Imagine the elevator doors closing and, suddenly, your heart races, you struggle to breathe, and an inner voice screams that you have to get out of there immediately. This is how millions of people who suffer from claustrophobia live their day-to-day. This phobia, one of the most common, can turn everyday situations like taking the subway, getting an MRI scan or even entering a small room into a terrifying experience.
What is claustrophobia?
Claustrophobia is a specific phobia characterized by an intense, persistent and irrational fear of enclosed, small spaces or places from which the person feels they cannot easily escape. It affects approximately 5% to 10% of the world's population, being more common in women than in men.
Unlike the simple discomfort that many people feel in cramped spaces, claustrophobia involves a disproportionate anxiety response that can escalate to a panic attack. The person knows that their fear is not rational, but they cannot control it: their nervous system reacts as if they were in real danger.
Situations that trigger claustrophobia
The most common situations that cause anxiety in people with claustrophobia are:
Everyday enclosed spaces
Elevators, subways, crowded buses, windowless rooms, small dressing rooms, unventilated bathrooms, cars (especially in the back seat), planes, tunnels and underground parking lots. Even wearing very tight clothing or scarves around the neck can cause a feeling of suffocation in some cases.
Medical situations
An MRI scan is one of the most feared situations: the patient must remain still inside a narrow tube for 20-45 minutes. Oxygen masks, casts that cover much of the body, or dental procedures with the mouth open for a long time also generate anxiety.
Crowded social situations
Concerts, nightclubs, parties in small spaces, long lines in enclosed areas, or any situation where the person feels "trapped" among many people without being able to leave easily.
Symptoms of claustrophobia
Symptoms can appear both when the person is in an enclosed space and simply when anticipating it:
Physical symptoms: Tachycardia, difficulty breathing or hyperventilation, profuse sweating, trembling, nausea, dizziness, muscle tension, a feeling of suffocation, chest pain and tingling in the hands. In severe cases, full panic attacks.
Cognitive symptoms: Catastrophic thoughts ("I will run out of air", "the walls are closing in", "I will never get out"), feelings of unreality or depersonalization, fear of losing control, fear of dying or going crazy.
Avoidance behaviors: Always taking the stairs (avoiding the elevator), avoiding the subway, refusing necessary medical tests, always sitting near the door, checking emergency exits, or simply not going to enclosed places.
Causes of claustrophobia
Traumatic experience: Being trapped in an elevator, being locked in a small space during childhood, or experiencing a situation of suffocation. Treatment with EMDR is especially effective for processing these memories.
Learning: Having seen a parent or close relative react with panic in an enclosed space can transmit the phobia. Child therapy is key in preventing children from consolidating this fear.
Biological factors: Some research suggests that the brain's amygdala in claustrophobic people is more reactive, triggering the alarm with less intense stimuli than would be typical.
Experiences of helplessness: Situations in which the person felt they had no control or escape, even if not directly related to enclosed spaces.
Treatment of claustrophobia
Claustrophobia responds excellently to psychological treatment, with success rates above 80%:
Gradual in vivo exposure
The gold-standard treatment. A hierarchy of exposures is built, from the least to the most anxiety-provoking. For example: first looking at photos of elevators, then standing in front of an open elevator, stepping inside without closing the doors, closing the doors briefly, going up one floor, then two floors. The goal is for the brain to learn that the enclosed space is not really dangerous.
EMDR
EMDR is highly effective when claustrophobia has a clear traumatic origin (being trapped, a suffocation episode). It allows the traumatic memory to be reprocessed so that it loses its emotional charge and the brain stops associating "enclosed space" with "danger."
Anxiety regulation techniques
Diaphragmatic breathing, emotional regulation, mindfulness and progressive muscle relaxation. These tools allow the person to feel that they have control over their reactions, which is exactly what someone with claustrophobia needs.
Take the first step
If claustrophobia is limiting you — you avoid elevators, subways, medical tests or social activities — know that overcoming it is possible. At my practice in Igualada and through online therapy, we will work together to reclaim the spaces that fear has taken from you. Contact me for a first informational session.