What Is Claustrophobia
Claustrophobia represents an anxiety disorder in which the person possesses an irrational fear linked to closed spaces. This is related to the fact that they feel they have no escape from that places and the sensation of being asphyxiated due to the association made by the mind with oxygen decrease in that area. Some situations in which this phobia can be triggered include rooms without windows, having to stand in a crowded elevator, or travelling with an airplane. There are certain individuals who experience anxiety even when they’re wearing clothing that is tight-necked.
The word comes from the combination between the Latin word “claustrum” that means “a shut in place” and the Greek word “phobos” that means “fear.” Recent statistics reveal that somewhere around six percent of people worldwide suffer from this issue, but most of these don’t try to find a treatment for it because they don’t feel like it’s a serious problem. Other sources suggest that the percentage is larger and situates in between fifteen and thirty seven percent, considering that the majority of cases aren’t diagnosed because individuals are too scared of not being consider normal that they don’t consult a specialized doctor and just ignore it. However, its presence may cause a series of inconveniences for individuals due to the fact that they try to go to great length to prevent being trapped in small places or situations that might trigger the anxiety or panic attack. This means that they generally don’t travel with the subway and would rather take the stairs than use an elevator.
The definition from the Medilexicon describes this disorder as "a morbid fear of being in a confined place.”
The first two cases of claustrophobia were recorded somewhere around 1870 by a physician of French origin. He described two of his patients that complained of being afraid and anxious when the doors in their apartment were closed. It should be mentioned that it was the period in which Paris was undergoing urbanization and individuals were staying in cramped quarters. The next documented case was of a person that was living in New York and stated that he was suffering the same feelings and was unable to stand himself when the doors were closed.
In some medical handbooks, claustrophobia is viewed as an anxiety symptom and not an anxiety disorder in itself. This is why there is a huge possibility for the person that develops it to have already suffered from some form of mild anxiety. Among the most common anxiety disorders in which claustrophobia may play a huge role, there are panic disorder, generalized anxiety disorder, and social phobias. For each of these, claustrophobia begins from different reasons. For instance, people with panic disorders suffer panic attacks when enclosed in small areas while those with social phobias have a constant desire of escaping everything, not only trapped spaces.
On the other hand, there are some who view the development of this disorder as a complex process which is related to anxiety, but it appears independently. The majority of adults suffer from it due to some childhood trauma. There are a wide array of examples such as children punished by being sent to a small closed room or those who were accidently locked into a small place like the inside of the couch, a bathroom with no windows, or a wardrobe.
A more controversial explanation for this disorder is the evolutionary theory that suggests people feel trapped because they used to live in houses which left them a big personal space, but after the modernization and appearance of cities, this luxury disappeared and individuals feel locked inside their small apartments and constantly need to get away from it. However, it is still viewed as an irrational fear and those who think have it should seek the advice of a personal healthcare provider or psychologist that might help them in this manner.
Signs & Symptoms
The main signs of this phobia are generally considered to be fear of suffocation as well as fear of restriction. A typical claustrophobic is likely to fear and have restriction against walking in regions like locked rooms, small rooms, airplanes, cars, tunnels, cellars, trains, caves, and elevators. Despite the fact that this applies to most of the situations, it doesn’t represent a mandatory characteristic because an individual who suffers from claustrophobia may begin to have panic attacks, shortness of breath, or headaches when he or she feels like they are confided in a specific region. When the panic attack occurs, it may soon be followed by clothes removal and abnormal behavior. A severe panic attack should be viewed as a very serious problem and start a treatment soon enough. Otherwise, that person would do anything that stands in her or his way to avoid being trapped which may further lead to other type of phobias or even come against one’s future career or life.
Other symptoms of claustrophobia are light-headedness, fainting, nausea, enhanced blood pressure, an accelerated heartbeat, sweating, hyperventilation, and powerful shaking of the legs, hands, or even the entire body.
Sometimes confused with cleithrophobia which is the fear of being trapped in a place, claustrophobia is viewed as either a part of an anxiety disorder or an anxiety disorder in itself. No matter the cause, the characteristic is simple: anxiety and panic attacks when the individual is situated within closed regions. The problem is that the person can’t make a logical argument when the idea of getting trapped and having no way to escape sets in and the mind begins to make scenarios in which he or she dies in terrible pain, mostly due to suffocating. There are certain ways to diagnose this condition.
The most two common ways to find out if an individual suffers from this disorder are the scale and the questionnaire. The scale method was created in 1979 and consists of twenty questions the patient is being asked in order to determine the levels of anxiety in specific situations. While it was developed more than thirty years ago, it was improved along the way. The second one is called the questionnaire and its creators were Taylor and Rachman who are two experts in this area of medicine. This way is more efficient when it comes to distinguishing the fear of restriction to the fear of suffocation. It was later modified, in 2001 from thirty six to twenty four items. Compared to other methods, this has proved to be efficient in the majority of tests.
Furthermore, a study that was conducted by Fumi Hayano observed that the right amygdala is smaller in individuals that suffer from panic disorder. This feature causes interference in the brain because the amygdala is one of its smallest structures. Due to the interference, the organism begins to manifest through abnormal reactions to the stimuli that are directly linked to their fear. In terms of claustrophobia, this means that a person starts to freak out when he or she finds himself or herself physically confined.
Treatment for Claustrophobia
After confirming that an individual suffers from claustrophobia, the treatment should be immediately begun. This is a complex process in most of the cases because it involves experiencing a large amount of fear at the beginning and later dealing with this fear. The most important feature of a successful treatment is represented by exposing that person to the thing they fear most. By doing this in repeated terms, the individual should slowly learn how to regain control of those situations and don’t interpret it like a no-escape case anymore. However, during the exposure, one should keep in mind that the person they’re dealing with it doesn’t connect the proper dots in those situations and they would immediately panic and try to do anything in their power to avoid feeling like this. This means that the first two tries should be stopped if a patient feels too uncomfortable to continue.
This type of exposure doesn’t have to be monitored by anyone, but can be done by the patient. For instance, if the person is too scared to take the elevator, he or she should try to take it one or two times and even call a friend or a relative if they feel more comfortable that way. That person can start to think that taking the stairs is the wrong approach in order to motivate and finally go with the elevator. While this represents a normal thing for some, it can be an achievement for others and there should be no shame in any step of the process, but only a look towards the future and the feeling of happiness when they eventually manage to tame the fear of closed spaces.
However, if the phobia represents only a sign of another anxiety disorder, people should think about visiting a specialized doctor because if it’s more serious, it might require anti-anxiety medication which can help with the symptom management. Additionally, there are some behavioral techniques like flooding or systematic desensitization which are generally used in combination with other cognitive methods like the “Stop!” technique.
There was a study published in CyberPsychology in the year 2007 which pointed out that immersive virtual reality can also be effective when it comes to treating individuals that suffer from claustrophobia because it gets them to the “fear-inducing” situation. Moreover, the study showed proved to be more effective than distracting the person with music or other type of tools. On the other hand, the study cannot be generally taken into account because they were only two people involved in it. One of them was distracted by music while the other was immersed into virtual reality. As compared with the virtual reality individual, the one who got distracted by music stated that he still felt anxiety at high levels and asked for the test to stop. Other forms of treatment are hypnosis or self-help techniques such as visualization.
Nutritional companies have even developed a series of supplements that are based on ingredients like Scutellaria laterifolia or Scullcap, Valerian, and St. John’s Wort whose soothing and relaxing effects are more likely to help with the symptoms management.
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"Treatment of Specific Phobias in Adults" Clinical Psychology Review
"Phobias: A Handbook of Theory, Research and Treatment" Chinchester; New York; Wiley; 1997
"Claustrophobia and the Magnetic Resonance Imaging Procedure" Journal of Behavioral Medicine
"Probability Ratings in Claustrophobic Patients and Normal Controls" Behavior Researrch & Therapy