Your panic is rising. The walls are closing in. You’re sweating, trembling, having trouble breathing and on the verge of fainting. It’s claustrophobia and it’s all-consuming. Many people experience claustrophobia and it can be utterly debilitating. Why, and what can be done?
Claustrophobia: like the walls are closing in… arrrgh! Image credit Catalina Olavarria via Flickr
When the ceiling is too close
Last week, I had an MRI. And for the first time, I had an inkling of what claustrophobia must feel like. I couldn’t see out either end of the MRI tunnel, and the ceiling did feel remarkably close to my face. Curiosity, rather than anxiety, filled my mind. But it wasn’t hard to imagine being engulfed by panic in that situation.
The word claustrophobia comes from the Latin, meaning fear of being shut in a place. Some of the most common places people experience claustrophobia are tunnels, cupboards, lifts, aeroplanes and MRI machines. Around 5% of the world’s population is thought to experience claustrophobia and women are more likely to suffer than men. The severity of symptoms vary: in extreme cases a person may choose to walk dozens of flights of stairs rather than take a lift, avoid tunnels at all costs, or refuse to get into an underground train for decades.
Get outta my space
Why do only some people experience claustrophobia when few of us would claim to like feeling trapped? There are a few different theories as to what causes it. Of course, in many cases, claustrophobia is the result of a traumatic experience like being stuck in a lift – or an MRI machine. It’s hardly surprising that after being trapped somewhere we feel anxious about going back into that place. But research suggests some people are also predisposed to feeling claustrophobic.
One study found people with panic disorders have a smaller amygdala than average. Your amygdalae – there are two in your brain and they’re shaped like almonds – process emotions like fear. Perhaps someone with smaller amygdalae perceives the risk of danger differently and these are the people more likely to experience claustrophobia. A few years ago, other researchers announced they’d found that a mistake in a single gene causes claustrophobia symptoms in mice. Humans have the same gene, found in an area of a chromosome linked to panic disorders. If a defect in this gene can also explain claustrophobia in people, the fact is some of us simply have claustrophobia in our genes.
A fascinating study connected people’s perception of their personal space to their experience of claustrophobia. We all have a perception of how far our personal space extends beyond our body – interestingly this distance is related to arm length. This personal space is our comfort zone, and we are very aware of anything entering it. But people who experience claustrophobic fear tend to feel their personal space extends further than we would predict. For these people, the larger space means there are more frequent intrusions into that personal space. They are more likely to feel like someone or something is ‘in their face’.
Claustrophobia makes sense
There are a variety of treatments for claustrophobia. Virtual reality has been successfully used to reduce fear of confined spaces and cognitive behavioural therapy has also helped many claustrophobes. There’s no lack of internet sites claiming to have the answer to solving claustrophobia. Some claustrophobes find that being forced to face their fears head on, for example, by being trapped in a lift is actually a good thing. Although terrifying at the time, people find their panic eventually disappears.
I completely understand that claustrophobia sufferers are desperate to find a cure for their fears. But it’s worth considering why we experience claustrophobia. If you think about it from an evolutionary point of view, claustrophobia makes very good sense. Of course we’ve evolved to be fearful of being trapped in a confined space. Throughout our past, and still today, many of the situations that result in us feeling trapped are life-threatening. Whether a collapsed cave, or collapsed building, we have every reason to fear for our lives. It’s to be expected that we’ve evolved to hate the feeling of being confined: claustrophobia makes complete sense.
The problem comes when a completely non-life-threatening situation evokes the same paralysing fear. I feel fortunate to be someone who can endure an MRI without panic. Although it did mean I got to focus all my attention on the terrible musac blaring through the headphones I was told to wear. The music is intended to mask the loud and decidedly unsettling noises made by the machine itself. To be honest I’m not sure which was worse.
Dr Jen Martin 
I had the same experience 3 years ago when I had an MRI – never felt claustrophobic before, but did find that machine overwhelming. It must have been so stressful, I don’t remember any music, but I do have a recollection of the noise being muffled (so must have been wearing headset of some sort)
Yes, no wonder it is a key claustrophobic experience for so many people when it had an effect on you and me. The noises were definitely loud despite the headphones!!