The underground train is packed and stuffy.
And then, to make matters worse, it stops in a tunnel – and stays put.
Most passengers will simply wait out the delay with varying degrees of irritation, perhaps killing time by reading, using their smartphone or nodding off.
For claustrophobics though, initial unease can swell into a full-blown panic attack.
Symptoms can include a dry mouth, dizziness, rapid heartbeat, sweating, trembling, ringing in the ears, difficulty breathing and feeling faint, among others.
Claustrophobia is the fear of confined spaces, such as lifts, tunnels, underground trains, planes, cars, caves, cellars, hotel rooms with sealed windows, narrow corridors or alleys, and MRI imaging machines.
Symptoms can also be triggered by crowded spaces, such as train stations and concerts.
The percentage of the world population affected by claustrophobia is difficult to gauge – estimates range from about 1% to 5%, depending on how it’s defined.
And there’s no clear boundary between extreme unease and an anxiety disorder requiring treatment.
There are various possible causes.
“Many factors can play a role in the development of a specific phobia such as claustrophobia, including genetic predisposition, early childhood experiences and traumatic events,” says psychiatrist and psychotherapist Dr Tobias Freyer in Germany.
“Phobias often arise in combination with depression,” he adds.
“In the broadest sense, the condition frequently has to do with an elevated need to control,” says Dr Miriam Schiele, chief psychologist in the Department of Psychiatry and Psychotherapy at Freiburg University Hospital in Germany.
Many claustrophobics have no trouble driving through a tunnel themselves, but break out into a cold sweat when they’re in the passenger’s seat, for example.
Fortunately, Freyer says, “claustrophobia is highly treatable”, so “it’s definitely worthwhile to get therapy”.
Therapy helps In many cases, cognitive behavioural therapy can help.
A type of psychotherapy, it involves exploring with the therapist why you’re claustrophobic, and developing ways to counter the thought patterns fuelling your fear.
Sometimes exposure therapy – also called desensitisation therapy – comes into play, in which you’re gradually exposed to your feared situation(s).
Medications can help as well, as can relaxation techniques.
In any event, it’s important to confront your claustrophobia head-on, Schiele says.
“If you avoid claustrophobia-inducing situations like the plague, you’ll only reinforce it.
You’ve got to tackle your fear and....
