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Fearing spaces and places: reasons and treatment for claustrophobia

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Imagine you’re in an enclosed space that you feel you can’t escape easily, like a crowded elevator or a room with no windows. For some, this can automatically trigger their response to get out of there, or cause avoidance of these situations altogether.

Claustrophobia can cause these feelings, and is something many people can suffer from. This week on “Take Care,” Dr. Robin Zasio, a psychologist who specializes in treating OCD, anxiety disorders, and related conditions, helps define claustrophobia and the treatment that can help eliminate it. Zasio is founder, owner, and director of The Anxiety Treatment Center, The Cognitive Behavior Therapy Center, and The Compulsive Hoarding Center, all located in Sacramento, Calif. Zasio is also the author of "The Hoarder In You: How to Live a Happier, Healthier, Uncluttered Life."

Zasio saysclaustrophobia is a fear of being in a closed or small space, or feeling uncomfortable in a situation that limits or restricts you.

“The experience is very chemical, and that chemical experience that causes people to be fearful can actually cause them to panic too. So that then leads into the psychological component of them having a tendency to avoid those places that they fear they will get stuck,” Zasio said.

As with other disorders, claustrophobia can be measured on a spectrum of mild to severe symptoms. In people with more severe symptoms, fear can creep up in situations like driving long distance. Even though a person with severe symptoms may be on an open road, they might feel if they were to get out of the car they wouldn’t have an idea where to go, says Zasio.

Although claustrophobia can be triggered by a traumatizing event that happened in the past, this is not always the cause. Claustrophobia can be genetic, and simply the way the body responds to what it thinks is danger. As a natural reaction to fear, the fight or flight response will kick in, but the instinct to flee will take over in those with claustrophobia instead of trying to overcome the fear, according to Zasio.

“If we don’t see any kind of genetic predisposition, then we want to look at whether or not there are any environmental influences,” Zasio said.          

But no matter the cause of claustrophobia, Zasio says the approach to treatment generally remains the same.

An example she gives is creating a list of different places a person is avoiding, and rating them on a scale of one to 10, with 10 causing the most anxiety. Then the most feared places can be overcome through small steps in treatment called exposure therapy.

If a person fears being in a room with no windows, Zasio would start by placing a chair just outside the entrance of the door with the door open. The person would then be asked to rate their level of anxiety every five minutes so they could see the longer they sit there, the more their anxiety goes down, and there’s nothing to fear. Zasio would then, systematically, move the person into the room little by little until they are able to sit in the room with the door closed, and no longer fear being in that space.

“We basically say, your perceived threat is far greater than your actual threat,” Zasio said.

Although it may take some time, Zasio says anxiety disorders, like claustrophobia, are very treatable with the proper therapy.