Trypophobia: the fear of closely-packed holes explained

If repetitive patterns, closely-packed holes or tiny protrusions turn your stomach, you could be suffering from trypophobia.

trypophobia and the fear of holes explained
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Do tiny holes leave you feeling cold? If the mere sight of patterns consisting of holes or bumps in anything from honeycomb to coral makes you shudder, then you could be suffering from trypophobia.

Trypophobia is an extreme fear or disgust of repetitive patterns, closely packed holes or protrusions and while it may simply make your skin crawl, for some people this unusual phobia can develop into extreme and debilitating anxiety.

Qualified CBT therapist Navit Schechter looks at trypophobia symptoms, causes, risk factors and treatment options so you can learn to face your fears head on:

What is Trypophobia

Trypophobia is the name given to an extreme fear of or aversion to small clusters of holes, bumps or patterns such as those seen in honeycomb or aerated chocolate. While many people with trypophobia will experience severe anxiety in response to these clusters, others will experience a strong feeling of revulsion or disgust instead.

As trypophobia is not a diagnosable condition and many of those who experience it are not aware that others do too, many suffer in silence.

Trypophobia symptoms

Trypophobia can be triggered in response to any object that has tightly packed holes, patterns or protrusions including the head of a lotus seed pod, beehives, the body of small fruit such as a strawberry, sponges, soap, bubbles, water condensation, coral, a close up of a person's pores, holes or bumps on flesh or animals or insects with spotted skin. When a person with trypophobia sees or imagines one of these objects they often experience a number of symptoms.

If you suffer from trypophobia you might feel:

  • Fearful, highly anxious or have a panic attack.
  • Revulsion or disgust in response to the feared object.
  • Shame or embarrassment if this is noticeable to others or affects your day-to-day life.

    It is also common for these feelings to be accompanied by physical symptoms such as:

    • Dizziness
    • Finding it hard to breath
    • Sweating
    • Feeling hot
    • A rapid heartbeat
    • Feeling shaky
    • Nausea or stomach pains
    • Goosebumps, itchy skin or 'feeling your skin crawl'
    • Visual discomfort eg eyestrain, distortions or visual illusions

      As a result of these symptoms, you may notice that your attention becomes focused on the objects that cause you to feel fear or disgust, or you might try and distract yourself from thinking about them. You may also worry about coming into contact with them or have images pop into your mind when you don't want them to.

      You may notice that your attention becomes focused on the objects that cause you to feel fear or disgust.

      Some people become so bothered by the sight of these objects that they can't stand to be around them. This may become so extreme that it affects how you live your day-to-day life. You may notice that you avoid triggers or places where you may come across them or endure them with distress, such as the fruit aisle of the supermarket where you may come across strawberries or other similar fruits. This can become so extreme that it restricts your life to the extent that it affects your work, you become isolated from friends and family and no longer experience enjoyment or pleasure from life.

      trypophobia fear of holes explained
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      Trypophobia causes

      Although the causes of trypophobia remain unclear, it has been hypothesised that it likely has an evolutionary basis as the feared clusters of holes or bumps may be instinctually associated with danger or disease, creating a natural aversion. It is suggested that the brain responds to the high-contrast pattern of clusters in everyday objects as a threat due to their similarity to potentially harmful snakes, insects and spiders or infectious skin diseases.

      Trypophobia risk factors

      The extent to which trypophobia exists is also unknown and little research has been conducted to ascertain its risk factors. Both men and women have been found to experience trypophobia, however it has been found more commonly in women than men. Trypophobia may also be more likely in those who experience mental health conditions such as obsessive-compulsive disorder (OCD), depression or generalised anxiety disorder (GAD).

      When to see a doctor

      If you experience frequent, intense and persistent feelings of anxiety and/or disgust that cause you distress and get in the way of your day-to-day life, work and relationships, then it may be time to seek help. You can speak to your GP about the symptoms you experience or find a qualified and accredited therapist who will also be able to help you find the right support and treatment.

      Trypophobia diagnosis

      Trypophobia is not a recognised anxiety disorder. It is therefore not included in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) or diagnosable in it's own right and relatively little is known about it.

      If you experience frequent, intense and persistent feelings of anxiety, it may be time to seek help.

      For some people, trypophobia may be best understood as a phobia; an intense and irrational fear of a specific object or situation which is either endured with intense distress or avoided completely to the extent that it impacts negatively on your life. However, this may not be the case for those who experience feelings of revulsion or disgust, rather than anxiety.

      trypophobia and fear of holes explained
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      5 trypophobia treatment options

      As Trypophobia is not a diagnosable condition, there are no diagnostic tests available or formal guidelines, so no treatment has officially been demonstrated to be effective. However some of the methods that have been shown to be effective in treating other phobias are likely to be beneficial in helping you to manage and overcome your symptoms. These include self-care techniques, medication and talking therapy:

      1. Self-care techniques and trypophobia

      Self-care techniques are useful to help you to feel generally calmer and more relaxed. While they may not help you overcome your fears in the long-term, they can help you to reduce the physical symptoms of anxiety you are experiencing and feel more able to deal with the symptoms of trypophobia when they arise. Self-care techniques include:

      • Relaxation exercises such as breath work and visualisations.
      • Practising yoga, meditation or mindfulness.
      • Eating a nutritious diet and minimising caffeine and sugar which can exacerbate anxiety.
      • Getting enough sleep and rest.
      • Ensuring regular exercise.
      • Seeing friends and family and talking about how you're feeling with those you trust.

        2. Medication for trypophobia

        Little is known about the effectiveness of medication in the treatment of trypophobia. Medication is sometimes used on a short-term basis to treat anxiety however it isn't usually recommended in the treatment of phobias, as talking therapies have been found to be so effective while having no side-effects.

        3. Cognitive behaviour therapy and trypophobia

        Speaking to a therapist or counsellor can be helpful in understanding and managing your symptoms. Cognitive Behaviour Therapy (CBT) is a type of talking therapy that is recommended for the treatment of trypophobia due to its effectiveness in the treatment of other anxiety conditions. During a course of CBT therapy, you and your therapist would work together to help you to understand your symptoms of trypophobia and how you can overcome them.

        4. Exposure therapy and trypophobia

        CBT might involve exposure therapy which involves gradually exposing yourself to the objects that trigger your trypophobia in a supported and safe environment. You would create a hierarchy of feared objects and gradually reduce your avoidance of these for an extended period of time, starting with your least feared object. For example, if a bath sponge triggered your trypophobic response then reading about a sponge or seeing a photo of one may be the first step of the hierarchy leading up to being able to hold or use one for an extended period of time.

        When you face these triggers in this way, it allows the brain to see that things you have been fearful of are not as threatening or harmful to you as they seemed and your anxiety reduces as a result. Exposure has also been found to indirectly reduce associated feelings of disgust.

        5. Applied relaxation and trypophobia

        Applied relaxation is another CBT technique that has been proven to be effective in the treatment of phobias. This involves learning to identify your early signs of anxiety, learning some simple relaxation skills and how to apply these at the first sign of anxiety.

        Recognising and adjusting any negative thoughts or assumptions that may be maintaining your experience of trypophobia can also help you to feel less anxious and help you to feel more confident in dealing with triggers when they occur.

        Trypophobia long term

        Trypophobia has received considerable attention online in response to a need from sufferers to find support. However, as yet, trypophobia has still not been definitively defined as a phobia.

        While the above can help you to manage your symptoms and the impact trypophobia is having on your life, further research is needed to understand the causes and nature of trypophobia as well as effective treatments.

        Further help and support

        If you have any anxious thoughts, feelings or phobias that are limiting your life, speak to your GP about the symptoms you experience or try one of the following resources:

        • No Panic: a registered charity which helps people who suffer from panic attacks, phobias, obsessive compulsive disorders and other related anxiety disorders.
        • BABCP: a multi-disciplinary interest group for people involved in the practice and theory of behavioural and cognitive psychotherapy.
        • Anxiety UK: a charity which specifies in helping those suffering from anxiety.
        • The Samaritans: a charity providing support to anyone in emotional distress.
        • Mind: a charity that makes sure no one has to face a mental health problem alone.

          Last updated: 18-03-2021

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