until I reach home, the threat of someone else vomiting finally at bay. When I’m out and I spot a person looking the slightest bit unwell, or they’re so drunk that they can’t keep their head up, I am immediately anxious. Fear pulses through me as I search for an exit route that would take me as far away from that person as possible.

I don’t know what it is about vomit that invokes such deep-seated horror in me. It’s always been this way. Once, in school, I accompanied a sick friend to the nurse’s office. We waited outside, and as she leant over the side of her chair and retched, I scarpered, running down the corridor like I was being chased. She laughed about it later, but I felt shame – I’d abandoned a friend when she was unwell, simply because I couldn’t handle it.

Surprisingly, I don’t go to terribly great lengths to avoid food that could make me vomit. I am lucky enough to have a fairly strong constitution, having grown up eating at hawker stalls and roadside restaurants. I love food and am game to try nearly everything – but I do avoid shellfish unless I know it’s fresh, and I am terrified of eating oysters because of all the horror stories I’ve heard. I rarely get food poisoning but when I do, it’s misery for at least two days.

I had food poisoning last year, having been unlucky enough to eat a rogue quiche. The time before that was three years earlier. Both times I sat in front of the toilet for an hour before finally succumbing to the roiling in my guts, dreading the moment, yet praying for relief. Others would tell me that if I made myself vomit after food poisoning, I’d feel so much better. But I’m paralysed by fear, too scared to bring myself to that point. I’d rather wait for my body to let me know when it’s ready.

Even in the aftermath of throwing up, I am still wary of both myself and others. If my husband’s been sick after a night of drinking, one of us has to sleep on the sofa because I can’t be next to him in bed. I can’t be near him, or anyone who’s just thrown up, because of my disproportionate feelings of disgust towards vomit. I imagine I can still smell it on them. The revulsion of simply being near someone who has vomited makes my skin crawl. I am wide awake with the fear that they will do it again – that I will have to hear it, see it, smell it.

Perhaps it is the sometimes explosive nature of puking that makes me so afraid, despite knowing it’s totally irrational. It’s like you lose control of your body while it’s happening; the wholehearted rejection of something within you. I sometimes think I can trace my fear back to a time in primary school when I threw up suddenly in assembly (there’s always one). I ran to the toilets, hand clamped helplessly over my mouth. And as if it wasn’t embarrassing enough to have projectile vomited in front of the entire school, the following day my particularly awful maths teacher screamed at me for getting puke in the corridor.

During a long-haul flight by myself several years ago, I sat next to a young boy, who sat between me and his mother. I fell asleep at one point and woke up to a sour smell, only to discover the boy was throwing up into a paper bag. I was horrified but there was nowhere to go – I felt imprisoned next to this vomiting child thousands of miles in the sky. I curled up as close to the window as I possibly could, covered my nose and prayed we would land soon. I’ve been wary of my fellow passengers since. At any moment, one of them could erupt in a veritable fountain of vomit.

I have always said I don’t want children for a myriad of reasons, from not feeling like I’ll ever be financially ready, to my desire to hold on to the freedom that comes with being child-free. But I’d be lying if I said being afraid of vomit wasn’t also a reason. Just the thought of pregnancy and morning sickness – which we all know now isn’t confined to mornings, or the first trimester – grips me with terror.

I also wonder if it would make me a bad, or at least a distant, mother. Children and vomit are an inevitable pairing from the jump, beginning with spit-up. I think I could handle a newborn spitting up milk, but I’m not sure I have the stomach for all the rest of it. Could I do the nights of rubbing backs and holding buckets? Could I bring myself to do the clean-up required? Without intensive cognitive behaviour therapy, the standard treatment for such phobias, I don’t think I could, which isn’t fair on a little, sick kid.

Until recently, I felt quite alone with this fear. Most people find it weird, thinking I’m being dramatic. But in the past year, I started noticing the word “emetophobia” cropping up in social media posts, particularly on TikTok. Some creators have talked about how they live with it, while others have taken to the comments to admit they have it, too. I even discovered a new friend has the same fear, which surprised both of us. Maybe someday I’ll be able to ride on a train with someone who smells of vomit without feeling like I’m about to be attacked. But until then, I’ll just keep running to the next carriage.