How do people get trypophobia

Triggers, Causes, Treatment, and More

Trypophobia refers to a strong fear or disgust of closely packed holes. The name, first introduced on a web forum in 2005, combines the Greek words “trypa” (punching or drilling holes) and “phobia” (fear or aversion).

People who have this phobia typically feel queasy, disgusted, and distressed when looking at surfaces that have small holes gathered close together or clustered into a pattern.

Experts don’t yet officially recognize trypophobia as a specific phobia. Studies exploring this phobia remain limited, and existing research hasn’t reached a conclusion on whether to consider trypophobia a unique mental health condition.

That said, there are plenty of anecdotal reports of people experiencing trypophobia.

Read on to learn more about the fear of holes, including potential triggers, causes, and how to get support when it causes extreme distress.

Trypophobia is mainly visual. If you have this phobia, you might feel anxiety, disgust, and discomfort when looking at things like:

lotus seed pods
honeycombs
strawberries
coral
seeded breads
Swiss cheese
scabs or lesions on skin
aluminum metal foam
pomegranates
sponges
pebbled or graveled roads
bubbles
condensation
cantaloupe
a cluster of eyes

Animals with spotted skin or fur — think leopards, Dalmatians, or poison dart frogs — can also prompt revulsion and fear.

Some people with a fear of holes have an aversion to surfaces with irregularly shaped holes only. They may not notice the same level of discomfort when looking at surfaces with holes of the same size, like those in a showerhead or on a fabric patterned with polka dots.

Others might find all closely packed holes uncomfortable and upsetting.

Pictures of trypophobia triggers

If you have trypophobia, you’ll generally notice feelings of disgust and discomfort when looking at an object or surface with small clusters of holes or shapes that resemble holes.

While you might associate phobias with fear, research from 2018 suggests most people with trypophobia experience disgust — not fear — as a primary symptom.

You might also begin to feel disgusted, uncomfortable, or anxious when thinking about something that has this appearance — if, say, your partner begins to tell you how much they love strawberries and you start to visualize the fruit.

Specific symptoms might include:

goosebumps, chills, or the sensation of your skin crawling
gagging or nausea
sweating
rapid heartbeat
dizziness or lightheadness
visual discomfort, including eye strain, distortions, or illusions
a general sense of discomfort or distress
a strong desire to get away from the image or object
feelings of panic or a panic attack
shaking or trembling

Scientific evidence has yet to pinpoint a clear cause of trypophobia, but there are a few potential explanations.

Some experts theorize this fear of closely-packed holes may develop as an extension of a biological fear of venomous or otherwise dangerous creatures.

Researchers who analyzed images that produced an anxiety response in people with trypophobia found that high contrast colors in a certain graphic arrangement tended to trigger anxiety, disgust, and other symptoms.

They also found that images of certain highly dangerous animals, including the king cobra, deathstalker scorpion, and blue-ringed octopus, shared certain spectral properties with the trypophobic images. Spectral properties refer to subtle things, like contrast and spatial frequency, that can impact how your eyes and brain take in images.

The fear of holes, then, may be less a fear of holes and more an unconscious association of harmless items (like lotus seed pods) with feared animals (like a blue-ringed octopus) because they share certain spectral features.

In other words, trypophobia may stem from your evolved ability to detect threats in your environment.

Many people with trypophobia also experience a strong aversion to scabs, pockmarks, or other patterns of rashes and skin markings, leading some experts to link this phobia to another evolutionary response: the drive to avoid germs or contagious skin conditions or illnesses.

Other experts aren’t so sure

In one 2017 study involving 94 preschoolers, who typically don’t have the same fear of snakes and spiders as older children and adults, researchers showed 4-year-olds several sets of images:

trypophobic images featuring small holes
images and line drawings of venomous animals
images and line drawings of nonvenomous animals

According to the results, children who experienced distress when looking at trypophobic images also experienced distress when looking at color images of venomous animals — but not when looking at the line drawings of the same animals.

Study authors believe these results support the idea that trypophobia relates only to the unique spectral characteristics shared by certain animals and clusters or patterns of holes, rather than an unconscious fear of dangerous creatures. They do, however, note the need for more research exploring the fear of holes.

Again, research on trypophobia remains in the early stages, so experts aren’t yet certain exactly what factors can increase your chances of developing a fear of holes.

That said, it’s not uncommon for a phobia to begin after an unpleasant or distressing event with the object of the phobia.

Based on the potential causes of trypophobia, it’s possible your aversion could begin after an encounter with a venomous snake, exposure to a contagious skin condition, or another trypophobia trigger.

One 2017 study found a possible link between trypophobia and major depressive disorder and generalized anxiety disorder (GAD). Study authors surveyed 195 adult members of a trypophobia support group and found that:

19 percent of participants had a diagnosis of major depression, and an additional 8.7 percent believed they could have major depression
17.4 percent of participants had a diagnosis of generalized anxiety disorder, while an additional 11. 8 percent believed they could have GAD
Many participants reported other mental health diagnoses, including social anxiety (8.2 percent) and panic disorder (6.2 percent)

Research from 2016 also noted a link between social anxiety and trypophobia, suggesting that for people with social anxiety, the fear of holes could in fact be a fear of eyes, or the human gaze. Seeing clusters of holes might provoke the sensation of many pairs of eyes gazing back at you, leading to distress and discomfort.

You also have a higher chance of developing any phobia if you have a family history of anxiety conditions and phobias in particular.

Only mental health professionals can diagnose phobias, like a fear of holes. Since there’s no official diagnosis of trypophobia, a therapist won’t diagnose trypophobia specifically.

All the same, they can certainly recognize when the appearance of clustered holes causes intense distress and offer guidance and support on working through that fear. They may offer a more general diagnosis of specific phobia.

Plus, a therapist can also help identify any other mental health symptoms you live with, including signs of anxiety conditions or depression, by asking questions about:

the symptoms you experience
the things that trigger them
how they affect your daily life

Learn more about what therapy involves.

Support from a mental health professional can go a long way toward helping ease symptoms of trypophobia.

Potential approaches to treatment might include:

Therapy

A few different types of therapy can help treat phobias, including exposure therapy and cognitive behavioral therapy (CBT):

Exposure therapy. This approach allows you to begin facing your fear in the safe environment of therapy so you can learn — with a therapist’s support — to change your response to the object or situation causing your fear. Experts generally consider exposure therapy the most effective approach for phobias.
CBT. This approach teaches strategies to help identify, challenge, and reframe unwanted thoughts and distressing feelings. CBT techniques can help you learn to manage overwhelming emotions, including feelings of anxiety and fear.

Learn more about therapy for phobias and when to reach out.

Medication

No medication specifically treats trypophobia symptoms, but a psychiatrist or other prescribing clinician might recommend medication if you experience:

extreme feelings of anxiety or panic in certain situations
anxiety overwhelming enough to get in the way of everyday life or keep you from making progress in therapy
symptoms that don’t improve with therapy alone

Medication options for specific phobias might include:

benzodiazepines
beta-blockers
antidepressants
buspirone

Learn more about medication for anxiety.

Other approaches

Your therapist might also recommend other strategies to help you manage anxiety and emotional distress. These might include:

relaxation techniques, including deep breathing, yoga, and meditation
spending time in nature and other calming environments
mindful breathing, observation, listening, and other mindfulness tricks to help cope with stress
taking time for hobbies and enjoyable activities

While taking care of your physical health may not address your phobia directly, good self-care can go a long way toward helping you feel more able to manage anxiety and other symptoms.

A few tips that may help:

Aim to get around 7 to 8 hours of sleep each night.
Eat a balanced diet and limit foods that can trigger anxiety.
Get regular physical activity, if you’re able — exercise can help ease anxiety and depression symptoms.
Limit caffeine, especially if you’re sensitive to its effects, since it could worsen anxiety symptoms.
Reach out to friends and family to talk through your feelings.
Find a support group to connect with other people living with the same symptoms.

Here’s how to create a personalized self-care checklist.

In search of a therapist?

If you’d like to try online therapy, our review of the best online therapy options can help you start your search for the right teletherapy service for your needs.

Experts may not yet recognize the fear of holes as an official phobia, but that doesn’t mean your symptoms aren’t real.

If your symptoms cause emotional distress and affect your daily life, talking with a mental health professional is a good next step. They can help you explore possible causes, triggers, and helpful strategies to manage anxiety, disgust, and other unwanted emotions related to trypophobia.

Triggers, Symptoms, Diagnosis, and Treatment

Written by Stephanie Watson

What Is Trypophobia?

Does the sight of a honeycomb, sea sponges, or soap bubbles make you shaky and sick to your stomach? You could have trypophobia, a fear of holes.

The name for this problem comes from the Greek words "trypta," which means hole, and "phobos," which means fear. But the term doesn't date back to ancient Greece. "Trypophobia" reportedly first appeared on a web forum in 2005.

It's one of many fears of harmless things, like chaetophobia, a fear of hair, or microphobia, a fear of small things.

People with trypophobia have a strong physical and emotional reaction whenever they see patterns made up of holes or spots. The bigger the cluster of circles, the more uncomfortable they feel.

Is Trypophobia a Real Phobia?

True phobias are those that cause enough fear and worry to interfere with your everyday routine, according to the American Psychiatric Association (APA). Trypophobia doesn't meet that standard.

The APA doesn’t officially recognize this disorder in its Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a large volume of all known mental illnesses and their symptoms. Experts say trypophobia is more likely disgust than fear.

Trypophobia Symptoms

The symptoms of trypophobia look a lot like a panic attack. You might have:

Nausea
Shaking
Shortness of breath
A fast heartbeat
Sweating
Itching, goosebumps, or a feeling like your skin is crawling

People with trypophobia may get these symptoms several times a week or every day. Sometimes, the fear of holes never goes away.

Trypophobia Triggers

Common things that can trigger trypophobia include:

Holes or pebbles in concrete
Air holes in a slice of bread
Patterns in the frosting of a cake or pie
The head of a lotus flower
The holes in an old hockey mask
Skin problems like sores, scars, and spots
Spotted animals
Shower heads
LEDs in traffic lights

Trypophobia Causes

Researchers have a few ideas about what causes trypophobia.

The powerful reaction might be a way to protect yourself from danger. Some of the most poisonous animals on the planet -- like the king cobra, puffer fish, and poison dart frog -- have hole-like patterns on their skin. Those patterns are like the ones that bother people who have trypophobia.

Deadly diseases such as measles and smallpox cause circular skin rashes. Trypophobia could be a reaction that humans have developed to avoid getting sick.

It's also possible that the images themselves trigger fear. Some people may be more sensitive to the mix of light and dark in pictures of holes. Researchers say that hole-like patterns have a type of visual energy that can cause an unpleasant reaction.

Other researchers believe that the fear comes from social anxiety. Circles look a little bit like clusters of eyes or faces staring at you, which can be upsetting if you get nervous in social settings.

Trypophobia Risk Factors

Trypophobia is more common in women than in men. It also runs in families. In one study, about 25% of people who had trypophobia also had a close relative with the condition.

Some people who are afraid of hole patterns also have other mental disorders, such as:

Major depression
Generalized anxiety disorder (GAD)
Social anxiety
Panic disorder
Obsessive-compulsive disorder (OCD)
Bipolar disorder

Trypophobia Diagnosis

Doctors don't know a lot about trypophobia, and it can be hard to diagnose. A psychologist or primary care doctor will ask about your symptoms and how they affect your everyday life.

One group of researchers created a list of 17 questions called the trypophobia questionnaire. It asks people to rate symptoms like anxiety or fear on a scale from 1 ("Not at all") to 5 ("Extremely") when they see pictures of holes.

A few self-tests are available online, including the Implicit Trypophobia Measure 0.5a. Before you click on one of these tests, remember that they could include images that are disturbing, even to people who don't have trypophobia.

Trypophobia Treatment

Because trypophobia isn't a true disorder, there’s no set treatment for it. Some studies show that an antidepressant like sertraline (Zoloft) plus a type of talk therapy called cognitive behavioral therapy (CBT) are helpful. CBT tries to change the negative ideas that cause fear or stress.

Trypophobia Outlook

If circular patterns bother you, it can help to talk with other people who share your fear. They might have some suggestions for ways you can manage trypophobia. Ask your doctor, or look online for support groups.

Scientists have linked trypophobia and aversion to disease

Scientists from the University of Kent in the UK came to the conclusion that trypophobia (fear of large accumulation of round holes) is caused by fear of infectious diseases and small parasites, and people suffering from such a phobia experience more disgust than fear. Research article published in the journal Cogniton & Emotion and available for reading at PubMed .

Trypophobia (from gr. tρύπα - hole and φόβος - fear) is the fear of a cluster of small round holes. Previously, scientists linked the appearance of such a phobia with fear that appeared as a result of evolution: the bodies of some dangerous animals (for example, blue-ringed octopus), posing a threat to the ancestors of modern man, had clusters of round patterns on their bodies.

Authors new work decided to test the theory that disgust at the sight of clusters of holes arises due to fear of traces of infectious diseases and the appearance of parasites. The researchers interviewed 367 members of online groups of people suffering from trypophobia, and 307 people who reported no fear of clusters of holes. They conducted an online survey in which subjects were shown four types of pictures. The first two groups of pictures were aimed at evoking trypophobia syndromes: images of clusters of holes associated with diseases and parasites (for example, a photograph of traces of measles) and not associated with diseases (for example, a photograph of the spongy texture of bread). The other two groups of pictures are not were aimed at provoking trypophobia and contained photographs of healthy people and non-parasitic animals, as well as plants and objects without holes on them surfaces. nine0007

Subjects were asked to indicate how unpleasant they found the image they saw scale from 1 to 9, where 1 is "very pleasant" and 9 is "very unpleasant". results survey showed that subjects from the group with trypophobia, on average, consider pictures depicting clusters associated with diseases and parasites by 0.3 points more unpleasant than people who did not report the presence of trypophobia. What concerns the images of clusters on the surface of objects and plants, then people who reported having trypophobia consider them 2.5 points more on average unpleasant than people without trypophobia. nine0007

Then scientists conducted a survey, the purpose of which was to find out whether the images of clusters of holes disgust or fear. The subjects were asked mark on the Likert scale how much they agree or disagree agree with the proposed statements (for example, "I would be scared if this object was close" or "If this object were close, I it would be disgusting).

Results the survey showed that both groups of participants in the experiment experience the indicated pictures have more disgust than fear, and people with trypophobia have an indicator disgust was high as when viewing images of ordinary objects from accumulation of holes on the surface, and when observing objects, associated with diseases or parasites. nine0007

Scientists also noted that the survey, during which participants in the experiment with trypophobia was asked to describe the sensations they experienced while watching images, revealed the presence of unpleasant sensations on the skin (slight itching, goosebumps and feeling as if someone is crawling on the body).

On Based on the data obtained, scientists concluded that trypophobia is based on fear of traces of various infectious diseases (measles, acne rash) and the appearance of parasites (for example, ticks), and this fear is so strong that disgust is caused even by harmless objects with clusters holes: sponges, cheese with holes or bubbles on the surface of the coffee. nine0007

Get to know with other phobias you can use our test, and you can find out how trypophobia finds its place in the process of creativity here.

Elizaveta Ivtushok

Found a typo? Select the fragment and press Ctrl+Enter.

Trypophobia: what it is and how to get rid of it

Trypophobia is the fear or disgust of seeing clusters of small holes, irregularities or patterns, such as honeycombs, plant seed pods, or close-up photographs of skin pores. The word comes from the Greek "tripa" (τρύπα), which means "drilling" or "hole". Doctors do not recognize trypophobia as a diagnosable disorder because it is poorly researched. nine0007

What is
Causes
Symptoms
How to get rid of
Trypophobia Test
When to See a Doctor

The material was commented by Ekaterina Kharina, counseling psychologist at the Center for Cognitive Therapy Yakova Kochetkova, psychotherapist, psychiatrist at the PsyMedClinic Mental Health Clinic

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What is trypophobia

Trypophobia can manifest itself in different ways. Its main trigger is a surface with a group of small contrast holes, bumps or patterns. Some feel discomfort only at the sight of “naturalistic” clusters, such as honeycombs, wormy meat, or a toad that carries fry in holes on its back. For others, even a photo of plastic cups standing side by side, cheese with holes in it, or traffic light LEDs can make them feel uncomfortable.

Researchers believe that trypophobia goes back to very ancient human instincts and accompanies it throughout history. However, it was "discovered" quite recently. The first case of cluster hole phobia was described in 1998, and the term itself appeared only in 2004 [1]. Therefore, today this phenomenon is poorly studied and is not an official diagnosis.

In 2009, the Trypophobia.com website appeared, thanks to which, by 2012, millions of people had learned about this disease, many of whom were surprised to find it in themselves. In 2016, American model Kendall Jenner admitted that she suffers from severe trypophobia.

Terrible clowns and mirrors: the strangest celebrity phobias

Scientists believe that the fear of cluster holes is not a phobia to the same extent as, for example, agoraphobia, that is, the fear of open spaces, or arachnophobia, the fear of spiders. Trypophobia doesn't fit most of the diagnostic criteria for a phobia—and here's why.

First, every sixth person experiences some manifestation of trypophobia, although it is quite possible that this phenomenon is even more widespread [2]. This allows scientists to consider discomfort at the sight of cluster holes as the norm. A phobia is a disorder in which a person experiences fear where most other people do not. nine0007

In addition, with a phobia, fear prevents a person from living, and this happens infrequently with trypophobia. “In practice, we very rarely encounter such complaints,” notes Ekaterina Kharina. “For the most part, people simply avoid such images, don’t look at them, and live their lives in peace.”

Secondly, the symptoms of trypophobia from a clinical point of view are quite different from the manifestations of other phobias. In 2018, scientists from the American Emory University conducted an experiment in which they proved that the emotion caused by cluster holes is rather not fear, but disgust [3]. nine0007

Groups of students were first shown snakes and spiders, the most commonly phobic animals. The pupils of the majority greatly dilated - scientists began to consider this a sign of a reaction of fear. However, images of the cluster holes did not lead to pupil dilation, and in some, they even narrowed.

Researchers have stated that fear causes arousal, and pupillary dilation is one of its signs. Disgust, on the contrary, suppresses a person, makes him refuse to act. nine0007

“ICD-10 (an international classification of diseases adopted in 1990, used in Russia) has specific isolated phobias, while ICD-11 (adopted in 2012) has specific phobias,” says Ekaterina Kharina. - In principle, the most pronounced cases of trypophobia with a stretch could be attributed there. But if we look at the description of these diagnoses, then they rather mean an obsessive fear of some situations or things, rather than disgust. And we often encounter disgust with obsessive-compulsive disorder. nine0007

I think that there may be people with obsessive trypophobic images, but I have never met such people. If a person feels disgust only when confronted with such images or objects, but there is no obsession, then this cannot be attributed to OCD either.

Causes of the fear of holes

The results of the experiment by scientists from Emory are consistent with the modern assessment of trypophobia from the point of view of evolution. Today, scientists believe that trypophobia is an evolved natural reaction of our nervous system, designed to protect us from the threats associated with infections or parasites. nine0007

If a person is faced with danger, such as a predatory animal, he needs stimulation and strength to escape, so the nervous system responds to such a trigger with an adrenaline rush.

But if a person encounters something unhealthy and potentially infectious, such as a worm fruit, spoiled meat with larvae, or a person with a skin disease, the brain should make him refuse the interaction - that is, on the contrary, suppress the activity. This is how disgust works in trypophobia [4]. nine0007

Most scientists agree on this interpretation of the origin of this disorder. However, it is not clear what was the original object, the aversion to which has developed into an abstract trypophobia in modern man.

According to one theory, trypophobia originates in a reaction to honeycombs, wasp nests, or burrows of poisonous snakes. Other scientists have similarly associated trypophobia with infectious human diseases [5]. Indirectly, this interpretation is confirmed by a study in which it turned out that in people with skin diseases, trypophobic reactions are on average stronger than in others [6]. nine0007

According to another version, trypophobia is associated with social anxiety disorder, and cluster holes on a subconscious level are associated with faces or eyes that constantly watch a person [7].

It is also known that trypophobia is more prone to women and people with a number of mental and mental disorders: OCD, depressive, bipolar, panic and anxiety.

Symptoms of trypophobia

The most common symptom of trypophobia is mild discomfort. Its manifestations include:

anxiety;
nausea;
increased sweating;
palpitations;
tremor;
sensation of itching in various parts of the body.

Despite the fact that trypophobia is not yet considered a disease, in some cases it can lead to serious problems - panic attacks, increased anxiety.

“With a strong degree of trypophobia, negative impressions from the seen cluster holes can persist for a long time,” says Ekaterina Kharina. - For example, a person looked at such pictures - and the next day or even several days he thinks about them. But in my practice there were no cases when trypophobia led to pronounced shock reactions. nine0007

If trypophobia goes beyond the usual discomfort, people may begin to avoid certain things or certain foods. One of the few reported cases of acute trypophobia is a 12-year-old girl who was disgusted by any porous or sesame-sprinkled bread, strawberries, and noodle soup. She also could not drink raspberry juice or eat marmalade: the sensation of stones or granules on her tongue evoked the same reaction in her [8].

How to get rid of trypophobia

Cognitive behavioral therapy (CBT)

The main treatment for trypophobia is cognitive behavioral therapy (CBT). The psychologist helps the patient "replace" implausible attitudes about the objects of fear with more realistic ones, and then change the behavior [9].

Exposure therapy

Another popular and effective method is exposure therapy, during which a person is gradually taught to control their level of fear. As Ekaterina Kharina notes, this is one of the subspecies of cognitive-behavioral therapy. nine0007

First, in a state of complete relaxation, the patient tells what he is afraid of, then he is shown a picture of the object of fear. Over time, a person may be able to stand next to him and even touch him. Sensitivity and the level of fear are thus reduced.

“Someone may have the idea that he will not be able to bear meeting with such an image, his discomfort will be prolonged or will not end, he will lose control of himself or go crazy,” explains Kharina. “With exposure, we test the patient’s “hypothesis” that their discomfort persists.” nine0007

The psychiatrist notes that exposure works well for ordinary phobias, but in the case of disgust, this method in the traditional format does not lead to a reduction in discomfort. Therefore, it had to be changed a little: a person is taught to endure what disgusts him, form positive associations and connections in memory.

Medications

In some cases, your doctor may prescribe medication to treat trypophobia with antidepressants or benzodiazepines. nine0007

Trypophobia test

Since trypophobia is not considered a diagnosis, it does not have precise diagnostic criteria. The tests described below are not scientific and involve looking at the triggers of trypophobia.

Japanese scientists have developed a questionnaire to measure the level of trypophobia in humans. It is necessary to evaluate the strength of 17 sensations that he experiences when looking at the cluster holes, on a 5-point scale, where 1 - the sensation does not manifest itself at all, and 5 - it manifests itself very strongly. Here is a list of these sensations:

fright;
disgust, loathing;
feeling of discomfort or heaviness;
feeling of panic, screaming;
alarm;
nausea;
bodily manifestations of excitement: "butterflies in the stomach", palpitations, sweating, pain in the abdomen, etc. ;
"feeling like I'm going crazy";
desire to destroy cluster holes;
itching;
tickling; nine0042
goosebumps;
desire to cry;
vomiting;
chills;
respiratory disorders;
trembling.

There is no exact methodology for assessing the level of trypophobia on this test, but in the experiment of the creators of the test, the average score of a sample of 582 people was 32.2, and the range of values was from 17 to 85 [10].

There are a huge number of tests for trypophobia on the Internet. Any of them will help to subjectively assess its level to one degree or another. Implicit Trypophobia Measure 0.5a is often recommended. nine0007

Trypophobia video test is very popular. It's very easy to get through. First you need to turn on the video and take a pose according to the instructions in it. Next, you will be shown trypophobic pictures that will become more and more unpleasant. When you feel like changing your position or turning off the video, do it.

There are no exact criteria here either, but the longer you can watch this video without discomfort, the less likely you are to have trypophobia. nine0007

The author of this article had itching sensations all over his body already at the 30th second, and soon a noticeable discomfort appeared. During the editorial experiment, which involved six women and one man, it was not possible to find people with serious manifestations of trypophobia. Their reaction was much less pronounced: some felt a little uncomfortable at the end, but only one woman experienced itching sensations typical of trypophobia.

However, they managed to find one trypophobe: it turned out to be the 33-year-old husband of an employee.

Learn more