Fear of closed, small, confined spaces known as Claustrophobia

Claustrophobia - cave

Claustrophobia is the irrational fear of being in a small room, space, elevator or confined area. Also having the feeling of being unable to get out or escape is common. It has many triggers most of which are situational. This means the individual who is subject of such fear finds himself physically in a confined space. People have commonly experienced triggers of this phobia in physically tight places. Elevators, small caves, holes in the ground, potholes, MRI scanners (or other places that are a tight fit for humans) are among those places. Sometimes its doesn’t necessarily mean that the place should be small or confined for someone to experience claustrophobia. You can be in open spaces, and as long as there are a lot of people or objects around you can get a feeling of suffocation and overcrowds.

A very common misconception about claustrophobia is that it is only the fear of being in closed, small or confined places. You can get similar anxiety attacks even from the simple fear of being locked inside – regardless of the space you are in. Even bedrooms with a lock on the outside, small cars all the way to extreme cases when being triggered by tight clothing.

Claustrophobia is sometimes confused with the fear of being locked in an enclosed place. Cleithrophobia or Cleisiophobia, or usually confound with the fear of being enclosed, Clithrophobia or Cleithrophobia.

What causes Claustrophobia?

Claustrophobia has a number of different reasons why it is caused.

  1. Amygdala
  2. Classical Conditioning
  3. Conditioning Experiences
  4. Prepared Phobia

1. Amygdala

The amygdala (/əˈmɪɡdələ/; plural: amygdalae; also corpus amygdaloideumLatin from Greek) is one of two almond-shaped clusters of nuclei located deep and medially within the temporal lobes of the brain in complex vertebrates, including humans. Shown in research to perform a primary role in the processing of memory, decision-making and emotional responses (including fear, anxiety, and aggression), the amygdalae are considered part of the limbic system. – Source: Wikipedia.org

The amygdala, even though one of the smallest parts of the human brain. Is one of the most important ones! It is what controls

Amygdala and phobias
Amygdala location in the human brain.

the so called fight-or-flight instinct in humans. As a result, without this instinct, survival in primitive times would nearly be impossible. This fight-or-flight response is triggered when someone is faced with a dangerous or threatening situation.

How does the amygdala create the fight-or-flight response?

The anterior part of the nuclei of the amygdala is associated with fear. The Nuclei is the one that sends impulses to other nucleus, which in terms influences heart rate, physical arousal, the release of adrenaline, blood pressure, the respiratory rate, behavioural fear response, and defensive responses. When these are triggered it is what is called an autonomic failure in a panic attack. What autonomic failure means is the physical freezing you experience. The inability to move and escape an apparent dangerous situation.

Fumi Hayano has seen a pattern in people with smaller amygdalas in the right part, experience anxiety attacks more often.

2. Classical Conditioning

Claustrophobia is caused when the subjects mind, correlates a small confined space with a dangerous situation. The root of such comparison and suggestion with danger may be result of traumatic past experiences. These experiences may have been result of past situations. It doesn’t necessary mean that someone should go through some traumatic experiences with confined spaces. An individual that is subject to claustrophobia can also have been through only one bad experience. That one bad experience has left a mark, that makes one get the impression of danger hence claustrophobia. In most reported cases, claustrophobia seems to have been as a result of past experiences.

3. Conditioning Experiences

Common experiences that have fuelled claustrophobia in adults and children have been:

  • Putting someone (most commonly children) in a crowded area with no outside view (a classroom, basement, etc.) and has run-ins with other people, or is put there as a means of punishment.
  • Falling into a deep pool and cannot swim.
  • A child gets separated from their parents in a large crowd and gets lost.
  • Getting the head stuck between the bars of a fence with no ability to get back out.
  • Crawling into a hole and getting stuck, or not being able to find a way back.
  • A child is left in their parent’s car, truck, or van.
  • A child is put into room with no lights and cannot find the light-switch or door to exit.

Some authors believe that claustrophobia might be developed since the moment of birth. Even though it might seem impossible they believe that memory might extend up to that moment.

4. Prepared Phobia

Another very famous idea about the root cause of such phobia might not be past experience but rather the way our brain works. Us humans tend to fear everything that might be dangerous hence phobias are formed hence the acquisition of claustrophobia may be part of a evolutionary survival mechanism, a dormant fear of entrapment and/or suffocation that was once important for the survival of humanity and could be easily awakened at any time. Hostile environments in the past would have made this kind of pre-programmed fear necessary, and so the human mind developed the capacity for “efficient fear conditioning to certain classes of dangerous stimuli”.

Claustrophobia Symptoms

Claustrophobia is an anxiety disorders! The main to pillars of claustrophobia are fear of restriction and fear of suffocation. A classic claustrophobe will feel anxiety or restriction in at least on of the following situations/locations: MRI or CAT, mall rooms, scan apparatus, cars, buses, airplanes, trains, tunnels, underwater caves, cellars, elevators and caves, locked rooms. In some severe cases a person can experience some sort of claustrophobic event even when faced with an authoritative figure and being unable to get out. Or when being at the doctors diagnostics table or at a dentist undergoing some sort of treatment.

Triggered because someone is trapped or confined in a small tight space brings a feelings of suffocation, hence not having the option to inhale appropriately, coming up short on oxygen, and nervousness of being limited. It isn’t generally the small spaces that trigger these feelings, rather than the potential outcomes of what could occur while restricted in those areas. In such situations some signs of claustrophobia are:

  • dizziness, fainting spells, and lightheadedness
  • dry mouth
  • hot flashes
  • confusion or disorientation
  • nausea
  • headache
  • numbness
  • accelerated heart rate and a rise in blood pressure
  • a choking sensation
  • tightness in the chest/chest pain and difficulty breathing
  • an urge to use the bathroom
  • shaking or trembling and a sense of “butterflies” in the stomach
  • fear of harm or illness
  • sweating and/or chills
  • hyperventilation

Diagnosing Claustrophobia

Diagnosis of claustrophobia should include some criteria. Specific phobias/prepared phobias such as this should include some criteria:

  • Fear caused by the anticipation of a specific situation
  • acknowledgment by adult patients that their fear stems from the anticipated threat or danger
  • engaging in procedures to evade dreaded object or situation, or proneness to face the situation but with discomfort or anxiety
  • the person’s evasion of the object or situation impedes with everyday life and relationships
  • the phobia is continuous, and has been persistent for 6 months

Another way is using the scale. A method developed in 1979 which consists of interpretations of patient files. From this patient files, questionnaires have been developed, usually consisting of 20 questions that determine the scale in which someone is experiencing claustrophobia. Though, this method is not to be confused with the other questionnaire created by Rachman and Taylor, two experts in the field, in 1993. This method is effective in distinguishing symptoms stemming from fear of suffocation and fear of restriction. In 2001, it was modified from 36 to 24 items by another group of field experts.

Treatment of Claustrophobia

There are 4 common methods for treating people suffering from claustrophobia.

Cognitive therapy

Cognitive therapy is very common when it comes to treating anxiety disorders. Especially when the patient does not have an immediate fear when actually being in that situation but rather of the outcome that might come out of it. Changing the thinking of the patient to differently approach and experience their situational triggers might greatly help in reducing their anxiety levels. For example, cognitive therapy would attempt to convince a claustrophobic patient that elevators are not dangerous but are, in fact, very useful in getting you where you would like to go faster.

Exposure

This method is more intrusive and forces the person suffering anxiety attacks from such phobias to actually face the situations that trigger it. Of course this is done in a progressive manner so that it doesn’t make it worse or hurt the person.

Interoceptive exposure

Different from actual exposure this method tends to re-create that exposure in a controlled environment. This has a smaller footprint on the patient because they actually know that the situations and triggers are staged for treatment porpouse. Interoceptive exposure might be a good preface to actual exposure.

Tips for managing claustrophobia

Some tips for managing an anxiety attack caused by claustrophobia would be:

  • to take deep breaths, one to three times. Then, focus on safe things like the time on your watch.
  • Reminding yourself that your fears and anxieties are transitional and will pass.
  • It’s irrational to challenge what triggers your attack by repeating the fear.
  • Imagine and focus on a place or moment that calms you down.

Famous people that are Claustrophobic.

  • Woody Alen
  • Uma Thurman
  • Paris Hilton
  • Ryan Renolds
  • Justin Bieber
  • Jessie J
  • Niall Horan
  • Kelly Macdonald

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