The Fear of Losing Control Over Our Bodies

We can be cursed by a particularly pernicious and shame-bounded fear which stops us from flourishing at work, going out socially or simply enjoying being alive: the fear that we will suddenly be seized by an overwhelming impulse to defecate or vomit.

If we take this to a doctor, they will ask us questions and run us through a battery of tests but they may end up concluding that there is nothing ‘wrong’ with us. Which only serves to show how narrow a concept of illness medicine sometimes works with. There is definitely something up with us; it’s just that the issue lies in our minds rather than in our bowels or stomachs.

The issue appears to revolve around a conundrum about acceptability. In the eyes of strangers, there can be few more disagreeable or unsettling things about us than our shit or vomit. These are substances that speak, however unfairly, of ignominy and shame, abasement and humiliation. They may be used to form a conclusive argument against our dignity. 

Normally, if we have been handled with love and learnt to treat ourselves kindly as a result, we can take a serene, benevolent view of these entirely natural effluvia. They may present certain challenges, but their appearance need never be a matter of particular repugnance or odium; only occasions for sympathy and care.

But we may not have learnt very much tenderness towards ourselves in this area – and by implication in many others too. We may have grown up with a background sense that much was displeasing and besmirched about us. Our presence didn’t delight those who put us on the earth or were entrusted with our care. Perhaps we didn’t look as nice as they had hoped, or we weren’t as clever or our arrival distracted them from their personal ambitions. They may have scolded us or rarely offered reassurance or sweetness. And as a result of ongoing neglect, we are liable to have developed intense feelings of redundancy and degradation. 

It’s a principle of psychology that dilemmas that haven’t been resolved in the past will constantly seek expression in the present, in the vain hope that some kind of better ending for them can be found. We repeat unpleasant feelings not just to torture ourselves but – more hopefully – to build a way out of our agonies. Therefore, one way to read the repeated feelings of nausea (emetophobia and coprophobia) is that they are articulations of unresolved torments around our right to be. We may, in adulthood, have become hugely accomplished, popular and charming (precisely from a fear of being none of these things). We may have secured an impressive job and earnt the friendship of many. But this only serves to highlight a dilemma in our assessment of ourselves: deep down, whatever others may say, we feel awful. We may look respectable, but in our core, we still take ourselves to be abhorrent, superfluous people. We are still – somewhere within – just a piece of shit who sickens everyone. 

It can be instructive to study when the desire to vomit or defecate reaches a pitch. It tends to be not when we are alone or getting on quietly with a task we’re confident about; the panic grips us when there start to be expectations of us, when people begin to think we are very skilled, or impressive, clever or nice. It can become overwhelming on a date, before a speech or at a gathering of new friends. 

The contrast between what we feel inside and who others take us to be then seeks a benighted and excruciating form of expression. Our fear contains a strangled honest cry: ‘I’m terrified that I can’t be the nice person you take me to be. There is so much that you couldn’t bear about me if you knew…’ It isn’t that we don’t want to please, just that we can’t believe that we have any right to do so. The shit and the vomit will finally prove to onlookers that we are the fundamentally awful people we suspect we are; they will align the outer verdict with the inner one. 

But destroying our image publicly isn’t really what we want to do. The true longing is more complicated and more hopeful: that we will be allowed to be less than impressive and still be deemed OK.

The fear teaches us about love. Though we may all want to be admired for our accomplishments, the true longing is that we be sympathised with for our weaknesses. Anyone can admire us for our power; the truly kind person feels tenderness for us in our befoulments. We might have as children have soiled ourselves in the playground but a loving parent would not have panicked. They would have taken us home, said calmly: ‘don’t worry, we’ll sort this out in a minute’ and given us a hug once we were in fresh clothes again. 

But if things never happened so gently, the shit and the vomit represent confused attempts to get back to the primal wound. Once we learn more about our inchoate psychological cravings, and the deprivations we went through, we may come to compensate for our losses through understanding and self-compassion, and our physical vulnerabilities may abate. We may with time be able to accept that we are worthy even in our illness and our weakness. We may learn, as we should always have known, that we amply deserve to exist.