Gag Reflections: Conquering a Fear of Vomit Through Exposure Therapy

by Dara Lovitz, David Yusko

Emetophobia--the disproportionate fear of vomiting or being in the presence of someone vomiting--affects millions of people yet is seldom discussed. Part-memoir, part clinical history, Dara Lovitz provides a brutally honest account of her life as an emetophobe. Written with her therapist, Dr. David Yusko, her story unravels the mystery of emetophobia. Lovitz spent years trying traditional talk therapy and self-help books yet nothing seemed to reduce her anxiety. In desperation, she tried exposure therapy. With a therapist's guidance, she was able to overcome emetophobia. The history of exposure therapy for treating emetophobes is covered.

Genres: Nonfiction

200 pages, Paperback

Published February 12, 2021

Reviews

[Alyssa Reichert · Rating 5 out of 5]

I mean I don’t particularly recommend if you don’t have emetophobia. But read it if you do!

[Bobbi · Rating 5 out of 5]

⭐️⭐️⭐️⭐️💫 (4.75/5)

Read for my professional mental health book club, @mytherapistreads, and we had the added bonus of the authors joining our discussion. Hearing Dara (client) and David (therapist) speak about how their relationship evolved and how they impacted each other was genuinely heartwarming and insightful.

The book is told through dual POVs: Dara’s experience as the client, with occasional reflections and commentary from David, her psychologist.

What Worked:
✨ Dara is funny! Her humor brought lightness to an uncomfortable topic (vomit - yep, the whole book is about it) and made the subject far more approachable. As someone who really struggles with even the idea of vomit, her candid, funny voice helped put me at ease.

✨ David feels like a real person. As a therapist myself, I loved that his personality came through, warm, down-to-earth, and relatable. It defied some of the outdated stereotypes I admittedly still hold when I picture an older white male psychologist.

✨ Educational + accessible. The book balances clinical language with plain language really well, making it great for both mental health professionals and the general public. The way exposure therapy is described is spot on.

✨ Insightful data. The book notes that emetophobia (a disproportionate fear of vomiting or seeing others vomit) affects an estimated 11–16 million Americans, affecting women at a significantly higher rate. Also: emetophobia is considered closer to OCD than a simple phobia.

📌 Recommended resource: Emetophobia NO PANIC (Recovery Group) on Facebook

Small Critique:
🌟 I deducted 0.25 stars for occasional health-value commentary that felt a little off. For example, during Dara’s exposure work (watching the infamous “Stand By Me” pie-eating scene), she comments that eating contests are “so unhealthy and gross and nothing good can come from them.” While I get that it’s part of her fear narrative, this felt more like judgment than necessary insight, and it distracted from the topic at hand.

Final thoughts: This book is funny, informative, vulnerable, and incredibly helpful. I’ll be recommending it both as a resource for clients and fellow clinicians—especially those curious about exposure therapy or working with emetophobia.

[Bryan Schwartzman · Rating 5 out of 5]

Dara Lovitz is an evocative memoirist who writes with candor, clarity and, above all, humor. Though her prose crackles with warmth throughout Gag Reflections, it does not diminish her portrait of emetophobia’s debilitating effects — if anything, it makes the account all the more devastating. In David Yusko, Lovitz clearly found the right therapist to guide her through exposure therapy and help her live a better life. On the page, patient and therapist complement each other perfectly, offering two vantage points on how exposure therapy works.

I picked up this book because a family member suffers from emetophobia. I hoped to understand what they are going through and what to expect from exposure therapy, both its potential and limitations. The book more than delivers on that promise. What’s more, I live with generalized anxiety myself and have read several books on the topic. Though Gag Reflections is focused on a specific phobia, it offers the clearest explanation yet of how and why anxiety can paralyze our thoughts and emotions. We live in an uncertain world where very little is within our control. Yet the human mind, and especially the anxious brain, craves control. Lovitz and Yusko teach us that the more we can learn to let go of control, the more at peace we’ll be.

[Aviva · Rating 5 out of 5]

What a fantastic, surprisingly entertaining book!!! Although I have a professional interest in cognitive behavioral therapy, I very much didn't expect to spend half the book laughing out loud. Ms. Lovitz writes a warm, engaging and tremendously brave narrative describing her failures and successes in the process of learning to live with and control her fear of vomit. She effortlessly brings the reader into her mind, explaining how pervasive and destructive emetophobia was in her life, and then brings us step-by-step along with her on the road to successfully managing her fear. Adding to this, commentary and chapters by Dr. Yusko provide an insightful and detailed description of the therapeutic process from the therapists perspective. Together, these viewpoints provide a holistic and valuable set of viewpoints and processes that will be incredibly useful to both people coping with emetophobia and therapists before, during or even after therapy. If you are interested in emetophobia, this is a must read.

[Sophie Dixon]

Highly niche, but great well-written book for its purpose!! this took me over three years to read - and I did finish it largely because 1) my other Libby books didn’t download on my flight 2) I reminded myself of my intention to close loops! even reading this was difficult in the beginning. Finishing the last 30% was a breeze! shout out to YouTube ❤️ and as Mad-Eye Moody taught us all, “stay vigilant”

[Becky · Rating 5 out of 5]

If you or someone you know is suffering from emetophobia (fear of vomiting) this book is a must read. It’s written with warmth and humor even though the subject is a terrible condition that can devastate lives. The chapters alternate between the patient’s pov and the therapist treating her. A great starting point for learning about how to recover from this awful condition. There is hope.

[Wendy · Rating 4 out of 5]

An interesting dual-perspective text on use of exposure therapy to treat an often treatment-resistant phobia. I appreciate the way the clinician who co-authored the text was realistic about outcomes, maintenance, and relapse even with the use of an evidence based approach.

[Emily Luna · Rating 3 out of 5]

Overall good book. Lovitz's chapters were more engaging than Yusko's. Definitely check out if you or a loved one suffers from emetophobia.

[Lindsay Rossum · Rating 4 out of 5]

This book was excellent- I really enjoyed having the dual perspective of a person with emetophobia and her therapist. As someone with emetophobia, everything Lovitz described about the way her fear has impacted her throughout her life resonated with me deeply. Dr. Yusko offers helpful commentary throughout that re-enforce how phobias are maintained (through avoidance) and how/why exposure therapy works. Both Lovitz and Yusko wrote in a way that was easy to follow and enjoyable to read. I was left feeling very validated and hopeful in the exposure work I’ve been doing personally.