Trypophobia and Social Anxiety Disorder

We all feel nervous from time to time, especially in social situations such as job interviews or while giving presentations. However, if you feel scared of interacting with others in such a way that it affects the communication and relationship with other people, you may have something called Social Anxiety Disorder. Social Anxiety Disorder or social phobia belongs to the group of mental illnesses with common physical signs such as stomach aches, shallow breathing, feeling tense, shaky or experiencing sweating and hot flashes. This type of mental disorder can have a very negative effect on a person’s well-being and the quality of life. It can cause many problems in building relationships with others and can seriously affect work life and career progress. 

The fear that people with this type of disorder experience in various social situations are so strong that they feel it is beyond their ability to control it. Sometimes, the sufferers end up staying away from places or events because they worry about what will happen if they confront their fears. The illness usually starts during youth and some researchers suggest that social phobia affects about 7% of Americans. The average age onset is between 15 and 20 years, and the early age of the disease has several repercussions. The sufferers may also develop other anxiety disorders as a result of their social isolation and traumatic events which often trigger the development of specific phobias (such as Trypophobia). 

What Causes Social Anxiety Disorder?

According to the Canadian Mental Health Association, there are some groups of people at higher risk of experiencing social anxiety disorder:



– The majority of people with the social anxiety disorder say their symptoms started before they were 18
– Women are more likely to experience social anxiety disorder than men
– Many people with social anxiety disorder have other mental illness like depression, panic disorder, bulimia nervosa (an eating disorder) and substance use disorders. However, social anxiety seems to appear before other mental illnesses. 

Although there are some theories about the causes of social anxiety or social phobia, some experts believe it is a learned behavior emphasizing the environmental factors. Others consider the greatest problem is in the perception of irrational thoughts, connecting it with psychological factors. However, some experts find that the main cause lies in the biological and genetic background and underdeveloped social skills. For example, if you have underdeveloped social skills, you may feel discouraged after talking with people or have a feeling that people are staring or frowning at you, even though they actually don’t notice you. Each of the theories has their own explanation, but they do not exclude each other. 

Many situations can cause social anxiety (or social phobia). Some of them are:

• public performance or public appearance
•  being the center of attention
•  Phone calls to unknown people
•  oral exams and tests
•  talking to important people or authorities
•  parties and similar social gatherings
•  meeting new people
•  meeting other people’s eyes, etc. 

Some research studies have shown that social anxiety disorder can be tracked down to genetic factors. It can be associated with the unbalanced serotonin levels responsible for the feeling of happiness and pleasant mood, or the increased sensitivity and activity of the amygdala, brain part responsible for the emotional experience of fear. 

Symptoms and Treatment

In order to diagnose social anxiety (social phobia), all aspects of social life should be taken into account. A person must experience high levels of anxiety in social situations that create such a level of discomfort that their daily functioning is impaired. Avoiding appearances in public places narrow the quality of social and business life and block the person from achieving their goals. The worst cases of social anxiety lead to the feeling of loneliness, unemployment, alcohol or drug addiction and depression. Symptoms of social anxiety or social phobia can be emotionally experienced, manifested physically, as well as to change the person’s behavior.

Emotional symptoms include: 

• irrational fear of negative assessment and social gatherings
•  excessive anxiety in everyday situations
•  extreme fear of possible embarrassment and humiliation
•  Spending time after a social situation, analyzing your performance and identifying flaws in your interactions
•  Expecting the worst possible consequences of a negative experience during a social situation
•  nervousness, etc. 

Physical symptoms include:

• sweating of the palms
•  dizziness
•  a headache
•  facial redness
•  increased heart rate
•  Having a shaky voice
•  being unable to speak to others, etc.

Symptoms associated with behavior:

• delaying the meeting with others
•  avoiding social situations and going out to the public
•  hiding from other people to avoid inconvenience
•  limiting social activities
•  the inability to create new friendships
•  Avoid going to work, school, date or eating in public or using public restroom
•  Isolation. 

People with social anxiety typically know their anxiety is irrational, is not based on fact, and does not make rational sense. Nevertheless, thoughts and feelings of anxiety persist and are chronic. It is the psychological treatment that proved to be essential for social phobia sufferers. It encourages the patients to confront the negative beliefs and feelings which actually cause the fearful response to various social situations. There are three basic forms of Psychological treatment available for Social Phobia sufferers:



– Social Skills Training, a form of therapy that helps people to feel more relaxed and confident in social situations by teaching them social and generally accepted skills in the society. This involves initiating a conversation with a stranger, working on the relaxation techniques, evoking positive thoughts, etc. 

– Exposure Therapy involves the process of learning how to confront with the fearful situations, conducted in stages according to the previously constructed fear hierarchy. Once the first phase is completed, the therapist starts with gradual desensitization to the feared situation. 

– Cognitive Behavioral Therapy helps social phobia sufferers to change how they perceive themselves and their surroundings. The therapist guides the patient through the cognitive cycle involving a more realistic and accurate way of perceiving his fear. The main goal is to encourage the patient to confront their anxieties since they may be initially hesitant to do so. 

– Real – life desensitization is one of the most effective psychological treatments for various social phobias. It involves a direct exposure to real-life interactions and unpleasant feeling of facing the fear in public. The phobic scenes are constructed within the given time frame and achieved through a step-by-step process. 

Almost 80% of people suffering from this type of anxiety disorder Social find relief from their symptoms when treated with a combination of medication and psychotherapy. Medications include the use of antidepressants and beta blockers. It is advantageous to make use of both forms of treatment since they complement each other and bring about more rapid, long-term recovery. 

Trypophobia and Social Phobia

People affected by Trypophobia experience phobic reactions when confronted with objects with the cluster of holes or patterns resembling these clusters. Recently, the notion of phobic reactions under these circumstances has been a subject of various studies trying to explain the origin and symptoms that Trypophobes experience. According to the study conducted at the University of Essex by A. Wilkins and G. Cole, Trypophobic reactions occur in as many as 16% percents of adults. Even though the American Psychiatric Association has not made any official references, this condition was linked to our innate feeling of danger, the fear of skin diseases and the way how our brain perceives these situations. Disruptive Trypophobic reactions may also be the result of other anxiety disorders, such as the social anxiety disorder involving the fear of eye contact or being gazed at. This notion suggests the fear doesn’t necessarily involve a group of holes.

A study conducted last year by a group of scientists from Japan showed significant parallels between the social phobia and Trypohobia. To investigate this issue, they have conducted two experiments on Japanese participants. The spectral properties of images with eye patterns were introduced through these two types of experiments. In Experiment 1, the participants completed a social anxiety scale on the basis of images showing eyes. The results provided by this experiment showed a significant bond and effect on the feeling of fear and discomfort experienced while looking at eye clusters. The researchers decided to further expand this to the Experiment number 2, showing the participants the images of human faces. The aim of the study was to show that these images can induce aversion and discomfort due to the Trypophobic images composed of clusters of human eyes. They cropped the images separately and observed how the Trypophobe’s brain functions while looking at these images. They also emphasized that the study’s limitation lies in the fact that there the correlation between the individuals from different cultures was not examined. They have concluded that these “findings suggest that both social anxiety and trypophobia contribute to the induction of discomfort when one is gazed at by many people. It says that we associate round clusters of objects with round eyes, which gives us the feeling that we are ogled at. This creates fear and anxiety in people who already suffer from the condition.” 

Various other studies were conducted on the basis of visual discomfort and the connection of Trypophobia with other anxiety disorders, including GAD, OCD, social anxiety disorder and many others. Trypophobia was associated with significant psychological distress and impairment, with 8,2% of participants being diagnosed with social anxiety disorder, showing also some Trypophobic symptoms.  All in all, it seems that mental illnesses involving the feeling of anxiety and fear overlap with the symptoms, and this need to be assessed and treated properly, with regards to Trypophobia and other anxiety disorder symptoms. 

References

http://www.heretohelp.bc.ca/sites/default/files/social-anxiety-disorder.pdf
https://www.rcpsych.ac.uk/pdf/Full%20Social%20Anxiety%20Guidelines%20(May%202013).pdf
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462017000400337
https://peerj.com/articles/1942/
https://www.lifehack.org/345660/fear-holes-scientific-explanation-why-you-have-trypophobia-and-how-cope-with-2