Let’s imagine the following scene together: the lotus seeds in the lotus pond, beehives, airy porous bread or cheese, the ceiling of the new terminal at Shenzhen Bao’an Airport… As these images flash into your mind one by one, do you start feeling uncomfortable? Maybe your heart races, and you feel nauseous? If the answer is yes, then you are likely one of the most common phobias in the world today—a sufferer of trypophobia.
What is trypophobia?
When it comes to trypophobia, most people are probably familiar with it, but many may not know that its original term—Trypophobia—derives from the Greek language. In Greek, “trypo” means holes, and “phobia” means fear. As the name suggests, it is meant to describe a condition where some people feel disgust and nausea when seeing objects with a clustered hole structure. Since the term first appeared on the internet in 2005, more and more netizens self-identifying with trypophobia have created forums, websites, and even Wikipedia entries, with a single trypophobia page on social media attracting tens of thousands of participants. The concept of this “phobia” has broadened to include not only objects with clustered holes but also flat patterns repeated on a sheet of paper and densely crowded protrusions, encompassing various forms of densely arranged objects that evoke feelings of discomfort.
Although trypophobia is so “popular,” it has not been officially recognized—in the renowned diagnostic manual of mental disorders, the DSM-5, trypophobia is still not listed. The explanation given by the American Psychiatric Association is that a true phobia must be severe enough to disrupt a person’s normal life, and scientists remain skeptical whether trypophobia meets this criterion. Some scientists even point out that the real symptoms of trypophobia are not fear but disgust and nausea, which fundamentally differ from recognized phobias worldwide.
Fear or disgust?
Various intertwining views have garnered widespread attention from scientists on whether trypophobia stems from fear or disgust. To clarify this, psychologist Lourenco from Emory University in the United States conducted an experiment with his team. They provided volunteers with two sets of photos: one containing images of threatening animals and the other comprising pictures widely known to trigger discomfort in trypophobia patients, such as sponges and beehives. They then observed the volunteers’ reactions and used eye-tracking technology to measure changes in their pupil size when viewing different images.
Unsurprisingly, when volunteers saw spiders and snakes, their pupils dilated. This is because, as visual animals, we immediately exhibit an aroused response to potential danger upon seeing threatening images, entering either a fight or flight mode. At this point, our heart rate and breathing rate increase, and the sympathetic nervous system activates the eye muscles, dilating the pupil.
However, to the researchers’ surprise, when volunteers saw images of sponges and beehives, their pupils constricted. The contraction of the muscles around the pupil is driven by the independent parasympathetic nervous system, which is activated not by external threat stimuli but by a sense of disgust.
Lourenco and other researchers believe this experiment clearly indicates that trypophobia arises from disgust rather than fear. But where does this disgust come from?
Ancestral instinctive reactions?
Arnold Wilkins, a psychology professor at the University of Essex in the UK and one of the earliest scientists to study trypophobia, conducted a survey in 2013 together with his colleague Jeff Cole regarding trypophobia. One volunteer’s report caught their interest—this volunteer claimed to feel particularly uncomfortable around blue-ringed octopuses. Blue-ringed octopuses are highly venomous creatures, and a single bite from one can be fatal. This report led Wilkins and Cole to have an epiphany: these eerie, brightly colored rings often signify toxic animals, so could trypophobia be related to the instinctive reaction of humans to avoid danger in the course of evolution?
To test this hypothesis, Wilkins and Cole, along with their research team, searched for images of highly dangerous toxic animals, including blue-ringed octopuses, wandering spiders, king snakes, etc. They also selected some images of octopuses, spiders, and snakes that were morphologically similar but not dangerous as controls.
Through their research, they found that compared to non-toxic animal images, toxic animal images had higher contrast at a certain spatial frequency and mostly featured dense repetitive patterns, which were considered key factors in triggering trypophobia. The experiments also demonstrated that these images almost always elicited physiological responses in trypophobia patients.
Therefore, Wilkins and Cole concluded that trypophobia is actually a manifestation of the “discovered-avoidance effect” towards toxic animals. And this effect may have originated early in human evolution. The discomfort towards visual features of toxic animals helped our ancestors detect and evade the threat of toxic animals in a timely manner, becoming ingrained deep in our human brains. “I think that, even if not consciously aware, every person actually has a tendency towards trypophobia,” Cole remarked.
Aversion arising from parasites?
However, some scientists have refuted this view. Firstly, many toxic animals do not possess these obvious visual features. Secondly, like all ideas stating that modern behavioral patterns stem from human evolutionary history, this cannot be conclusively proven. How can we be sure that our ancient ancestors were already capable of stress responses towards “visually toxic” animals?
Thus, Professor Koopfer from Vrije Universiteit Amsterdam put forth a new perspective. He believes that the aversive reaction in trypophobia is not directed at dangerous animals but at detestable diseases and parasites. Throughout human history, we have endured countless traumas caused by diseases, and many diseases such as measles, rubella, and spotted fevers cause small rashes or blisters on certain parts of the body. Professor Koopfer suggests that trypophobia originates from people’s evolutionary aversion responses to parasitic infections and various infectious diseases, leading us to keep ourselves away from these potential carriers of pathogens.
However, this viewpoint lacks sufficient convincing clinical trials to support it. The true origins of trypophobia and its relationship with human evolution remain challenging questions that many scientists are actively researching.
How to treat trypophobia?
It is regrettable that effective treatments for trypophobia are still non-existent. We know that fear and anxiety can be treated with medication or psychological interventions, but these methods are ineffective in the face of aversion.
Interestingly, Cole himself is a trypophobia sufferer. Perhaps experiencing it long term has made him somewhat of an expert. He suggested exposure therapy as a treatment for trypophobia, wherein under the guidance of a therapist, patients gradually face objects or situations that trigger fear or disgust. However, if trypophobia is truly a result of human evolution, we may not necessarily need to treat it as a disease, as it might be an advantage for us to adapt to nature and avoid risks.
