Trypophobia: Is the fear of holes real?

Trypophobia, which may affect many people, is a term coined from the Greek words “trypa” (hole) and “phobos” (fear). The term is believed to have first appeared on a digital forum in 2005, and refers to a fear of clusters of small holes or repetitive patterns in things such as strawberries, lotus seed pods and honeycombs. This is not a clinically recognised phobia, but this fear of holes can be very unsettling for someone who experiences it.

What is trypophobia?

Trypophobia refers to an intense, irrational fear or aversion to clusters of small holes, bumps, or patterns. Despite the significant distress it can cause, trypophobia is not formally recognised as a clinical diagnosis. It is, however, acknowledged among mental health professionals as a genuine phenomenon affecting many people, says psychiatrist Dr Rahul Rai Kakkar. About 10 to 18 percent of adults experience anxiety when they see clusters of small holes, according to a research published in the BJPsych Open journal in February 2024.

What are the symptoms of trypophobia?

People with this phobia often show a range of physical and emotional symptoms when exposed to trypophobic patterns. These symptoms can vary in severity, but generally include:

• Intense feelings of disgust, fear, anxiety, or repulsion
• Goosebumps
• Sweating
• Nausea
• Increased heart rate
• Shaking
• Dizziness
• Intrusive thoughts about the patterns, avoidance behaviour
• Panic attacks in severe cases

What triggers trypophobia?

Triggers for trypophobia typically involve natural or man-made objects with repetitive patterns of small holes or bumps. Common triggers include:

• Honeycombs
• Lotus seed pods
• Coral
• Showerheads
• Strawberry
• Images of expanded pores on human skin.
• Pictures or videos containing clusters of holes.

The causes of trypophobia are still not known, but it may due to a heightened sensitivity to disgust or differences in brain activity while viewing triggering images.

While trypophobia can occur in anyone, certain factors may increase the likelihood of developing it:

• A family history of anxiety disorders or phobias may predispose a person to trypophobia.
• Traumatic experiences involving clusters of holes or patterns could trigger the development of trypophobia.
• People with other anxiety disorders, depression, or obsessive-compulsive disorder (OCD) may be more susceptible to developing trypophobia.

How is it diagnosed?

Since trypophobia is not officially recognised as a clinical disorder, there is no standardised diagnostic criteria, says the expert. However, mental health professionals can still assess the condition by:

• Discussing the patient’s experiences, triggers, and reactions to specific stimuli.
• Evaluating the intensity and impact of symptoms on the patient’s daily life.
• Using tools like the Trypophobia Questionnaire (TQ) to gauge the severity of the response to trypophobic images.

What are the treatment options for trypophobia?

Although there is no specific treatment protocol for trypophobia, several therapeutic approaches can help manage the symptoms –

1. Cognitive Behavioral Therapy (CBT)

CBT can help people reframe their thoughts and reactions to trypophobic stimuli, says Dr Kakkar. Exposure therapy, a component of CBT, gradually desensitises people to the triggers in a controlled manner.

2. Medication

Trypophobia may severely impact daily functioning in a person’s life. In such cases, medications such as anti-anxiety drugs or antidepressants may be given by a doctor.

3. Mindfulness and relaxation techniques

Mindfulness, meditation, progressive muscle relaxation, and deep breathing exercises can help reduce anxiety. These techniques may also improve emotional regulation.

4. Avoidance and environmental control

Identifying and avoiding known triggers can be one of the best ways to manage the symptoms. This might involve modifying your environment or media consumption to minimise exposure to the triggering patterns.

5. Support groups and counselling

You can get emotional support by joining support groups or engaging in individual counselling. Getting to know about coping strategies from others who experience similar symptoms can be helpful.

Trypophobia is not a clinical diagnosis, but many adults do have a fear of holes. Therapy or avoiding the triggers can help manage the symptoms of trypophobia.