Claustrophobia

A phobia is a form of anxiety disorder in which someone has an intense and irrational fear of certain objects or situations.  Claustrophobia is one of the most common phobias.

As an introduction to fear, anxiety, and phobias, see the Fears and phobia and Phobia sections of this website. 

Claustrophobia is an anxiety disorder that involves the fear of enclosed or confined spaces. A person with claustrophobia suffers from panic attacks, or fear of having a panic attack, in situations such as being in elevators, trains or aircraft.  If a panic attack occurs while they are in a confined space, then the claustrophobic person fears not being able to escape the situation. Those suffering from claustrophobia might find it difficult to breathe in closed auditoriums, theatres, and elevators. Like many other disorders, claustrophobia can sometimes develop due to a traumatic incident in childhood.

Popularly, claustrophobia is considered to be the opposite of agoraphobia, or a "fear of open spaces". This is an oversimplification however since claustrophobics may also fear being in crowds, and agoraphobia can also be characterized as a "fear of public spaces".   So, a crowded city square might trigger claustrophobics and agoraphobics alike.

If a person suffering from claustrophobia suddenly finds themselves in an enclosed space, they may have an anxiety attack. Symptoms can include:

Sweating
Accelerated heart rate
Hyperventilation, or ‘over-breathing’
Shaking
Light-headedness
Nausea
Fainting
Fear of actual harm or illness.

Once a person has experienced a number of anxiety attacks, they become increasingly afraid of experiencing another. They start to avoid the objects or situations that bring on the attack. However, any coping technique that relies on avoidance can only make the phobia worse since the anticipation of the possibility of confinement within a small space typically intensifies the feelings of anxiety and fear.

As is the case with social phobia, the precise cause of claustrophobia is not known.  Environmental and biological factor may both be involved.  Some people are born with a personality style that may lend itself to the person becoming claustrophobic. Others may learn a cautious style depending on experiences they have, the way others react to them, or the behaviors they see in their parents and others.  Biological and chemical processes in the brain may also play a part.

Claustrophobia can be treated in similar ways to other anxiety disorders, with a range of treatments including cognitive behavior therapy, reality therapy and the use of anti-anxiety medication.  Effective treatment is based on the assumption that claustrophobia is a learned response to being in certain situations. A response that is powerful, uncomfortable, embarrassing, inconvenient, debilitating at times, perhaps even seriously debilitating - but still a learned response. And just as you can learn to have a particular response you can un-learn it.

Therapists can help people who have claustrophobia to develop coping skills to manage their fear and anxiety. This involves understanding and adjusting thoughts and beliefs that help create the anxiety, learning and practicing specific behavioral social skills to increase confidence, and then slowly and gradually practicing these skills in real situations.

Cognitive behavior therapy is an approach where the person is encouraged to confront and change the specific thoughts and attitudes that lead to feelings of fear. Systematic desensitization, which is a type of cognitive behavioral therapy (CBT), is a preferred behavioral technique used to treat claustrophobia and other phobias. It based upon having the person relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Gradual exposure to real life phobias has also been used with success to help people overcome their fears.  According to the National Institute of Mental Health, about 75% of people with specific phobias overcome their fears through cognitive-behavioral therapy. 

Relaxation and stress relief techniques are frequently used with other therapeutic approaches.  Relaxation techniques may include things like specific ways of breathing, muscle relaxation training, guided mental imagery, or soothing self-talk.

Anti-anxiety and anti-depressive medications are sometimes used to help relieve the symptoms associated with agoraphobia. Certain medications that help to regulate the function of serotonin (a brain chemical that helps to transmit electrical messages having to do with mood) are sometimes used. Though medication doesn't solve the whole problem, it can reduce anxiety so the person can more easily deal with their problem. Drugs such as tranquilizers and anti-depressants and drugs known as beta blockers may be used to treat the physical symptoms of anxiety, such as a pounding heart.

Hypnotherapy can also be effective.  This usually consists of systematic desensitization and other therapeutic techniques conducted under hypnosis by a clinical hypnotherapist.

For more information about claustrophobia and mental health issues, please click on the linked websites listed below.

For a list of the many phobias please visit the page List of Phobias.

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