Generality
Claustrophobia is the morbid fear of closed or confined spaces .
Those suffering from this disorder are assailed by a feeling of anguish, severe discomfort or panic as soon as they find themselves locked up in small rooms, without windows, or in other situations that create oppression and give the impression of being trapped .
In addition to being accompanied by anxiety manifestations, claustrophobia often involves somatic symptoms such as: accentuated sweating, chills or hot flushes, rapid heart beat, nausea, a lack of oxygen and fear of dying. Consequently, the claustrophobic person tries not to expose himself to the phobic stimulus, that is to the situations in which he considers himself surrounded and deprived of spatial freedom, adopting strategies of avoidance or seeking the reassuring presence of a family member.
Claustrophobia can have negative repercussions in a person's daily life, in terms of limitations in social and working life. Fortunately, this disorder can be tackled and overcome through a course of psychotherapy, aimed at overcoming the phobia.
What's this
Claustrophobia: definition
Claustrophobia is the fear of closed spaces, confined, narrow or very crowded, from which escape would be difficult or impossible. The disorder is also associated with the avoidance of objects or situations that create oppression and a feeling of lack of freedom of movement or action.
Like any phobia, the severity of claustrophobia can vary widely from person to person. In severe cases, full-blown physical symptoms or panic attacks may occur, with cold sweats, increased heart rate (tachycardia), nausea, shortness of breath and a sense of suffocation.
Claustrophobia: what are phobic stimuli?
Those who suffer from claustrophobia often fear ordinary and common, apparently harmless situations.
Triggering the fear of enclosed spaces can be, for example, small rooms or without windows, elevators, some amusement park rides, public baths, basements, subways, revolving doors and many other situations.
Claustrophobia can even make it difficult or impossible to perform medical tests or use diagnostic tools, such as, for example, the magnetic resonance scanner (MRI) in which we find ourselves having to be immobilized.
The fear of suffocating can also be caused by everything that limits the possibilities of movement: for some people, wearing tight-fitting or high-necked dresses (t-shirts or sweaters) can induce the symptoms of claustrophobia; other subjects, on the other hand, feel a strong discomfort in fastening their seat belts in the car or while traveling by airplane.
Causes and Risk Factors
Claustrophobia is a disorder in which the phobic stimulus is represented by the idea of being surrounded and free of spatial freedom around it.
The word " claustrophobia " comes from the Latin term " claustrum ", which means "enclosed place", and from the Greek " phóbos ", meaning " fear " or " phobia ".
The causes of claustrophobia are not yet fully known. In most cases, however, this disorder seems to result from a traumatic experience, associated with the memory of a narrow environment, experienced during early childhood. Sometimes claustrophobia is related to specific situations, such as, for example, imprisonment or the need to resort to shelters during war conflicts.
Why do you suffer from Claustrophobia?
- According to some scientific studies, at the origin of claustrophobia there could be a malfunction of the amygdala, a structure belonging to the limbic system able to influence the process of perception of danger .
- Other experts in the field argue, instead, that there is a dysfunction related to the perception of space correlated to an evolutionary mechanism, which in ancient times had to have a fundamental role from the point of view of survival instinct . People who suffer from claustrophobia, in fact, live with extreme concern what could happen to them in confined spaces, since they perceive the danger most when they are unable to move.
- Like other phobias, claustrophobia can be rooted in experiences of traumas or particular perceptive modalities experienced during childhood and adolescence : if the natural instinct to explore is discouraged, a block is generated that also affects the perception of oneself and one's own possibility. In adulthood, this reaction can be emphasized by low self-esteem and results in an anxiety towards what is able to limit freedom, or closed places or particular "symbolic" situations, such as a relationship or the birth of a child.
Psychoanalytic interpretation of Claustrophobia
The psychoanalytic interpretation maintains that claustrophobia is connected to an important conflict on the psychological level, which is "converted" into mental representations related to the phobic stimulus. In this context, the search for "air" can be translated into the avoidance of situations characterized by not only physical closure. The feeling of oppression can be applied, for example, to over-oppressive relational or social ties, which is why we seek greater freedom, able to make our spaces regain.
Symptoms and Complications
Claustrophobia: how does it manifest itself?
The symptoms and severity of claustrophobia can vary widely from case to case. Some people experience mild anxiety or discomfort when they are indoors, confined spaces and cramped rooms. On the other hand, other claustrophobics show a serious sense of anxiety and, in extreme cases, full-blown panic attacks .
The most characteristic element of claustrophobia is the fear of suffocating or feeling trapped.
Like other phobic disorders, claustrophobia can also cause physiological reactions, such as:
- Accelerated beats;
- Chills and goose bumps;
- Cold sweat or, on the contrary, hot flushes;
- Tingling and itching;
- Nausea and / or vomiting;
- Sense of fainting or dizziness;
- Headache;
- Confusion and feeling of "empty head";
- Difficulty breathing (wheezing, feeling of suffocation);
- Visual disturbances, such as eye fatigue, sprains or optical illusions;
- Whistling in the ears;
- Dry mouth;
- Tremors;
- Cry;
- Numbness;
- Urinal urgency;
- Sense of oppression or chest pain.
Some people report having the perception that the walls are approaching them or feel like they are suffocating. Others try to get out and / or get away from the claustrophobic situation by any means possible. In severe cases, claustrophobia can lead to fear of fainting, losing control or even dying.
Somatic symptoms in phobias
The physical symptoms that manifest themselves in claustrophobia, as in other phobias, signal the occurrence of an abnormal response to an emotional level: the body is responding to the phobic stimulus with an extreme expression of the physiological reaction of " fight or flight ". In other words, the mind interprets the thought that closed rooms are a threat to a potential danger, so it automatically prepares the body to fight for survival. This excessive emotional response is one of the clearest signs that a person is prey to a phobic disorder.
Possible consequences of Claustrophobia
Claustrophobia can severely limit the lives of sufferers. In severe cases, the symptoms of phobic disorder are activated even just thinking about situations that typically trigger fear.
Over time, the fear of confined spaces leads to avoiding all the daily activities that could make you feel locked up, surrounded or limited from the point of view of space. The claustrophobic may not go, for example, to particularly crowded parties or feel a great discomfort in using seat belts in cars or on airplanes.
In this sense, traveling is also more difficult:
- Airplane flights force the person suffering from claustrophobia in a small place, surrounded by strangers;
- In the train, the seats can be more comfortable and there is the possibility of getting up to stretch your legs, but the journey can take longer;
- Driving the car can give the feeling of being limited in a small space, but it offers the possibility of stopping, when desired, for breaks.
Claustrophobia can also lead to various solutions, such as leaving the door open when entering small rooms or taking the stairs instead of taking an elevator.
The anxiety related to the phobic disorder is also responsible for a persistently high state of stress, which, in the long run, can be harmful to health.
From the medical point of view, claustrophobia can be dangerous, since it could cause the avoidance of diagnostic tests strongly indicated to the patient, such as MRI.
Disorders associated with claustrophobia
In some patients, claustrophobia is related to anxiety disorders and other phobias, such as darkness, heights and air travel.
Did you know that…
Claustrophobia is generally considered the antithesis of agoraphobia .
Diagnosis
Claustrophobia can be a highly debilitating disorder, as it can affect multiple activities and contexts. For this reason, if the symptoms significantly limit normal daily life and have been present for over six months, it is advisable to consult a doctor, a psychiatrist or a psychologist. In some cases, the diagnosis of claustrophobia may emerge during a patient consultation for another anxiety-related problem.
Claustrophobia: how is the diagnosis established?
The initial evaluation of the claustrophobic subject is fundamental to understand the reasons behind the inconvenience, identifying the meaning and quantifying its scope.
Therefore, the doctor:
- He asks the patient for a description of the symptoms and what triggers them;
- Try to establish how severe the symptoms are;
- Excludes other types of anxiety disorders or general pathology.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), claustrophobia is considered a specific phobia and, as such, is defined by some criteria:
- Fear is unreasonable, excessive, persistent and caused by the presence of a specific situation or involves anticipatory anxiety with respect to it;
- In case of exposure to the stimulus, an anxiogenic response is evoked: in adults, this can take on the features of a sudden panic attack; in children, it is possible to manifest itself in the form of nervousness and crying;
- Adults recognize that their fear is groundless and disproportionate to the perceived threat or danger;
- Avoidance measures and strategies are adopted to avoid the feared situation, as well as showing a tendency to face new experiences with a certain sense of anxiety;
- The person's anxiety reaction, anticipation or avoidance interferes with daily life and relationships or causes significant distress.
Furthermore, claustrophobia has persisted for some time (usually 6 months or more) and involves symptoms that cannot be attributed to another mental condition, such as obsessive-compulsive disorder (OCD) or post-traumatic stress disorder ( PTSD).
Treatment and Remedies
Claustrophobia can be a passing phenomenon, destined to disappear spontaneously. When it is particularly debilitating, however, this disorder must be managed with a course of psychotherapy or the use of other interventions useful to face phobic stimuli and the anxiety that results.
How can Claustrophobia be overcome?
Claustrophobia can be tackled with different therapeutic options, even in combination with each other. The choice depends on the person and the severity of the clinical picture. The most effective interventions include relaxation techniques, meditation and cognitive-behavioral psychotherapy aimed at overcoming the fear of enclosed spaces.
These interventions aim to induce the patient to rationalize his morbid fear towards closed and restricted rooms, trying to concentrate on the possibility of reacting to anxiety-provoking thoughts and to face the negative beliefs associated with claustrophobia.
drugs
In combination with psychological treatment, the psychiatrist can prescribe drug therapy to control the symptoms associated with the phobic disorder, such as anxiety.
The drugs that are usually indicated are benzodiazepines, beta-blockers, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOI).
It should be emphasized that the use of medicines can temporarily calm the problem, but it does not resolve it definitively.
Exposure therapy and desensitization
An effective result in the treatment of claustrophobia is the presentation of phobic stimuli to the patient in controlled conditions, until a systemic desensitization is obtained.
The therapy involves the gradual and repeated exposure over time to the situation that he considers claustrophobic (for example: closed room, but with open windows), to learn to manage anxiety and face the negative ideas associated with the fear of confined spaces and situations of encirclement.
Cognitive behavioral therapy
Desensitization can be practiced in combination with cognitive and behavioral techniques, in order to modify the vicious circle of claustrophobia and work on the meaning of phobic stimuli for the patient.
In this way, the claustrophobic subject is exposed to the feared situations, with the possibility of learning emotional self-control techniques, which allow him to reduce his fear.
Relaxation techniques
To deal with claustrophobia effectively, psychotherapy can be practiced in association with relaxation techniques, such as autogenic training, breathing exercises and yoga. These treatments can help manage the anxiety related to the situation he considers claustrophobic.
Another approach that may prove useful for some people is hypnosis . This alternative treatment provides a state of relaxation such as to induce the person concerned to recognize the causes of his fears and overcome them.
