By Teddy Amenabar
As rescuers continue to search the ocean for a missing submersible vessel, people following the news are responding with a common sentiment: feelings of claustrophobia.
"Just watching this story about the lost submersible under the sea, is giving me claustrophobia and palpitations," tweeted Ana Navarro-Cárdenas, a political commentator on CNN.
The vessel named Titan is 22 feet long and can travel about 2.4 miles below the surface of the Atlantic Ocean, holding a five-person crew in a cabin with "about as much room as a minivan."
"Good lord, I couldn't imagine willingly entering that thing," one person wrote on Reddit in response to the news. "It's like some of my worst nightmares combined into one hyperventilating package."
But is the anxiety we're feeling really a sign of claustrophobia? Would most people struggle in such a small space? The Post asked the experts.
Are we all experiencing collective claustrophobia?
It may seem that way, but claustrophobia is an irrational fear of enclosed spaces, and can trigger feelings of panic, trouble breathing, chills and tightness in the chest, among other things. In the case of the missing submersible, fear for the stranded vessel is not irrational.
If you haven't had claustrophobia before, the feelings of anxiety and queasiness you're experiencing when you read news accounts or see images of the missing vessel and passengers are probably induced by empathy.
"I think what we can recognise about this particular situation is that it's quite a dire circumstance," said Corrie Ackland, clinical director of the Sydney Phobia Clinic in Australia.
"For a number of people witnessing this story, if they are not typically anxious about normal activities like riding in an elevator or being on a subway, we can probably safely say they are not claustrophobic. But the anxiety they are experiencing with this story is due to distress and empathy for these people."
It's not uncommon for people to feel panicky when hearing about people who are trapped, say mental health experts.
Many people described claustrophobic feelings when a youth soccer team and coach in Thailand were trapped in a flooding cave in 2018. (During a daring and ultimately successful rescue, one diver drowned and another died a year later from an infection acquired in the cave.)
"An excess of empathy, of attempting to feel the afflicted person's feelings, may amplify every fear of our own to an unacceptable level of anguish," said William F. Haning, III, a physician and professor emeritus of psychiatry at the University of Hawaii John A. Burns School of Medicine.
"A common demonstration of this is panic. The idea of being caught in a space from which there appears no escape is too often a trigger for that selfsame panic."
Wouldn't most people be claustrophobic in the tight space of the submersible?
Not necessarily, say experts. Claustrophobia has been estimated to range from about 2 to 12.5 percent of the population and most sufferers are female.
Maximilian Cremer, director of the ocean technology group at the University of Hawaii Marine Center, trained in or piloted an even smaller submersible for nearly 20 years. His vessel was a seven-foot, steel sphere packed with equipment that could hold three people.
"Quite frankly, it wasn't very common that people had to fight off claustrophobia," he said.
"Usually even people who felt some apprehension due to the close proximity to the other passenger and pilot, once you're underwater that very quickly disappears and gives way to the wonder of the ocean."
Cremer said he remembers two times over 20 years when the dive had to be aborted because of feelings of claustrophobia.
"You cannot take somebody down who is claustrophobic," Cremer said. "I had maybe a handful of incidents where during a safety briefing someone decided to forgo their chance at this coveted adventure. I recall two incidents where a person discovered their discomfort with claustrophobia or other fears during the descent. We would immediately abort the dive and come back up."
Cremer said he recalls even as a boy playing in basements and small spaces without any fear. "But I can tell you that my wife maintains to this day that she would not set a toe into such a small sphere," he said. "It's just not her thing."
What's the difference between normal fear and claustrophobia?
Discomfort around or fear of enclosed spaces is "more or less normal," said Nassir Ghaemi, a psychiatrist at Tufts Medical Center in Boston. There's probably a biological reason humans are scared of heights, bugs or enclosed spaces.
"It's normal to be anxious about many things," Ghaemi said. "These are all normal physiological reactions that human beings have evolved over millennia."
But, "for some people, it gets to the point where they're not able to function well," Ghaemi said. The fear becomes a "phobia" when someone's concern of enclosed spaces doesn't match the actual risk presented by the situation. A person's concern starts to affect their daily life at home, work or school.
"The fear gets in the way such that people can't do the things that they want to do," said Joe Bienvenu, professor of psychiatry and anxiety disorders at Johns Hopkins School of Medicine. "It's an irrational fear that interferes with a person's life."
What causes claustrophobia?
A tendency to heightened anxiety and claustrophobia can run in families at times, Bienvenu said. It may even be genetic, although Bienvenu said exactly how is still unclear.
And past traumatic experiences where people have felt trapped, without a sense of control or a way to escape, can lead someone to feel claustrophobic, said Adam Borland, a clinical psychologist at Cleveland Clinic.
"There's a fear of the lack of control," Borland said. "That I am in this situation and I cannot remove myself."
Ghaemi said there is some research suggesting the phobia is a "physiological reflex," or what's called "a suffocation alarm," in someone who believes there's a higher level of carbon dioxide - or a lack of oxygen - while in close quarters with others.
"They get the physiological signal that there's not enough oxygen," Ghaemi said. "They feel like they're going to suffocate. That's when the panic attack happens. Those are the people who get claustrophobia."
People who are claustrophobic will often go out of their way to avoid confined spaces. But, staying away from certain situations, like taking the elevator or riding the subway, can actually reinforce the phobia, Bienvenu said.
What triggers claustrophobia?
An inability to breathe due to the actual or perceived lack of oxygen will trigger the symptoms of claustrophobia, Bienvenu said.
And enclosed spaces without a clear exit can induce feelings of claustrophobia. People commonly feel claustrophobic while lying still for an MRI, which can trigger a sense that you've been buried alive.
For some, images and news reports can trigger feelings of claustrophobia as well. With all the videos and photos available on our phones, we're able to imagine what it'd be like to be in some cramped situation, like on the vessel Titan deep below the Atlantic Ocean, Borland said.
"Here I am looking at these renderings and I'm thinking to myself: 'Oh my God. This is frightening,'" Borland said. "We inevitably put ourselves in that situation and think: 'How would I manage this? How would I feel if I was in this situation?'"
"And then things start to spiral from there," Borland said.
Tom Bunn, a retired airline pilot and the author of "Panic Free," a self-help book to curtail panic and claustrophobia, said the fear of enclosed spaces - such as flying in an airplane - is triggered by a lack of control and an inability to leave.
"The fear develops because of a trauma you couldn't escape," Bunn said. The brain has associated a place where you don't have control or the ability to leave as a potentially life-threatening situation.
Every day, Bunn works with four to five people who have a fear of flying through a program he started in 1982.
To address their fear, Bunn asks people to imagine going through various events that take place on a flight - such as when the plane lands on the tarmac - with a friend with whom they feel comfortable.
"We're just linking each of those airplane scenes to a physical person who you feel completely safe with," Bunn said. "It changes the code of the airplane scene from danger to safety."
Bunn said the trick is finding the right person. It's not necessarily your spouse, who you may associate with some stress. Instead, you need to pick "someone who doesn't care whether you fly or not."
Haning, from the University of Hawaii, agreed. "In considering the fear of entrapment, certainly generalizable to all people, comfort most commonly comes from the presence of other people," he said.
How do you overcome claustrophobia?
Claustrophobia is a learned behaviour, a conditioned response to certain experiences or fears, and it's possible for someone to "unlearn" these reactions, Ghaemi said. Calming drugs like Xanax only offer temporary relief, and can be useful to help someone get through an MRI scan.
Lasting improvement can happen through talk therapy, prescription medications such as antidepressants and "exposure" therapy, in which therapists create a safe environment to expose the person to the thing they fear.
"You just increase the exposure and then the phobia gradually decreases," Ghaemi said. "That's the most effective treatment."
The Washington Post's Tara Parker-Pope contributed to this report.
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