Why does social anxiety play such a big part in emetophobia?
Channel: Emetophobia-Free
Date: 2023-05-26

The massive part social anxiety plays in creating and maintaining emetophobia / Why all emetophobes have social anxiety / The key connection between social anxiety and emetophobia

Social anxiety plays a big role in the development and maintenance of emetophobia, but it isn’t a concept that’s likely crossed many emetophobe’s minds. Social anxiety is often misinterpreted as being shy or introverted - ‘I go to parties, I chat to everyone, I manage a successful team at work, how can I be socially anxious??’ 

Well, the definition of social anxiety is quite different to what many people think! This week’s podcast explores the definition of social anxiety, taking a deep dive into the pivotal role it plays in emetophobia, with steps you can take to build social confidence.

What is Social Anxiety?

Let’s get straight down to brass tacks. Fundamentally, social anxiety is a fear of embarrassment and being judged. As well as social anxiety, emetophobes also have (to a greater or lesser extent) perfectionism and low self-esteem. The three feed off each other. If you have low self-esteem, you’re likely to also have social anxiety. If you’re a perfectionist, you’re likely to have very high standards and berate yourself for not reaching them, which, you can guess, leads to low self-esteem.

Taking this in to account, social anxiety is a massive projection of how you feel about yourself right now. If you have low self-esteem and berate yourself all the time, criticising every flaw on your face or cringing every time you say something ’stupid’, you're likely going to think everyone is thinking the same and judging you! 

But it’s important to recognise that it is not based on actually being judged.

If I feel confident in a bright new shirt I bought and wear it to work, I don’t care what other people think because I like it and I feel confident in it. I have high self-esteem around how I look in the shirt, so I don’t worry what other people think, regardless of whether they actually are judging my bright shirt.

Think about a part of your body that you like. Maybe you like your legs or your ears, fingernails, hair, nose… How often do you worry what other people think about that body part? Likely never right? 

But if you feel particularly insecure about one bit of your body, you’re likely to feel self-conscious about it and think everyone is judging you and thinking the same. 

Social Anxiety in Emetophobes

A key part of emetophobia is social anxiety about throwing up in public. Research has shown that people with a fear of being sick feel more anxious about vomiting in public than in the privacy of their own home. 

95% of emetophobia sufferers are female, and, unfortunately, however much society is changing, they are still conditioned differently to men. In anglo societies such as the UK, US, Canada and Australia, there is a lot more pressure on young girls to appear clean, tidy, neat, nice and in control of bodily functions, which can lead to the unhelpful belief that bodily functions (like vomiting) are ‘disgusting'. For example, there is still stigma around the menstrual cycle: campaigners fought to have the realities of people’s periods shown on adverts for sanitary products, but there was a lot of backlash.

This pressure to be clean and perfect is directly linked with social anxiety and the development of emetophobia. A lot of sufferers we treat say how ‘embarrassing,’ it would be to vomit in public, fearing that people would judge them and find them ‘disgusting.’  

How can I build social confidence?

Like Rob and Joe mention in the podcast, you may be the most sociable person in the room, but you can still experience social anxiety. It’s all a belief about you right now. So you need to identify areas where you feel socially anxious and build up your coping skills in them. Rob gave an example of a woman he took through the programme, who challenged her social anxiety by wearing odd socks to work every day for a week. She felt uncomfortable and awkward at first, but tolerated that discomfort and by the end of it, she didn’t care! 

It's important not to run before you walk. Don’t push yourself too far or else you’ll overwhelm yourself. As perfectionists, you’re going to want to jump straight into doing a presentation in front of a 1000 people to ‘challenge’ your social anxiety. If you feel anxious, you’re somehow a hopeless failure. This is entirely unrealistic and unhelpful. To change a belief, you need to take small steps. Why not start off by doing a presentation in front of one person, then 5, 6, 10, 100?

The key antidote for low self-esteem, social anxiety and perfectionism is being kind and loving to yourself. What would you say to your best friend who stepped out of their comfort zone? However small it may seem, I bet you’d be pretty proud of them!