Trypophobia and the Fear of Holes

Table of ContentsView AllTable of ContentsSymptomsTriggersCauses of TrypophobiaRisk Factors for TrypophobiaTreatments for Trypophobia

Table of ContentsView All

View All

Table of Contents

Symptoms

Triggers

Causes of Trypophobia

Risk Factors for Trypophobia

Treatments for Trypophobia

What is trypophobia?Trypophobia is an irrational, disruptive aversion or fear of clusters of small holes, bumps, or patterns. When people with this phobia see such objects, they can experience severe fear, nausea, itching, sweating, shaking, and evenpanic attacks.

What is trypophobia?

Trypophobia is an irrational, disruptive aversion or fear of clusters of small holes, bumps, or patterns. When people with this phobia see such objects, they can experience severe fear, nausea, itching, sweating, shaking, and evenpanic attacks.

Trypophobia is often described as “the fear of holes,” but it also can apply to bumps or other patterns clustered together. When people see trigger objects, they experience symptoms such as severe fear, nausea, itching, sweating, shaking, and evenpanic attacks.

Whether trypophobia is a genuine condition is the subject of debate.Trypophobia was first described in an online forum in 2005, but the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-V-TR) has not recognized it as a distinct diagnosis.

If it were to be listed in theDSM-5, trypophobia would likely fall under the broad classification of specific phobias, which are persistent and excessive enough to cause significant impairment or distress.

Signs and Symptoms of Trypophobia

Fear is one common symptom of trypophobia, but disgust tends to be the overwhelming emotion. Trypophobia also tends to be highly visual.Seeing images online or in print is enough to trigger feelings of revulsion or anxiety.

1:30Click Play to Learn More About the Phobia of Holes

1:30

Click Play to Learn More About the Phobia of Holes

The symptoms of this condition are similar to those of other specific phobias. After seeing clusters of small holes or bumps, whether in reality or in an image, people often experience:

Symptoms are persistent, leading to functional impairments in daily living.One case report illustrates how trypophobia often presents.The patient, a 12-year-old girl, experienced feelings of discomfort when she encountered surfaces and objects covered with holes or dots. When asked to draw a picture of her fear, she filled a paper with a repetitive pattern of clustered, round dots.

How Common Is Trypophobia?Some research indicates that trypophobia may be quite common. One 2013 study published inPsychological Sciencefound 16% of participants experienced disgust or discomfort when looking at an image of a lotus seed pod.

How Common Is Trypophobia?

Some research indicates that trypophobia may be quite common. One 2013 study published inPsychological Sciencefound 16% of participants experienced disgust or discomfort when looking at an image of a lotus seed pod.

Common Triggers of Trypophobia

Research on trypophobia is still relatively rare, but some of the trigger objects that have been observed include:

Man-made patterns, as well as animals that have spotted or patterned coats, can also cause a phobic reaction.

Trypophobia can lead to symptoms related to fear, disgust, or both, although research suggests that people report feeling greater disgust rather than fear.

In addition to experiencing symptoms such as fear and disgust, people with trypophobia often experience behavioral changes as well. Avoidance of trigger objects is common. For example, a person might avoid eating certain foods (such as strawberries or aerated chocolate) or avoid going to certain places (such as a room with dotted wallpaper).

Research on trypophobia is still quite limited, but there are some theories about why it happens.

Evolution

This theory suggests that this phobia has an evolutionary basis. It is also consistent with the tendency for those with trypophobia to experience greater disgust than fear when they see a trigger object.

Associations With Dangerous Animals

Another theory suggests that clustered holes share a similar appearance to skin and coat patterns on some venomous animals. People may fear these patterns out of unconscious associations.

There is some research that supports this idea. A 2013 study looked at how people with trypophobia respond to certain stimuli in comparison to those without the condition. When viewing a honeycomb (a common trypophobic object), people who don’t have trypophobia immediately think of things such as honey or bees.

The researchers believe that those with trypophobia non-consciously associated the sight of a honeycomb with dangerous organisms that share the same basic visual characteristics, such as rattlesnakes. While they are not consciously aware of this association, it may be what causes them to feel feelings of disgust or fear.

Associations With Infectious Pathogens

A 2017 study found that participants tended to associate hole patterns with skin-transmitted pathogens. Study participants reported feelings of skin-itching and skin-crawling when viewing such patterns.

Disgust or fear of potential threats is an adaptive evolutionary response. In many cases, these feelings help keep us safe from danger. In the case of trypophobia, researchers believe it may be an overgeneralized and exaggerated form of this normally adaptive response,

A Response to Visual Characteristics

Some research suggests that the discomfort people feel has more to do with the visual characteristics of the patterns themselves.

One study published inPsychological Reportsfound that while people experience discomfort when viewing trypophobic patterns, these feelings were more related to the visual patterns themselves than to associations with dangerous animals.Such results call into question whether or not trypophobia is actually a phobia at all, or simply a natural response to certain types of visual stimuli.

Symptoms of trypophobia typically meet DSM-5 diagnostic criteria forspecific phobiasrather than other conditions such asobsessive-compulsive disorder (OCD). However, researchers have found that people with trypophobia were more likely to experience other conditions, too.These include:

It’s more common in women and in people with close relatives who also have trypophobia.

No specific treatment has been demonstrated particularly effective in the treatment of this condition.However, many of the treatments used for specific phobias and mood disorders are also likely to be helpful in reducing symptoms.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) involves working with a therapist to change the underlying thoughts and behaviors that might contribute to trypophobia. This might involve discussing unrealistic thoughts, replacing these with more realistic ones, and then making changes in behaviors. CBT might also involve gradual exposure to feared things or situations to decrease one’s reactions to them.

One of the reasons people experience phobia symptoms is because they often believe there is something inherently dangerous or threatening about the fear object. This leads to negative automatic thoughts as soon as they encounter the source of their fear.

Through CBT, people work to replace their often irrational beliefs and negative thoughts with more positive and realistic ones. Withexposure therapy, patients may potentially encounter an object without feeling excessive disgust, fear, or anxiety.

Relaxation Techniques

Differentrelaxation strategiescan also be useful for reducing feelings of disgust, fear, or anxiety. Visualization, deep breathing, and progressive muscle relaxation are a few strategies that might be helpful.

Visualization involves picturing soothing images or situations. A person with trypophobia might try to envision a beautiful sunset or a field of flowers whenever they encounter something covered with tiny holes.

A simple distraction can also be a useful coping technique. If you see something that triggers a trypophobic response, you might simply look away and find something else to think about or look at until your symptoms ease.

Medications

Anti-depressant oranti-anxiety drugsmay sometimes be prescribed, particularly if the individual also experiences depression or anxiety. These may include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or beta-blockers.These medications may be used alone, but they are often used in conjunction with another treatment approach such as CBT or other types of psychotherapy.

Takeaways

Further research is needed to determine its nature, prevalence, and treatment. Fortunately, most people who experience this condition can find relief through treatment options ranging from therapy to medication to self-help.

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Martínez-Aguayo JC, Lanfranco RC, Arancibia M, Sepúlveda E, Madrid E.Trypophobia: What do we know so far? A case report and comprehensive review of the literature.Front Psychiatry. 2018;9:15. doi:10.3389/fpsyt.2018.00015American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). 5th edition. Washington, DC: American Psychiatric Association; 2013.Vlok-Barnard M, Stein DJ.Trypophobia: an investigation of clinical features.Revista Brasileira De Psiquiatria (Sao Paulo, Brazil: 1999). 2017;39(4):337-341. doi:10.1590/1516-4446-2016-2079Cole GG, Wilkins AJ.Fear of holes.Psychological Science.2013;24(10):1980-1985. doi:10.1177/0956797613484937Wabnegger A, Schwab D, Schienle A.The hole story: an event-related potential study with trypophobic stimuli.Motiv. Emot., 2019;43(6):985–992. doi:10.1007/s11031-019-09784-8Kupfer TR, Le ATD.Disgusting clusters: trypophobia as an overgeneralised disease avoidance response.Cognition & emotion. 2018;32(4):729-741. doi:10.1080/02699931.2017.1345721Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Akinci MA, Uzun N.Sertraline for trypophobia: Report of an adolescent case.Clinical Neuropharmacology. 2020;43(6):196-197. doi:10.1097/wnf.0000000000000414Anxiety & Depression Association of America.Types of therapy.Additional ReadingLe ATD, Cole GG, Wilkins AJ.Assessment of trypophobia and an analysis of its visual precipitation.Q J Exp Psychol.2015;68(11):2304-2322. doi:10.1080/17470218.2015.1013970

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Martínez-Aguayo JC, Lanfranco RC, Arancibia M, Sepúlveda E, Madrid E.Trypophobia: What do we know so far? A case report and comprehensive review of the literature.Front Psychiatry. 2018;9:15. doi:10.3389/fpsyt.2018.00015American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). 5th edition. Washington, DC: American Psychiatric Association; 2013.Vlok-Barnard M, Stein DJ.Trypophobia: an investigation of clinical features.Revista Brasileira De Psiquiatria (Sao Paulo, Brazil: 1999). 2017;39(4):337-341. doi:10.1590/1516-4446-2016-2079Cole GG, Wilkins AJ.Fear of holes.Psychological Science.2013;24(10):1980-1985. doi:10.1177/0956797613484937Wabnegger A, Schwab D, Schienle A.The hole story: an event-related potential study with trypophobic stimuli.Motiv. Emot., 2019;43(6):985–992. doi:10.1007/s11031-019-09784-8Kupfer TR, Le ATD.Disgusting clusters: trypophobia as an overgeneralised disease avoidance response.Cognition & emotion. 2018;32(4):729-741. doi:10.1080/02699931.2017.1345721Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Akinci MA, Uzun N.Sertraline for trypophobia: Report of an adolescent case.Clinical Neuropharmacology. 2020;43(6):196-197. doi:10.1097/wnf.0000000000000414Anxiety & Depression Association of America.Types of therapy.Additional ReadingLe ATD, Cole GG, Wilkins AJ.Assessment of trypophobia and an analysis of its visual precipitation.Q J Exp Psychol.2015;68(11):2304-2322. doi:10.1080/17470218.2015.1013970

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Martínez-Aguayo JC, Lanfranco RC, Arancibia M, Sepúlveda E, Madrid E.Trypophobia: What do we know so far? A case report and comprehensive review of the literature.Front Psychiatry. 2018;9:15. doi:10.3389/fpsyt.2018.00015American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). 5th edition. Washington, DC: American Psychiatric Association; 2013.Vlok-Barnard M, Stein DJ.Trypophobia: an investigation of clinical features.Revista Brasileira De Psiquiatria (Sao Paulo, Brazil: 1999). 2017;39(4):337-341. doi:10.1590/1516-4446-2016-2079Cole GG, Wilkins AJ.Fear of holes.Psychological Science.2013;24(10):1980-1985. doi:10.1177/0956797613484937Wabnegger A, Schwab D, Schienle A.The hole story: an event-related potential study with trypophobic stimuli.Motiv. Emot., 2019;43(6):985–992. doi:10.1007/s11031-019-09784-8Kupfer TR, Le ATD.Disgusting clusters: trypophobia as an overgeneralised disease avoidance response.Cognition & emotion. 2018;32(4):729-741. doi:10.1080/02699931.2017.1345721Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298Akinci MA, Uzun N.Sertraline for trypophobia: Report of an adolescent case.Clinical Neuropharmacology. 2020;43(6):196-197. doi:10.1097/wnf.0000000000000414Anxiety & Depression Association of America.Types of therapy.

Can W, Zhuoran Z, Zheng J.Is Trypophobia a phobia?Psychological Reports. 2017;120(2):206-218. doi:10.1177/0033294116687298

Martínez-Aguayo JC, Lanfranco RC, Arancibia M, Sepúlveda E, Madrid E.Trypophobia: What do we know so far? A case report and comprehensive review of the literature.Front Psychiatry. 2018;9:15. doi:10.3389/fpsyt.2018.00015

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). 5th edition. Washington, DC: American Psychiatric Association; 2013.

Vlok-Barnard M, Stein DJ.Trypophobia: an investigation of clinical features.Revista Brasileira De Psiquiatria (Sao Paulo, Brazil: 1999). 2017;39(4):337-341. doi:10.1590/1516-4446-2016-2079

Cole GG, Wilkins AJ.Fear of holes.Psychological Science.2013;24(10):1980-1985. doi:10.1177/0956797613484937

Wabnegger A, Schwab D, Schienle A.The hole story: an event-related potential study with trypophobic stimuli.Motiv. Emot., 2019;43(6):985–992. doi:10.1007/s11031-019-09784-8

Kupfer TR, Le ATD.Disgusting clusters: trypophobia as an overgeneralised disease avoidance response.Cognition & emotion. 2018;32(4):729-741. doi:10.1080/02699931.2017.1345721

Akinci MA, Uzun N.Sertraline for trypophobia: Report of an adolescent case.Clinical Neuropharmacology. 2020;43(6):196-197. doi:10.1097/wnf.0000000000000414

Anxiety & Depression Association of America.Types of therapy.

Le ATD, Cole GG, Wilkins AJ.Assessment of trypophobia and an analysis of its visual precipitation.Q J Exp Psychol.2015;68(11):2304-2322. doi:10.1080/17470218.2015.1013970

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