Trypophobia: Does looking at small holes make you feel queasy?

I’ve been asked to cover some pretty stomach-churning articles over the years - ones on pubic lice  and runny bowel movements immediately come to mind (it’s a glamourous life) - but this is probably the piece that’s really put my gag reflex to the test. It’s on trypophobia, or fear of clusters of rounded shapes, which until recently, I didn’t know I had, or even knew existed.

And, it seems I'm not alone in my fear of tiny circles. According to a new survey commissoned by physicworld.com  trypophobia is the UK's most commonly Googled phobia with 120,000 people per month trying to find some meaning behind their fear of groups of holes. This is pretty surprising considering I'd never even heard of the term until recently. Across the whole of Europe and the US, it shares the most-searched spot with claustrophobia. So, what is it about small holes that make so many of us squirm? Is trypophobia real and can you take a trypophobia test?

Let me explain, I’ve always been slightly repelled by images of collections of holes like you’d find on a cut open pomegranate or a piece of coral or honeycomb. The only thing is, I never realised that there was a name for it until I Googled it one day and saw pages upon pages of blogs and articles with people’s first-hand experiences of having it and the various ways that it affects their day-to-day lives. Triggers are everywhere - from kitchens to bathrooms and TV screens. In fact, American Horror Story came under fire recently for upsetting sufferers by using images of body parts and clowns photo-edited with holes to promote a previous season.

What is trypophobia?

Although it’s not clinically recognised as a mental health condition, it’s still to be taken seriously, says psychologist and author of The Shrinkology Solution, Dr Meg Arroll,  (who has trypophobia herself). “If the sight of specific stimuli (in this case, clustering of holes in specific formation) causes someone to experience symptoms of anxiety, panic attacks and/or leads them to avoid certain activities, this phobia could certainly be viewed as a notable psychological phenomenon.”

She points to a 2013 University of Essex study, where 16 per cent of participants reported adverse sensations when presented with triggering images. “It is therefore likely that trypophobia is under-reported in the general public and psychological or mental health services.”

Feelings of nausea and repulsion are common symptoms among those who have trypophobia, says Dr Arroll. Others include an increased heart rate, sweating, feelings of panic, goosebumps and the feeling that something is crawling on them. For those who suffer from it severely though, it may even cause a panic attack.

What causes trypophobia?

There’s a lack of research in the area however, there are two studies in particular that help provide valuable insight. For instance, the aforementioned study conducted by the University of Essex theorised that it was linked to the patterns of holes that you can find on some of the world’s most poisonous animals (snakes, alligators and poisonous spiders for example). Our feelings of disgust could be the result of our natural survival instinct kicking in and telling us to run away. “These reactions may have an evolutionary basis that allowed us to avoid unnecessary threats,” says Dr Arroll.

However more recently, a study conducted by the University of Kent  suggested that the condition may, in fact, be due to our response to infectious diseases - ones that manifest themselves as clusters of rounded shapes on the skin. Examples include smallpox, measles and rubella. It might also be connected to our reaction to parasites like tics and botflies, bites of which can cause a similar clustering of bumps on the skin, as well as associations with decay (which is why mould on bread or vegetables can be a trigger for some people).

Who may be likely to have trypophobia? Is there a test for trypophobia?

Again, more research is needed. However, there is some evidence suggesting links. “Some initial work suggests that people with clinical depression and/or generalised anxiety disorder are more at risk of developing trypophobia,” says Dr Arroll. “This is not to say that other people with mild/moderate mental health conditions have trypophobia, it’s just that we simply don’t have the data on this yet to make firm conclusions. However, in my experience, there is often an overlap.”

Because trypophobia isn't currently recognised as a disorder there isn't a medical test for it. However, there are several online tests that involved showing various images to assess how you feel when you see different patterns. If you think you have trypophobia talk to your health care practitioner and they can advise you on the next steps.

What are the best ways to overcome trypophobia?

More high-quality treatment studies are needed in Dr Arroll's opinion, in order to see what the most effective course of action would be. That being said though, she notes that it’s worth exploring methods that are usually used to treat other phobias (such as arachnophobia) to see if they could help. “Systematic desensitisation would be a sensible approach - gradually presenting an individual with images that trigger a reaction so that, over time, the fear response is reduced,” she says. “It would be useful to pair this with cognitive behavioural therapy  to help the sufferer overcome any negative thought patterns that surround these images and objects too.”

When it comes to desensitising yourself, her recommendations are to start with something that’s the least distressing such as a strawberry, and work yourself up to an image that you find particularly unpleasant. However, if your symptoms are particularly severe, skip the self-treatment and seek out professional help instead. If this article has taught me anything, it’s that there are plenty of people who are experiencing the same.

Read more: Hypnotherapy helped me with my anxiety, and now I use it to help others