Claustrophobia

A specific phobia is a form of anxiety disorder in which someone has an intense and irrational fear of certain objects or situations.. One of the most common phobias is claustrophobia, or the fear of enclosed spaces. A person who has claustrophobia may panic when inside a lift, aeroplane, crowded room or other confined area.

The cause of anxiety disorders such as phobias is thought to be a combination of genetic vulnerability and life experience. With appropriate treatment, it is usually possible to overcome claustrophobia or any other phobia.

Symptoms of phobias

Claustrophobia is a type of specific phobia. Specific phobias include the following symptoms:

• An intense fear or anxiety about a specific object or situation – in this case, small or enclosed spaces. People with claustrophobia typically experience an intense fear of suffocation or restriction, and desire to escape.
• This situation almost always provokes fear or anxiety
• Avoiding this situation, or enduring it with intense fear or anxiety
• The fear or anxiety is out of proportion to any actual danger
• The fear, anxiety or avoidance lasts for six months or longer and causes significant distress

Types of avoidance may include the following:

• inside a room – automatically checking for the exits, standing near the exits or feeling alarmed when all doors are closed
• inside a vehicle – avoiding travelling when traffic will be heavy
• inside a building – preferring to take the stairs rather than the lift
• at a party – standing near the door in a crowded room, even if the room is large
• avoiding MRI or CT scans
• for a person with severe claustrophobia, a closed door can trigger feelings of panic.

Symptoms of an anxiety attack

If a person suffering from claustrophobia finds themselves in an enclosed space, they may have an anxiety or panic attack in response to overwhelming fear. Symptoms can include:

• sweating
• accelerated heart rate
• hyperventilation, or 'overbreathing'
• shaking
• light-headedness
• nausea (feeling sick)
• fainting
• intense fear of harm.

The catch-22 of avoidance as a coping technique for claustrophobia

People often cope with phobias by avoiding situations that trigger worries around suffocation or confinement, and also want to avoid the experience of panic itself. Once a person has an anxiety or panic attack, they can become increasingly afraid that they might experience another anxiety or panic attack. 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. This is because people anticipate panic, and struggle to learn how to cope with triggering situations, which can actually intensify anxiety and fear.

Fear of treatment for claustrophobia

Treatment can have real benefits. But it is understandable that many people with phobias do not access treatment. Treatment can feel scary and can cause anxiety. Since most treatment options depend on confronting the feared situation or object in some way, the person may feel reluctant to start treatment.

Support and encouragement from family and friends can be helpful. A person trying to overcome a phobia may find some treatment methods particularly challenging and will need the love and understanding of their support people. The therapist may even ask the family members or friends to attend certain sessions, in order to support the person seeking treatment.

Treatment for claustrophobia

Treating phobias, including claustrophobia, relies on psychological methods. Depending on the person, some of these methods may include:

• cognitive behaviour therapy (CBT) – a structured therapy where the person is educated about phobias and anxiety, is encouraged to confront and change the specific thoughts and attitudes that lead to feelings of fear
• exposure therapy – this is a specific type of CBT used to treat phobias and other situations that can cause high levels of anxiety or panic. Exposure can be in person, imagined, or via technology such as virtual reality. There are many types of exposure and these can include:
• gradual exposure –The person is taught to use specific relaxation and visualisation techniques when experiencing phobia-related anxiety. Triggering situations are slowly introduced, step-by-step, while the person concentrates on attaining physical and mental relaxation. Eventually, they can confront the source of their fear without feeling anxious. This is also known as systematic desensitisation
• flooding – this is a form of exposure treatment, where the person is exposed to their phobic trigger until the anxiety attack passes. The realisation that they have encountered their most dreaded object or situation, and come to no actual harm, can be powerful
• modelling – the person watches other people confront the phobic trigger without fear and is encouraged to imitate that confidence
• medications – such as anxiolytics (anti-anxiety medications) and antidepressants may also be helpful in addition to psychological treatment.

Length of treatment for claustrophobia

The person may be treated in the community or as an outpatient or, sometimes, as an inpatient if their phobia is particularly severe. Some psychological treatments are brief and may only involve 1-2 sessions, whereas others are more gradual or comprehensive, and typically require 10-12 sessions.

Where to get help

• Connect with SANE’s free counselling service online or on Tel. 1800 187 263, between 10am-8pm Monday to Friday AEST/AEDT.
• SANE Forums are full of people who want to talk to you and offer support.
• Your GP (Doctor)
• Psychologist
• Psychiatrist
• Lifeline Tel. 13 11 14
• Kids Help Line Tel. 1800 551 800