Claustrophobia: features, causes and treatment

Some more centuries ago, people were not aware of mental disorders, and those who behave differently than others were simply called “possessed” and implied that they were controlled by otherworldly forces with clearly unkind intentions. But in general, the number of mentally ill was less than now.

Unfortunately, the modern pace of life, the people to create and maintain their space under the sun do not predispose to the preservation of mental health. Therefore, disorders such as claustrophobia are considered diseases of our advanced technological age, in which space for humans in all senses has become multidimensional.

The name of their disorder leads from two languages ​​- claustrum (lat.) - "closed room" and φ? Βος (al Greek) - "fear." In this way, claustrophobia is an irrational fear of confined and tight spaces. Phobia is considered psychopathology. Together with agoraphobia (fear of open spaces, squares, crowds), it is the most common pathological obsessive fears in the modern world.

A claustrophobic one is extremely anxious if it suddenly finds itself in a small room, especially if it has no windows or few of them. The front door of such a person tries to keep open, and he is afraid to go deep into the room, trying to keep as close as possible to the exit.

Everything becomes even worse if there is no possibility at certain times to get out of the small space (the elevator is going, the railway car is also not going to leave quickly, but there’s nothing to say about the toilet on the plane). But claustrophobic patients are not only afraid of tight spaces, but also being in a dense crowd.

According to the results of recent studies, today from such a pathological condition suffer from 5 to 8% of the population on the planet, and women face such fear about twice as often as men. Such fear can develop in children.

But, despite widespread, the real treatment of the psychopathological state is only a tiny percentage of claustrophobes, since many of them have learned to live in such a way that they do not create circumstances for panic (there is no closet in the house, instead of an elevator - a ladder bus - walk to the point of destination). It is to such conclusions that the University of Wisconsin-Madison experts, who devoted a whole scientific study to the spread of claustrophobia in the world, came to the conclusion.

Thus, it is foolish to deny the scope of the problem and the very fact of its existence. Claustrophobia is a disease that is called so, not even because fear itself is directly caused by closed or narrow spaces.. Animal horror and claustrophobic panic cause the prospect of being closed in them, losing the opportunity to exit.

Claustrophobia is often confused with gluten-phobia (this is a specific fear of being trapped), although they really have a lot in common. But claustrophobia is a broader concept.It is almost insurmountable fear, which the patient himself usually does not find a rational explanation.

With this diagnosis live famous actress Michelle Pfeiffer and Naomi Watts. Uma Thurman, who has suffered from claustrophobia since her childhood, went to a real feat: during the filming of the sequel to “Bill” (the second part of it), she refused the backup and she herself played in the scene where she was buried alive in a coffin. Then the actress said more than once that she didn’t have to play anything at that moment, all emotions were real, the horror was genuine.

In the origins of the fear of confined space lies a very ancient fear, which once advanced a civilization far ahead, helping it to survive. This is the fear of death. And once it was he who helped save the lives of entire tribes in the world, where much depended on the human response to changes in the external environment. The world of the ancients was indeed much more dangerous, and it was worth gape, as it was possible to get to the predators or the representatives of the competing tribe as the main dish for lunch.

Today, we are not threatened by hungry tigers and aggressive neighbors with axes, no one tries to eat, kill, destroy in the physical sense, but everyone (yes, absolutely everyone!) Has a fear of not finding a way out deep in the subconscious of the human race. The human brain did not have time to get rid of the ancient strong instincts, because they were formed for thousands of years. But some of these fears are slumbering as unnecessary, while others are as strong as before, and even stronger, which is a manifestation of claustrophobia.

Many researchers consider claustrophobia a so-called “prepared” phobia, and it was prepared by human nature itself. All that is needed is a strong trigger so that the fear that lives in each of us wakes up and shows itself in all its glory.

Modern psychology has several points of view on the causes of fear of closed and closed spaces. First of all, we consider the version of the feeling of personal space. If a person has a wide personal space, then any penetration into it will be perceived as a threat, and the risks of claustrophobia increase. However, this "buffer" zone has never been seen, touched, and empirically discovered it. That is why the most probable today is another version - hard experience from childhood.

Many people who have such a problem have no complaints about their own parents, but they remember that they experienced strong fear and fear for their lives in childhood when, out of hooligan motives or inadvertently playing, their comrades or siblings were locked in a close room (in chest of drawers, chest, closet, basement). The child could be lost in the crowd and for a long time adults could not find it. The fear that he experienced in all these situations is the main factor for the development of claustrophobia in the future.

The most severe forms of the disorder occur when, in childhood, a person faces aggression or violence that occurs to him in a confined space. Such fear is firmly fixed in the memory and immediately reproduced throughout life in all situations when a person finds himself in the same or similar place.

The hereditary cause is also being considered, in any case, medicine knows the facts when several generations of the same family suffered from such a disorder. However, no specific gene, mutations of which could underlie the fear of small enclosed spaces, was not found. There is an assumption that the whole thing is in the type of upbringing - the children of sick parents simply copied the behavior and reactions of their moms and dads.

Since children themselves cannot be critical of parental behavior, they simply accepted the adult perception model of the world as the only correct one, and the same fear became part of their own life.

If you look at this phobia from the point of view of medicine and science, the mechanisms of claustrophobia should be sought in the work of the amygdala of the brain. It is there, in this small, but extremely important part of our brain, that a reaction occurs that psychiatrists call "run or protect yourself." As soon as such a reaction is activated, the nucleus of the amygdala begins to transmit to each other along the chain an impulse that affects both breathing and the release of stress hormones, and arterial pressure, and heart rate.

An interesting explanation for claustrophobia was suggested by John A. Spencer, who discovered in his writings a connection between mental pathology and birth injuries. He suggested that in pathological childbirth, when the child goes slowly through the birth canal, is experiencing hypoxia (especially its acute form), he has a true claustrophobia.

Researchers of our time have paid attention to the fact that the use of MRI at times increased the number of people with fear of confined spaces. The need to lie still in a closed space for quite a long time by itself can cause the first attack, which will then be repeated when a person finds himself in similar or similar circumstances.

Sometimes a phobia develops not on personal experience, but on the experience of others, which a person observes (the child's psyche is most capable of empathy). In other words, a film or a news report about people stuck somewhere underground in a mine, especially if there are already victims, can form a clear link between a closed space and danger and even death in a child.

Disorder can manifest itself in different ways, but there are always two important signs - a strong fear of limitation and a fear of suffocation. The classic claustrophobia implies that the following circumstances are terrible for a person (one, two or several at once):

• small room;
• a room closed outside if the person is inside;
• diagnostic devices CT and MRI;
• the interior of the car, bus, plane, train car, coupe;
• any tunnels, caves, basements, long narrow corridors;
• shower cabins;
• elevator.

It is noteworthy that the fear of being in a barber's chair and the horror of the dental chair have a considerable spread. At the same time, a person is not afraid of pain, dentists and dentistry, he is afraid of the limitation that occurs at the time of shrinkage in the dentist’s chair.

Caught in one of these situations, more than 90% of patients begin to experience fear of suffocation, fearing that in a small room they simply do not have enough air to breathe. Against the background of this double fear, signs of loss of self-control appear, that is, a person cannot control himself.The claustrophobic brain sends the wrong spatial signals to it and there is a feeling that the outlines of the surrounding are blurry, there is no clarity.

Instant disruption of the central nervous system under the action of adrenaline leads to rapid breathing, increased heart rate. It dries up in the mouth - the salivary glands reduce the amount of secretion, but the work of the sweat glands increases - the person begins to sweat. There is a feeling of pressure in the chest, it becomes difficult to take a full breath, there is a strong tinnitus, ringing. The stomach is compressed.

Everything that happens to the body, the brain perceives as "A sure sign of a deadly threat", and therefore the person immediately has a fear of death. In response to this thought, the adrenal glands come into play, which also contribute to the development of additional adrenaline. Panic attack begins.

After several such situations, the claustrophobic begins by all means to avoid possible attacks, simply moving away from situations in which this can happen again. Avoiding fixes existing fear. Indeed, the number of attacks begins to decrease, but not at all because the disease has receded. Just a man learned to live in such a way as not to fall into difficult situations. If he does get into them, the attack is almost inevitable.

With a severe violation, a person deprives himself of the opportunity to live fully - he must always keep the doors open, may refuse to work his dream only because it is somehow connected with the need to go through a long corridor in the office or in a closed room. A person stops traveling, unable to overcome fear even before the mere prospect of entering a train compartment or getting into the passenger compartment of a car.

This type of phobia is quite simple in diagnosis, therefore, difficulties do not arise not only among specialists, but also among patients themselves. The details of what is happening helps to establish a special questionnaire Rahman and Taylor, after answering the questions which the doctor can not only accurately diagnose claustrophobia, but also determine its exact type and depth of disorder. The scale of anxiety, also used in the diagnosis, contains 20 questions.

To get rid of claustrophobia yourself is very difficult, almost impossible. Despite the fact that the claustrophobic is well aware that there is no real reason to fear for his life in the elevator cabin or in the shower room, he cannot overcome himself, because fear has become a part of him. That is why those who want to truly overcome their weakness (and fear makes a person weak and vulnerable), Be sure to consult your doctor.

Firstly, one may encounter dubious recommendations in which a person may be advised to withdraw into himself and stop sharing fears with loved ones, to avoid elevators and corridors. All this will only aggravate the course of the disease. Secondly, while the person is trying to heal himself, the mental disorder becomes more persistent, deep, and it will take longer to heal him. In other words, time is precious.

Simultaneously with treatment, in order to achieve better and faster results, one should try to adhere to such recommendations of psychologists.

• Get a small soft toy, a talisman (any little thing that you can put in your pocket). It is important that it reminds you of a pleasant event, immediately caused clear pleasant associations.If you begin to feel anxiety, immediately take it in your hands, touch, look, smell, do what you want, but try to reproduce in memory those pleasant memories that are associated with this thing.
• Do not limit yourself to communicate. Try to communicate and meet with friends and colleagues more often. A “call to a friend” also helps - at the first signs of anxiety increase, it is worth dialing the number of a close and dear person who can just chat with you about something.
• Master the breathing techniques and gymnastics, it helps to better control yourself, if there is a strong anxiety.
• Do not avoid closed rooms and corridors, elevator and showers, gradually form in your installation that closed is not always dangerous, and even vice versa, because a dangerous enemy or evil spirits cannot enter the closed room.

In the conduct of MRI sometimes there is a vital need - this is a very informative diagnostic method. But how to make yourself lie down in a narrow capsule of the apparatus and stay there for quite a long time is a big question. The procedure lasts about an hour, and it is absolutely impossible to survive this time, for example, to make an MRI scan of the brain or another part of the body.

It is clear that no one is to force anyone. Any patient has the right to refuse diagnosis for personal reasons, without even explaining them to the doctors. But is it a way out? After all, dangerous pathologies may not be diagnosed and the person will not receive the treatment he needs on time.

If the form of claustrophobia is not heavy, then you can use the formation of a new psychological attitude. The staff shows the claustrophobia that the capsule of the device is not fully sealed, the device can be left at any time when you want, on your own without the help of specialists. If a person understands this, it may be easier for him to undergo the necessary procedure.

If the facilities of a medical institution allow an open tomograph to be offered to a patient with claustrophobia, then it should be used. If there is no other device besides the closed one, then other options can be considered. With a pronounced mental disorder, it is shown with the patient's consent that drugs are used that cause a strong drug sleep (by the way, MRI is done to young children who simply cannot be forced to lie still for an hour).

It is accepted to treat claustrophobia in a complex way, and one should not think that there are pills with which you can quickly defeat the problem. Requires an individual approach high-quality psychotherapy, and medicines just do not show a pronounced effect in the fight against the fear of confined spaces.

As in most cases with other anxiety disorders, drug therapy does not show high efficacy. Tranquilizers help only partially and temporarily eliminate some of the symptoms (they reduce fear), but after the end of their intake, the development of drug dependence is possible, and panic attacks return again and again. The use of antidepressants shows higher efficacy, but only in combination with psychotherapeutic techniques.

In most cases, a method such as cognitive therapy helps to cure claustrophobia. The doctor reveals not only the situations in which the person is scared, but also the causes of these fears, and they usually lie in the wrong beliefs and thoughts. A specialist in psychology or psychotherapy helps to create new convictions, and a person’s anxiety decreases markedly.

Psychology is aware of several studies of the effectiveness of cognitive therapy in the case of claustrophobia. A great specialist in the issues of this mental disorder, S. J. Rahman (he is also the co-author of the diagnostic technique) has proved experimentally that approximately 30% of patients with the method helps even without additional measures.

At the next stage, the patient can be offered an in vivo immersion - this method allows a person to look into their own fears in the face. First, the patient is placed in circumstances in which he feels less fear, and gradually increase the level of fear to the maximum, moving to the most terrible experiences for him. It is proved that the effectiveness of this method is about 75%.

The method of interoceptive exposure is more benign for the patient than in vivo, since all “dangerous” situations are created and controlled by specialists, and immersion in them is very smooth and gradual. The effectiveness of the method is somewhat lower than that of cognitive therapy and in vivo - only 25%.

Recently, more modern methods and techniques have appeared in the arsenal of psychiatrists, for example, the use of distraction by virtual reality. The experiment was performed on patients with clinically diagnosed claustrophobia. They were asked to undergo an MRI. And only those who received augmented reality glasses with a special 3D program, SnowWorld, were able to undergo the MRI procedure completely, without resorting to the use of medicines.

Specific prevention does not exist. Parents need to take care of it - punishment in the corner, closet or storeroom should not be practiced, especially if the child is sensitive and very impressionable. As an adult, it is recommended to learn to relax - this is exactly what will help to avoid panic attacks.