Emetophobia Help with Anna Christie

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

Anna Christie Season 4 Episode 7

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

Support the show

Anna's Website: www.emetophobiahelp.org
Resource site for Clinicians: www.emetophobia.net
MERCH for stress, anxiety, panic: www.katralex.com

Speaker 1:

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:

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:

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:

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:

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:

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:

Yes.

Speaker 1:

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

Speaker 2:

Yeah.

Speaker 1:

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

Speaker 2:

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:

Thank you.

Speaker 2:

In the.

Speaker 1:

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:

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

Speaker 2:

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:

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:

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:

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

Well, I also have this kind of figures.

Speaker 2:

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:

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:

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:

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:

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:

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:

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:

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:

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:

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:

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:

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.

Speaker 2:

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:

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:

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.