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TRYPOPHOBIA by FU SHIN HUI J18028103 CHOW UAI-TNG J18027822 LEONG CHI SWEN J17024449 CHONG YING WEN J18028126 SAMANTHA JANE CHEN J18027872 Introduction to Psychology PSY108S MS Jane Wai INTI International College Subang 4th July 2018 INTRODUCTION Trypophobia is also commonly known as the fear of holes

March 17, 2019 0 Comment

TRYPOPHOBIA
by
FU SHIN HUI J18028103
CHOW UAI-TNG J18027822
LEONG CHI SWEN J17024449
CHONG YING WEN J18028126
SAMANTHA JANE CHEN J18027872
Introduction to Psychology
PSY108S
MS Jane Wai
INTI International College Subang
4th July 2018
INTRODUCTION
Trypophobia is also commonly known as the fear of holes. It is derived from Greek words, which “trypa” means holes. Trypophobia is the extreme feelings of fear and anxiety towards clusters of holes or bumps and even repetitive patterns, such as honeycombs, lotus pods, body of strawberries and bubbles. Due to lack of studies on trypophobia, it is not officially recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual, as it stated that a phobia should affect one’s daily routine.

HISTORY OF TRYPOPHOBIA
The word trypophobia only went viral on internet in 2005 when it was published by an unidentified Irish woman. However, back to 1990s, Rufo had described where a little girl expressed extreme terror towards holes and paralyzed fear when looking at repetitive patterns on musical instrument. But the first study on trypophobia only be published in 2013, by Geoff Cole and Arnold Wilkins from the University of Essex, in Psychological Science, which is a journal of the Association for the psychological science. Their study concluded that trypophobia is the results of visual discomfort when people unconsciously relate trypophobic images with the features of venomous animals besides is also triggered by the high-contrast colour of the images in midrange spatial frequency. In 2015, Le AT constructed a scale which is known as Trypophobia Questionnaire (TQ) to evaluate the level of discomfort and trypophobic symptoms. His studies show that the bigger the bumps or holes, the higher the discomfort triggered. Le AT had also confirmed Cole and Wilkins study on the influence of spatial frequency on this phobia. While in 2016, Chaya K had done her study on the relationship between trypophobia and social anxiety and it showed that both contribute to the fear of people being gazed at. At the same time, Imaizumi S speculated that the disgust towards scars, sores and scaly-skinned animals could lead to trypophobia too. He suggested that the tendency to have trypophobia is predicted by core disgust sensitivity, personal distress and visual discomfort proneness. Only in 2017, curiousity about whether trypophobia is a specific phobia or obsessive-compulsive disorder is being studied by Vlok-Barnard M and Stein DJ as trypophobia is more to disgust than to fear. Their research also shows that major depressive disorder and generalized anxiety disorder are commonly related to the symptoms of trypophobia. While Can’s studies proven that unconscious association between clusters of holes and bumps with poisonous animals is not present, besides arised the question whether is trypophobia a real phobia. In the same year, Kupfer and Le discovered that trypophobic groups might also be affected by their disgust towards skin diseases as previously virulent skin diseases used to form circular shapes on human skin. While in Sasaki’s studies on trypophobia, it stated that both low-range or mid-range spatial frequency could affect trypophobic discomfort as well. Apart from that, Sasaki and Yamada did further researches which suggested that discomfort triggered by trypophobia is more likely to happen on people who had skin diseases before and was not confirmed due to lack of evidence.

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EPIDEMIOLOGY
DSM-5 (2013) states that a phobia has to interfere ”significantly with the person’s normal routine”. While it might not significantly interfere with a person’s life, this is probably the normal reaction for someone who suffers with the ‘proposed’ fear. Current findings indicate that significant numbers of people throughout the world may have a phobia called trypophobia.

An T. D. Le, Geoff G. Cole, and Arnold J. Wilkins (2015) constructed a study based on symptoms of trypophobia. Participants for the study included two samples. 155 individuals aged from 18 to 73 years old which are 28 males and 127 females and 117 individuals which consist of 33 males and 84 females aged from 18 to 50 years old were gathered from users of an online page about trypophobia (Trypophobia: Fear of Clusters of Holes, no date) and University of Essex student and staff volunteers respectively. The first sample is called the “web-based” trypophobic cohort, and the second sample is the “university” group.
Comments after viewing 39 trypophobic images from 200 individuals who used the online page (Trypophobia: Fear of Clusters of Holes, no date) were collected, dated from 19th Sept 2012 to 15th April 2013, and used as the symptoms. For example, one of the comments states “I was so uneasy and itchy and disturbed.” were coded as “uneasy”, “itchy” and “disturbed”. Comments regardless the symptoms were disregarded. (Le et al., 2015)
The results based on viewing trypophobic images shown 17 comments in total were the most common symptoms (Le et al., 2015). The comments were divided into 3 categories which are cognitive-related symptoms, skin-related symptoms and physiological symptoms and 6 comments, 4 comments and 7 comments were included in the categories respectively (Le et al., 2015). For example, “Unsasy” or “Aversion” is under cognitive-related symptoms, “Itchiness” or “Skin crawl” is under skin-related symptoms, and “Nausea” or “Have trouble breathing” is under physiological symptoms. (Le et al., 2015)

Table 1 shows the factor loadings based on the symptoms in Trypophobia Questionnaire (TQ). (An T. D. Le, 2015, p.42)
Note that the TQ identifies trypophobia were based on reports of various symptom types, and with only ideal images. (An T. D. Le, 2015, p. 46)
Individuals were invited to participate in rating images from 3 categories in terms of unpleasantness after finishing the TQ. The number of volunteers from the “web-based” trypophobic cohort decreased by 17 as they had the choice to opt out of the image rating. Therefore, 138 individuals which consist of 23 males and 115 females and 117 individuals which consist of 33 males and 84 females are the participants for this study.

Le et al. (2015) provide 3 categories in terms of unpleasantness:
a) Trypophobic images from an internet-based supporting group (Trypophobia: Fear of Clusters of Holes, n.d.).

b) Non-trypophobic images from Google search “objects with holes” (e.g. trumpet)
c) Unpleasant images from Google search “unpleasant images” (e.g. rubbish, blood)

Figure 2. Scatterplot shows the average image rating of each participant as a function of their TQ score: (a) trypophobic images, (b) neutral images and (c) unpleasant images (Le et al., 2015).

“The ratings of unpleasantness were coded numerically from -4 through 0 to +4(i.e., ?4 = extremely repulsive; +4 = extremely attractive).” (Le et al., 2015) Figure 2 shows the average image rating of each participant and TQ score (Le et al., 2015). Figure 2a shows the average image rating of each participant and TQ score for trypophobic images (Le et al., 2015). Figure 2b shows the average image rating of each participant and TQ score for non-trypophobic images (Le et al., 2015). Figure 2c shows the average image rating of each participant and TQ score for unpleasant images (Le et al., 2015). Based on this, a little evidence suggested that the symptoms shown by the participants when viewing trypophobic images were specifically related to the unpleasantness induced by those images and not other images.

SYMPTOMS OF TRYPOPHOBIA
One of the symptoms of Trypophobia is having goosebumps. Goosebumps are the condition of the skin when it is rough, induced by fear; disgust or the cold; very much like the resemblance of a plucked goose. An individual who suffers from trypophobia would look at a bunch of closely packed holes and feel disgusted. Hence, the sensation of the goosebumps on the skin. This sensation happens momentarily and therefore not for a long time. It stops when the individual is no longer triggered by the phobia. This is from the erection of papillae as a response towards the fear of looking at closely packed holes.
Another symptom is panic attacks, which are also known as an anxiety attack. It is when something so worrisome affects a person physically, and the person feels out of control. It feels like impending doom. When a person feels discomfort from the triggering of trypophobia, he or she may start feeling a rush of emotions which then results in the person beginning to have a meltdown, in which is from anxiety. Hence, the occurrence of a panic attack. When an individual comes across an object with small clusters of holes, the symptoms may be triggered.

Thirdly, trypophobia’s symptoms also include visual discomfort. According to SpringerPlus 2016, if a person has visual discomforts and sensitivity he or she has trypophobia. Visual discomfort is the feeling of the eye-straining. This is caused when a person who suffers from trypophobia is looking at a cluster of holes. “We found an association between trypophobia proneness and visual discomfort, both of which are induced by stimuli showing excessive energy at medium spatial frequencies that are unnatural and physiologically stressful for human vision” (Fernandez and Wilkins 2008; Cole and Wilkins 2013; Le et al. 2015). Both cognitive and physical properties may trigger trypophobia. (Calder et al. 2001)
Besides that, nausea is also a symptom of trypophobia. Nausea is the feeling of wanting to vomit. “This feeling sends an unusual taste through the mouth causing it to water and results in a look of disgust.” (Urban Dictionary,2009). When a person with trypophobia is in eye contact with holes, the individual may experience a stomach discomfort which may lead to the possibility of throwing up. This is from the sick feeling in the stomach from utter disgust of the holes. The feeling of disgust is a cognitive property of visual stimuli.

The fifth symptom is sweating. Sweating is basically the process of perspiration where sweaty liquid is released from the sweat glands. Although this process is able to cool the body off, the anxiety from trypophobia may not make an individual feel this way. According to anxietycentre.com, this is because when a person is having anxiety from trypophobia, he or she may sweat very profusely and excessively. The whole sweating process may also be uncontrollable. Hence, the excessive sweating, whether hot or cold sweat. It is difficult to stop the anxiety and excessive sweating immediately. (Folk. J, Folk. M, 2018).
Lastly, a person with trypophobia may experience itches on the skin. An itch is when the skin is irritable and it requires scratching to ease it. The itchiness would be caused by the feeling of discomfort form the clusters of closely packed holes. This discomfort would result in the skin feeling itchy and crawly. By the fear of holes, the individual may have the thought or imaginations of holes appearing on his or her own skin and as a result, the person would start scratching more and more as the itching gets worse. According to Lewis T, 2014, research shows that the feelings of itching involve a complex system of molecules and cells.

CAUSES OF TRYPOPHOBIA
There are many causes will lead to Trypophobia. First of all, it is causes by evolutionary survival respond. “There may be an ancient evolutionary part of the brain telling people that they are looking at a poisonous animal,” Cole said in a 2013 press release. Humans have the natural defense and fear against the poisonous animals and any other living things. Many poisonous animals and living things have the similar visual features resembling holes and craters. As results, when people are exposed to pockmarked objects, the brain will perceive it as something bad, harmful and dangerous. Next, it is also a way for the humans to avoid themselves from infecting disease. For example, thousands of years ago, when we saw a person covered in boils or a body covered in flies, we will immediately keep ourselves away from them. This is because the natural aversion to the sight would have helped us to avoid catching whatever they had. This means this fearful instinct may be already established in the genes only.

Moreover, Trypophobbia may be result of deep-rooted emotional problem. There can be an object or bad experiences from the childhood and these make them to suffer with trypophobia. For example, they may trigger some traumatic memories which associated with hole and most probably is bee stings. Possible bee stings and traumatic events in the past that led to swelling wherein the swollen skin display every pore is the good example of why people having trypophobia. It shows that the unpleasant incidents that happens in the past may plant a deep-rooted emotional problem inside a person and this situation is similar to conditioned stimulus.

Next, excessive brain oxygenation is also one of the causes that lead to trypophobia. This is due to the energy their brain uses when looking at the visuals. Our brain uses around 20% of our body’s energy. This excessive use of energy by the brain causes discomfort, headache or eye strain. So, they avoid looking at the image that pressurizes their brain. Trypophobia is not limited to images; some individuals may also fear the holes on the skin, meat, on fruits and vegetables, wood, honeycombs etc. There are also people who think there are some harmful organisms living inside those holes which would come out and cause an infestation.
In addition, learning behaviour also donates to the causes of why people suffer with trypophobia. This is because there are some people reported that they were not feeling unpleasant toward the clustered holes until they heard or saw someone else feeling that way. Therefore, it shows that it may be an influence or learnt fear from peoples around that such holes are disturbing.

TRYPOPHOBIA TREATMENTS
As of time today, there are a lot of powerful tools offered by modern psychotherapy to tackle isolated phobias such as trypophobia. To go into detail, there are a number of ways to treat trypophobia, but to do so one must learn to distinguish fear from disgust. “It is different for everyone, like all phobias there is more than one solution” (ConsumerHealthDigest, 2018). Whether it’s a bad experience, bad memory or simply disgust, do so discover what triggers the repulsiveness.

In some cases, there are therapeutic methods that help treat trypophobia which deals with the brains perception on particular objects and how to overcome it. The most commonly used therapy for treating and managing phobias is exposure therapy, which can be applied to trypophobia by constant exposure to objects which frightens the individual. This method will significantly lessen their fear as the exposure to clustered holes in a safe environment helps reduce fear and decreases avoidance. There are several types of exposure therapy, and each one offers a similar technique but different procedure. The first type is In vivo exposure, which is directly facing a trypophobia; looking at a picture of clustered holes edited on a humans’ body. Besides that, another type of therapy called graded exposure, by which the psychologist helps the individual construct an exposure fear hierarchy of pictures of clustered holes that are ranked for the least horrifying or disgusting to the most unbearable level. Furthermore, there’s systematic desensitization; exposure therapy combined with relaxation exercises. This makes trypophobia more manageable with association to relaxation methods such as meditation. That’s said, during exposure the individual can learn to attach new and more realistic beliefs about trypophobia and become more at ease with the experience of fear.

Moving on to the next treatment which is cognitive therapy. The main goal of cognitive therapy is to change the destructive perception of the patient to improve the symptoms. “Cognitive behavioural therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving” (Martin, 2018). It aims to help deal with trypophobia in a more positive way; improving the way you feel by showing how to perceive these negative patterns. It is focused on the beliefs, attitude, thoughts and images that holds a person’s cognitive process and how these processes relate to the way the individual behaves. By improving the way you feel towards clustered holes will alter the way you see it and thus reducing the fear. Not resembling to some talking treatments, cognitive behavioural therapy deals with your current issues, rather than focusing on problems from your past by using practical methods to improve your state of mind on a daily basis.
A new profound therapy called havening or Amygdala Depotentiation Technique ADT, as referred to clinical setting that was developed by Doctor Ronald Ruden from New York is a very effective process that combines therapeutic patterns such as counting and havening touch. How does havening actually work is to first focus on the symptomatic feeling, close your eyes and think about typophobic images and focus in the sensation and the feeling you would get. Then rate the feeling of uneasiness from 0 to 10. Keeping the number in mind, open your eyes and distract yourself by applying havening touch such as crossing your arms and stroke with your hands down from your shoulders to your elbows, this act is called arm havening. Other than that, there is hand havening by which you rub your palms against each other, these will immediately trigger the release of endorphins and serotonin in your body that will enable your neurology to actually deconstruct the phobia so former triggers won’t be able to have any effect on you anymore.
Whilst applying havening touch, imagine a relaxing situation while counting from 1 to 20 in your own rhythm and pace. Then begin humming a melody that you like, this will activate a different part of your brain, therefore aiding in the de-linking of the former symptom.
Then, looking from the very far right to very far left and repeating it five times. This will stimulate different regions in your brain, assisting in loosening the neurological connections causing trypophobia. Keep repeating these steps till the trypophobia desire becomes a thing in the past which won’t bother you anymore.

From the psychological point of view, a phobia is an anxiety disorder, which has been thought to arise due to a known danger. Thus, people who suffer from trypophobia should know that there is no exact threat to them and should use therapies to overcome their fears.

CONCLUSION
As a conclusion, even though trypophobia is not an officially recognized phobia, many still claim themselves as trypophobic groups especially the females. Extreme terror and panic tend to arise in them whenever they are exposed to images of tiny holes, bumps and repetitive patterns. Some might even have the feeling of nausea and wanting to throw up just thinking of the trypophobic images. There are still researchers trying to find out the exact cause of this fear. At the moment, ways to treat this phobia are almost the same as other phobias such as exposure therapy, cognitive therapy and combination therapy. However, it will still take some effort for psychological scientists to prove that trypophobia is a phobia as it is always triggered often by disgust instead of fear. Fortunately, there are already few evidences shown that trypophobia have an impact on one’s daily life when it is triggered.

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