Trypophobia
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Trypophobia is an aversion to the sight of repetitive patterns or clusters of small
hole A hole is an opening in or through a particular medium, usually a solid Body (physics), body. Holes occur through natural and artificial processes, and may be useful for various purposes, or may represent a problem needing to be addressed in m ...
s or bumps. Although not clinically recognized as a separate mental or emotional disorder, trypophobia may fall under the category of '
specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
' in cases where it causes excessive fear or distress. Most sufferers normally experience mainly
disgust Disgust (, from Latin , ) is an emotional response of rejection or revulsion to something potentially contagious or something considered offensive, distasteful or unpleasant. In ''The Expression of the Emotions in Man and Animals'', Charles D ...
when they see trypophobic imagery, although some experience equal levels of fear and disgust. , trypophobia is poorly understood by the scientific community. In the few studies that have taken place, several researchers
hypothesized A hypothesis (: hypotheses) is a proposed explanation for a phenomenon. A scientific hypothesis must be based on observations and make a testable and reproducible prediction about reality, in a process beginning with an educated guess or thoug ...
that it is the result of a biological revulsion, causing the afflicted to associate trypophobic shapes with danger or
disease A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
, and may therefore have some
evolutionary Evolution is the change in the heritable characteristics of biological populations over successive generations. It occurs when evolutionary processes such as natural selection and genetic drift act on genetic variation, resulting in certa ...
basis, and that
exposure therapy Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the patient to the anxiety source or its context (without the intention to cause any danger). Doing so is thought to help them overc ...
may be a possible treatment. The term ''trypophobia'' was coined by a nameless participant posting to an online forum in 2005. It has since become a common topic on
social networking A social network is a social structure consisting of a set of social actors (such as individuals or organizations), networks of Dyad (sociology), dyadic ties, and other Social relation, social interactions between actors. The social network per ...
sites.


Classification

Trypophobia is not recognized as a mental disorder and thus is not associated with a specific diagnosis in the
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...
's ''Diagnostic and Statistical Manual'', Fifth Edition (DSM-5). However, it may fall under the broad category of
specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
s when it involves excessive, persistent and possibly irrational fear, and is associated with significant distress or even impairment. Whether trypophobia can be accurately defined as a specific phobia may depend on whether the person suffering responds mainly with fear or with disgust. Because
phobia A phobia is an anxiety disorder, defined by an irrational, unrealistic, persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected ...
s involve fear, a response to trypophobic imagery that is based mostly or solely on disgust renders its status as a specific phobia questionable. In one study, most of the participants with trypophobia met the DSM-5 criteria for a specific phobia, even though they experienced disgust with an absence of fear when shown imagery of clusters of holes; however, they did not meet the distress or impairment criteria.


Signs and symptoms

Trypophobia often presents with an
autonomic nervous system The autonomic nervous system (ANS), sometimes called the visceral nervous system and formerly the vegetative nervous system, is a division of the nervous system that operates viscera, internal organs, smooth muscle and glands. The autonomic nervo ...
response, for example, a ''cringe''. Shapes that elicit a trypophobic reaction usually include clustered holes in innocuous contexts, such as fruit and bubbles, as well as in contexts associated with danger, such as holes made by insects or holes caused by wounds and diseased tissue—for example, caused by mango flies in animals, especially dogs. Upon seeing these shapes, some people said they shuddered, felt their skin crawl, experienced
panic attack Panic attacks are sudden periods of intense fear and Comfort, discomfort that may include palpitations, otherwise defined as a Tachycardia, rapid, Arrhythmia, irregular Heart rate, heartbeat, Hyperhidrosis, sweating, chest pain or discomfort, s ...
s, sweated, palpitated, or felt nauseated or itchy. Other reported symptoms include
goose bumps Goose bumps, goosebumps or goose pimples are the bumps on a person's skin at the base of body hairs which may involuntarily develop when a person is Tickling, tickled, cold or experiencing strong emotions such as fear, euphoria or sexual arousa ...
, body shakes (i.e., cringing), nosebleeds, emotional or visual discomfort (e.g., eyestrain, distortions, illusions.) Trypophobia may manifest also with reactions of fear, disgust or both. Disgust is usually the stronger emotion in those who suffer.


Causes

The understanding of trypophobia is limited. Several possible causes have been proposed. Geoff Cole and Arnold Wilkins believe the reaction is an "unconscious ic
reflex reaction In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus. Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs ...
" based on a biological revulsion, rather than a learned cultural fear. Various venomous animals (for example, certain types of snakes, insects, and spiders) have visual characteristics similar to trypophobic imagery. Furthermore, other animals such as the frog ''
Pipa pipa The pipa, pípá, or p'i-p'a () is a traditional Chinese musical instrument belonging to the plucked category of instruments. Sometimes called the "Chinese lute", the instrument has a pear-shaped wooden body with a varying number of frets rangi ...
'' have been known to be a trypophobia trigger. Because of this, it is hypothesized that trypophobia has an
evolutionary Evolution is the change in the heritable characteristics of biological populations over successive generations. It occurs when evolutionary processes such as natural selection and genetic drift act on genetic variation, resulting in certa ...
basis meant to alert humans of dangerous organisms. Can ''et al.'', however, believe the connection between trypophobia and evolution as a result of a threat from deadly creatures to be weak and that, if a connection does exist, it manifests later in life rather than in childhood. Martínez-Aguayo ''et al.'' described trypophobia as usually involving "an intense and disproportionate fear towards holes, repetitive patterns, protrusions, etc., and, in general, images that present high-contrast energy at low and mid-range
spatial frequencies In mathematics, physics, and engineering, spatial frequency is a characteristic of any structure that is periodic across position in space. The spatial frequency is a measure of how often sinusoidal components (as determined by the Fourier tran ...
." Cole and Wilkins also stated the imagery has high spatial frequency with greater energy at mid-range. Whether together or separate, it appears that low and mid-range spatial frequencies are necessary for inducing trypophobic reactions. Based on the imagery's visual cues, An Trong Dinh Le, Cole, and Wilkins developed a symptom questionnaire that they believe can be used to identify trypophobia. Researchers have also speculated that trypophobic reactions could be perceived as cues to infectious disease, which could be alerts that give one a survival advantage. In a study by Kupfer and Le, trypophobic and non-trypophobic participants showed significant aversion to disease-relevant cluster images, but only trypophobic participants displayed a significant aversion to disease-irrelevant cluster images. Martínez-Aguayo ''et al.'' stated that, because the reactions could not be attributed to different sensitivity levels or
neuroticism Neuroticism is a personality trait associated with negative emotions. It is one of the Big Five traits. Individuals with high scores on neuroticism are more likely than average to experience such feelings as anxiety, worry, fear, anger, shame ...
differences, Kupfer and Le believe it supports their hypothesis that trypophobia is "an overgeneralized aversion towards cluster stimuli that indicates a parasitic and infectious disease threat". Yamada and Sasaki also propose that trypophobic reactions are due to the imagery's visual similarities to
skin diseases A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this sys ...
. Whether trypophobia is associated with
obsessive–compulsive disorder Obsessive–compulsive disorder (OCD) is a mental disorder in which an individual has intrusive thoughts (an ''obsession'') and feels the need to perform certain routines (''Compulsive behavior, compulsions'') repeatedly to relieve the dis ...
(OCD) has also been studied. A significant minority of those with trypophobia meet the DSM-5 criteria for an obsessive-compulsive disorder. Martínez-Aguayo ''et al.'' stated that other findings refer to trypophobia having common
comorbid In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sicknes ...
psychiatric diagnosis, such as
major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive depression (mood), low mood, low self-esteem, and anhedonia, loss of interest or pleasure in normally ...
or
generalized anxiety disorder Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning. Individuals with GAD are often overly con ...
, although Le ''et al.'' felt that general anxiety does not cause trypophobia.


Treatment

There are no known treatments for trypophobia, but
exposure therapy Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the patient to the anxiety source or its context (without the intention to cause any danger). Doing so is thought to help them overc ...
, which has been used to treat phobias, is likely to be an effective treatment.


Epidemiology

The extent to which trypophobia exists is unknown, but the available data suggests that having an aversion to trypophobic imagery is relatively common. 16% of a sample of 286 participants in a 2013 study reported discomfort or repulsion when presented with an image of a lotus seed pod and its authors found that non-trypophobic individuals also experienced more discomfort when viewing trypophobic imagery than when viewing neutral images. Trypophobia appears to be more prevalent in women.


Etymology

The term ''trypophobia'' is believed to have been coined by a participant in an online forum in 2005 from the , ', meaning "hole" and , ', meaning "fear".


Society and culture

Groups on social media sites such as
Facebook Facebook is a social media and social networking service owned by the American technology conglomerate Meta Platforms, Meta. Created in 2004 by Mark Zuckerberg with four other Harvard College students and roommates, Eduardo Saverin, Andre ...
and
Instagram Instagram is an American photo sharing, photo and Short-form content, short-form video sharing social networking service owned by Meta Platforms. It allows users to upload media that can be edited with Social media camera filter, filters, be ...
exist for self-identified trypophobics to share and discuss images that they say induce the reaction. Because trypophobia is not well known to the general public, many people with the condition do not know the name for it and believe that they are alone in their trypophobic reactions and thoughts until they find an online community to share them with. This has led to an increase in trypophobic images on social media; in some cases, people seek to intentionally induce trypophobia in those who have it by showing them trypophobic images, with the most trypophobic response-inducing images being holes and clusters (especially the lotus seed-head)
photoshopped Photograph manipulation involves the transformation or alteration of a photograph. Some photograph manipulations are considered to be skillful artwork, while others are considered to be unethical practices, especially when used to deceive. Mot ...
onto human skin. Cole and Wilkins also stated that the level of disgust with trypophobia increases if the holes are on human skin. Writing in ''
Popular Science Popular science (also called pop-science or popsci) is an interpretation of science intended for a general audience. While science journalism focuses on recent scientific developments, popular science is more broad ranging. It may be written ...
'', Jennifer Abbasi argues that
emotional contagion Emotional contagion is a form of social contagion that involves the spontaneous spread of emotions and related behaviors. Such emotional convergence can happen from one person to another, or in a larger group. Emotions can be shared across indivi ...
within such social media groups may be responsible for some of the averse reactions to such images. In 2017, trypophobia received media attention when ''
American Horror Story ''American Horror Story'' (''AHS'') is an American horror film, horror anthology series, anthology television series created by Ryan Murphy (producer), Ryan Murphy and Brad Falchuk for the Cable television, cable network FX (TV channel), FX. Th ...
'' featured a trypophobic character and trypophobic response-inducing advertisements promoting the storyline; some people were disturbed by the imagery, and criticized the show for "insensitivity towards sufferers of trypophobia". Although there was sentiment that the increased media attention could lead to people trying to induce trypophobia, there were also opinions that it might help people understand trypophobia and encourage more research on the matter. Some users responded to the September 2019 release of Apple's
iPhone 11 Pro The iPhone 11 Pro and iPhone 11 Pro Max are smartphones developed and marketed by Apple Inc. Serving as Apple's flagship models of the 13th generation of iPhones, they succeeded the iPhone XS and iPhone XS Max, respectively, upon their rele ...
, which features three closely spaced camera lenses, with comments that it triggered their trypophobia. Writer and editor Kathleen McAuliffe suggested that trypophobia is yet to be extensively studied because researchers have not given as much attention to topics of disgust as they have to other areas of research, and because of the revulsion viewing the images could incite in researchers.


See also

*
List of phobias The English suffixes -phobia, -phobic, -phobe (from Greek φόβος ''phobos'', "fear") occur in technical usage in psychiatry to construct words that describe irrational, abnormal, unwarranted, persistent, or disabling fear as a mental di ...
* Ommetaphobia


References


External links

* {{commons 2005 neologisms Holes Phobias