Closely related to several other phobias, including claustrophobia (fear of enclosed spaces), thanatophobia (fear of death) and coimetrophobia (fear of cemeteries), taphophobia is the irrational fear of being buried alive.
Taphophobia falls into a family of anxiety disorders that revolve around irrational fears of events that are very unlikely to occur. Historically, taphophobia is grounded in actual occurrences of people being buried alive. This phobia was more common in the 18th, 19th and early 20th centuries than it is today. There are documented cases of patients being declared dead and then apparently “rising from the dead” hours or even days later.
These cases led to a number of measures being put into place, particularly in the 19th century, to prevent people actually being buried alive. These measures included ropes placed in coffins with bells attached so the person could ring the bell if they “awoke” from death and tubes for air being buried with the corpse so he or she could get air until they were rescued. Even today, it is considered best practice to wait at least ten minutes after life saving measures such as CPR are discontinued before declaring a patient actually dead in the event that he or she may spontaneously revive.
Patients suffering from taphophobia are likely to suffer from more than one irrational fear and may also struggle with claustrophobia or an overriding fear of death. These conditions are also usually part of a more generalized anxiety condition.
Patients suffering from taphophobia, as with any specific phobia, will experience real fear and/or panic when forced to face that situation directly. If the phobia is acute, patients may experience that fear or panic outside of direct contact with the object of their fear, leading to a more generalized state of anxiety.
The anxiety and fear may manifest itself in the some or all of the following physical symptoms:
- hot flashes
- difficulty swallowing
- fear of dying
- irregular heart rate and palpitations
- feeling faint
- shortness of breath or difficulty breathing
- nausea or diarrhea
- tightness in the chest or pain in the chest
- feeling of cold or uncontrollable shaking or trembling
- tingling in the extremities
These symptoms may lead to what could be considered a full blown panic attack, that often results in the patient seeking emergency medical treatment.
The discomfort caused by these symptoms, as well as embarrassment or a fear of loss of control may perpetuate and strengthen the phobia by increasing the lengths to which the patient will go to avoid the situation or object of his or her fear. In the case of taphophobia, patients will avoid funerals, hospitals, cemeteries or other situations where death and burial are unavoidable.
Particularly acute phobias are often linked to generalized anxiety issues, either causing them or occurring in conjunction with other phobias and anxiety.
Taphophobia, like any other irrational fear or phobia, may be caused by a variety of factors, some of which are genetic and some are environmental. Possible causes may occur individually or in combination with others. Some possible causes include:
- Inherited tendencies – there is some research that would indicate that phobias and anxiety disorders are more likely to run in families. Patients with a family history of anxiety may be more vulnerable to development of a phobia like taphophobia.
- Chronic stress – patients who experience long stretches of stress may be more likely to develop phobias because they are less able to handle situations that are particularly stressful or anxious.
- Response to a particular incident – This trigger may be especially powerful if the incident occurs in childhood when the patient is less able to process the event rationally. The fear of being buried alive can often be a response to a childhood experience with death, either with a relative or a pet.
- Learned response – Specific phobias such as taphophobia often develop in light of familial or contextual responses to situations in childhood. The patient learns the response or fear from a parent or sibling.
There are many avenues of treatment for Taphophobia. A doctor is a good place to start, but effective treatment usually requires specialized treatments that can include the following:
- Talking treatments. This form of treatment gives the patient the opportunity to explore the beginnings of their phobia as well as identify the situations or actions that may trigger its onset. In a safe and controlled environment, the patient can discuss their fears with a qualified professional.
- Cognitive Analytic Therapy: CAT marries the focus of Cognitive Behavior Therapy on current thoughts and feelings with the focus of psycho-dynamic therapy on the patient’s past experiences.
- Cognitive Behavioral Therapy: This therapy has proven particularly effective in the treatment of taphophobia and other related fears. Cognitive behavioral therapy focuses on giving patients strategies and tools for managing their fears by helping them understand the connections between their thoughts, feelings and actions. Strategies may involve avoiding triggers or the opposite, exposure to them. Exposure therapy is the repeated and controlled exposure to the situations that cause the phobia to manifest, lessening the effect of the phobia over time. Exposure therapy gives the patient a greater sense of control over their thoughts and physical selves which lessens the anxiety.
- Hypnotherapy: Effective hypnosis may also relieve the fear around the phobia by giving the patient more control over their reactions.
- Medication: There are several different families of medications that may be used to treat taphophobia or other anxiety disorders. They function in different ways.
- Antidepressants are commonly prescribed in the treatment of a range of mental disorders, including specific phobias. The most prevalent of these are selective serotonin reuptake inhibitors (SSRIs). Scientists are not quite certain how SSRIs work, but they have proven effective in reducing levels of anxiety. There are other forms of antidepressants available, such as tricyclics that may also be prescribed. Another form of antidepressant are the monoamine oxidase inhibitors (MAOIs) which are used less frequently as they interact negatively with other medications and foods and have many side effects.
- Tranquilizers: These medications may be prescribed if the patient’s anxiety levels are particularly acute or interfere with the patient’s ability to live a normal life. While medications like Valium are very effective, they are also highly addictive and have many side effects. They should only be prescribed with caution and for short periods of time.
- Beta-blockers: These medications (most commonly in the form of propranolol) do not actually affect the chemistry of the brain in the way that antidepressants and tranquilizers do. Their primary use is in controlling the physical symptoms and manifestations of anxiety linked to irregular heartbeats, tremors and palpitations. Beta-blockers control the speed of the heartbeat thus reducing the physical aspects of the phobia. These medications have limited side effects and may be more attractive than tranquilizers and antidepressants as they are not addictive. They can cause issues with sleep and low blood pressure.
For patients whose phobia and anxiety is less severe, there are several areas of self treatment that may be explored by the patient to manage their conditions. First, at the onset of fear and anxiety, the patient may try a number of relaxation techniques that include meditation and visualizing the fear in different ways. There are also breathing exercises the patient may try to focus their thinking. Grounding techniques can also be effective in reducing fear and anxiety. Another option is seeking out a support group, either online or in person. These groups can provide the patient with a community of people who understand what he or she is going through, as well as offering other strategies and techniques for management of their condition. Groups like this can provide other resources for patients as well.
Prevention of taphophobia may not be possible if it is caused by a specific event experienced by the patient at some point in his/her life. For patients who have a family history with this phobia, careful monitoring of anxiety levels and general mental health may prevent escalation of unhealthy thoughts into full blown phobia.
For patients who may have been exposed to a particularly traumatic event around death or funerals, immediate counseling would be indicated to prevent the onset of taphophobia.