What Is Coulrophobia? (An Overview)

In this blog we will discuss the symptoms, causes and treatment of Coulrophobia.

Fear of clowns is known as Coulrophobia. It is one of the most common types of phobias with which people, usually children suffer from.

The fear of clowns has deep roots in history, which aggravated as the time progressed.

The clowns date back to 2400BC, found in the Fifth Dynasty of Egypt. During these ancient times, clowns had a socio-religious and psychological role.

In non-Western cultures, they were referred to as fool characters but in these ancient times, also took the role of priests.

The modern clowns that we see in today’s time are known as circus clowns. This is because of their comedic role in theater plays and circuses, which started to rise in the 19th and 20th century.

Clowns are seen as characters whose actions become extraordinary. They are a source of laughter and spreading happiness in people’s lives by the silly acts they do on stage.

Clowns dressup in many different ways, trying to appear more appealing and humorous.

They use heavy make-up on their faces which makes them stand out in public, wearing fancy, colourful costumes.

Their entire get up is made in such a way that people see them as jolly and comical.

The most famous clown in modern times is called the red clown type.

This type dresses up with fancy wigs, excessively colorful clothes and shoes with a distinct type of heavy make-up (usually the face is painted as white as snow, with large red lips-making a big smile on their faces).

Their purpose is to entertain people or audiences.

Nowadays, these clowns are not only seen in theaters and or circuses but nearly everywhere, such as shopping malls and hospitals.

Even the most famous fast food chain McDonald’s mascot is a clown named Ronald McDonald. The sole purpose of these clowns is to entertain children by doing silly acts and being playful.

However, not all see clowns as happy, unharmful people/characters. Coulrophobia is a real, very threatening fear for its sufferers.

This phobia is not new, but stems from the past. Someone suffering this phobia gets extremely anxious when exposed to clowns or at the mere thought of them.

Their anxiety is so intense that one can even undergo full-blown panic attacks.

These overwhelming reactions to clowns persuade one to avoid getting exposed to them. Because of this avoidance, one’s social and occupational functioning is also affected.

For example, a sufferer will refrain from going to see theater plays or films because they have a fear of getting exposed to a clown.

An individual will not attend parties, festivals or visit malls because one has a higher chance of encountering a clown over here.

For children going to school or hospitals can be tough if they saw a clown at either of the places.

Coulrophobia can lead one to develop OCD and or depression in the future because of the repetitive acts of avoidance one does, which affects his mental health and intensifies his fear.

Coulrophobia is an irrational fear of clowns. It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.

Symptoms of Coulrophobia

The Diagnostic and Statistical Manual for Mental Disorders-5th Edition (DSM-V) suggests a number of psychological and physiological symptoms one suffers from in all specific phobias, including Coulrophobia.

Anxiety is the pivotal symptom of all types of specific phobias.

This anxiety gives way to an adrenaline rush which aggravates other physiological symptoms, such as heart rate, breathing rate and one’s mood.

These symptoms persuade the repetitive acts of avoidance as mentioned earlier.

Coulrophobia is an irrational fear of clowns. One’s fear is out of touch with reality because of his inability to rationalise his fear/anxiety.

Each individual experiences this phobia differently (based on their past experiences). One will suffer from more severe symptoms, as compared to someone else.

According to the DSM-V, anxiety that one experiences in Coulrophobia should last for at least 6-months.

Other than this, one should also suffer from 3-5 symptoms, out of the list mentioned below.

Excessive anxiety when exposed to clowns
Excessive anxiety when thinking about clowns
Inability to manage anxiety
Full-blown panic attacks
Avoiding clowns
Feelings of dizziness/fainting
Feeling depressed
Fear of an impending doom
Excessive sweating
Tremors
Hot/cold flashes
Butterflies in the stomach
Increased heart beat
Breathlessness
Muscle tension
Nausea
Drying up of the mouth
Disorientation
Migraine

Causes of Coulrophobia

It is argued that all anxiety disorders, including specific phobias have no real cause.

They are caused by either a genetic predisposition and or environmental factors.

According to the genetic/biological model, specific phobias are developed due to a genetic predisposition.

Someone who has a family history of anxiety disorders has a higher chance of developing Coulrophobia.

This is because any alteration in the genes of his parents will be transferred to him.

Someone who has alterations in their neurotransmitter levels of the brain can also develop Coulrophobia.

These alterations are low dopamine levels and high serotonin levels.

This genetic tendency to develop a specific phobia is further explained by the Diathesis-stress relationship.

This suggests that someone with a genetic predisposition will develop Coulrophobia only in the presence of the correct environmental trigger event.

All phobias are referred to as irrational fears. However, Coulrophobia is not wholly irrational because of the fact that in past times there was a group of clowns called as the ‘killer clowns’ who were known to kill children and or forcible violation them.

For someone who might’ve gone through this traumatic experience in their childhood or heard of these incidents are very likely to feel real threat from clowns and develop Coulrophobia.

Additionally, films have played a very significant role in the widespread rise of Coulrophobia.

The movie makers have left no stone unturned in dramatizing clowns and making them a symbol of not just happiness and laughter, but terror and intense fear.

Films like Poltergeist (1982) and one of the most famous Stephen King’s IT have projected clowns as people who murder children.

Films like these have contributed heavily in showcasing clowns as evil, dangerous, murderous and or potentially terrifying.

Many people, especially children started to develop Coulrophobia because of the way clowns are portrayed in films.

Apart from this, one can also develop this intense fear of clowns because of the way they dress up.

Their make-up and costumes, though look appealing, but for children they seem to be scary. The big, red smile on a clown’s face looks very unreal to them.

Children mostly feel fearful of the clown’s appearance because they not only are unable to see his face but also the make-up tends to hide his feelings.

Secondly, the mischievous and highly unpredictable behaviour of a clown scares children or people because they are unaware of what and when the clown will do (though this behaviour is adopted by a clown to develop a friendly relationship with his audience of people).

To conclude, Coulrophobia is developed by a number of environmental factors, as well as a genetic predisposition.

Treatment of Coulrophobia

Coulrophobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.

Like all the other specific phobias, Coulrophobia is treated using Psychological therapies, and or biological treatment to lower anxiety.

Psychological Treatment:

• Cognitive-Behavioral Therapy (CBT)

It is one of the most frequently used treatments for patients with almost all kinds of mental disorders.

Coulrophobia is defined as the irrational fear of clowns. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.

The patients are helped out in analyzing and justifying the way they feel about their fear stimuli.

Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts.

The therapist tries to prove to them, with the help of these rational thoughts that vampires are not real and thus, unharmful.

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for:

i. A (antecedents) a situation or triggering event.

ii. B (belief) the thought that comes to one’s mind when in that triggering situation.

iii. C (consequences) the symptoms/feelings caused by that event/thought

iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.

• Exposure Therapy

It is one of the most frequently used ways of treating patients with Coulrophobia (or any other kind of specific phobia).

In this therapy, the patient is exposed to the source of his fear over a certain span of time.

To begin with the therapy, the therapist exposes the patient to the least triggering stimuli, a picture of clowns for example.

As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further.

In this part of the treatment the patient is asked to visualize/imagine a situation in which he is exposed to a clown During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.

Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to a real clown.

While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises.

These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation.

This teaches them how to remain calm when exposed to the fear stimuli.

Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patient’s fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes.

However, these steps desensitize one to their fear of clowns, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.

• Eye Movement Desensitization and Reprocessing (EMDR)

This another form of treatment used with patients suffering from specific phobia or anxiety disorders. It is used with patients who know the cause of their phobia.

First, the therapist collects the patients’ history of different fears. They then identify the real cause of the particular fear/phobia the patient has.

They then discuss any new/latest event that triggered their anxiety and fear in the past few weeks.

People coming with specific phobias are told to imagine their distress causing stimuli.

The therapist then works with the individual in order for them to overcome their fear.

In the case of Coulrophobia, the patient will be advised on how to overcome his fear of clowns. They do this by creating a positive imagery for the patients’ feared stimuli.

• Yoga/Meditation

They are not just one of the many treatment therapies used for Coulrophobia, instead they are one of the most common ways of relaxation used by many people.

Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.

Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.

Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.

The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about their fear stimuli.

• Dialectical Behavior Therapy (DBT)

This is another effective therapy used to treat Coulrophobia. It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobia.

Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group).

i.Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

ii.Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment.

This helps in breaking the link between their mind and any negative thought that might come to them then.

For example, a person is told to focus on his breath or on the sound of the wind around them, making use of their auditory sense.

iii.The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.

• Mindfulness-Based Stress Reduction (MBSR)

MBSR is a meditation therapy, used to manage stress or anxiety. It is an 8-week program which includes group sessions.

Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example, focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing.

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

Biological Treatment:

• Drug Therapy

Drugs are used to reduce the physical symptoms caused by Coulrophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken.

This type of biological treatment is usually more effective if the cause of phobia is only genetic.

However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.

Two types of drugs are used in the treatment of this phobia:

i. Anti-anxiety Drugs

These include medicines like Klonopin.

They are most commonly used with patients who experience panic attacks and also lowers the anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.

ii. Antidepressant Drugs

These drugs as the name suggests don’t only treat depression but are also very effective in treating phobias.

Medicines like Lexapro reduce the anxious feelings of a person and makes him feel calm.

They need to be taken on a daily basis but not without a doctor’s advice.

Whether the cause of Coulrophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Titles to read

Coulrophobia & Fata Morgana: Stories

by Jacob M. Appel

Coulrophobia

by Tim Miller

Overcome Your Fear of Clowns: How To Stop Your Coulrophobia

by Angie Walters

When Clowns Attack: A Survival Guide

by Chuck Sambuchino

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

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