'I feel like if I throw up, I'd die'

Yael Bibi suffers from emetophobia, which manifests as a deep anxiety about the possibility that she or someone around her might vomit; It's a life-disrupting condition that has led her to avoid many things, including pregnancy

Ifat Manhardt|
When asked if she and her partner plan to bring a child into the world, Yael Bibi responds that it's still too early. She's only 31 and her partner is 30 ("and he's still very much a Tel Avivian"). Even though they've been together for six years and live together, they need to get married first.
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While all this is true, it's not the primary reason for waiting. As it turns out, Bibi has a profound fear of pregnancy, but not for the reasons that concern most women.
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יעל ביבי
יעל ביבי
Yael Bibi
(Photo: Tal Shahar)
"I'm not afraid of gaining weight, not of the pains, not of giving birth, and I'm definitely not afraid of becoming a mother," she says. "My only fear is that I will feel nauseous and need to vomit."
She's a naturopath and clinical herbalist who suffers from emetophobia - a fear of vomiting. This is a phobia she wasn’t even aware of until three years ago. "I've had symptoms since I was a child, but I didn’t know it was a recognized disorder and that there are others who suffer from it."
How did you find out? "It was during my studies. In psychopathology class, we were learning about phobias. Suddenly, I saw 'emetophobia' on the list, which was described as a fear of vomiting. I was shocked. I immediately went online to look it up and found a Facebook group in Israel for people suffering from it. Today, the group has 280 members, but back then it was even smaller. However, there was something very comforting in knowing that there are others like me in the world."

I won’t go on buses

Her experience started at age 12. Bibi, who grew up in a religious household in Safed, went on an annual class trip. "It was a journey with many twists and turns," she recalls.
"At some point, almost all the girls and the teachers began feeling nauseous, and the bus pulled over. I also felt sick, like everything was coming up, and then I was overcome with immense fear. I felt that if I were to vomit then, it would be the end of the world. A sensation that if it happens, I'd die.
“Around me, I heard the girls and teachers saying they were about to throw up, which exacerbated the situation for me. I sat on the ground, felt extremely dizzy and everything went black. No one realized that my crying and hysteria stemmed from my fear of vomiting. They assumed I just wasn't feeling well and offered me water and lemon. I knew there was no way I was getting back on that bus. I can't remember what happened afterward, how the trip ended, or how I got home."
"One time my partner drank a lot of alcohol. He woke up in the middle of the night, told me he had to throw up, and I immediately ran out of the apartment. I waited outside the building until he informed me that I could return"
What she distinctly remembers is that after that trip, she refused to travel by bus. "Both to my elementary school and high school, I was supposed to take a bus, but I preferred to walk more than 20 minutes each way every day. Only on really cold days, when it snowed, would I agree to get on a minibus, and even then, I'd keep the window open with my head sticking out for the entire ride."
What did your parents say about this phenomenon? “I didn't share my anxiety with them extensively. I told them what I tell everyone to this day: that buses make me feel nauseous, even though I don't typically get motion sickness. Even on that annual trip, the nausea I felt wasn't that severe. But just knowing that buses could induce nausea and vomiting was enough for me."
This anxiety surely kept you from many social activities. "Definitely. In Safed, there aren't many entertainment options. If my friends were traveling out of the city by bus, I wouldn't join. I missed out on numerous class trips. The anxiety also manifested in relation to food. I was very wary of consuming anything that might be spoiled and lead to an upset stomach. I'd only eat what my mom prepared, and even that only if it was cooked that day or at the very latest the evening before.
“I wouldn't take any medications unless I was already familiar with them. For instance, I've taken cough syrup since I was young and knew it didn't make me nauseous, so I was okay with it. However, at age 13, I had severe toothaches and my parents suggested a painkiller. I couldn't bring myself to take it. Not to mention going to the dentist – that was an absolute nightmare."
Why? "Because I was scared to lie down on the treatment chair, afraid they'd put things in my mouth that might slip down my throat and trigger a gag reflex. Luckily, my aunt worked in a dental clinic, so there was a dentist who accommodated my fears. He agreed to treat me while sitting up and even let me hold the suction tube myself. But even now, I avoid dentists as much as possible. I even lost a tooth because of it."
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(Photo: Moti Kimchi)
She was exempted from military service because of her religious background, and at the age of 20, she moved to Tel Aviv. Before relocating, she made sure to get a driver's license and buy a car. "I have no problem driving a car, but on long journeys, I always prefer to drive myself," she says. "Just recently, my boyfriend and I returned from a trip to Mitzpe Ramon, and I was the one driving."
How does he cope with your phobia? "We met at a time when I didn't even know it was a phobia, but I told him right from the start about my immense fear of nausea and vomiting. For instance, that's the reason I don't drink alcohol; once I drank and it made me feel sick.
“He's been very understanding and supportive. He always listens and is accommodating. He knows, for example, that if he ever feels the need to throw up while near me, he has to warn me beforehand. It's not just that I'm afraid of vomiting myself, but I also can't bear to see others do it. It sends me into extreme stress, and I start crying."
"One time, for example, he drank a lot of alcohol. He woke up in the middle of the night, told me he had to throw up, and I immediately ran out of the apartment. I waited outside the building until he informed me that I could return."
And what if he gets a stomach virus that involves vomiting? "It hasn't happened during our time together. But he knows that if it does, I'll have to leave the house. I won't be able to care for him or be by his side during that time."
That's tough. "Fortunately, he understands and avoids sharing things that might stress me out. One evening, I prepared ravioli. A few hours later, he felt nauseous but kept it to himself. He knew that if he told me, I'd instantly feel sick too, since I had eaten the ravioli as well, and it would trigger my anxiety."
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יעל ביבי
יעל ביבי
Yael Bibi
(Photo: Tal Shahar)
"You need to understand that the main issue with this phobia is not just the act of vomiting, which is relatively rare, but the constant fear that it might happen. You should see the conversations in our group. Someone might write, 'My boss told me she has a virus. I'm terrified I've caught it too.' Or 'My husband and I just came back from a restaurant, and he says his stomach feels weird. I'm in a panic.' Almost every week, you find yourself caught in some sort of anxious scenario."
Have you not had any stomach viruses that made you vomit since you were 12? "Actually, no. When I was 16, I stayed with my aunt, who later informed me that her younger daughter started vomiting and had diarrhea. She wasn't aware of my anxiety. Initially, I thought to myself, 'How lucky that I left there in time.' I didn't realize viruses take time to incubate. The next night, I woke up feeling very nauseous, but I stopped myself from throwing up. I went outside, feeling the cold air helped, and I sat on the stairs for hours until I felt better."

‘When I become a mother, I won't run away’

While many people in her situation avoid being around children and babies, known carriers of viruses, Bibi explains that this doesn't bother her. Perhaps over the years, she's discovered that her body is relatively resistant to viruses.
"Up until a year ago, I even worked as a caregiver," she says. "But during job interviews, I always clarify to parents that if the child is sick and vomiting, I won't come to work.
"When I was a teenager, I once babysat my cousin. We were alone at home, and suddenly he started to throw up. At that moment, I ran to the next room, cried, and only returned after I heard he was done. I take solace in the fact that in unavoidable situations, a sense of responsibility prevails.
“Four years ago, I took care of a little girl. We strolled by the port and I bought her a shake. Suddenly, she said her stomach hurt and that she had to throw up. I lifted her onto a bench as she threw up, diverting my eyes and murmuring in tears, but at least I didn't run away. That experience gave me hope. I know that when I become a mother, I won't run away."
Other things Bibi tries to avoid include visiting hospitals ("because you can catch diseases and also encounter people vomiting"), boat rides ("I once went on a ship, it made me nauseous and I swore never to do it again"), and even watching movies and series is not trivial for her. "Since I can never anticipate when there might suddenly be a vomiting scene, I'm always on edge," she shares.
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(Photo: Shutterstock)
"If I'm at home, I stop and fast-forward. If I'm in a cinema, I exit the hall. Recently, we went to see an Israeli comedy and there was a scene where I sensed they were about to vomit. I covered my ears and ran outside. I waited until my boyfriend messaged me that the scene was over and I could return."
Is the reason you chose to become a naturopath and herbalist related to your anxiety? "Not directly, but the fact that I can now concoct various formulas for myself definitely helps. I can prepare formulas against pain, nausea or anxiety without having to take pills. My boyfriend has a fear of flying. He's afraid the plane will crash, and I'm afraid I'll feel nauseous. So, before every flight, we drink a shot I brew from valerian, a plant that alleviates anxiety."
How did the COVID pandemic affect you? "It was tough. When the pandemic began, me and the other members of our Facebook group would dive into every article and start searching to see if vomiting was among the symptoms. Someone mentioned that her cousin got sick, and everyone immediately asked her, 'Did he vomit?'. There's a pandemic, people are dying, and that was the only thing that scared us."
Did you get vaccinated? "No, because I heard of people who got vaccinated and it caused them to feel nauseous and vomit. When I weighed 'vaccine or COVID,’ I preferred COVID."

'When I vomit, it will all pass'

From the moment Bibi realized she was dealing with a phobia, she tried to find ways to address the issue, including undergoing short-term Cognitive Behavioral Therapy (CBT).
"I also felt sick, like everything was coming up, and then I was overcome with immense fear. I felt that if I were to vomit then, it would be the end of the world. A sensation that if it happens, I'd die"
Did it help you? "It didn't cure me, but it did help reduce some of the drama surrounding vomiting. During the therapy, I realized that my fear is related to losing control. For instance, I'm not afraid of heights and can stand on a tall cliff, but I wouldn't stand on a chair if someone's nearby, fearing they might knock me over. I'm not afraid of water and swim well, but I would be fearful near large waves."
Why was it important for you to be interviewed and share your story? "For many years, I felt alone in this situation. I felt like I was the only one suffering. Now, as I mentioned, I'm part of a Facebook group where other girls are dealing with the same issue. Every time a new member joins, she writes, 'I never believed something like this existed. I thought I was alone in the world.' I believe there are many others out there suffering, and it's crucial for them to know they're not alone and that they have someone to talk to."
"I also wish society was more aware of this phenomenon. I recall numerous instances when friends and family members downplayed my feelings. They'd say things like, 'Why are you so dramatic? Why are you crying just because someone is throwing up? How does it concern you?' or 'Why can't you attend a family event just because a child is throwing up?' It's important for people to know."
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(Photo: Shutterstock)
Do you believe you can overcome this anxiety? "Yes. I think the only thing that might help me overcome it is exposure. The moment I vomit, I might not fear it anymore. It's similar to the anxiety I once had about dogs. I was extremely afraid of them to the point where if I saw a dog in front of me, I wouldn't cross the street. But then I met my boyfriend, who had a dog. Initially, I refused to let her approach me and would scream in fear, but gradually I got used to her. Today, not only does she live with us, but she also sleeps in our bed."
So, why don't you just vomit and be done with it? "Do you think it's that easy? Why don't you jump out of a plane? Or enter a lion's den?"
Because that's not just scary. I could die. "Do you get it now? That's exactly how I feel. As if it happens, I might die. That's the best way I can explain the fear."
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