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Trypophobia: What It Is and How to Treat It

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Have you ever gotten the heebie-jeebies looking at a zoomed-in picture of a sponge, coral or a beehive? Gross, right?

All those tiny holes make a lot of people shudder, but for people with trypophobia — an anxiety condition that refers to intense fear or disgust of closely-packed holes — looking at images like these can feel downright impossible.  

If you’ve never heard of trypophobia before, you’re definitely not alone. For those who have heard of it, it might be because model Kendall Jenner opened up about experiencing it in 2016 (“I can’t even look at little holes — it gives me the worst anxiety. Who knows what’s in there???” she wrote in a blog post). Or maybe you saw those horrible posters two years ago for American Horror Story’s seventh season entitled “Cult,” which used trypophobia as a scary plot device.

Because many people haven’t heard of trypophobia before, we wanted to do a deep dive into what it actually is, what causes it and how you can treat it so we spoke to three different therapists who specialize in treating anxiety disorders and phobias to fill in the gaps.

What Is Trypophobia?

Trypophobia is not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but like other specific phobias, it’s characterized by intense and irrational fear when presented with a trigger — in this case, tightly-packed holes. 

“Trypophobia is a phobia that involves fear, discomfort or disgust when viewing objects that contain multiple holes that are closely gathered together,” Jameeka Moore, Psy.D., a psychologist who specializes in obsessive-compulsive disorder (OCD) and other anxiety-related disorders, told The Mighty. “Viewing honeycombs, coral, lotus seed pods, strawberries and animals that have spotted fur or skin are examples of things that could trigger this phobia.”

Symptoms of Trypophobia

Though a lot of us might dislike the way closely-packed patterns or holes look, people with trypophobia can experience intense physical manifestations of fear and disgust when they see groupings of holes. According to clinical postdoctoral fellow Samantha Myhre, Ph.D., some common physical symptoms people with trypophobia can experience include:

  • Muscle tension (especially in the face)
  • Nausea
  • Tingling in the skin
  • Goosebumps
  • Heavy breathing
  • Panic attacks
  • Excessive sweating
  • Itchiness

BuzzFeed staff member Krista Torres, who lives with trypophobia, wrote about the symptoms she experiences when she encounters a visual trigger.

“I’ve suffered from [trypophobia] for as long as I can remember. So, what happens when I see holes? A whole bunch of bad things,” she wrote. “My skin starts to crawl, my stomach turns, I get shortness of breath, and even physically itchy. IT. IS. HORRIBLE.”

Aside from physical symptoms, one of the tell-tale 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 trypophobia may go to extreme lengths to avoid looking at tightly-packed holes. Examples may include avoiding certain foods that contain hole-like patterns (like strawberries) or avoiding locations entirely (for example a house with hole-patterned wallpaper).

What Causes Trypophobia?

Though there isn’t a lot of research on trypophobia out there, there are two main theories on why it occurs. In the past, trypophobia was believed to be a subconscious evolutionary response to threatening animals (like snakes or spiders), which may be associated with spotted skin or clustered circular eyes. But recently, research has leaned more toward the belief that trypophobia is probably related to an evolutionary aversion to disease.

Based on research findings in 2017, psychologists from Emory University argued that trypophobia might not be a fear-based phobia, but instead an intense disgust response. In the study, researchers exposed subjects to images of clustered holes, dangerous animals and neutral objects. Using eye-tracking technology (called pupillometry), they noted changes in the size of each subject’s pupils. 

Pupil dilation corresponds with the body’s fear response, while pupil constriction is more commonly associated with feelings of disgust. Researchers noticed when exposed to images of holes, subjects’ pupils constricted, indicating that trypophobia might be more of a disgust response than fear. 

The researchers noted that both fear and disgust are built-in defensive responses. According to a news release, research authors theorized that reacting in disgust to clusters of holes might be an evolutionary response to avoid contamination and disease, as tightly packed holes may resemble infected skin or rotten or moldy food.

Regardless of whether trypophobia is an official phobia, disgust response or both, the reality is that some people do experience debilitating anxiety symptoms when they see closely-packed holes and deserve support for what they are experiencing. 

Treatment for Trypophobia

Phobias seldom go away on their own without treatment, Philip Pierce, Ph.D., a licensed clinical psychologist, told The Mighty. If trypophobia is standing in the way of your ability to function on a daily basis, don’t worry — you’re not alone and there is help available.

Recovering from phobias is extremely likely with proper treatment. According to most clinicians who specialize in treating anxiety disorders, exposure and response prevention therapy (ERP) is the gold-standard treatment for phobias.

ERP is a type of therapy that involves gradually exposing yourself to the trigger that causes you anxiety and resisting the way your anxiety wants you to respond to it. In treatment, an ERP-trained therapist will very slowly lead you through a series of “exposures” designed to gradually acclimate you to your fear so it becomes less anxiety-inducing over time. 

“Exposure therapy for trypophobia would involve a therapist helping you expose yourself to images of or real objects that contain closely-packed holes,” Dr. Myhre told The Mighty, adding:

Throughout this process, your brain learns it does not need to fire off the alarms and lead to a big reaction in your body [when you see holes]. Instead, you learn to tolerate the anxiety or disgust. With repeated exposure, you typically see the intensity of the anxiety or disgust decrease.

If this kind of therapy sounds scary to you, that’s because it can be! Confronting your fears is never easy, but with the help of a trained therapist who is sensitive to your anxiety, you will go at a pace that feels do-able to you. 

If you’re struggling with trypophobia or another phobia, you deserve to get the help you need. To find a therapist who specializes in ERP, we encourage you to use this therapist finder tool from the International OCD Foundation. To get support from our Mighty community, post a Thought or Question with the hashtag #CheerMeOn. Our community wants to rally around you, no matter what you’re facing today.

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

Originally published: November 8, 2019
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