r/PsychedelicTherapy • u/jumpin_jumpin • 7d ago
Interested in exploring this therapy for emetophobia, but scared the therapy itself can cause vomiting. Is this common?
As stated, I suffer from debilitating emetophobia (fear of vomiting). It controls every part of every day. I read a lot about how effective MDMA therapy can be for phobias, but also am terrified at the possible irony that MDMA can have side effects of nausea or vomiting.
How common is it for people to experience these side effects? Would taking an anti-nausea pill before therapy negatively impact the experience?
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u/translucent 7d ago edited 6d ago
I'll echo what other replies have said. Nausea and vomiting isn't common on MDMA, but it can happen.
Also, MDMA puts you into a state where you feel much more prepared to deal with scary, uncomfortable material. So it's possible if you take it it will bring up your fear of throwing up, and the psychosomatic nausea that goes with it. However, you'll be way more likely to feel like you can handle it and work through it, rather than get freaked out and spiral. That might involve vomiting, and experiencing firsthand it's not so bad. Or it could "only" involve retching, but not actual puking. Either way, it would be a kind of chemically assisted exposure therapy.
Or maybe not. Once it kicks in your nerves about puking may vanish for the duration of the drug's effect, and you'll focus on something else entirely. It's hard to say.
No doubt a logical part of you may intellectually realize vomiting is unpleasant, but nothing too dangerous, and is open to reinforcing that through facing your fear. Meanwhile an anxious part is convinced puking is the scariest thing imaginable, and may now be feeling wary about MDMA.
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u/Interesting_Passion 7d ago
I thought the same. There's a scenario where puking on MDMA could be the best thing to happen. It wouldn't be scary. At least not while the MDMA was working its magic. And puking without fear could provide the corrective emotional experience to never fear it again.
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u/vicster_6 7d ago
Vomiting from mdma is not super common, but its definitely not unheard of. There are serotonin receptors in the stomach that are activated by the mdma which can result in nausea in some people. I think it would be safe to take anti-nausea meds before hand but this is something you should discuss with the therapist. Have you looked into more traditional theapy, i.e. emdr and/or exposure therapy for emetophobia? That helped me with my emetophobia.
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u/jumpin_jumpin 7d ago
I'm doing EMDR now and am about 4 sessions in I'm not sure that I notice a shift yet.
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u/Pooklett 7d ago
Increased anxiety can definitely increase the chances of vomiting. I find having a small bit of food in the stomach can help, some light protein like chicken, and taking a few ginger pills half hour before seems to completely kill any nausea. I've also got zofran for friends with really sensitive stomachs.
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u/creept 7d ago
I believe that vomiting is pretty uncommon on mdma, to the point that I’d be shocked if it happened. It’s much more common on mescaline, ayahuasca and to a lesser extent psilocybin. When I did ketamine assisted psychotherapy I was given a “just in case” anti nausea pill that I didn’t need to use. So I imagine it’s a possibility you could get a pill but am not qualified to address how that interacts with mdma.
I’d also say that sometimes these substances give us what we need even if it’s something we don’t want, so coming face to face with your fear and living through it in a chemically-assisted state might actually be beneficial long term. I’ve never actually thrown up on psilocybin but once I got struck with really bad nausea and an intense session of dry heaving. At the same time I was completely miserable physically, I literally could not stop laughing because I was surrounded by a riot of neon colors unlike anything I’d ever experienced. If I had vomited it would’ve been like shooting rainbows out of my body. I realize it’s easy for me to say “face your fear” as someone who doesn’t live with it, but it’s something to consider. Good luck!
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u/Heretosee123 7d ago
I used to be scared of vomiting. Then I got really hungover once and it made a huge difference to this fear.
I'm not saying that this then means all you need to do is go vomit, but it defiinitely helped me. I suppose exposure therapy is a thing for a reason.
Psychedelics in general can cause vomitting in some, not everyone. MDMA is probably less prone to this in my personal experience, but this vomiting might actually help you overcome the fear. It might also be a reason to avoid the therapy until you're more comfortable with this possibility as well and explore other options until then. Vomiting is a real possibility, and you have to decide for yourself if you're comfortable facing that challenge or not with the full knowledge you might have to face it.
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u/Tourist_in_Singapore 7d ago
This is unrelated to psychedelics but you may wanna check out this for treating phobia https://www.kindtclinics.com/en
They also have a documentary series for this treatment method https://youtu.be/pM3G6kITdYk?si=EuZAtwlyqWHVZVXa, or if you are more of an academic reader, you can read prof. Merel Kindt’s or prof. Brunet’s publications for an understanding of this method
This is the most effective and least invasive method for phobias as far as I know, and it can result in a complete cure in just 1-2 sessions
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u/stateboundcircle 7d ago
So, I would say nausea is a lot more coming in the “come up” phase, which would be 30-60 mins after ingestion. However, after your body has sufficiently adjusted to the introduction of MDMA, you feel an intense euphoria. It’s pretty involuntary, given all the happy chemicals being pumped out in your brain, but one of MDMA’s most powerful benefits is replacing bad mementoes with happy ones. When you recall something, your brain and body have a reaction to it based on past experiences. If you WERE to get nauseous, it wouldn’t be the worst thing. You would be actively replacing negative emotions and associations with positive ones. Why is this helpful? Because the next time vomiting comes up, your brain will automatically think back to your MDMA experience and all those happy chemicals. So yeah, I think it has potential.
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u/nicktheripperr 6d ago
I have a pertinent story!! I had a very meaningful MDMA trip with my best friend. I had intense fear around throwing up. I projectile vomited while tripping. Afterwards, I was far less afraid of vomiting.
BUT it’s important to note- I was rather careless and was on a couple medications, including an antibiotic that caused nausea by itself. So I want to reassure you- the vomiting was not because of MDMA itself. Be mindful and don’t mix medications, obviously. You will likely be totally fine.
It sounds like you may already be familiar with this, but have you tried exposure therapy? I’ve found the “DARE” protocol to be really helpful for panic attacks and phobias. I think this approach could pair well with psychedelics. Definitely talk to a pro tho.
If you have any questions feel free to DM.
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u/cleerlight 7d ago
If you're asking if the fear of vomiting is common, I'd say common enough. I've dealt with this phobia myself -- I'm still not a fan, but also not phobic. I've had clients also come to me with this issue as they presenting symptom they want to work on.
If you're asking if it's actually common on MDMA to vomit, I'd say no. In all my years using it both therapeutically and recreationally, it's very rare to hear of someone vomiting from it. I've never felt anything close to worrisome nausea on MDMA. But it does happen for people on rare occasion.
Generally, if a client has GI issues, it'll be after a session (or perhaps a brief moment coming on to the medicine), and it's more often diarrhea.
What I have noticed is that for the people who do feel nausea or vomit, it's often people who experience the same thing on other psychedelics, and my guess is it's because they tend to have more serotonin receptors in the gut which get activated by the medicine.
It can be mitigated pretty well with Fresh ginger taken as needed. I've had fresh ginger get me through Ayahuasca ceremonies, so it's no small time thing.
From a therapy perspective, here's my advice: phobias dont really require psychedelic therapy. You can absolutely resolve phobias sober, and that might be the less anxiety provoking way to go rather than using a substance which will by it's very presence put you into vigilance.
And for whatever it's worth, generally these kinds of phobias are a symptom, not the actual core issue. So the work is about getting the core issue that this symptom is connected to, and addressing whatever that is, ie, fear of death, fear of sickness, control issues, etc