Scopophobia

Spotligectophobia, scopophobia, scoptophobia or ophthalmophobia is an anxiety disorder characterized by an excessive fear of being stared at in public or stared at by others.^[1]

Similar phobias include erythrophobia, the fear of blushing. Scopophobia is also commonly associated with schizophrenia and other psychiatric disorders. Often, scopophobia will result in symptoms common with other anxiety disorders. Scopophobia is considered both a social phobia and a specific phobia.

Origin of the term

The term scopophobia comes from the Greek σκοπέω skopeō, "look to, examine",^[2] and φόβος phobos, "fear".^[3] Ophthalmophobia comes from the Greek ὀφθαλμός ophthalmos, "eye".^[4] Another, lesser known, term for this disorder is spotligectophobia, a humorous blend of the spotlight effect and the combining form -phobia meaning fear.

Signs and symptoms

Individuals with scopophobia generally exhibit symptoms in social situations when attention is brought upon them like public speaking. Several other triggers exist to cause social anxiety. Some examples include: Being introduced to new people, being teased and/or criticized, embarrassing easily, and even answering a cell phone call in public.^[5]

Often scopophobia will result in symptoms common with other anxiety disorders.^[6] The symptoms of scopophobia include an irrational feelings of panic, feelings of terror, feelings of dread, rapid heartbeat, shortness of breath, nausea, dry mouth, trembling, anxiety and avoidance.^[7] Other symptoms related to scopophobia may be hyperventilation, muscle tension, dizziness, uncontrollable shaking or trembling, excessive eye watering and redness of the eyes.^[8] For a epileptic, it may precipitate an attack.^[9]

Related syndromes

Though scopophobia is a solitary disorder, many individuals with scopophobia also commonly experience other anxiety disorders. Scopophobia has been related to many other irrational fears and phobias. Specific phobias and syndromes that are similar to scopophobia include erythrophobia and the fear of blushing (which is found especially in young people). Scopophobia is also commonly associated with schizophrenia and other psychiatric disorders. It is not considered indicative of other disorders, but is rather considered as a psychological problem that may be treated independently.^[10]

Sociologist Erving Goffman suggested that shying away from casual glances in the street remained one of the characteristic symptoms of psychosis in public.^[11] Many scopophobia patients develop habits of voyeurism or exhibitionism^{[citation needed]} . Another related, yet very different syndrome, scopophilia, is the excessive enjoyment of looking at erotic items.

Causes

Spotligectophobia is unique among phobias in that the fear of being looked at is considered both a social phobia and a specific phobia, because it is a specific occurrence which takes place in a social setting.^[8] Most phobias typically fall in either one category or the other but scopophobia can be placed in both. On the other hand, as with most phobias, scopophobia generally arises from a traumatic event in the person's life. With scopophobia, it is likely that the person was subjected to public ridicule as a child. Additionally, a person with scopophobia may often be the subject to public staring, possibly due to a physical disability. ^[12]

According to the Social Phobia/Social Anxiety Association, U.S. government data for 2012 suggests that social anxiety affects over 7% of the population at any given time. Stretched over a lifetime, the percentage increases to 13%.^[5]

Psychoanalytic views

Building on Freud's concept of the eye as an erogenous zone,^[13] psychoanalysts have linked scopophobia to a (repressed) fear of looking,^[14] as well as to an inhibition of exhibitionism.^[15] Freud also referred to scopophobia as a "dread of the evil eye" and "the function of observing and criticizing the self" during his research into the "eye" and "transformed I's."^[16]

In some explanations, the equation of being looked at with a feeling of being criticized or despised reveals shame as a motivating force behind scopophobia.^[17] In the self-consciousness of adolescence, with its increasing awareness of the Other as constitutive of the looking glass self, shame may exacerbate feelings of erythrophobia and scopophobia.^[18]

Treatments

There are several options for treatment of scopophobia. With one option, desensitization, the patient is stared at for a prolonged period and then describes their feelings. The hope is that the individual will either be desensitized to being stared at or will discover the root of their scopophobia.^[8]

Exposure therapy, another treatment commonly prescribed, has five steps:

Evaluation
Feedback
Developing a fear hierarchy
Exposure
Building

In the evaluation stage, the scopophobic individual would describe their fear to the therapist and try to find out when and why this fear developed. The feedback stage is when the therapist offers a way of treating the phobia. A fear hierarchy is then developed, where the individual creates a list of scenarios involving their fear, with each one becoming worse and worse. Exposure involves the individual being exposed to the scenarios and situations in their fear hierarchy. Finally, building is when the patient, comfortable with one step, moves on to the next.^[19]

As with many human health problems support groups exist for scopophobic individuals. Being around other people who face the same issues can often create a more comfortable environment.^[20]^{[unreliable source?]}

Other suggested treatments for scopophobia include hypnotherapy, neuro-linguistic programming (NLP), and energy psychology.^[21] In extreme cases of scopophobia, it is possible for the subject to be prescribed anti–anxiety medications.^[12] Medications may include benzodiazepines, antidepressants, or beta-blockers.^[19]

History

Phobias have a long history. The concept of social phobias was referred to as long ago as 400 B.C. One of the first references to scopophobia was by Hippocrates who commented on an overly-shy individual, explaining that such a person "loves darkness as light" and "thinks every man observes him.” ^[22]

The term "social phobia" (phobie sociale) was first coined in 1903 by French psychiatrist Pierre Janet. He used this term to describe patients of his who exhibited a fear of being observed as they were participating in daily activities such as talking, playing the piano or writing.^[23]

In 1906 the psychiatric journal The Alienist and Neurologist, described scopophobia:^[24]

Then, there is a fear of being seen and a shamefacedness, which one sees in asylums. [...] We called it scopophobia — a morbid dread of being seen. In minor degree, it is morbid shamefacedness, and the patient covers the face with his or her hands. In greater degree, the patient will shun the visitor and escape from his or her sight where this is possible. Scopophobia is more often manifest among women than among men.

Later in the same paper (p. 285) scopophobia is defined as "a fear of seeing people or being seen, especially of strange faces".^[24]

In popular culture

In The Neverending Story, the Acharis are a race of beings so ashamed of their ugliness that they never appear in daylight.^[25]
The character Ryoshi Morino in the light novel series Okami-san has the condition, wearing his hair long to avoid eye contact, and breaking down crying when he notices people staring at him.^{[citation needed]}
The character Marimo Kaburagi in the second season of the anime television series Active Raid has scopophobia, but her symptoms are alleviated by her wearing special glasses which digitally censor the eyes of whomever she looks at.^{[citation needed]}
The SCP Foundation character SCP-096 is a humanoid monster that expresses great distress and reacts violently whenever its face is seen through any medium, relentlessly hunting down and killing whoever views it, either in person or through a photograph or video footage; when it is necessary to present 096’s appearance in a visual medium, this is typically avoided via showing an artistic depiction to prevent direct viewing.
The Endermen, mobs found in the Swedish sandbox game Minecraft, are said to possibly have scopophobia, as they become hostile when looked in the eyes.

References

^ The Free Medical Dictionary, 2012, http://medical-dictionary.thefreedictionary.com/scopophobia
^ σκοπέω, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
^ φόβος, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
^ ὀφθαλμός, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
^ ^a ^b "Social Anxiety Fact Sheet". Social Phobia/Social Anxiety Association. Archived from the original on 12 November 2012. Retrieved 8 November 2012.
^ "What is Scopophobia?". Wise Geek.com. Retrieved 8 November 2012.
^ "Symptoms of Scopophobia". Health Grades. Retrieved 8 November 2012.
^ ^a ^b ^c "Scopophobia". All About Counseling. Retrieved 8 November 2012.
^ M. Matsuura/Y. Inoue, Neuropsychiatric Issues in Epilepsy (2010) p.??
^ "Scopophobia". The Free Medical Dictionary. Retrieved 8 November 2012.
^ Erving Goffman, Relations in Public (1972) p. 415
^ ^a ^b Duffey, Tammy. "Phobias: Scopophobia, The Fear of Being Stared At". Yahoo. Retrieved 8 November 2012.
^ Sigmund Freud, On Sexuality (PFL 7) p. 84
^ D. W. Allen, The Fear of Looking (1974) p. 6
^ O. Fenichel, The Psychoanalytic Theory of Neurosis (1946) p. 177
^ Henelly Jr., Mark (September 1998). "The 'Surveillance of Desiree': Freud, Foucault, and Villette". Victorian Literature and Culture. 26 (2): 421–440. doi:10.1017/s1060150300002497.
^ Fenichel, p. 139
^ Fenichel, p. 112
^ ^a ^b "Treatment and Cure: Two Very Different Things". Change That's Right Now. Retrieved 8 November 2012.
^ Duffey, Tammy. "Phobia's: Scopophobia, The Fear of Being Stared At". Yahoo. Retrieved 30 October 2012.
^ "Scopophobia Treatment". Phobia Treatment. Archived from the original on June 16, 2004. Retrieved 8 November 2012.
^ Cuncic, Alan. "A Brief History of Social Anxiety Disorder". About.Com. Retrieved 8 November 2012.
^ Leora R. Heckleman, Franklin S. Schneierer; Social Phobia Diagnosis, Assessment, Treatment. 1995
^ ^a ^b "The Alienist and Neurologist", edited by Charles Hamilton Hughes, 1906, p. 165, p. 285 (digitized by Google)
^ Michael Ende, The Neverending Story (1983) p. 260-1