Hi all!

I wonder if anyone could give me an idea of which direction to look in for this one...
a vomiting phobia. Very (and many!) complicated symptoms all around, but just want to concentrate on this aspect, see if other symptoms fall in line. Not asking for a prescription, per se, just some thoughts on rubrics, rems, essence of problem, etc.

Is absolutely petrified of vomiting, self or others. Entire life is ruled and hampered by this phobia, as it's something that could happen at any moment, there is no rest from it. Even when feeling well, the thought is never far away. Avoids all situations where vomiting is more likely. Has said death is preferable to vomiting, but doesn't fear it will cause death. Will go to such great lengths to avoid it. Checks, smells, inspects all food for spoilage. Great terror when a stomach virus is known to be going around-terror the same if virus is next door or other side of the planet. Will not ride in other's cars, will not fly-not for fear of crashing but for airsickness. The slightest off feeling in stomach, be it anything from indigestion to a full stomach, sets off a panic attack with instant feeling of gagging and throat constriction. Naturally, if you feel as if you'll gag, the next logical thought is that you'll vomit, and this just adds to the terror. Has had a few episodes of actual heaving from severe gagging feeling, but nothing came up. A gagger by nature prior to this phobia, never been able to tolerate tongue depressors, throat cultures-forget about it, dentists hands have been pulled from mouth when they've gotten too far back in throat, etc. Has gone off in a frenzy when this gagging sensation comes, from running through the street in pajamas to self inflicting injury to cause pain elsewhere that would take mind off stomach and throat. If anyone nearby looks funny, they're always asked if they're sick, and when anyone says they're sick, they're always asked if it's their stomach. Always wants to know if someone is sick to their stomach-kind of like watching a train wreck, you don't want to see but can't help looking.

Had bad food poisoning as a child, which is vividly remembered to this day, which may be the underlying cause, resurfacing as a phobia in adulthood. Why though, since many get food poisoning yet don't become phobic?

However, there is no vomiting at all, ever. Ironically, there is a daily sick stomach of some sort-not a day goes by without some stomach complaint-so forced to deal with this most feared thing each day.

Any and all thoughts, comments, ideas greatly appreciated.

Thanks,
Sunny

Sunny,

What is behind this phobia, is she afraid she'll be embarrassed if she starts vomiting? In which case the problem is probably worse in public than when she is home alone. Does she feel like she's choking and is fearful of not being able to breath? etc.

Hi Barb,

Fear is equally great whether home alone or out in public. No fear of choking or not breathing properly. Just thinks that vomiting is the most disgusting thing there could be. Has said "It should be outlawed" and that nobody should have to do something so disgusting and awful. Like I said, I really think the food poisoning as a child is key here, causing this adult phobia (it didn't surface for over 12 years mildly,10 more years before it became this severe), especially since it's so vividly remembered in detail over 30 years later. I guess there had to be a predisposition for this to trigger a phobic response even years later...but what, why? I just don't know.

Thanks,
Sunny

Hi Sunny,

Have a look at arsenicum. I recently read about a case very similar to this one, but there was a much further developed aspect of obsessive/compulsiveness in that patient, in every aspect of life. Arsenicum had worked well for that patient but Hyoscyamus was the next remedy in consideration for that case. Perhaps arsenicum will match the symptoms you don't mention as well as the ones you do for your patient.

As for your question about how a person would develop such an intense fear over something relatively common, like food poisoning as a child, well, that's the whole idea of homeopathy, isn't it? The experience must have scared her profoundly.

Let me know what you think,
Divina

Hi Divina,

Of course you're right about the food poisoning profoundly scaring her, and indeed what homeopathy is all about.

Ars was the first remedy tried, in 30c, with a profound, instant improvement. Great mood & energy, no panic, desiring (and actually eating!) foods not eaten in years (eggs most pronounced, specifically fried eggs in real butter only, not margarine, still eats them almost daily even now, a year later, and will now only use real butter for everything), went on a well deserved cleaning binge, just overall feeling good. Concerned about no aggravation at all, but possibly symptoms were already so aggravated they wouldn't go higher. Tried a second dose of 30c when the first either wore off or was accidentally antidoted, which caused extreme anger, rage really with extreme hyperness, much yelling and screaming, just angry at the world and no bettering of symptoms like first time. Long story, but a 200c was given, not a good result at all and self-antidoted...however, things get a little fuzzy here regarding notes and what exactly happened with the 200c-another long story! So, I do think back to this rem now and then, wondering about it. What do you make of this reaction?

Thanks,
Sunny

Hi Sunny,

Sounds like what might have happened is that second dose of Ars 30c interrupted...a severe aggravation resulted which the 200c didn't help. Is she still in the same state as she was when you first took the case? There's a good possibility that she may be, but you have to follow up and see if there have been any changes. Also, see if there are any mental/emotional symptoms lingering from that really angry, mad at the world state she was in after the 200c. I don't know what self-antidoting means, but suspect that the severe aggravation passed. It's not a good sign that the mental/emotional state was so affected by that 200c dose, though. I'd be glad if I saw that had abated.

Time to take the case again and look for differences in the patient's state after all this time. Is the fear of vomiting still so pronounced? Does she still feel it should be outlawed? (that's truly arsenicum-like, IMHO!)

Can't find a rubric for fear of vomiting, but did find in the Complete, MIND, anxiety, vomiting, on: includes ant-c, ars, ars-h, crot-h, cupr-acet, dulc, germ, gran, ip, nit-ac, nux-v, samb, seneg, tab, tong, vip.

You may want to think about dosing with water (split dosing) or by LMs with this patient, too. Sounds extremely sensitive...

You know what else comes to mind? Maybe the fear is not so much of vomiting as it is of illness--perhaps a huge anxiety about her health. There is a remedy which feels all anxiety in the gut...possibly Kali-arsenicum, which gets a big 4 rating in the Complete rep under the rubric "anxiety about health"...but I have to look as I'm just pulling rems out of my head at this point. Gonna go look it up...what do you think?

Divina

Sunny, perhaps David J can help with information on this rem--from Scholten's book on the elements?

Divina

Divina,

Just to clarify, the anger came after the second dose of 30c. The 200c was taken much later, and was largely a physical reaction, but since there are daily stomach complaints, it's hard to say what is an aggro and what would have happened anyway in this case. She antidoted herself, couldn't tolerate whatever the feeling was, which is what I meant by self-antidoted, sorry not to be more clear. This 200c was taken in water.

The severe anger reaction left on its own, but there is much anger in her regardless so maybe it just came to the surface. Wants everything her way, when and how she wants it, wants to be in control and criticizes any and all who don't do things the way she thinks is right-not to anyone's face, but behind their backs. Hates someone one minute when they repeatedly annoy her (read into this ignore her! (forsaken?) which is what she feels when someone doesn't call her as they said they would, include her, think of her, etc.), loves them the next-after they treat her the way she wants to be treated. Big road rage!

The vomiting phobia is just as severe now as a year ago. I wouldn't necessarily say anxiety about her health - she smokes-a lot, eats junk or doesn't eat, no exercise, just doesn't do things to prevent any health issues. There is some apprehension about having medical tests, xrays, etc. for fear of what they'll find, not an uncommon fear. Some hypochondria also but does nothing to prevent illness and everything that could cause it. When an illness happens, even a cold or sinus problem, there is worry that somehow it may cause vomiting, or the medicine to fix it will, so really, it's all about the vomiting phobia. She once said if there was no such thing as vomiting, if she knew absolutely that she would never vomit, her entire life would be changed.
There have been a few health scares, abnormal pap smears for one, and THEN she was terrified and became very religious, praying over and over that she wouldn't have cancer, going to church at 6am almost daily, making deals with God...even held rosary beads during the biopsy (everything turned out fine with this biopsy, by the way)....however, many people suddenly "find religion" when faced with potential serious illness, so maybe not so abnormal except in the intensity, but she's an intense person. There was talk once about fear of cancer, not because of death but because the chemo would cause vomiting and well.....around we go.

Ars being key for food poisoning, and this being potentially the underlying cause, along with the rubric fear of death from vomiting (although no fear of death, but closest I could find) I still have somewhat of a feeling for this one. The fastidiousness just isn't there though, her home totally unpresentable, herself not showing any care to personal hygiene, appearance, and though she cares what others think of this, apparently not enough to do anything about it. She does want things a certain way, anything else is wrong and angers, a bit of a perfectionist about how things should be or be done, is horrified to see a typo she actually sent out to someone, for example, so perhaps another facet of fastidious.

Thanks for all your input.
Sunny

Hi again Sunny,

That "unpresentable home" is just the other side of the fastidiousness of arsenicum's coin. I dunno, it still sounds like that remedy comes so close...a tough one, but you may want to keep the remedy in consideration, as only 2 of the potencies have been tried, and there was a good reaction with the first dose...

Divina

Taking
Generals, sensitivity to remedies
+
Mind, praying

Gives only Arsenicum and Medorrhinum

Since Ars has given significant relief in the past, and the causation might be food poisoning, why not try Ars LM1 and see how far that takes the case?

See if it reveals Med or another remedy.

One other thought, if this is the same patient who has desire for ice and amel at the seashore, Med has to be strongly considered. All the signs would point to Med then.