by Shea Tuttle
This is what it’s like.
Imagine you are afraid of snakes. Your fear is a phobia in that it’s not quite rational—even pretend snakes or snakes you know to be harmless send your body into fight-or-flight—but it’s not exactly crippling. You still leave the house. You still walk in the woods. For the most part, you live normally.
But then imagine, for some reason (a new world order dictatorship, a demented neighborhood bully, a bad reality show) your world changes. You learn that now, twice or so a year, snakes will be released into your house.
Here are the rules to this new game: there are virtually no rules. The snakes can be released any day, any time. Though houses will average two releases per year, some houses will receive none; some houses will receive snakes every day. Releases may include one snake, but usually will include more than one. The more people in your household, the more likely you are to receive a multiple-snake release.
Remember: you are afraid of snakes. So you do not like this game. Almost no one likes this game, but you really, really do not like this game. You begin each day expecting snakes, listening for them, watching for them, wondering if maybe you smell them or sense their presence in your home. You end each day wondering if they’re coming, if you’ll wake in the night to a slither through the sheets, a gliding across your neck, a winding around your wrist. You turn on every light in every room. You look in every corner. When you see one—because you will; you will see one—you live the next countless days knowing there are probably more. You expect, every moment, to uncover one under your kitchen sink or curled in your sweater drawer or threaded between the toilet and the wall.
One more rule: they are harmless. These snakes are not venomous or constricting. They cannot hurt you or those you love, not really. They certainly cannot kill you. They might even keep your house free of mice. So go about your day. Make supper. Take a shower. Relax with a glass of wine, music playing, lights low. Go to sleep.
Can you?
I have emetophobia. Fear of emesis: vomit. This is what it’s like.
Background Information: Phobia
I have a vivid memory of throwing up as a very young child, leaning over the toilet, my mother wiping my face with a washcloth as I cried. Between sobs, I said, “I don’t like this.” In elementary school, I went through a phase when I’d feel sure, before leaving home several mornings a week, that I was sick and couldn’t go to school.
I had an anxious stomach in junior high too—I guess I figured everyone did—and during high school, I remember sitting in assemblies in the auditorium and worrying, if I was mid-row, about what I’d do if I suddenly needed to throw up. When I stumbled upon a description of “emetophobia” sometime in college, I thought, “Yes! That’s me!” But all in all, I didn’t spend too much time thinking about it.
Only in the last few years, since having children, has my phobia transformed from unobtrusive oddity to something that regularly sets my heart racing. And only in the three years since my son’s birth has it evolved into a serious obsession that runs through my every day like an electrical current.
Catalog: Things That Make Me Nervous (Subcategory: Everything)
roller coasters, hotdogs, public restrooms, cars pulled over to the side of the road, coughing children, trash cans in strange places, public transportation, dark circles under people’s eyes, splatter marks in parking lots, adults running who aren’t dressed for running, meat, eggs, kitchen counters, cooking utensils, buckets, leftovers
Hypothesis: Postpartum Anxiety
Five years ago, in the last days of a blistering June, my daughter was born. In the weeks that followed, I was stunned and overwhelmed, reeling from the omnipresent change, struggling to adjust to her temperament and needs and schedule and more tired than I’d ever been. During the initial hormone swing and culture shock, I was weepy and despondent, but that stage passed quickly, even if it felt like an eternity.
The anxiety lasted longer. I lay in bed in our sweltering house, my daughter in her cradle beside me. I wondered if I should turn the ceiling fan off so it couldn’t fall on us. I started to sink beneath the surface of sleep only to be yanked back by visions of the fan slicing through the air like a circular saw, my tiny baby cut to bits. Later, when I was fully awake, I worried about when and how my daughter would sleep. Once she did, I worried about what we’d do when she woke up. I sat at the table with tins of food lovingly provided by friends and neighbors. I stared at the food, and I tried small bites, but the clenching in my stomach wouldn’t relent enough to make room.
After a lifetime, we hit the six-week mark. I still longed to run to mothers in the grocery store, mothers with babies mere months older than mine, and clutch at their shirts, and say, “You survived this. You made it through. How? Tell me I will too.” But I was also starting to feel the slightest shift. Each tick of the calendar—ten weeks, twelve weeks, six months, nine months, a year—was a small, grubby triumph. And one day, shortly after my daughter turned one, I noticed: it was finally starting to get a little bit fun. And I could take a deep breath again.
When my son was born, I was ready. I had meals arranged. I had Gilmore Girls on DVD. I had air conditioning. More importantly, I had been preparing myself emotionally for this. Of course I would cry for two weeks. Of course I wouldn’t sleep, eat with both hands, or enjoy anything even remotely for a year. And it would be okay.
Braced as I was for the worst, everything seemed great. Labor was fast. We birthed at a birth center, and I was home by breakfast time. When I woke up a few hours later from a great nap, my mom was there, and she helped with food and errands and care for my three-year-old. My daughter was practically beatific, awed by and gentle with her brother. My son slept curled into me, and we slept well. We were golden.
Then around three or four weeks postpartum, odd yet familiar fears started popping into my mind. One sunny spring afternoon, we were cruising down the freeway, doing about 70, windows cracked open and a breeze in my face. And suddenly, I was sure our car windows weren’t strong enough to withstand the pressure of the wind. I knew they would shatter, and shards of glass would rain in on us, me in the driver’s seat, my son strapped snugly behind me. We would be cut to ribbons, my white knuckles, his perfect face.
Now, three years into life with my son, I can say with some perspective that, by and large, the transition from one to two children has been easier for me than the transition from none to one. Except for this. The anxiety of those early days still hasn’t really faded. It has transformed—I don’t worry anymore about the car windows’ ability to withstand wind—but it has remained. Now I fear vomit. All the time.
Experimental Data: Frequency
Almost every time I tell people about my phobia, they respond with recognition. “Oh yes,” they say, “I have that. I don’t like vomit either.”
I have learned not to stammer through an explanation or grill them with questions. Recently, I stumbled on shorthand that distinguishes what I’m living from the general distaste for vomiting: “I think about it every day.”
I usually get rewarded with an astonished, “Really?” or “Wow.” And that’s enough. But my new go-to sentence is, in reality, a serious understatement. I think about vomit dozens of times every day. At the height of the fear, probably hundreds.
And I’m a mild-to-moderate case. I do not have regular panic attacks or agoraphobia. I do not have obsessive-compulsive disorder—at least not the compulsive part. I do not run from my children when they are sick. I don’t insist on washing my hands before I eat. I touch door handles and use public restrooms. I eat in restaurants and at picnics and at church. Many things make me uncomfortable, but by and large, I am able to do them anyway. For many, my fear might seem covetable in much the way I wish I could shrug and say, “Yeah, I don’t like vomit either.”
This is what it’s like.
At the beginning of my freshman year of high school, I met Adam. He was two years older than me, kind, funny, smart, and flirtatious. He was adorable too, a handsome farm boy: trim-fit flannel shirts tucked into jeans, twinkling dark eyes behind glasses, an easy smile. We were in show choir together, and one day in the late spring, after I’d been doodling his name in my journal for months, we happened—through no shortage of scheming on my end—to get paired as rehearsal partners. We were practicing our song-and-dance routine for “Footloose,” which involved handholding and waist-touching. Late in the rehearsal, when our director stopped the group mid-phrase to clarify a move, Adam held on to my hand a little longer, then joked about it. And then we repeated the routine—dance, stop, hold on, joke, release, giggle—a few more times before the end of practice.
A couple of weeks later, passing in the hall just before class in the early morning, Adam asked me if I wanted to see a movie with him on Friday. I positively floated through the rest of the day.
Over the summer, we saw a few movies, took a few walks, danced a few times at the Yorkville American Legion where our friends liked to gather on Friday nights. And then we gradually parted ways, as puppy-lovers do.
But oh, the grip of young love! Tally up the months of infatuation pre-first-date, the flirtation and movies and dances that summer, and the months (and months) of continued obsession following our break-up: I spent at least a solid year, maybe more, thinking about Adam. All the time.
Okay, not all the time. I did my homework. I paid attention, mostly, in school. But Adam became my mind’s default setting. In downtime, in daydreams, in the slow hours at my retail job or in the last minutes before sleep: Adam. Whenever my mind wasn’t otherwise occupied, it turned to him. He became the companion to my internal monologue, its subject and its audience. I couldn’t have cut him out of my thinking if I tried. I couldn’t have stopped the habitual turn toward him if I wanted to.
Background Information: Emesis
- As a very young child, I threw up several times that I can’t distinguish in memory.
- One day in fourth grade, I felt ill all day long and visited the nurse’s office once or twice only to be sent back to class. In the afternoon, as my class was lining up, I went to Mrs. McDonough and said, “I really don’t feel good.” She took one look at me and said, “Go to the bathroom! Go!” I started down the hallway, but I knew fourth graders weren’t supposed to use the fifth and sixth grade bathroom. Never mind this was an emergency. I continued down the hall, walking as quickly as my short legs would allow. Well past the fifth and sixth grade bathroom but well short of the third and fourth grade one, I threw up. I swerved around the puddle and kept walking. I threw up two more times before reaching the bathroom, where I spit pathetically into the toilet. In my memory, I can see my classmates filing past my vomit puddles on the way back to Mrs. McDonough’s room, holding their noses and groaning, delighting in their collective disgust. It’s not possible that I really remember this—I was dozing on a green plastic cot waiting for my mother—but I could swear I was there.
- New Year’s Day, when I was a junior in high school, I woke up early in the morning and bolted for the bathroom. I vomited again later in the day. I remembered the night before when, at a low-key New Year’s Eve party with some friends, I had mentioned to someone that I hadn’t vomited since fourth grade.
- My junior year of college, I woke predawn, felt strange and overfull, and then hurried down my dorm hallway. My stomach heaved as I neared the bathroom. I ran the last few steps, bypassed the sinks and showers and their industrial sanitizer smell, turned into a stall, and practically projectile-vomited. It was salsa—so much salsa—which I had eaten and eaten the night before at a dorm function. The chips were nowhere to be seen, but the salsa seemed exactly the same, only this time I kept finding the slick skins of peppers and tomatoes lodged between my gums and the insides of my lips and cheeks.
- Five-and-a-half years ago, in labor with my daughter, I was mildly nauseated for hours. At transition, the last, most intense phase of labor before pushing, I finally vomited. It felt like my body was contracting in every possible direction, all at once.
Hypothesis: Control
I do not like roller coasters. Of course, I am always afraid that they will make me (or someone near me) vomit. But more fundamentally, I do not like them because I cannot push stop or go. I cannot get off if I change my mind.
When I was a child, I was afraid of water (and most other things), so I was apprehensive when my parents signed me up for swim lessons. During the first two sessions, I joined in the bubble-blowing and scissor-kicks tentatively and went home proud of my daring. But at the third lesson, the teacher introduced the dead man’s float. As if the name wasn’t bad enough, she explained the float: face down in the water, relaxed. When I whimpered and reached for the poolside, my teacher physically picked me up and dipped my face in the water. When we got home, I retreated to my room and paged through Shel Silverstein’s A Light in the Attic until I found the poem “Fear” about a boy who is so afraid of water that he cries until he drowns in his own tears.
This is what it’s like.
In the Hebrew Bible, writers recurrently refer to “the wilderness” and its beasts: jackals, ostriches, hyenas, wildcats. The madness and danger of the wilderness is contrasted with the order and safety of the city. The wilderness is chaos. So when the psalmist bemoans his place among the dogs, he is saying he has been cast out of civilized life into the lonely and threatening wilds. When the prophet warns of jackals in the streets, he forecasts a day when chaos has triumphed, when madness infests and corrupts long-safe rhythms. Order has given way to disorder. Chaos has won. The jackals are in the city. The ostriches are in the street.
The snakes are in the house.
Catalog: Things That Make Me Nervous (Subcategory: My Children)
text messages from their babysitters, coughing, loss of appetite, grumpiness, sleeping more than usual, sleeping less than usual, looking pale, looking flushed, clinging, crying in the night
Experimental Data: Response Time
In the months before my daughter turned five, she loved to pretend that she was six. This was, in her mind, the ideal “big kid” age, completely mature and enormously capable. Every time she said, “Mama, I’m six,” in the split second between “sick” and the s-sound that followed to finish the word, my heart leapt, my stomach clenched, and I practically broke out in a sweat. It was full-on fight-or-flight. And it was that fast.
Catalog: Things That Make Me Nervous (Subcategory: Myself)
unusually large appetite, unusually small appetite, unusual sleepiness, waking for no reason, headaches, vertigo, dry mouth, dizziness, feeling full, every, every, every digestive feeling
This is what it’s like.
A few years ago, I read a stunning memoir about a woman discovering that she has face blindness. The technical term is prosopagnosia, from the Greek prosopon, which means “face,” and agnosia—like agnostic—for “not knowing.” In her book, the author explains how she looks at a face and sees everything I see: all the details, the colors, the lines, the shapes of the eyebrows, the slant of the nose, constellations of freckles, scars and blemishes. But when she looks away, she can’t see it anymore. She can’t reconstruct it in her mind. And when she sees the same face again, she may not know whether she’s seen it every day for years or if this is her first encounter with someone new. She certainly won’t say, “Oh, it’s you! I saw you once or twice, years ago. I remember.”
Hypothesis: Body
My many childhood fears notwithstanding, I was a pretty confident kid. Even through junior high, I carried myself with a self-assurance that saved me from most of the taunts and jeers common to the PE locker room and the jammed halls as we all waded through the hormones to class.
But then came high school. While certain aspects of my confidence—my ability to do math problems or pass the clarinet sight-reading test, for example—stayed intact, my confidence in my body seemed to take hit after hit.
I auditioned into show choir as a freshman, but as each year ticked by and I moved up the ranks of seniority, I still got placed in the back row. I auditioned with the drama department for all of the plays in my first couple of years, but when the results were taped to the cinderblock wall early the next morning, I often found my name on the list for the chorus or the light crew before finally deciding I preferred the orchestra pit where the spotlight didn’t shine. Meanwhile, in the opposite wing of the school, junior high’s athletic egalitarianism gave way to high school’s competition, and in every conceivable sport, I was decidedly uncompetitive.
And then there was the almighty voice of religion. I fell victim to the tendency of pop Christianity to teach adolescents that their bodies are sexual dangers—to themselves and others. Fervent as I was about taking faith seriously, I took this teaching to heart too, shopping and dressing and moving with care to minimize the chance that I might be noticed at all. When I encountered an irresponsible religious leader who commented on my body and touched me in lingering, barely inappropriate kinds of ways, I couldn’t untangle his religious influence from his sexual transgressions, so I took responsibility. I didn’t get too cute or move too much or let down my guard. I grew watchful and small.
Experimental Data: Involuntary Responses
Vomiting is highly psychosomatic. I don’t mean psychosomatic dismissively—like, oh, it’s all in her head. I mean psyche, meaning mind, soma, meaning body: vomiting is so much mind, so much body, and I am constantly trying to figure out its equation. Is it 50/50? Is it 20/80? Surely it is different for different people. Some people sympathy vomit: 100/0. My son, at six months old, vomited in his sleep without waking up: 0/100. Many emetophobics, in my anecdotal experience, go long stretches of years without vomiting. Does this mean they have a higher psyche percent and their frightened minds saying “no, no, no” prevent their vomiting? Or does this mean they have a higher soma percent that requires serious upheaval (literally) to vomit? Does the phobia cause infrequent vomiting, or does infrequent vomiting cause the phobia?
Vomiting’s psychosomatic quality disturbs me, and I chase it in circles in my mind. The psyche offers me some control, but how much? If I can completely control my thoughts, can I completely circumvent the need to vomit? How extreme does my somatic need to vomit have to be to overcome my psychic resistance? What happens if I lose control over the psyche? What if its power backfires? What if I start thinking about vomiting so much that I make it happen? What if my psyche’s frequent control over my soma turns upside down?
Of course, all sorts of body processes operate with a psyche/soma split. On a psyche-soma continuum, sneezing would land far to the right; you get a touch of control, but not much. Somewhere to the left of sneezing: yawning. Digestive processes—belching, passing gas, pissing, shitting—would land well to the left of center, at least most of the time. What about vomiting?
Each of these processes is also nuanced, though. Like sleeping. How do you quantify the psyche/soma split of sleeping? I have a gift for sleeping; I can think myself into sleep almost anywhere, almost anytime, tired at that moment or not. Maybe I’m 70/30. But when my grandmother fell asleep at the wheel last week, was she 0/100? Or did her drifting mind play its own role?
And then: orgasm. Orgasm is highly psychic, highly somatic, and highly nuanced. People can—often in abusive situations—orgasm against their will, their psyche: 0/100? Some people, in some or all moments, can’t orgasm despite their will: 100/0? or another version of 0/100? Orgasm’s math is more like chemistry—maybe alchemy. Is it mysterious or just weird? Is it transcendent or earthy? Is it jubilant or heartbreaking or both?
How can vomiting and orgasm be so different and so the same?
Hypothesis: Everything is Fine
My therapist told me a story about a woman who had panic attacks before going to bed at night because of her very specific phobia: she feared she would sleepwalk to her kitchen, open the drawer, pull out a knife, and stab herself in the chest.
“Have you ever woken up with a knife in your hand?” my therapist asked her.
“No.”
“Have you ever woken up digging through the kitchen drawer?”
“No.”
“Have you ever woken up in the kitchen?”
“No.”
“Have you ever sleep-walked before at all?”
“No. Never.”
The woman and my therapist began charting her phobia: the nights it occurred, its severity, what else was going on in her life, the season, the food she had eaten that day, her menstrual cycles. Finally, after months of tracing patterns that broke down, drawing lines that led nowhere, they saw it. The woman panicked about stabbing herself in the night when nothing at all was wrong. When she had no real problems to occupy her mind, she returned to her phobia like a home.
Report from the Field: Norovirus
Last winter, when my children caught the annual round of norovirus, I caught it too. I spent that long, smelly, laundry-filled night intensely nauseated. A few days later, in the midafternoon, a stomach pain hit so hard, I moaned. I spent the next 12 hours in a nauseated misery. I have experienced nothing so intense outside of childbirth: time was passing in strange, unequal intervals; the world shrank down to the size of the bathroom floor, the bucket, my body. I was miserable enough to want to vomit. I never did.
For a while, after my bout of norovirus, I was less afraid. This was partly because I didn’t vomit. But it was mostly because the experience made me sure that I will know when it is coming. So much of my day-to-day fear has been about knowing when to leave the room or get off the bus or interrupt the conversation. I have asked myself so many times a day for so many days, Is this it? Is it happening right now? Are you sure?
Proposal: Vomiting is “Unpleasant.”
I believe in language. I believe in the power of narrative to shape perception, even reality. I believe that how we name things matters. What if vomiting isn’t “chaotic” or “terrifying” or “wretched”? What if it is “unpleasant”?
Lots of things are unpleasant: cleaning out the refrigerator, having a cold, getting a pap smear. I don’t dread these things on a daily basis, little though I like them.
So catch your mind before it runs away. Rein it in with narrative. Say, “unpleasant.”
Proposal: Playing Pretend
Last summer, my family went to the beach. Usually, traveling is extra cause for worry about vomit. If someone is sick, what will we do? Where will the bathrooms be in relation to the beds? How will we have enough sheets? What if we’re en route and I have to catch someone’s vomit in a plastic bag or drive the car safely while someone else vomits? Catch or drive: which is worse?
Instead, something magical happened. Somehow the interruption of the usual patterns of our days interrupted the usual patterns of my thoughts. I didn’t pace the usual paths; I went whole hours without feeling anxious. Then, when I’d wonder if my nephew, who vomited before arriving at the beach house, might not be motion-sick after all but actually have a virus, I’d sense the trailhead for the usual route, but then decide, no; let’s go another way.
When you see a post on Facebook about the stomach flu, pretend you don’t care. When you start to count the days since you were around that person or since your kids were around their kids, pretend it doesn’t matter. When you start to pass up the second half of the brownie because you’re afraid you’re coming down with something, pretend you’re not afraid. It’s yours.
Proposal: Practice Relinquishing Control
Ride a roller coaster. Drink two beers instead of one. Go to a haunted house.
Proposal: Vomiting is a Feminist Act
Vomiting is strong, enfleshed, full-bodied. It is not concerned with delicacy or propriety. It is a “fuck you” to any “shoulds” or “oughts” about femininity. It is an act of personal, physical power. It is enormous.
Practice being big. Take up space. Stretch out. Wear big earrings and buy bold makeup and learn how to talk with your hands. Interrupt sometimes. Be loud sometimes. Leave the room early, or arrive late without apology. Every now and then, risk belligerence.
Proposal: Vomiting is like Childbirth
I gave birth to two babies—the second one over nine pounds—without a drop of medication. I did it by trusting my body, by believing I carry within myself an ancient and deep knowledge of how to birth and how to manage the work and pain of that process. I did it by paying attention to myself throughout pregnancy and labor, by moving the way my body urged me to move, by making the noises my body urged me to make, by opening myself to something so physical and mysterious and strange.
Trust your body, your good body, your body that has gifted you with sex and children, that has gifted your children with flesh and milk, that has known when to sleep and when to rise, when to bleed and when to store up. Lean into its wisdom; give it, at last, a little credit; and rest.
Postscript: Results
A year ago, I attended a two-day conference—a gathering that was important in my personal and professional life. Each night, I fought panic all through dinner. I felt nauseated and restless, nearly left the table to pace outside. I worried that I wouldn’t be able to eat, but I made myself speak calmly, move slowly, take small bites, swallow. I made it. Still, the second night, a few hours after falling asleep, I bolted awake and dashed for the bathroom only to realize that it was just anxiety, persisting. I trembled. I self-talked. I settled. I slept.
In the last year, I have worked so hard to address my fear. I understand it better than ever. I have more tools to respond when it shows up. I have alternate (healthier) obsessions and counter-narratives. I still think about vomiting all the time, but less than I used to and with less anxiety. At times, I am proud of my progress. I am mostly just relieved.
But tonight, I had a work dinner—another fancy meal with professional significance. The moment we sat down, I became overly aware of my throat. I sipped water—the only coping substance I allow myself. I fought nausea—the manufactured kind, I knew, but it didn’t matter. I flushed and shook; I mapped escape routes and glanced toward them often while I made myself speak and listen and stay in my seat. I ate a tiny biscuit and two bites of appetizer, declined the wine, and checked the clock. When my food came, I took one bite, felt it hesitate to go down, and replaced my fork. When it was mercifully time to go, I requested a box and packed up my meal. It took the entire 30-minute trip home for me to calm down.
In some deep part of myself, I shelter the naive conviction that understanding something releases its power over me. I am wrong. All my intellectual hubris is put to the lie. This phobia has undone me.
Oh, not completely. I made it through dinner. I contributed to the conversation. Only one person even noticed that I didn’t eat. Finally, home, I ate half of my food, cold, from a Styrofoam container. I am not sick.
No—I should say it this way: I am not vomiting.
Shea Tuttle is a writer living in Richmond, Virginia with her husband and children. Her work has appeared at The Toast, The Other Journal, and Role Reboot. This fall, she is beginning an MFA program at Spalding University.