Fear of small or closed spaces

This is the fear of restriction: being held in place, squeezed in, or unable to leave when you want to.

You might always sit near the door, keep the car window open, or avoid rooms that lock.

This is the fear of suffocation. Research suggests it may be the stronger of the two fears for many people.

Panic itself can make breathing feel tight and choking, which can make the fear feel true even when there is plenty of air.

People describe

• A choking feeling or breathlessness
• Dizziness or feeling faint
• Feeling sick
• Hot flushes or chills
• Racing heart or tight chest
• Sweating or shaking

In stronger episodes, people may fear losing control, fainting or dying, or feel detached from their body.

Claustrophobia is often linked to a frightening experience in early childhood, like being trapped in a small space, or being bullied or abused.

It can also start after an unpleasant experience as an adult, such as turbulence on a flight or being stuck in a train tunnel.

Having a parent with claustrophobia can play a part. Children can learn fears by watching how others react.

Twin studies suggest phobias are moderately heritable. Situational phobias, like fear of enclosed spaces, show up more in relatives of people with the same type.

Being trapped or short of air were real dangers for our ancestors, which may be why the brain learns these fears quickly.

Avoiding the situations you fear can reinforce claustrophobia. Each escape teaches your brain that the space really was dangerous.

Lifts are one of the most common triggers. Some people climb many flights of stairs, arrive exhausted, or skip places that are only reachable by lift.

Tunnels, underground trains and cars can all trigger claustrophobia. Some people plan long detours to avoid a tunnel.

Public toilets, rooms that lock from the outside and hotel rooms with sealed windows are common triggers.

Planes are a common trigger for people with claustrophobia.

Being squeezed into a crowd can bring up the same fear of being trapped. When fear of crowds and places where escape feels hard spreads widely, it may be agoraphobia instead.

The closed-in space of an MRI machine can trigger anxiety in some people.

Breathlessness and a choking feeling are common panic symptoms. They can feel convincing even when there is plenty of air.

Learning that these feelings rise and fall on their own, without harm, is a key part of getting better.

Avoiding the situations you fear can reinforce the fear over time.

Claustrophobia can bring on sweating, shaking, a racing heart and panic. It is a recognised anxiety condition, not attention-seeking.

The technologist can see you, hear you and talk to you throughout the scan, and you hold a call button to use if you need them.

Talking therapies, especially CBT and exposure therapy, are recommended for claustrophobia. Adding work on fearful thoughts seems to help with claustrophobia in particular.

Ideas for steps

• Ride in the back seat of a car with the windows closed
• Sit in a small room with the door open, then closed, then locked from the inside
• Stand in a walk-in closet with the light on, then off
• Walk through a short tunnel, then a longer one
• Wear a hooded top with the hood up, then zipped up

Before a step, write your prediction, like “I’ll run out of air.” Afterwards, write what really happened. That surprise is where much of the learning comes from.

If the scary part is the body feelings, a therapist may use interoceptive exposure: bringing on feelings like a pounding heart on purpose, so you learn they are uncomfortable but not harmful.

Little safety habits, like hovering by the door or holding your breath, can stop your brain learning that the space is okay. Drop them gradually.

Virtual reality exposure can help when real-life practice is hard to arrange.

Telling the hospital about your claustrophobia ahead of time gives them a chance to plan with you.

Talk with your clinical provider about options to help you stay calm during the scan.

Open MRI machines have a more spacious design and are open on the sides. Some facilities offer stand-up scanners.

Not every center has them, and some scans need a standard machine, so ask when you book.

The scanner makes loud tapping and knocking sounds, which are normal. You’ll be given earplugs or headphones.

Most scans take 30 to 60 minutes. Ask how long yours will be and whether there are breaks.

The technologist can see you, hear you and talk to you during the scan through an intercom. You hold a call button for any worries.

Some centers let a friend, relative or comforting item come into the room with you.

Ideas people use

• Ask the technologist to talk you through each part
• Breathe slowly, with long breaths out
• Count the knocking sounds, or count breaths in tens
• Imagine a calm place in detail
• Keep your eyes closed from before you go in

Some people practise lying still under a table or in a small space at home, with headphones playing scanner sounds, building up the time. A therapist can help you plan this.

The NHS suggests not rushing to a place of safety during a panic, if you can safely stay.

Choking and breathlessness are panic feelings. Reminding yourself of that can take away some of their power.

Focusing on something calm and visible can help you ride it out.

Being trapped in a small space in childhood is one of the common starting points for claustrophobia. Choose time-outs in open, safe spaces.

Acknowledge your child’s fear without agreeing that they are in danger.

Small, playful steps, with your child in control of the “door”, can build confidence. Move up slowly and praise brave tries.

Helping a child avoid what they fear can make it stronger. But talk with them first, rather than forcing a scary situation.

Scares like these can deepen fear and break trust. Claustrophobia is an anxiety condition, not a choice.

In a panic, gently remind them it will pass, and help them focus on something calm they can see.

Helping a loved one avoid what they fear is called accommodation. Kindly cutting back on it, with their agreement, can help anxiety improve.

Some MRI centers let a friend or relative come into the room. Even waiting outside can help.

A doctor or a specialist like a psychologist can help. Talking therapies, especially CBT and exposure therapy, are recommended.

The answer should be yes. In the U.S., FindTreatment.gov, run by SAMHSA, is a free, confidential way to search for mental health services near you.

• “Agoraphobia: fear of places and situations”
• “Panic attacks”
• “Phobias explained”
• “Travel anxiety & fear of flying”