Thalassophobia

Thalassophobia (Greek: θάλασσα, thalassa, "sea" and φόβος, phobos, "fear")[1] is the persistent and intense fear of deep bodies of water such as the sea, oceans, pools or lakes. Though very closely related, thalassophobia should not be mistaken with aquaphobia which is classified as the fear of water itself. Thalassophobia can include fear of being in deep bodies of water, fear of the vast emptiness of the sea, of sea waves, sea creatures, and fear of distance from land.[2] The causes of thalassophobia are not clear and are a subject of research by medical professionals as they can vary greatly between individuals.[3] Researchers have proposed that the fear of large bodies of water is partly a human evolutionary response, and may also related to popular culture influences which induce fright and distress.[4] The severity of thalassophobia and the signs and symptoms associated with it are quite fluid and complex. Those who suffer from thalassophobia go through numerous episodes of emotional and physical anguish caused by a variety of triggers.[5] Treatment may comprise a combination of therapy and anxiolytics, and is most effective when administered to patients during childhood, when thalassophobia is generally at its peak.[6]

Thalassophobia
SpecialtyClinical Psychology
DurationMore than six months
TreatmentSystemic Desensitisation, Exposure Therapy, Counselling, Cognitive Behavioural Therapy (CBT), Medication

Causes

Evolutionary context

It is thought that the fear of large bodies of water is an evolutionary and ancestral trait passed on from generation to generation. Humans prefer certainty to risk and adapt based on learning history and situational variables.[7][4] A 2016 study by Nicholas Carlton establishes that the ‘Fear of Unknown’ is an evolutionary mechanism that has driven the survival of the human race since the beginning.[8] Showing fear towards deep bodies of water is in effect justified since ancestors to the human race understood that their survival was reliant on remaining in territorial land and not aquatic environments.[7] This in return developed into a fundamental fear passing down from generation to generation in order to ensure the survival of human kind.[9]

Martin Antony, Professor of Psychology at Ryerson University and co-author of The Anti-Anxiety Workbook, states that "From an evolutionary perspective, it makes sense that humans would develop a tendency to fear and avoid deep water because of all the associated risks". He continues by commenting on the genetic aspect of fears, saying; "We are essentially 'programmed' through evolution to fear some situations (e.g., heights, deep water, snakes) more easily than others (e.g., flowers, teddy bears)" [10]

In Judeo-Christian mythology, the sea is often depicted as a space of disaster and punishment. This is evident in the first book of the Bible (Genesis), through stories such as those of Noah's Ark. Texts like William Shakespeare's The Tempest featured a shipwreck as the driving force behind its narrative and gave the sea an "otherworldly" and "evil" personification. Authors of Beasts of the Deep: Sea Creatures and Popular Culture Sean Harrington and Jon Hackett believe that these narratives are a driving force for the widespread fear of oceans.[4] Literature of the gothic and supernatural have gravitated towards the sea as a fertile environment, and as a result create an unpleasant and fearful image in the minds of audiences.[7] This is thought to be true for both ancient and contemporary societies. The 1975 blockbuster film Jaws is often referenced as being an influential motion picture which drove the modern movement of thalassophobia. The mainstream media also affects the collective emotions of the public.[7] News reports of great white sharks, electric eels or other dangerous sea predators attacking swimmers in the ocean induce fear in viewers and are thought to have great influence.[11] Similarly, real cases of ships like the Titanic sinking with their passengers drowning have been made terrifyingly realistic through their movie versions. People who are very afraid of violent death or particularly of drowning are also more likely to develop thalassophobia. These cultural influences (both ancient and modern) are thought to have added to the prevalence of the fear of deep bodies of water throughout time.[4]

Past experiences and genetics

A negative or past traumatic event can also trigger a deep fear of oceans.[12] Traumatic experiences of being frightened while swimming, or almost drowning are also leading causes of thalassophobia. In addition to this, observing others, particularly parental figures and other influential adults, who also had a fear of deep water are considered contributing factors for developing thalassophobia later in life.[13] Scientists also believe that genetics and biological heredity plays a major role in attaining a fear of seas, oceans and lakes.[13] Such genetic factors include having a family member with thalassophobia, personal mental state such as being negative, sensitive or anxious, and even hearing terrifying stories on water accidents. Personal experiences and one's upbringing are all factors that could potentially be the cause of thalassophobia.

Diagnosis and symptoms

Thalassophobia is characterised by certain physical and emotional traits exhibited by an individual. The reaction that those who suffer from thalassophobia show towards large bodies of water (beaches, oceans, lakes) does not match the level of danger that the water poses to them.[14] Hence, they illustrate abnormal behaviour under situations or environments which trigger their fear. Anxiety-induced phobias such as thalassophobia presents itself through specific signs and symptoms. Individuals with a moderate fear of deep bodies of water may experience agitation and restlessness on a day-to-day basis.[5]

Common emotional symptoms of thalassophobia include:[12]

  • Constant worrying
  • Trouble falling or staying asleep (possibly insomnia)
  • Panic and anxiety attacks
  • Having a sense of imminent doom
  • Needing to escape
  • Feeling detached from the situation
  • Being overwhelmed

Common physical symptoms of thalassophobia include:[6]

  • Shortness of breath
  • Sweating
  • Shaking or trembling at the sight of the sea
  • Weeping or running away when near deep bodies of water
  • Nausea
  • Dizziness
  • Rapid breathing
  • Screaming and/or shouting at the sight of the sea

According to the 'Diagnostic and Statistical Manual of Mental Disorders (fifth edition)' (DSM-5) which is a manual for assessment and diagnosis of mental disorders developed by the American Psychiatric Association; in order to be diagnosed with a phobia of deep bodies of water:[14]

  • The individual's fear of deep water must be persistent, excessive and unreasonable
  • The individual must feel this fear every time they are exposed to deep or open water
  • The individual either avoids the ocean or other open bodies of water or endure them with intense fear
  • The individual's fear of large bodies of water interferes with their normal functioning
  • The individual's fear has been present for six months or longer

The prevalence and frequency of thalassophobia or any phobia is unknown for the most part. Researchers have concluded that the severity and prevalence of thalassophobia is in a constant state of change amongst different demographics and many may not be aware that they suffer from mild thalassophobia.[4]

Treatment

Individuals who suffer from thalassophobia often improve their symptoms from specific strategies and procedures employed by therapists and medical professionals. It is extremely important to note that if left untreated, thalassophobia could lead to other mental disorders such as post-traumatic stress disorder, anxiety, depression and/or panic attacks.

Thalassophobia can be managed through a psychological tool known as Cognitive Behavioural Therapy (CBT). CBT is a type of psychotherapeutic treatment that helps patients learn how to identify and manipulate disturbing thought patterns into positive and realistic behaviours.[15] Psychologists and therapists employ CBT to inflict a negative influence on certain behaviour and emotions so that they will be replaced by more appropriate and realistic reactions. A meta-analysis study in 2013 found that CBT has a positive effect in changing the neural pathways and activation of the brain on patients with phobias, resulting in more controlled behaviour when exposed to the fear.[16]

Systematic desensitisation is a treatment in which patients who suffer from certain phobias are exposed to increasingly more anxiety-provoking stimuli and taught relaxation techniques simultaneously.[12] Majority of individuals who have thalassophobia actively avoid the situation they are afraid of, which in return creates a false and even more frightening fake reality. Systematic desensitisation techniques allows patients to confront their fear with controlled emotions and realistic views.[6] It involves three steps, the first involves learning muscle relaxation techniques followed by patients being asked to create a list of fearful scenarios, ranking them in terms of their intensity. Finally, the patients are instructed to face their fear on a gradual spectrum. The focus of this technique is to focus on relaxation as they put themselves through stressful situations until the environment/event no longer causes discomfort.[17] The underlying theory behind systemic desensitisation is classical conditioning which aims to replace feelings of fear and anxiety with a state of calm. Relaxation techniques taught for dealing with thalassophobia through systemic desensitisation include diaphragmatic breathing, progressive muscle relaxation, meditation and mindfulness.[13]

Exposure therapy is the act of an individual coming into close contact with the situation or environment that triggers their phobia in a safe way. The overall goal of exposure therapy is to prove to the patient that a situation, object or environment is not as dangerous or worrisome as they might believe. This treatment also allows patients to feel more confident in their ability to cope with the situation that frightens them; should they face the situation they are afraid of.[3] In the case of thalassophobia, exposure therapy is employed to lessen the fear and anxiety associated with large bodies of water. There are several variation of exposure therapy and psychologists may use different techniques to achieve optimal results. These variations include:[18]

In vivo exposure: This is a technique whereby patients are instructed to directly face a feared object, situation or activity in real life. Those who suffer from thalassophobia are often instructed to enter the water at beaches, lakes or ponds. The downside of in vivo exposure is that participants have high dropout rates and poor treatment acceptance compared to other therapy options.

Interoceptive exposure: Deliberately inducing physical sensations that are harmless, yet feared. For instance, individuals with thalassophobia are often shown images of the sea, oceans or lakes or video footage of people in water. This induces a reaction which can then be changed or manipulated by the therapist.[3]

Virtual reality exposure: In certain circumstances, virtual reality technology can be employed when in vivo exposure is not practical. This could include when an individual doesn't reside near beaches, oceans or lakes. It can also include when some other factor inhibits the patient from entering such environments (including health, personal or religious factors).

Imaginal exposure: Vividly imagining the feared situation, object or environment. This technique is commonly used for those who have had a past traumatic experience or witnessed an event leading to their diagnosis of thalassophobia. It allows individuals to reduce their feelings of fear in regards to certain triggers.[12]

  • Medication

Most patients improve or completely eliminate all their symptoms of thalassophobia through therapy; however, some might require a combination of therapy and medication to accurately treat their symptoms.[13] Medication cannot cure phobias such as thalassophobia however, it can help reduce symptoms of anxiety and fear. Selective serotonin re-uptake inhibitors (commonly known as SSRIs) are a type of antidepressants which can be prescribed by a qualified physician. Other common medication used for treating thalassophobia include beta blocker (which assists by blocking the flow of adrenaline that occurs when one is anxious) and benzodiazepines (fast-acting anti-anxiety medication). Benzodiazepines should only be prescribed only when other therapeutic or medicinal options have not worked as they are sedative and addicting.[19]

See also

References
  1. "thalass(o)-, comb. form". OED Online. Oxford University Press. June 2018. Retrieved August 7, 2018. from Greek θάλασσα sea, and θαλάσσιος marine, formative elements of learned words. ... thalassophobia [is] a morbid dread of the sea.
  2. Snyder, Kari (2003). "Attack of the Water Monster". Boating. New York: Hachette Filipacchi Media. 76 (4): 44. ISSN 0006-5374. Thalassophobia is the fear of the sea and can be associated with the fear of water or waves, fear of the vast emptiness, or fear of distance from land.
  3. "Thalassophobia: Causes and treatments for the fear of the ocean". www.medicalnewstoday.com. 2020-11-19. Retrieved 2020-11-24.
  4. Beasts of the deep : sea creatures and popular culture. Hackett, Jon, Harrington, Seán. Herts, United Kingdom. 2 February 2018. ISBN 978-0-86196-939-5. OCLC 1024275039.CS1 maint: others (link)
  5. "Thalassophobia: Signs, Symptoms, & Treatments". Choosing Therapy. Retrieved 2020-11-25.
  6. "What Is Thalassophobia And How Can You Cope with It? | Betterhelp". www.betterhelp.com. Retrieved 2020-11-25.
  7. The spaces and places of horror. Pascuzzi, Francesco, Waters, Sandra. Wilmington, DE. 16 January 2020. ISBN 978-1-62273-863-2. OCLC 1122452212.CS1 maint: others (link)
  8. Carleton, R. Nicholas (2016-06-01). "Fear of the unknown: One fear to rule them all?". Journal of Anxiety Disorders. 41: 5–21. doi:10.1016/j.janxdis.2016.03.011. ISSN 0887-6185. PMID 27067453.
  9. Garcia, René (2017-09-01). "Neurobiology of fear and specific phobias". Learning & Memory. 24 (9): 462–471. doi:10.1101/lm.044115.116. ISSN 1072-0502. PMC 5580526. PMID 28814472.
  10. "Thalassophobia: Do You Fear the Deep Ocean?". HowStuffWorks. 2020-08-26. Retrieved 2020-11-24. From an evolutionary perspective, it makes sense that humans would develop a tendency to fear and avoid deep water because of all the associated risks. We are essentially 'programmed' through evolution to fear some situations (e.g., heights, deep water, snakes) more easily than others (e.g., flowers, teddy bears).
  11. Phobias : the psychology of irrational fear. Milosevic, Irena (Clinical psychologist), McCabe, Randi E. Santa Barbara, California. 2015. ISBN 978-1-61069-575-6. OCLC 895030322.CS1 maint: others (link)
  12. "Fear of the Ocean: What You Need to Know to Overcome It & Feel Better". Healthline. 2019-07-30. Retrieved 2020-11-25.
  13. "Thalassophobia: Do You Fear the Deep Ocean?". HowStuffWorks. 2020-08-26. Retrieved 2020-11-25.
  14. teo (2019-10-10). "Thalassophobia - fear of sea, sea travel, large bodies of water, emptiness of sea". FearOf.org. Retrieved 2020-11-25.
  15. PaulLee. "Thalassophobia". TranceForm Psychology. Retrieved 2020-11-25.
  16. Ipser, Jonathan C.; Singh, Leesha; Stein, Dan J. (2013). "Meta-analysis of functional brain imaging in specific phobia: Imaging meta-analysis of specific phobia". Psychiatry and Clinical Neurosciences. 67 (5): 311–322. doi:10.1111/pcn.12055. PMID 23711114.
  17. "Systematic Desensitization - A Treatment for Phobias | Simply Psychology". www.simplypsychology.org. Retrieved 2020-11-25.
  18. "What Is Exposure Therapy?". www.apa.org. Retrieved 2020-11-25.
  19. "CTRN: Change That's Right Now | Drugs & Medication". Retrieved 2020-11-25.
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