The Hafephobia Also known as afenophobia, hafophobia, hapophobia, haptophobia or quirapophobia, is the fear of a person to be touched. Etymologically the word phobia means"fear, terror or panic".
Hafefobia is part of the so-called specific phobias, focusing on fear or phobia in a particular element, in this case, the fact of being touched by another person.
In general, people tend to protect what we call our"own space"or personal space. In this case, this specific phobia would refer to the exacerbation of this tendency to personal protection.
People with hafephobia tend to exaggeratedly protect their own space, coming to fear for pollution or invasion, for example.
In this case, it is a specific phobia where the person is afraid of touching or being touched.
We must emphasize that it is not an exclusive phobia towards strange people. In fact, the person with hafephobia is protected even from people who are known to her.
When we speak of this phobia as being exclusive to people of the opposite sex, the hafephobia is called"contrelophobia"or"agrafobia".
In all cases we should note that this is a specific phobia considered rare. We refer to this phobia as"specific"because although the anguish is intense it crystallizes on a particular element, in this case, to the fact of being touched by another person.
In this sense, the person elaborates or carries out a series of strategies in order to avoid it. For example, behaviors of avoidance, with which he manages to avoid confronting that which causes him so much fear (the fact of being touched).
Specific phobias, and in this case in hafephobia, there is an intense and persistent fear that is excessive or irrational and that is triggered because the person witnesses the feared situation or anticipates it (or he is facing the situation that someone touches him Or anticipates it).
Etiology and Epidemiology of Specific Phobias
In general, specific phobias often have a discreet trigger and are being established and developed throughout the years of childhood and adolescence, persisting in many cases if not treated in adulthood.
The causes by which the person ends up developing hafephobia are derived from a bad learning. The person with hafephobia generally has suffered a negative experience that has made him face and react in this way to his surroundings.
Thus, the person may have suffered, for example, some situation of invasion that makes him react in such a way.
Different theories have been developed about the etiology and genesis of specific phobias. Some of them are psychoanalytic, for example, and others are more cognitive-behavioral.
Through classical conditioning has explained the origin of phobias, so that the fear that the person suffers, in this case to be touched by other people, has its origin in inadequate learning.
If you do not intervene in specific phobias, your course tends to be chronic. It is important to note that it is quite common for people to have more than one specific phobia.
Generally, the person with a specific phobia usually fears an average of 3 situations or objects (DSM-5, 2013) and approximately 75% of people with specific phobias fear more than one situation or object.
In the United States, for example, the annual prevalence of specific phobias in the general population is 7-9% and European countries are similar, around 6%, being lowest in Asia, Africa and Latin American countries, On 2 and 4%.
However, we must emphasize that we speak of the general prevalence of specific phobias, with hafephobia being a specific phobia of those considered rare because they are rare.
Symptoms of hafephobia
The symptoms that the person with hafephobia presents are, in the first place, an intense and persistent fear before said situation. A fear that is excessive and that is irrational and that is presented because the person fears that the fact of being touched.
When this situation occurs, the anxiety response is triggered in the person, which may even end up leading to a panic attack .
In children, symptoms such as crying, triggering a tantrum, clinging to a loved one or staying still, for example, can occur.
In addition to intense fear, other symptoms that are part of the diagnostic criteria to diagnose this specific phobia according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) are the fact that this situation causes immediate anxiety and is avoided Or actively withstand with intense fear or anxiety.
In addition, to be considered hafefobia should last six months or more and cause clinically significant discomfort or deterioration in the workplace, social or other important areas of human functioning.
When we speak of hafephobia, as in all specific phobias, there is an autonomous activation when the person fears to be in the dreaded situation; In this case, to the idea of being touched by another person.
In this situation, the person is afraid and the Sympathetic nervous system , Having symptoms such as tachycardia, palpitations, sweating, more rapid breathing, an increase in blood pressure and lower gastrointestinal activity.
In addition, as the person is afraid, avoidance behaviors (the person avoids coping), as well as security-seeking behaviors that seek to minimize threats and find themselves better reducing anxiety.
Evaluation
Specific phobias are a Anxiety problem Which can very negatively affect the quality of life of the person who has it. For this reason, and in order to be able to intervene in them, it is important to carry out a good evaluation in order to make the treatment a success.
There are several types of specific phobias that are collected in the DSM-5, for example: animals, the natural environment, blood, injections or wounds and situational phobias, in addition to the subgroup of other phobias.
It is also considered that many of these specific phobias have an explanation Phylogenetic , Thinking that they could be derived from fears that the species has had and have helped to survive, such as fear of animals, for example.
If we talk about the most frequent within the typology above, we could say that the most frequent are the situational ones, followed by the phobias of the natural environment, those of blood, injections and wounds and finally that of animals.
The evaluation of hafephobia as a specific phobia can be done through four methods: through the interview by a qualified professional and expert, self-registrations offered to patients during the evaluation sessions, questionnaires or self-reports that Will help the professional to obtain more information and the observation itself.
The interview can be done in various ways; However, the DSM-IV has a diagnostic interview following the criteria of this diagnostic manual, ADIS-IV (Brown, DiNardo and Barlow, 1994).
ADIS-IV is the Interview for Anxiety Disorders and evaluates these problems with a duration of one to two hours. It allows to evaluate at the same time other problems of clinical attention as can be the problems of the mood, the Drug abuse disorders , the hypochondria Or the Somatization disorders .
It also evaluates the patient's family history of psychological disorders or medical history, for example, allowing a more complete evaluation of the history of the patient's problem.
However, a good evaluation of hafephobia through the interview can be carried out if we have an expert psychologist and trained in anxiety problems.
Through this evaluation, the psychologist must obtain information about the history of the problem, the fluctuations of the problem, what it has done before to try solve the problem And what has been achieved, what are the limitations that it presents and what is its motivation towards the treatment, its objectives and the expectations that it presents.
It should also be evaluated about the situations that it fears and that it avoids (considering that the main focus resides in the fear that the person has to be touched by the others), besides evaluating at cognitive level, motor, etc., the Symptoms present and seeing intensity, duration and frequency.
We must also evaluate the variables, both personal and situational that maintain the problem behavior and how it interferes in the different areas of life.
As we said at the beginning, the evaluation can also be done through questionnaires and self-reports.
The problem that exists when evaluating the hafephobia is that we are faced with a phobia considered rare, so it is difficult to find a specific instrument to evaluate this phobia, so it is better to obtain the information through other means as can Be the interview we were discussing.
Another useful tool when evaluating can be self-registration, including the situation, the time of day, who is present, what happens before and what the person does in the situation.
Finally, observation can also be a means to evaluate hafephobia. Evaluating in the natural situation is one way to do it (you can observe the psychologist but if it is not possible, it can be done by a co-therapist, who can be, for example, a relative).
Psychological treatment
According to the explanation of behavioral court, based on inadequate learning, it will be through the Cognitive-behavioral psychological techniques Through which they can intervene to solve this problem.
So, that the person learn to condition again is a good strategy to end phobias; In this case, with hafephobia.
The treatments with greater evidence and scientific rigor to solve specific phobias such as hafephobia are in vivo exposure (EV), participant modeling and Öst treatment (Bados, 2009).
For example, in vivo exposure improves by reducing fear or avoidance behavior. In order to apply the treatment with the patient it is important to reach an agreement with him, explaining the problem that he has and justifying the treatment to be followed.
In vivo exposure allows the patient to eliminate the association between anxiety and the situation he or she fears, allowing him to learn to manage anxiety and to verify that the negative consequences he fears do not actually occur.
In order to make a good exposure in vivo, it is important that the exposure is gradual and that the speed is adequate according to the needs of the patient (and consensual with it).
It must perform a hierarchy ordering from less to greater anxiety and always starting from the situations that less anxiety produce the patient.
A hierarchy or several can be constructed and the patient must be exposed to overcome the anxiety that produces the dreaded situation, in this case, the fear of being touched.
References
- American Academy of Psychiatry (2013). Diagnostic and Statistical Manual of Mental Disorders. Pan American Medical Editorial.
- Bados López, A. (2009). Specific phobias. Facultat de Psicologia, Universitat de Barcelona.
- Gómez Torres, V. (2012). Beware: you may be a victim of sex phobias. Get to know them.
- Tortella-Feliu, M. (2014). Anxiety Disorders in DSM-5. American Journal of Psychosomatic, 110.
- Vilaltella, J. V. The phobias. University of Lleida.