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How to Treat Pistanthrophobia: The Irrational Fear of Trusting Others


Anxiety can often make relationships tricky to navigate. But for people with pistanthrophobia, an anxiety-related phobia characterized by the irrational fear of trusting others, relationships can feel downright impossible. Thoughts like “I’m going to get hurt again” and “I can’t trust anyone but myself” plague folks with pistanthrophobia to the point that they avoid relational intimacy completely. If this sounds familiar, you’re not alone. We hope the below information provides you the support and relief you need to navigate this intense fear.

What Is Pistanthrophobia?

Pistanthrophobia is a phobia centered on extreme difficulty and anxiety in trusting others — often due to bad experiences with prior relationships.  

“[Pistanthrophobia] is the irrational fear of getting close or feeling vulnerable in a relationship with others where you may experience hurt or disappointment or rejection,” Julian Herskowitz, Ph.D., who specializes in treating phobias and other anxiety-related disorders, told The Mighty. 

One of the ways to differentiate a regular fear from a phobia-level fear is to look at the extent to which someone avoids their fear. People with phobias often shape their lives around avoiding a particular trigger. For someone with pistanthrophobia, this usually means avoiding emotional intimacy in relationships. 

“They tend to exaggerate the probability of something going wrong, which is typical for people with anxiety,” Dr. Herskowitz explained. “They overestimate the probability of the worst-case happening.”

Some common examples of the “worst case” people with pistanthrophobia fear are being cheated on, being viewed as unworthy or not good enough, being rejected, or being broken up with or abandoned.

Samantha Myhre, Ph.D., clinical postdoctoral fellow at Austin Anxiety & OCD Specialists, told The Mighty people with pistanthrophobia often don’t engage in social or romantic relationships, and if they do, they only do so on a surface-level basis. Other behaviors may include not sharing personal details about themselves, not being alone with others and not expressing their emotions.

It’s important to remember that struggling with trusting others or avoiding intimacy can be common symptoms of past trauma or other mental health conditions — not just pistanthrophobia. If you think you may be struggling with pistanthrophobia, talk to your doctor about the symptoms you are experiencing so they can give you a proper diagnosis and treatment plan.

What Causes Pistanthrophobia?

For the most part, people develop pistanthrophobia as a result of negative relational experiences, whether it be from a messy breakup or another traumatic ending of a relationship. But in some cases, patients may just be particularly sensitive to social rejection, leading them to hide from others. 

“Most of the people that I’ve treated have had bad [relationship] experiences, but I think there are certain people that just have a fear of intimacy based on a feeling of not being good enough,” Herskowitz said. “They don’t want to let people get too close to see that and reject them.”

No matter what past experiences may have contributed to someone’s pistanthrophobia, it’s important to put the fear of intimacy into perspective. Herskowitz helps his patients do so with a shower metaphor. He explains that if you were to turn on the shower without checking the temperature and it scalded you, would that mean you never take a shower again? If someone avoided showering after a negative experience, they would miss out on the benefits that come from showering like taking care of yourself and being clean.

Similarly, if a person with pistanthrophobia were to avoid relational intimacy altogether, they would miss out on the benefits of a relationship — such as being fully seen (flaws and all) and loved anyway.   

If you’ve ever avoided connecting with others due to fear of rejection, you’re not alone. Pistanthrophobia or not, it’s important for you to get the help you need. Reach out to a trusted mental health professional and loved one for support. To connect online with people who care, we encourage you to post a Thought or Question on The Mighty with the hashtag #CheckInWithMe.

Treating Pistanthrophobia

Making the decision to pursue treatment for any kind of anxiety is difficult — after all, facing your fears is almost never a walk in the park. For anyone who feels like avoiding intimacy in relationships is keeping them from living a full life, Dr. Myhre has a suggestion:

“I would encourage [someone struggling] to consider what they value in the life they want to live and assess whether their current ways of responding to their fear of trust are moving them toward those goals or away from them,” she said.

If your goal is to eventually be in a romantic relationship, avoiding intimacy is likely keeping you from taking steps toward that goal. The good news is you don’t have to do it alone. 

With the proper treatment, recovery from phobias is extremely likely. In fact, many psychologists find treating phobias particularly rewarding because they get to see patients live freer lives, uninhibited by the phobia they faced prior to treatment.

Though treatment for phobias is incredibly successful, it’s worth mentioning it can be uncomfortable at times. The gold-standard treatment for obsessive-compulsive disorder (OCD) and phobias is exposure and response prevention (ERP), a type of therapy that involves exposing yourself to the trigger that causes you anxiety and resisting the way your anxiety wants you to respond to it. This treatment can be difficult for people (especially at first) because it forces you to face your fears head-on.

“People with anxiety tend to be more comfort-seeking, and tend to avoid negative emotions,” Herkowitz said. “They tend to be more self-protective of feeling anything that’s uncomfortable.” 

In the case of pistanthrophobia, where feelings of discomfort and anxiety arise from intimacy in relationships, a therapist might “expose” you to your fear by asking you to imagine being in a relationship, thinking through what it would look like to care for another person and be vulnerable. They might encourage you to download a dating app and go on a few dates. They might help you simulate a breakup conversation and ask you to think through what would happen should a person ever decide they don’t want to be romantically involved with you any longer — would you die? Would you never recover? Would you never find love again? Treatments and exposures will depend on how your particular fear manifests.

It’s important to find a supportive and skilled therapist who can help you tackle pistanthrophobia. Even in times you might feel alone, you never truly are.

For more on ERP and phobias, check out the following stories from our community: