Fear of Tight Spaces

A. What is Fear of Tight Spaces?

Fear of tight spaces (Claustrophobia) is the 4th most common (34%) fear, according to a Gallup poll.  This is one of the most unique fears in that it varies dramatically from person to person.  It can be linked to a general fear of tight spaces or a particular enclosure type.  Like nearly all fears, the most common trigger for claustrophobia is early childhood trauma, such as being trapped or confined in a room. 

The good news is that claustrophobia is treatable using conventional cognitive behavioral therapy. 

B. Diagnosing Fear of Tight Spaces.

 There are several techniques for determining if someone is claustrophobic. 

In-Depth Interview. The most accurate method of diagnosing claustrophobia, and the gold standard by which it is determined, is an interview with an expert. Unfortunately, this is also the most expensive.

Written Tests. Many professionals use a 12 to 25-item scale for assessing claustrophobia. The following table lists confinement situations starting with the most extreme.  Each of these environments lasts for 15 minutes; after that time, the participants rate their fear levels.  There is both a restriction fear level and suffocation fear level number.  Each is rated with a number between 0 (no effect) and 10 (highest fear level possible). 

TABLE -- Claustrophobia Fear Level Scale

NO Environment for 15 minutes Restriction Level Suffocation Level
Locked in the trunk of a car.
Standing in a straight jacket.
Tied to a chair while blindfolded.
Locked in a small dark room.
Lying in a tight sleeping bag up to our neck.
Riding in a crowded elevator with the door closed.
Locked in a public restroom with no escape.
Riding in a crowded train with people standing.
Locked in a well-lit small room.
Wearing tight fitting cloths that you cannot remove.
Working under a sink.
Swimming with nose plugs.
Going to a full sports stadium.
Lying on the bottom bunk bed.
Waiting on an airplane with the doors closed.
Sitting in the middle row of a darkened theater.
In the middle of a crowd of 50 people outdoors.

There are very few people who do not have a fear of items 1-3. Notable exceptions include escape artists like Houdini. 

Even once you take the test, it is important to realize that it will take an expert to understand the meaning of the scores. This professional insight requires an extensive interview.  The test does not determine “why.”  For example, a person locked in a public restroom or crowded place may have a fear of germs that influences the rating values.  The scale questions are presented to give you a general understanding of how experts gauge fear levels. 

Sleep Apnea Connection. There is a potential connection between tight spaces and perceived suffocation.  A study of claustrophobia and those having sleep apnea showed a statistically significant relationship.  Those claustrophobic participants taking CPAP (positive airway pressure) therapy had a drop in claustrophobic 15-item rating scale as compared to those not on a CPAP regimen.  [Chasens et. al. (2005) Claustrophobia and Adherence to CPAP Treatment, Western Journal of Nursing Research, Vol. 27(3) 307-21.]  This suggests a potential connection as well as a possible treatment.

Larger Personal Comfort Zone.  One researcher used 35 people who stood close to a horizontal line on a wall.  A laser pointer marked the mid-point.  They moved back a few feet and pointed to the mid-point for nine different intervals.  All participants drifted away from the first line.  By looking at how quickly their estimates changed, the researchers determined their “near space.”  They found that persons with the widest near space reported the highest claustrophobic symptoms.  This suggests the obvious – a claustrophobic person needs a larger comfort zone around them. 

C. Determining the Cause.

Sometimes the existence of claustrophobia is apparent to you, and sometimes it requires substantial research.  Multiple things can cause this fear, including trauma, observing parents, manipulation, and genetics. 

Trauma. This is the most frequent cause. The critical period for developing claustrophobia is between 5 and 10 years old. But when coupled with physical abuse, it can occur at any age.

The Read More Link has more interesting facts relating to trauma-induced claustrophobia and other causes.

Being in a locked room for prolonged periods is the usual suspect of claustrophobia. However, research on adult prisoners locked in solitary confinement showed no significant connection to claustrophobia.  Those locked away for extended periods developed the opposite phobia.  They developed a fear of wide-open places.  Their minds were conditioned to associate safety with a small, locked room. 

Youth in solitary confinement [Human Rights Watch, Growing Up Locked Down, 10/10/2016 ACLU] might have a connection to claustrophobia.

Most animals instinctively seek safety in tight caves, nests, or burrowed tunnels. Dogs do not fear their kennels.  They find peace and security in those tight spaces.

They are observing the Parents. This phobia is created in the younger years, between 5-10 years old when parents are the most important influence on a young child. Children observe everything, including the fears of their parents.  This is not the same as over-protective parenting.  That deals with actions directed toward the child, such as barring or preventing the child from doing certain activities. 

Manipulation. The movie Room is about a mother and her son being trapped in a room for seven years.  Stuck In is a movie about being buried alive.  Many scary movies make money off of exaggerating claustrophobic fears.  To avoid manipulation, the solution is straightforward – do not let your kids go to such films.   

Genetics.  There is also a genetic link.  Studies have shown that the mutations in a single gene in mice induce claustrophobia-like symptoms.   [El-Kordi, A., Kästner, A., Grube, S. et al. A single gene defect causing claustrophobia. Transl Psychiatry 3, e254 (2013)].  In humans, this gene is in a region linked to panic disorder. 

D. Personality Trait Connection.

The personality traits most applicable would be the A-Type and D-Type. Being in control is a major trait of the A-Types.  The D-Types have anticipation and Caution traits.  A few famous people believed to have this fear include Woody Allen, Uma Thurman, David Grohl, Paris Hilton, Ryan Reynolds, Brittany Snow, Justin Bieber, Liz McClarnon, Hans Cristian Anderson, and many more.