My guests this week are Dr. David Yusko and Dara Lovitz. We talked about the book they wrote together called Gag Reflections (affiliate link), which describes Dara’s history of emetophobia—an intense fear of vomit—and her treatment with David. We discussed things like the difference between ordinary fear or dislike of something, and an actual phobia; why avoidance is the real problem, even though it’s so understandable that we want to avoid the things we fear; how to do exposure therapy effectively; and lots more.

If you suffer from a fear of vomit, this conversation can give you a lot of hope. And whether or not you deal with emetophobia, there’s a lot to take from this discussion.

Other topics we got into included:

• How common emetophobia is
• When an aversion to vomiting becomes an actual phobia
• Dara’s experience with emetophobia, and what drove her to seek help
• The irritability that often goes along with high anxiety
• The implications of emetophobia for parents, and mothers in particular
• The low probability of passing out from high anxiety, with specific exceptions
• The usefulness of general talk therapy, and its limitations in treating phobias
• Why “avoidance is the disease” in phobias, and how exposure is the cure
• Why not vomiting doesn’t remove the fear in emetophobia
• Why vomiting doesn’t tend to reduce the fear of vomiting
• What motivates people to do exposure
• The difficulty in understanding others’ fears, especially when the fear is a phobia
• The difficulty in feeling proud of oneself for facing one’s fears
• The expected ups and downs on the way to recovery from a phobia
• The importance of doing exposure intentionally
• The difficulty in understanding one’s fear of vomiting
• Similarity between emetophobia and obsessive-compulsive disorders (OCD)
• The extent of Dara’s recovery following a lot of hard work in exposure therapy
• Benefits of mindfulness in treating phobias

Dara Lovitz is an adjunct professor of animal law, a publications manager for a continuing legal education provider, and co-founder of the nonprofit organization Peace Advocacy Network.

Her previous books include (affiliate links):

• Muzzling a Movement
• Twinsight: A Guide to Raising Emotionally Healthy Twins
• Catching Falling Cradles: A Gentle Approach to Classic Rhymes

Find Dara online at her website.

David Yusko, PsyD, is an expert in the treatment of anxiety disorders, with special expertise in prolonged exposure for PTSD and exposure and response prevention for OCD.

He received his doctorate in clinical psychology from Rutgers University.

David worked for twelve years at the Center for the Treatment and Study of Anxiety at Penn’s Perelman School of Medicine, which is where I met him. His office was one door down from mine.

More recently he co-founded the Center for Anxiety and Behavior Therapy, where he continues to treat patients and disseminate evidence-based therapies for anxiety disorders to therapists around the country.