Gag Reflections

Conquering a Fear of Vomit Through Exposure Therapy


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About the Book

Emetophobia–the disproportionate fear of vomiting or being in the presence of someone vomiting–affects millions of people yet is seldom discussed. Part-memoir, part clinical history, Dara Lovitz provides a brutally honest account of her life as an emetophobe. Written with her therapist, Dr. David Yusko, her story unravels the mystery of emetophobia. Lovitz spent years trying traditional talk therapy and self-help books yet nothing seemed to reduce her anxiety. In desperation, she tried exposure therapy. With a therapist’s guidance, she was able to overcome emetophobia. The history of exposure therapy for treating emetophobes is covered.

About the Author(s)

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. She lives in the Philadelphia area.




David Yusko, Psy.D., is a licensed clinical psychologist and co-founder of the Center for Anxiety & Behavior Therapy, in Bryn Mawr, Pennsylvania. He spent 10 years with the Center for the Treatment and Study of Anxiety at the University of Pennsylvania developing cognitive behavioral treatments for anxiety disorders with a particular emphasis on exposure-based therapies.


Bibliographic Details

Dara Lovitz and David Yusko, Psy.D.
Format: softcover (6 x 9)
Pages: 200
Bibliographic Info: appendices, bibliography, index
Copyright Date: 2021
pISBN: 978-1-4766-8509-0
eISBN: 978-1-4766-4256-7
Imprint: Toplight

Table of Contents

Introduction 1

Act 1: Avoidance
One—Growing Up as an Emetophobe 5
Two—Applying Cognitive Behavioral Therapy on My Own 18
Three—The Proverbial Straw That Broke the Proverbial Camel’s Back 37
Four—Easing Into Exposure Therapy 51
Five—Learning. Doing. Learning. Repeat. 63

Act 2: Exposure
Six—The History of Exposure Therapy 83
Seven—How the Wonderfully Awful World of YouTube Changed My Life 99
Eight—“Join the Fiesta, Bitches!” 114

Act 3: Maintenance
Nine—Relapses and How to Prevent Them 127
Ten—Maintaining Recovery 142
Eleven—My Life as a Recovering Emetophobe 153

Appendix I: Exposure Therapy Treatment Rationale for Emetophobia 169
Appendix II: Exposure Homework Forms 172
Appendix III: SUDS Thermometer 175
Appendix IV: Instructions for In Vivo Exposure 176
Appendix V: Sample Exposure Hierarchy 178
FAQs with Dr. Yusko 179
References 189
Index 191

Book Reviews & Awards

• “I recommend [Lovitz and Yusko’s] volume wholeheartedly, both for individuals who suffer from emetophobia but also for therapists treating individuals with anxiety disorders of any kind: the rich clinical detail and humanity on display here provides something that few formal treatment manuals ever can, which is an insider’s view both from the therapist’s and the client’s perspective. I fully expect that I will be assigning this to my own trainees forthwith, and look forward to engaging with them around the ideas presented herein. I have every confidence that these myriad audiences will be better off for having done so, whether in the service of confronting a difficult problem of their own or helping other people to do so as part of their professional life.”—Martin E. Franklin, Ph.D., associate professor of clinical psychology in psychiatry, University of Pennsylvania School of Medicine, clinical director, Rogers Behavioral Health, Philadelphia

• “Lovitz and Yusko offer the best of both worlds for those who suffer with an intense fear of vomiting: an engaging and relatable story of one person’s journey to recovery, coupled with the expert perspective of the therapist who showed the way. You’ll be educated, entertained, and inspired.”—Seth J. Gillihan, PhD, bestselling author of The CBT Deck and Cognitive Behavioral Therapy Made Simple