Trypophobia (fear of holes): causes, symptoms and treatment

Phobias are irrational and persistent fears to objects, living things or situations that cause an intense desire to escape. In case of not being able to escape the causes of fear, the phobic person suffers from intense anxiety and discomfort, even though he knows that they are irrational and out of proportion to the real danger.

Trypophobia is an example of fear irrational to which an innate origin is generally attributed. In fact, it is a case especially known among rare phobias because it has become a real internet phenomenon. Let’s see what it is.

What is tripophobia?

The word “tripophobia” literally means “fear of holes” in Greek. The term is very recent and would even have been coined on an Internet forum. More generally, it refers to the anxiety caused by repeating patterns, mostly small agglomerated holes, But also packets, circles or rectangles.

Trypophobia is usually related to organic elements found in nature, such as lotus flower seeds, bee hives, skin pores, cells, mold, corals, or pumice stone. Objects created by people can also generate a similar reaction; examples are sponges, aerated chocolate and soap bubbles.

What tripophobic images have in common is the irregular or asymmetrical configuration of the elements that compose them. People who experience this phenomenon report being disgusted and uncomfortable seeing images like these, and the greater the contrast between their elements, the more unpleasant it is for them to observe them.

Unlike most phobic stimuli (elements that produce pathological fear), those that induce tripophobia in general cannot be considered dangerous or threatening. David Barlow (1988) called phobic responses to “false alarms” given without threatening external stimuli, as in tripophobia.

The background: specific phobias

The DSM-5 manual covers several types of phobias in the “Specific phobias” category: Panic in animals, in the natural environment, such as phobia of storms, situational phobias (eg claustrophobia) and fear of blood, injuries and injections. Agoraphobia and Social Anxiety or Phobia have their own sections in the DSM for their frequency and severity.

Although specific phobias are the most common anxiety disorder, they are also the least disabling, as often the person can easily avoid the phobic stimulus or rarely find it in its usual context. Extreme fear of snakes, for example, does not usually affect those who live in large cities.

Among the specific phobias we find some very particular ones, such as the fear of money or the fear of long words, called with some malice “hypopotomonstrosesquipedaliophobia” (we have already mentioned these phobias and other curious ones in this article) .

However, it should be borne in mind that in the case of trypophobia what generates discomfort is not a living being or a particular objectBut a type of texture that can appear on virtually any type of surface.

This texture is generally perceived through the visual system and generates a response of strong aversion and irrational anxiety. however, the fact that the person is aware that the reaction is irrational does not cause it to dissipate.


Some people with tripophobia describe extreme reactions similar to the physiological symptoms of anxiety attacks, such as tremors, tachycardia, nausea, or difficulty breathing. They may also experience headaches and skin symptoms, such as itching and goosebumps. Of course, these symptoms also cause the person to try to move away from the phobic stimulus, either by looking away, covering their eyes, or retreating to another location.

Unfortunately, the discomfort does not go away immediately, as the memory of the image continues to be “marked” in the consciousness, and it continues to fuel the appearance of different symptoms (although over time they weaken. until the anxiety attack occurs completely).

This change in the activity pattern of the nervous system of people with tripophobia usually appears when we see pictures with color patterns reminiscent of a solid surface. deviations very close to each other, Almost forming a mosaic of cracks. The contrast between the surface of these bodies and the darkness which indicates the degree of depth of the interstices is usually the property of the image which has the most disturbing power.

Let us now consider a classification of the symptoms of trypophobia by distinguishing between its different types. Of course, they don’t usually all happen at the same time, but only some of them, and in varying degrees of intensity. The cases in which they are very extreme are rare; it is normal to notice significant discomfort without falling into a panic attack.

physiological symptoms

Some of the psychological symptoms caused by trypophobia include tremors, rapid heartbeat and muscle tension, as well as dizziness and the feeling that when exposed to the stimulus, it is difficult to breathe.

psychological symptoms

Among these psychological factors we find entering into a state of alert and catastrophic thoughts, such as it will give us a heart attack if we keep looking at what produces tripophobia.

behavioral symptoms

Behavioral symptoms are, as in all specific phobias, the tendency to avoid all situations in which the phobic stimulus is suspected it will make us feel bad, And once we are exposed to this, the tendency to flee.

Causes of this reaction in clustered holes

Geoff Cole and Arnold Wilkins (2013), psychologists at the University of Essex, found in two studies that about 15% of participants appeared sensitive to tripophobic images, so a slightly higher percentage in women than in men.

Authors attribute tripophobia to human evolution: the rejection of images similar to tripophobic images it would have been useful for us to reject the poisonous animals, Such as different types of snakes, scorpions and spiders which have repeating patterns on their body.

Likewise, tripophobic reactions could have been useful for avoid contaminants like those that can be found in molds, open wounds or corpses pierced by worms.

Cole and Wilkins’ explanation ties in with the concept of biological preparation of Martin Seligman (1971), best known for the theory of learned helplessness with which he explained depression.

According to Seligman, throughout the evolution of living things, we have not only adapted physically but also we have inherited predispositions to associate certain events because they increased the chances of survival of our ancestors. For example, people would be particularly prepared to associate danger with darkness or insects. The irrationality of phobias could be explained because they have a biological origin and not a cognitive one.

Alternative explanations of this irrational anxiety

Other experts offer very different hypotheses about tripophobia. In an interview with NPR, anxiety psychiatrist Carol Matthews of the University of California said that while any object is likely to cause pathological fear, perhaps the case of tripophobia is rather due to the suggestion.

According to Matthews, people who read trypophobia are suggested by others who say they experienced anxious reactions to seeing the same pictures and paying attention to the sensations. bodily effects that their mind would otherwise filter or ignore.

If they ask us if a picture turns us off or itches us we are more likely to experience these sensations that if they hadn’t told us anything; this is called the “priming effect”.

Even in the event that we feel real distaste or anxiety at seeing tripophobic images, if they are not intense or frequent enough to interfere with our lives, we might not consider ourselves to have a “phobia of holes”. It is important to keep this in mind, because for fear of being considered a phobia (pathological fear) it must seriously harm those who suffer from it.

How to overcome this phobia?

As we have seen, some degree of tripophobia is normal in most people; we are also “designed” to feel at least some anxiety and discomfort when contemplating surfaces full of holes very close to each other.

However, in the same way that individual differences in personal traits such as height or strength occur to varying degrees among members of our species, in some cases trypophobia it can become so intense that it becomes an obstacle to normal life. As is always the case with psychological phenomena, there are different degrees of intensity.

In these cases, it is advisable to undergo psychological therapy, which will allow you to learn the dynamics to better manage the symptoms and lessen their impact.

There are several ways to resolve the anxiety caused by this type of phobia. Some patients may require only one or more of these treatments. In all cases, they should be entrusted to a mental health professional, preferably specialized in this type of disorder.

1. Psychological treatment

Specific phobias are mainly treated by exposure procedures, Which consist in facing what frightens us, anxiety or disgust and pushes us to escape. For exposure treatment to be effective, the person must pay attention to the phobic stimulus when exposed to it, which will gradually reduce the discomfort it causes.

This is a procedure in which the person gradually acquires autonomy, although, especially in the early stages of it, the role of the therapist is very important for good progress.

In addition, it is important that to go through this process, patient engagement is very importantAs they must strive to progress and deal with situations of discomfort. Fortunately, motivation is also part of the role of therapists, who will also work on how patients perceive the tripophobia they are experiencing.

2. Pharmacological treatment

Pharmacological treatment has been shown to be ineffective in overcoming specific phobias; exposure and other variations of psychological intervention focused on interaction with phobic stimuli are primarily recommended. In contrast, drugs can be helpful for agoraphobia and social phobia, especially anxiolytics and antidepressants. Except in the latter case of trypophobia, psychotherapy concentrates most of the effort, and only if the discomfort is extreme.

However, this does not mean that in some specific cases health workers will avoid the use of drugs in all cases. There are certain circumstances in which they can be helpful, particularly if tripophobia overlaps with other psychological disorders; in all cases, the indication or not of drugs remains subject to the criteria of professionals who supervise each patient in a particular way.

3. Exposure therapy

People with tripophobia, whether severe or not, may cause discomfort caused by this phenomenon. it is reduced by exposing itself to images tripophobic. Exposure can be applied gradually, that is, starting with pictures that cause moderate anxiety or disgust and gradually increasing the intensity of phobic stimuli.

Well-known YouTuber Pewdiepie was recently recorded “curing his tripophobia” using a kind of computer-assisted self-exposure. Some of the images he uses are germs, human skin with holes in it, and worms sticking out of a dog’s back. It doesn’t seem like you have to have a tripophobia to feel disgusted at seeing pictures like these.

Bibliographical references:

  • Barlow, DH (1988). Anxiety and its disorders: nature and treatment of anxiety and panic. New York: Guilford Press.
  • Cole, GG and Wilkins, AJ (2013). Fear of holes. Psychological Sciences, 24 (10), 1980-1985.
  • Doucleff, M. (February 13, 2013). Afraid of melons and grallas? A “phobia” is emerging from the web. NPR. Retrieved from
  • Le, ATD, Cole, GG & Wilkins, AJ (2015). Assessment of tripophobia and analysis of its visual precipitation. The Quarterly Journal of Experimental Psychology, 68 (11), 2304-2322.
  • Seligman, MEP (1971). Phobias and preparation. Behavioral therapy, 2 (3), 307-320.

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