S4E7-E Italian Psychiatrist & Emet Specialist Dr. Manuela Bassetti (English version)

SEASON 4 of Emetophobia Help TRIGGER WARNING: Words such as "vomit,” “throw up” and "sick" may be used. 

Host: Anna Christie, Psychotherapist and Emetophobia Specialist

Intro Music: YouTube Audio Library, "Far Away (Sting)" by MK2, Used with Permission.

Anna’s Website  - INFO for emetophobics: www.emetophobiahelp.org

10 Emetophobia CLASSES with Anna: info at www.emetophobiahelp.org

Facebook Group: Emetophobia NO PANIC

ANNA & DAVID’S BOOK: Emetophobia: Understanding and Treating Fear of Vomiting in Children and Adults: Russ, David, Dr., Christie, Anna S., 

EMETOPHOBIA RESEARCH CHARITY: www.emetaction.org

FOR KIDS:
 "Turnaround Anxiety Program" with Emetophobia supplement (McCarthy/Russ) and 

 Emetophobia! The Ultimate Kids' Guide eBook : Russ. PhD, David

Transcript

Understanding and Treating Emetophobia in Italy

Speaker 1 0:00

Hi and welcome to a Metaphobia Help . I'm Anna Christie recovered , a Metaphobic and licensed psychotherapist specializing in a Metaphobia . These podcasts have a trigger warning of words associated with a Metaphobia . If you enjoy these podcasts or you find them helpful , you can buy me a coffee . Just scroll down in the notes , click on the link and for a couple of bucks you can support the podcast . So , season four , here we go . Music I'm thrilled to welcome Dr Manuella Bassetti , from Italy , who is a psychiatrist , joining us today here . I'm thrilled to have you here .

Speaker 2 0:54

Thanks , Anna . It's a pleasure to be invited by you . I would like to welcome all the people who are going to take part in this podcast .

Speaker 1 1:09

Yes , great , we do have some downloads , occasionally from Italy . I will send you some social media hashtags and links . Perhaps you can have the podcast advertised there .

Speaker 2 1:27

Well , thanks , because I informed my clients that I would have had this interview with you , with Anna Christie , so they are thrilled and looking forward to listening to what we are going to say tonight . So , anna , I'm ready to start this interview with you and to share further information and insights concerning Metaphobia and specifically the situation in Italy , because actually in Italy , people don't talk much about Metaphobia . It's still a disorder that is not well known , but something is changing actually , so I'm pleased to share our experiences . From the professional point of view , okay , I'm a doctor specialized in psychodynamic approach that actually is integrated with psychoanalysis and with CBT , and so all of these different approaches actually are integrated .

Speaker 2 2:51

And my interest arose some years ago while I was working as a freelancer , and one of my first clients was a 25-year-old man suffering from hematophobia , and so I started studying , reading books and journals on an international level , because I wanted to treat him in the best possible way , and so I realized that there was a deep gap between this crippling disorder and the fact that this was a disorder that was not really studied , it was underestimated , and so I was really impressed by this gap , by this difference and the fact that this disorder did not attract the attention of doctors and specialists . So hematophobia became the core , the heart of my work , not just to open a center to treat hematophobics , but also to write a book , as you know .

Speaker 1 4:05

Thank you , that is so wonderful . I want to say first , I'm so thankful that there are people like you , and I think if there are people like you , if there is someone like you in Italy , there will be others in other countries , and that , I think , is going to be so important . Maybe I'm old , so I don't know if I will live until the day when everyone in the psychotherapeutic community knows about this , but I hope so . And I was thinking , I wonder , serena , if you would be so kind as to sort of translate what I see into Italian , so that I can make an Italian version of the podcast . That would be nice , I know , I know .

Speaker 2 5:09

Yes .

Speaker 1 5:12

Yes , right , yeah , that would be great if you could repeat .

Speaker 2 5:19

Yeah .

Speaker 1 5:21

I'm glad and I think one day it'll be . You know , that's basically it .

Speaker 2 5:25

Yes , Thank you , I'm Anna because I think you've been one of the first ones to talk about emetophobia and to focus on this specific disorder in a war where emetophobia , unfortunately , is more and more present . Unfortunately , in Italy there are not many centers dealing with this kind of disorders and usually clients are treated specifically for emetophobia . After many years they have been under treatment for different disorders because probably they got wrong diagnosis , probably they were diagnosed with social phobia , hypochondria or other kinds of disorders that maybe are secondary to emetophobia and are not the primary disorder . So the journey is quite a long journey , actually not really solving the problem . Over the years I started reading articles in Italian blogs and nowadays there are also some communities on social media focusing on emetophobia in Italy . So something actually is changing and I realized that in Italy there's not much research concerning this topic , unlike in the UK , for example , where there's more literature concerning the topic . So we still have a long way to go , but I hope for the future so that this disorder can gain the dignity it deserves .

Speaker 1 9:30

Thank you .

Speaker 2 9:40

In the .

Speaker 1 9:40

English speaking world where I kind of work , you know , in Canada , usa , uk , australia there are many misconceptions about emetophobia and misdiagnoses and misconceptions . I wondered if you have come across common misconceptions that you could speak about to Italian listeners today .

Speaker 2 10:16

Okay , yes , unfortunately , I went through many different wrong diagnosis or misconceptions connected to immidia .

Speaker 2 10:28

As I was saying before , some clients had been treated for several years for different disorders skin disorders , anorexia so they had been treated for years for a symptom that was not the right one , because the core , the heart of the problem was the fear of vomiting , not the fear of gaining weight , for example .

Speaker 2 10:56

So in my experience and I don't know if my experience corresponds to yours the misconception concerning emetophobia is that this disorder is a rare disorder , often underestimated for its gravity because people tend to think that this disorder is present only in the exact moment when that shows itself .

Speaker 2 11:27

But actually it's not only that moment , the moment that the person is experiencing that problem , because the emetophobic object , let's say , is inside the body of the client and the client leaves with this fear 24-7 . So this is a pervasive fear that involves different settings professional , school life , personal life , emotions , diet as well and so , unfortunately , the problem is that this disorder is not understood enough by people who don't know about this disorder . For example , some doctors said that clients were complicated , complex or just funny people just because they had this kind of disorder , without realizing that these people had a problem living every single day with emetophobia inside of them . So it's not just the fear of vomiting , but the idea that this problem could arise anytime , anywhere , and so , basically , this is a threat that could become a concrete situation every single day , and this is the real problem for the emetophobic .

Speaker 1 13:02

Absolutely , absolutely true Everything that you said we have understood here .

Understanding and Treating Emetophobia

Speaker 1 13:14

It is a rare disorder , but at least in the research , in English-speaking , 0.2% of the population has a problem bad enough that they will seek treatment for it . So I think that's important , for maybe you can say that out loud , oh well , yes , you will translate , serena . Sorry , I get confused . So let me say something different . 7% of people are afraid of vomiting , but 0.2% . It is bad enough that we could probably diagnose it as a phobia , because they will actually seek treatment for it . So that's what that's really Okay .

Speaker 2 14:07

Well , I also have this kind of figures .

Speaker 2 14:11

I can say it's specific to the Italian situation because unfortunately in Italy we don't have any specific literature concerning emetophobia , but I would say that more or less the estimates are the same and I would say that in Italy , between 60,000 and 120,000 people suffer from bad emetophobia .

Speaker 2 14:37

That is considered as a disorder to be treated . And as for Italy , well , I don't know if we are different from northern countries , but actually you should know that food here in Italy is a very important element because it's associated with a very important moment when the whole family reunites or when people go out together , so it's a moment to share with other people . It's connected with the concept of hospitality , care , love , friendship . So when the concept of food is so connected with all of these positive opportunities and occasions and people suffering from emetophobia can't access these type of experiences , of course they feel excluded from certain occasions and here we have a sense of diversity that is connected and related to the disorder . Of course , this doesn't mean that emetophobics live in other countries than in Italy suffer less , of course , but this was just to say that when emetophobics live in countries where the food culture is so important , that could be even worse .

Speaker 1 16:06

Yeah , true , that's true too , yes , okay , let's talk about just briefly your practice of how you treat people with emetophobia . Outro .

Speaker 2 16:24

Okay . So , as we have anticipated , my approach is integrated . So there are different approaches that I use . Altogether , of course , I use CBT to help people build gradual exposure in order to identify and then eliminate those safety behaviors that make emetophobia a chronic disorder . So we have to find and identify those vicious circles to be eliminated . And then I also have a relational approach through the development of ABC skins to find the connections between negative and positive experiences . And also a psychodynamic approach in case of trauma , especially in childhood , because sometimes childhood traumas are connected to vomiting directly or because of family or collateral situations that created some gaps in the self and if the self is not safe , the people are going to develop an unsafe attachment , especially in childhood .

Speaker 2 17:44

So I integrate all of these components when CBT is not enough and I also use psychosomatic approaches mindfulness , breathing techniques for clients with very strong neuro-vegetative symptoms so no gene vomiting and to fight against the hyper vigilance towards all of these symptoms . So I use different approaches according to the person I have in front . I have individual treatments , of course , for sufferers or family members or parents of sufferer . I also offer a full psychotherapy that is much longer for more severe cases and I've also developed a shorter approach . That is the M20 program . It's 20 different sessions where I teach people to manage emetophobia . So basically it's psychoeducation and training . So according to the person I have in front , I decide which is the best journey for them .

Speaker 1 18:58

Let's talk about your book . Have you talked about your book ? Which is very exciting that your book is coming out in December .

Speaker 2 19:11

Thanks for asking , anna . I'm very proud of my book . Actually , the English version is about to be published . This month . The book is already available in Italian and , thanks to Serena , the book has been translated into English as well .

Speaker 2 19:31

I think it's a very important resource because , through this book , emetophobics could relate to their experience and they could find in the book their own story , and they also invited family members , partners , friends to read this book so that they could understand their suffering and what they were going through . So I think this is very useful from this point of view , and I got very precious feedback from the people who were able to read the book in Italian , and I was very happy because I felt I could help a lot of people . Actually , this is not a self-help book . Maybe in the future I'm going to develop something concerning this specific aspect . The book is a descriptive overview because actually , as I was saying , in Italy this disorder is not well known , and so I think there was the need to spread the knowledge and to raise the awareness among the population concerning this disorder . So it's the foundation from which you can start to get to know the disorder .

Speaker 2 20:49

It's divided into three different sections , so in the first section I talk about the sentence , the safety , behaviors . I also put some lists of symptoms so that people could recognize their own experiences and behaviors . I talk about the vicious circles and why this disorder can become chronic over time . And then , in the second section , I focused on the development of the disorders . So I focused on the fact that it's not the sufferer's fault if they have some genetic related problems , if they have a specific family history or problems in terms of attachment or childhood traumas . So this is the message I wanted to convey , so that people could feel reassured , while in the third and final section , I give help to people so that they can self-manage all of those cases that are not so crippling and , of course , I invite them to embark on a different journey in terms of treatment and psychotherapy if the disorder is more severe .

Speaker 1 22:20

Sorry , I'm not sure how much discussion we can have about this , but I find I have found it is almost always true that something happens with the attachment to a process with mother or first caregiver in every metaphobic person . Sometimes it's something very simple . Sometimes mother went back to work , mother was in the hospital having another baby and a child is sick . It doesn't mean that there's a disordered attachment or that there's a terrible mother not at all but it can be a simple premature baby can't be with mother , adopted people , things like that I found .

Speaker 2 23:36

Okay . So in my experience , some patients are really fragile in terms of their attachment system , so they went through some specific traumas . In other cases they didn't have any dysfunctional families , but very simple events that children read as a form of abandonment , because they didn't feel protected by their family members or the primary caregiver usually the mother , of course and sometimes there's also this emotional substrate , let's say , where clients feel overwhelmed and feel this sense of helplessness . So they often say I feel at the mercy of my own body , and so this is the feeling they have . So , regardless of trauma , this sense of helplessness is as if there's something lingering in the year , as if there's something traumatic the clients can't really face . So I realized that some experiences are really based on trauma .

Speaker 2 24:58

When I talk with my clients , one of the aspects I want to give back to my clients is the sense of mastery . So I want to empower my clients saying that they were not guilty for their disorders . So I would like to pass from this concept of guilt to the concept of responsibility and empowerment , because they are responsible for their own change . Nobody can change or execute and implement that change in their place , but it's the clients having the responsibility to do that . So clients have their destiny in their own hands , and my mission is to empower them , to give them the tools . Sometimes , when we were children , we were told stories about boys who got lost in the dark wood . Well , in that case , you have to go through that dark wood and nobody else can do that in your place . So I want to focus on this concept of empowerment with my clients .

Author Discusses Website, Events, and Instagram

Speaker 2 26:21

My book is available on Amazon , of course , and my website is wwwmanuellabassetticom Probably I could spell it www Icanhearyou Perfect . In my website , you can find all the information connected to my work publications . There's also calendar for the events I organize . Recently , I held a seminar with a community of emetophobics and in the future I'm going to organize other events . By the way , I also have an Instagram profile , so you can follow me on Instagram and you can access my Instagram profile from my website as well . I sponsor my events there , and these are events both online and in person . So if you're interested , you can find me online through my Instagram profile and my website .

Speaker 1 27:38

I only want to say I love you . I wish we spoke the same language . I would see I would fly to Italy and eat food and talk with you . But yes , okay , okay , thank you . I love the concepts that you just spoke of abandonment , helplessness , empowerment , mastery , responsibility .

Speaker 2 28:36

Thanks , anna . It was a pleasure to talk with you and I hope I could give you a pinch of Italy to your country . It's really an honor to virtually cross the ocean and speak to your audience . I wish you the best from the personal and professional point of view and I hope to have the chance to meet in person to discuss these topics even further with you . Of course , you're going to receive a free copy of my book so that you can remember this meeting together .