Claustrophobia: The Fear of Restricted & Confined Spaces

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Wear a mask inside: from movie poster
The Facemask – An UN-Usual (claustrophobia-causing) Suspect. 
“The greatest trick the devil ever pulled was convincing the world he didn’t exist,” proclaims Kevin Spacey’s Roger Kint, in The Usual Suspects. He was commenting on the mythical nature of crime boss Soze Kint.

 

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Far from being a simple embarrassment, claustrophobia is a very painful phobia to live with and can become debilitating in everyday life. To heal, it’s necessary to find the cause of inner anxiety. The disorder is one of the most common phobias of our time.

Claustrophobia is the fear of tight spaces and confinement. This phobia affects between 4 and 5% of the population and can become highly debilitating in everyday life.

The claustrophobic person has the impression of suffocating when in an elevator, confined to the subway, or any other small closed space. In extreme cases, this feeling of choking is accompanied by intense anxiety that can lead to a panic attack or the sensation of going crazy.

The causes of claustrophobia are difficult to define because they depend on each person’s history: trauma at birth or in childhood, for example, or an act of aggression in a confined space such as in a train car.


To overcome claustrophobia, it’s necessary to find the root cause of the anxiety: psychoanalytic psychotherapy can be very useful.

It’s estimated that 4-5% of people in the general population suffer from claustrophobia. The etymology of the word claustrophobia comes from the Latin claustro, resulting from claustrate (cloister, enclose) and Greek phobos, which means fear.  Claustrophobia is the fear of restricted spaces, confinement.” Oftentimes, the fear of confined spaces is accompanied by a fear of falling.

Lockdown Got You Feeling Trapped? Coronavirus, Facemasks & Claustrophobia

Since The World Health Organization (WHO) declared COVID-19 a ‘Pandemic’ on March 11th 2020, even those of us who have not been infected by the virus have been affected in multiple other ways. Governments around the world have imposed varying levels of lockdown over their citizens, and even in less strict countries, many people will choose to self-quarantine for several weeks.

For those with larger houses and private outdoor spaces, this might be nothing more than a minor inconvenience. Those without the luxury of spacious accommodation may start to experience claustrophobia from the invasion of private spaces by partners, children, and extended family members.

Fortunately, there are some things that anyone can do, regardless of their current living situation:

  • If secure, open the windows and doors to let some fresh air in.
  • If you have them, spend time sitting on your doorstep or out in the garden. If you’re near the street, remember to keep a safe distance from those passing by.
  • If it’s not possible to open windows, place a chair nearby and spend some time gazing at the sky. This should give you a sense of space.
  • Change the rooms that you spend time in as much as possible. If you don’t have access to different rooms then try to switch up the areas you sit in (eg. on the couch, at the table, etc.)
  • Take some exercise alone and away from other people, if your local jurisdiction allows it.

Locked Down Doesn’t Have to Mean Locked In

If you’re feeling trapped or locked in by extreme restrictions on movement in your areas due to COVID-19, it could be that you are confusing claustrophobia with cleithrophobia. While they are similar conditions that cause similar symptoms, the causes and triggers are slightly different.

What is Cleithrophobia?

  • A fear of being trapped
  • Small spaces don’t cause panic unless locked in
  • May experience anticipatory anxiety

As you can see, the conditions are subtly different from claustrophobia and it may be difficult to distinguish between the two. Claustrophobia suffers may feel trapped or locked in, even though they know they are not. The two phobias may even co-exist.

Fortunately, treatment of the conditions is similar. Most local and national authorities have not gone to the extremes of trapping people inside their homes and have instead issued guidance for social distancing, and only leaving the house in limited circumstances.

Check local restrictions to see if you’re permitted out of the house for exercise or dog-walking. In the UK for example, residents can leave their house for one form of exercise per day as long as they take it alone.

The Facemask – An UN-Usual (claustrophobia-causing) Suspect

“The greatest trick the devil ever pulled was convincing the world he didn’t exist,” proclaims Kevin Spacey’s Roger Kint, in The Usual Suspects. He was commenting on the mythical nature of crime boss Soze Kint.

Fortunately, though today’s antagonist cannot be seen, scientists have already proved its existence and are developing drugs, tests, and measures to fight the coronavirus.  While their effectiveness is debated, facemasks are one such measure.

Wearing a mask that covers the nose and mouth maybe be particularly difficult for claustrophobic patients. So what should they do if they’re living in a country that insists upon their use?

Wearing facemasks for claustrophobics – some recommendations:

  • Address your fears. Ask yourself why you’re scared about wearing the mask. Try and pinpoint exactly what worries you, so that you can start to deal with it.
  • Get to know your mask. Examine the mask from top to bottom and get familiar with it, hold it and examine it (make sure you have clean hands before doing this).
  • Wear the mask in the house. Try the mask our inside the house when you’re under less pressure. Wear it for a few minutes at first until you feel more comfortable.

 

Phobia

Possible Treatments for Claustrophobia

It’s necessary to consult from the moment when claustrophobia affects daily life, or it could become seriously debilitating because if one does not do anything, the phobias extend.

Many people in the USA are turning to cannabinoids (CBD)  as a cure-all for anxiety. Be they drops under the gums or gummy bears, the effectiveness is anecdotal, though very compelling.   Research into cannabis extracts will tell us more precisely if they are a solid alternative to serious, addictive medications like valium or benzodiazepines.

If psychotherapy of psychoanalytic inspiration is advised for a phobia,  it helps to put the broader context of the personality in perspective and helps us to know where the anxiety comes from. If we can solve the problem, the phobia has a better chance of disappearing completely.

Behavioral work can be introduced in parallel. Depending on the claustrophobe’s progress, over time the therapist may take the patient to take the elevator more often, for example. At a certain point, the more we handle the situation, the more we can extricate it from harmful associations.

cognitive-behavioural therapy (CBT) is a very effective choice for treating phobias.  It involves confronting and changing thought processes and/or behaviors through symptom-centred practice exercises.

Analysis Of A Claustrophobia Case

Example of a patient: Sam is a 28 year old man who always loved to fly. He once made a trip with his spouse and was seized with paroxysmal anxiety during this flight disturbed by turbulence. From that point forward, he carried a fear of being on a plane, to the point of sometimes doing more than 3 days of travel by other, slower means of transport.

“In fact, he felt very guilty of deceiving his wife, a mother of a baby, the real events – the turbulence – and his agonizing guilt combined to give a fear of the plane, his anxiety came from elsewhere but crystallized on an unpleasant situation” explains his psychoanalyst.

Famous claustrophobes: American actress Uma Thurman suffers from claustrophobia.

Behaviors Associated With The Phobia of Confinement

Claustrophobia is an anxiety disorder. This fear and panic of confined spaces without escape can in some cases be associated with ochlophobia, which is the fear of being suffocated or crushed by a crowd. The sensation of suffocation is the same as that which a claustrophobe feels. Taphophobia, or the fear of being buried alive, is also a form of claustrophobia.

What is the causes of claustrophobia? It depends on the history of each.  Otto Rank, Austrian-born psychoanalyst 1, has hypothesized that this is linked to birth trauma, including the process of moving through a narrow passage, which leaves an imprint traumatic to the child,” he reports. Regarding the link between claustrophobia and pregnancy, it’s also possible that excessive stress on the mother during these 9 months can have an impact.

In any case, there’s always a trigger; it can be a trauma experienced in childhood or a shocking experience of confinement. Nevertheless, to understand the source of claustrophobia in an individual, we must question the severity of the traumatic event.

If it’s an assault in a subway, the trauma is strong enough to have generated a phobia of tunnels and underground passages. On the other hand, if the phobia is declared after feeling a sensation of suffocation in an elevator, then it’s probable that the claustrophobe has merely discovered an already underlying phobia.

Physical, Psychic and Behavioral Consequences

As for most phobias, the cause of anxiety is not the object of phobia. Because it’s impossible to escape into oneself, the mechanism of phobia is used to enable it, through an unconscious mechanism; the claustrophobe projects this anguish on the outside. The situation, object or action in this situation is responsible for the anxiety. It is, therefore, crucial to avoid the phobic object to avoid anxiety.

When the claustrophobe finds his- or herself in a closed space, an unconscious mechanism is triggered and can generate palpitations, tremors, hot flashes or difficulty breathing. The subject has the impression of running out of air or suffocating, sometimes to the point of a physical disruption in breathing.

What makes the difference between unpleasant sensations and pathology is the intensity of the anxiety. Thus, if a person has paroxysmal anxiety connected with the fear of a panic attack in a situation of confinement, he or she must set up counter-measures such as no longer taking the elevator, the train et cetera.

This is because claustrophobia is much more than a simple apprehension; it can result in very painful experiences,” insists the psychoanalyst and psychotherapist.