Vomit phobia in 7 year old?

[RainieBon]

Dear Dr,

My 7 year old daughter witnessed a close friend vomit at school about 6 weeks ago.

Since then she seemed traumatized by the event.  She fears she will vomit in school.  Last year she had a few stomach bugs which must have been really bad experiences.

She asks me constantly "will I throw-up in school mommy", several times a day.  Sometimes her anxiety level is so high, that she doesnt realize she is hungry, or full.  Before bedtime, she also asks me if she will throw-up.

I think she actually sees the other kids reactions and combination of looks of horror or amusement when they vomit at school.
She doesnt like the fact that she will be caught off gaurd, as she sees with her classmates.  One minute they are fine, the next minute they are sick.  Its not like a cold, where there is some warning, perhaps a sore throat, or runny nose.  She tries to anticipate if she will be sick by a feeling in her stomach.
The problem with this is it is bi-directional, where anxiety creates stomach discomfort, the stomach discomfort creates more anxiety, etc...Also hunger gas all create more anxiety of impending vomit.

We have just started her in CBT therapy because I am afraid it will get worse..  

Do you know of any success rates with this phobia in children?  Is this a common fear in kids? I am really concerned about her future and her level of anxiety.

[Kevin Kennedy, Ph.D.]

Progress is not a steady line forward. It is more like two steps forward, one step back, but the child ends up 'ahead of the game', so to speak.

[Kevin Kennedy, Ph.D.]

Yes, there is every reason to be optimistic that her worry will disappear. CBT is the standard of care in the treatment of such a condition, so you have made the correct choice. Try to be casual in the face of her questions, and don't allow yourself to engage in too much talk about the matter,

[tafai]

HI,
I just read your post and wanted to reply.
I've had a phobia of throwing up ever since i was a child and it got worse when i was a teenager. I also was overly concerned about several other things (insects getting  into the car, fainting, a filling falling out etc) and looking back i was probably developing the anxiety disorder i still have today (it's going better with therapy and medication but still very anxious about a lot of things and i'm 36 now).

I'm really glad you take her seriously and got her some help; not to emphasize her fears, just to acknowledge them. I think I might have benefitted from help earlier in my life and i'm glad that you are giving your daughter that.
There are ways to learn to deal with your fears or (hopefully!) get over them completely and I wish you and your family the best!

Tafai

[RainieBon]

Dear Dr,
Thank you so much for your response.  I am trying to be positive with all going on.  You have given me some hope.

We have been doing quite well for the last 2 weeks.  She still asks me if she will throw up, and complains about her stomach, however she has been o.k. in school again.  

Finally today she did call from the nurse saying her tummy felt "weird".  I know her eating habits are not so good right now because the hunger is usually felt as anxiety. And she may have been hungry.  There were also a couple of kids out in her class yesterday with I think set her back a bit.
Is this common to have setbacks during therapy??  I am really discouraged.  We have been doing pretty good.

Any help you could offer would be wonderful.