Emetic Exposure and Desensitization Procedures in the Reduction of Nausea and a Fear of Emesis

Abstract

An emetic syrup was titrated according to a reduction schedule to recreate graduated levels of nausea in the exposure of a 34-year-old female who developed the fear of nausea and emesis (vomiting) after vomiting on stage during a piano recital. In this particular case, the patient was taught breathing retraining and anxiety-reduction techniques such as double swallowing, in addition to some imagery as a desensitization procedure to avoid reacting to nausea by vomiting. Results in similar case designs suggest that, at times, artificial methods such as the above may be used to create variations of a situation that cannot always be duplicated through pure imaginal exposure or during in vivo exposure, especially when the stimulus involves certain physiological responses such as a gastric regurgitation. A 2-year follow-up yielded no indication of relapse and a full return to prebaseline status.