In the US alone it is reported that 5% of the population suffers from claustrophobia of varying degrees, from mild discomfort to extreme levels (source). Yet this fact is of no comfort to the sufferer.

Claustrophobia is the fear of being confined in enclosed spaces and not being able to get out. The most common examples where suffers experience anxiety include lifts and planes however they could easily find themselves distressed in any small room in any house or building.

I have outlined below some practical tips one could use for helping someone through claustrophobia:

Tips for parents, partners or friends of sufferer

1. Patience is a virtue. Like all phobias this one is irrational and not grounded in reality. It is important to comprehend that the sufferer is not choosing any of this and that what they are experiencing is very real and can be very upsetting.

2. Don’t smother them. It’s natural to be protective, especially if it is your son or daughter, but constantly asking them if they are ok and what’s going on when a panic attack occurs will only amplify the intense and overwhelming feelings.

3. Speak to them. Keep the conversation basic; ask them what their plans are for the week, what they are having for dinner, what they did yesterday. The questions will distract them and focus on practical matters.

4. Create small challenges to slowly expose the sufferer to their fears. This should be done with zero pressure but consistently so they can be mentally prepared. Start with picking a different room in your house every week; encourage them to lock the door with both of you in it. The goal is to get them to stay in the room alone with the door locked.

5. Be patient. No it isn’t a typo, I am including this twice to emphasize the fact that overcoming any fear is a process. Sometimes giant leaps are taken and sometimes the smallest situation can sets us back tenfold. Being patient will help them accept the setbacks and continue on the road to recovery.

Tips for sufferers

1. Create a checklist. A pilot doesn’t just start the plane and take off; they go through a detailed list of tasks they need to do in preparation for a safe flight. The same is true for anyone about to expose themselves to a phobia.

Write down the facts of the current situation. For example, before getting on a flight, ask yourself: Am I alone on the flight? How long is the flight? Are other people experiencing the feelings I have now, such as heart racing, tension in head, neck and shoulders? Ask yourself when was the last time you were involved in an incident on a flight, I’m guessing never.

2. Draw. Creatively drawing or even just doodling invokes the right side of the brain which is used for spacial awareness. Activating this side of your brain helps to reduce the negative thinking associated with the left cognitive side of the brain (source). Listening to music is also be very effective for this.

3. Visualise a safe place. I always encourage my clients to pick a specific place where they go to relax. This could be the sitting room of their house where the family sits and chats, a place in nature where they walk or run or even a foreign landmark where they had a positive experience. When the overwhelming feelings rise holding onto this image intently can invoke the calm feelings associated with that place. Similar to drawing, using imagery invokes the right brain to balance out the overactive left brain which is working at 100% trying to understand the emotions.

4. Breath. Deep belly breathing fills your lungs with air and increases circulation, it helps to focus your attention and changes the messages sent to the brain, informing it to relax and stay calm. Just imagine your belly as a balloon and watch it gently rise as you inhale and then lower as your exhale.

5. Reach out. Spatial awareness can often be a problem for sufferers of Claustrophobia. If they are in a confined area, touching walls may create a better sense of the area they are in and the size of the space.

6. Cognitive training. Cognitive Behavioural Therapy (CBT) is often the go to tool for helping overcome many phobias. My personal preference is the Rational Emotive Behavior Therapy (REBT) method as described by Albert Ellis.

REBT uses an ABC model to define a step by step guide to assess any life problem and teach us how to positively re-frame our thoughts around it.

Here’s one simple example:

A (Activating event): I’m about to get into a lift and the anxiety is beginning.

B (Belief’s around A): The lift door will not open. I’ll be stuck here forever. The anxiety will completely overwhelm me. I won’t be able to breath.

C (Consequences of C): You feel extreme tension beforehand. If you knew you were getting in the lift, it might have played on your mind all day. You might avoid getting on the lift altogether and miss out on the view.

D (Dispute B): How many times have the lift doors opened today, all week, all year? Is there people waiting to use the lift after you? Have you ever actually been suck in a lift? If the door doesn’t open, will staff have to address it quickly? Are you surrounded by friends? Would getting stuck with friends be such a bad thing? Have you felt the anxiety before? Did it pass then? Will it pass again, like the last time?

E (Effective thinking around A): The chances of the lift door opening are very slim. It has never happened to me before so there is no reason to believe it will happen now. My friends are not nervous so there is no reason for me to be. The anxiety is not a problem; the feelings always disappear after a few minutes. It’s ok to just relax and enjoy the view.

7. Face the fear. Ultimately, the only way to take power away from this phobia is to face it head on. Plan your attack. Set mini goals every week, such as locking the door of a small room in your house. Stick to the goals and reward yourself with little things after you have met the task. Persevere, this is not going to be easy, but don’t be hard on yourself if you do experience a setback. Validate yourself when you do well and if you experience any set backs, regroup and get back to the plan.

There are some great resources available to help with claustrophobia. The is a fantastic book for helping people through anxiety conditions with the use of CBT techniques. The following YouTube video also has some great tips for dealing with anxiety.

I hope this helps, please feel free to comment and share.

Take care,
Karl