What is Masklophobia?

Masklophobia, an extreme and overwhelming fear of masks and costumes, is a relatively unknown phobia that mainly affects children, although it can also occur in adults.

Approximately 120,000 children across the UK have masklophobia, with many of them growing out of the phobia before they reach adulthood.

Today, we are going to look at masklophobia in more detail, including the common causes, triggers, symptoms and treatments.

What is Masklophobia?

Masklophobia, also commonly referred to as maskaphobia, is an extreme and overwhelming fear of masks and costumes. Masklophobia is an extremely individualised phobia, in that it manifests differently in different people. Some people are afraid of all masks, costumed clothing, costume characters and mascots, whereas other people’s phobia of masks is centralised on a specific type of mask, such as horror masks, religious masks, masquerade masks or medical face masks.

Masklophobia is most commonly found in children. This could be because children often find it difficult to distinguish fiction and imagination from reality, have difficulties recognising familiar faces and facial features until the age of six, and find it difficult to rationalise their thoughts and emotions. Masks, particularly when paired with adult-sized costumes, can result in extreme fear, anxiety and panic.

Many children grow out of this fear, particularly when they learn that there is a person behind the mask and that they won’t hurt them. Masks and costumes are also frequently used for children’s mascots, as learning aids or to represent popular children’s brands, TV shows and movies. However, in some cases, the child does not grow out of the fear and the symptoms of the phobia can worsen over time. Masklophobia can also occur in adults.

An individual with masklophobia will likely experience intense, overwhelming and irrational fear, anxiety or panic when faced with masks or costumes. They may also implement avoidance behaviours, whereby they avoid certain places or situations to reduce the risk of them encountering masks or costumes. This can be problematic at certain times of the year, such as Halloween and Christmas, when there are a significantly higher number of masks and costumes and you are more likely to encounter triggers that you associate with masks and costumes, such as Halloween decorations. Avoidance behaviours can negatively impact your social life and your relationships, as well as your ability to carry out everyday tasks.

Someone with masklophobia may also have difficulty concentrating or functioning in certain situations and find that their fear interferes with their day-to-day life. Some people find that they are consumed by thoughts of masks or the fear that they could encounter masks, for example, they may feel stressed and anxious in a theme park, a restaurant or a farm, in case any of the staff are wearing fancy dress or dressed as a character.

Although masks and costumes can be scary to many people, particularly during Halloween when people purposely wear masks and costumes designed to scare you, masklophobia is a medical condition which is much more serious. People with masklophobia usually fear masks even when there is minimal risk of coming into contact with them or they may fear masks which don’t have negative connotations attached to them, such as masquerade masks, religious masks or medical masks. An irrational fear of masks and costumes can have a significant impact on your day-to-day life and can cause you to experience fear, anxiety and panic even in situations where there is no risk.

To be classed as masklophobia, your fear of masks and costumes will include:

• Feelings of intense fear, panic or anxiety that are difficult to manage.
• Fear or anxiety that is out of proportion to the potential danger.
• A fear of masks and costumes that lasts for a minimum of six months.
• Avoidance behaviours that aim to prevent encounters with masks or costumes.
• A fear of masks and costumes that interferes with your day-to-day life, overall wellbeing or sense of safety.

Symptoms of masklophobia don’t only occur when you see a mask or costume. They may also occur when you think about them or if you remember a stressful or traumatic event involving masks or costumes.

You may be aware that your fear is irrational and disproportionate to the threat. However, even if you are aware that masks don’t really pose a danger to you, you may still be unable to control your fear and prevent or reduce your physiological and psychological responses to your triggers.

Masklophobia is often related to and can appear in conjunction with other phobias, including:

• Coulrophobia: An extreme fear of clowns.
• Scopophobia: An extreme fear of being stared at.
• Kyrofelonoshophobia: An extreme fear of cartoon characters.
• Iatrophobia: An extreme fear of doctors.
• Dentophobia: An extreme fear of dentists.

How common is masklophobia?

As mentioned earlier, masklophobia is significantly more common in children compared to adults. It is thought that approximately 1% of children experience masklophobia, equating to more than 120,000 children across the UK. However, the majority of children with masklophobia grow out of the condition before they reach adolescence.

Although many people experience fear or anxiety when confronted with a mask or costume, particularly those that are designed to be frightening or gory, this does not mean they have masklophobia. Negative thoughts and emotions in relation to masks and costumes occur on a spectrum, ranging from low levels of fear and anxiety to severe fear, panic and anxiety that can impact your ability to function in your day-to-day life and can impact your decision-making and result in avoidance behaviours of certain places, situations or objects.

Many people with masklophobia never receive an official diagnosis for the condition, particularly if the phobia occurs in childhood.

This could be for a number of reasons, such as:

• The parents or guardians expect the child to grow out of their fears.
• The child cannot articulate or explain their fears properly.
• The parent or guardian is not aware that masklophobia is a diagnosable phobia.
• The parent or guardian is not aware that treatment is available.
• Encounters with masks or costumes are infrequent enough that the condition may not impact severely on the child’s wellbeing, or the parent may be able to effectively implement avoidance techniques, for example, by not taking the child to places where they are likely to encounter masks or costumes.

All of these factors can contribute to the low diagnosis rates for this phobia. This could mean that masklophobia is much more common than figures suggest.

Who is at risk of masklophobia?

Although anyone can develop a fear of masks and costumes, there are certain risk factors that can increase the likelihood of you developing a phobia, including:

• Having another related phobia, such as coulrophobia or kyrofelonoshophobia.
• Having a previous negative or traumatic experience involving masks or costumes.
• Having a close family member, such as a parent or sibling, with masklophobia.
• Having a close family member, such as a parent or sibling, with another phobia.
• Being a naturally more anxious or fearful person.
• Being exposed to the fear of masks or costumes during childhood or adolescence.
• Being exposed to masks or costumes (during childhood) that are not age-appropriate, for example, being exposed to horror movie masks during Halloween.
• Experiencing high levels of stress.
• Being part of a culture or religion that portrays masks and costumes negatively.
• Having a history of anxiety, depression, panic attacks or another relevant mental health disorder.

As mentioned earlier, masklophobia is more likely to develop during childhood. However, the condition can develop at any age. A child who experiences a traumatic, negative or stressful event, even if this is unrelated to masks, is more likely to develop masklophobia. This is because stress and trauma can cause feelings of anxiety and fear and can reduce their ability to cope with certain situations, particularly situations that involve fear or a loss of control. For example, a child who experiences physical, sexual or emotional abuse or violence, the death of a parent or parent separation is more likely to develop masklophobia than their peers.

However, it is important to note that although the above risk factors raise the likelihood that you will experience masklophobia, they do not guarantee that you will develop the condition. A child or adult with none of the above risk factors may develop masklophobia, whereas someone with several risk factors may never develop the condition.

How to deal with masklophobia

You may think that the best way to deal with your phobia is to avoid your triggers; after all, you don’t experience fear or anxiety when there are no masks and costumes present. However, avoiding your triggers can be much more difficult than it sounds, particularly following the Covid-19 pandemic when wearing face masks became normalised. Although avoidance behaviours may be effective at times, it is not possible to always avoid your triggers. Additionally, avoidance behaviours can have a significant impact on your day-to-day life.

Failing to deal with your phobia can cause your symptoms to become more severe in the future. There are certain coping strategies you can implement, both short term and long term, which can reduce the frequency and severity of your symptoms and reduce the negative impact your phobia has on your life. Coping strategies can also help you to manage your masklophobia more successfully and reduce avoidance behaviours in the future.

You can deal with the symptoms of your phobia by implementing long-term coping strategies, which you can employ on a daily basis to help reduce the likelihood of your phobic symptoms occurring and reduce the frequency and severity of your symptoms. You can also learn some short-term coping and calming strategies which you can utilise in the moment, when faced with your triggers.

Some long-term and short-term coping and calming strategies that you can use to help you deal with your masklophobia are:

Learn about your phobia

When trying to reduce the impact your phobia has on your life, identifying what initially caused your phobia of masks and costumes to develop and thinking about the first time you experienced symptoms is key. Understanding the onset of your phobia allows you to address the root cause and any negative thoughts and emotions that are connected to it. As part of learning about your phobia, you should also identify your triggers and determine which of your triggers result in more severe symptoms. Understanding your phobia can help you to rationalise your thoughts and emotions and reduce your fear response.

Create a fear ladder

A fear ladder can help you to analyse and understand your phobia and determine which triggers create more severe fear, anxiety and panic than others. When creating your fear ladder, you will organise your triggers from least severe to most severe.

For example, your fear ladder can look like this:

1 = Wearing a mask or costume yourself.
2 = Being in close proximity to someone who is wearing a mask.
3 = Being in close proximity to someone who is wearing a costume.
4 = Seeing a mask or costume in a shop (for example, on display).
5 = Watching a movie or TV show where someone is wearing a mask or costume.
6 = Going to a Halloween event where no one is wearing masks or costumes.

Once you have created your fear ladder, you can then confront your fears one at a time, starting at the bottom of the ladder (the trigger that results in the least phobic response). This can help you to build up your tolerance of your triggers gradually and reduce your fear of masks and costumes.

Desensitise yourself

Because face masks are worn increasingly within society and when travelling on aeroplanes, learning to be more comfortable with them is more important than ever, particularly as you will not be able to travel to another country or go to the hospital without a mask. Practise desensitising yourself at home, for example, by having a mask in your home, wearing a mask looped over one ear or under your chin or having someone you trust gradually wearing a mask in your home (or another place you are comfortable). This can help you to gradually reduce your fear response.

Challenge negative thoughts and feelings

Fear rumination is a significant factor in the development and persistence of phobias. Challenging negative thoughts, feelings, stories and memories surrounding masks and costumes can help you to manage your phobia more effectively. Try and disrupt negative thoughts and try not to recap any negative memories you have that could be perpetuating your fear. Remind yourself that the risks are minimal and that you are not in danger. If you begin to experience symptoms of masklophobia, remind yourself that the feelings will soon pass and that your fear is irrational.

Avoid negative depictions of masks and costumes

Masks and costumes are frequently used in horror movies, such as Scream and It, and in other movies or TV shows, such as Harry Potter, to depict who the evil characters are. Masks are also used during crimes such as kidnappings and burglaries to hide identities, and this is often reported in the news or depicted on TV shows and in films. Seeing these negative depictions of masks can validate your negative thoughts and feelings and increase your fear and anxiety responses. Avoid any negative depictions of masks and costumes to prevent your phobia from escalating.

Practise yoga, meditation or mindfulness

Yoga, meditation and mindfulness can all be implemented as long-term coping and calming strategies to help you manage or reduce your phobia. They teach you how to control your breathing and manage your body’s response to your triggers and can help you to feel more in control and calm. Yoga, meditation and mindfulness can all reduce the physiological and psychological responses you may have when faced with your triggers in the future. Practising yoga, meditation or mindfulness every day can help to improve the symptoms of masklophobia over time and reduce the likelihood of you experiencing a phobic response.

Practise deep breathing exercises

Deep breathing is another long-term strategy that can help you to reduce the impact your phobia has on your life. Deep breathing exercises are proven to be an effective way of lowering your stress levels, relieving tension in your body and reducing anxiety and panic. Deep breathing sends a message to your brain to relax and calm down. It can also help you to control your central nervous system, which is central to your phobic responses. Practise deep breathing regularly, as part of your daily routine, and implement the strategies you have learnt if you encounter a trigger in the future.

Implement lifestyle changes

Multiple lifestyle factors can worsen the symptoms of phobias, including masklophobia. For example, lack of sleep and high stress levels can worsen anxiety and make your symptoms more likely to occur. Implementing a successful sleep routine and reducing your daily stress can reduce the severity of your phobia both short term and long term. Other lifestyle factors that could help you deal with your phobia include eating a healthy, balanced diet and increasing the amount of exercise you do.

Implement distraction techniques

Distraction techniques are a great short-term coping strategy that can be implemented in the moment – when you are faced with your triggers or feel fear or anxiety. Learning distraction techniques allows you to implement them in the future and keep yourself calm when faced with your triggers. Different distraction techniques work for different people, so it may be trial and error to determine what works for you. Some examples include listening to music, playing a game, watching a video and reading.

Implement visualisation techniques

Visualisation techniques are another short-term coping and calming strategy. These techniques can help you to reduce the symptoms of your phobia. If you are in a triggering situation, visualise a place or memory that keeps you calm or elicits positive emotions to help you to alleviate your symptoms and prevent your phobia from escalating. Popular visualisation techniques include recalling some of your favourite memories or visualising yourself in your favourite place or a calming environment.

What triggers masklophobia?

There are many different things that can trigger your masklophobia. Your triggers can vary, depending on what initially caused you to develop masklophobia, your perception of danger, the severity of your symptoms and your current mental health and mindset.

It could be that you only have one trigger or that multiple things trigger the symptoms of masklophobia. In many cases, certain triggers result in a more severe phobic response than others.

There are many different types of masks and costumes that can trigger masklophoia, including:

The most common trigger for masklophobia is seeing someone who is wearing a mask or costume. However, there are other triggers that can cause someone to experience the symptoms of masklophobia.

The most common triggers for masklophobia are:

• Seeing someone wearing a mask or costume.
• Events such as Halloween, Christmas or Mardi Gras where masks and costumes are more common.
• Seeing something you associate with masks or costumes, such as Halloween decorations or face paint.
• Seeing a character on TV or in a film that wears a mask, such as Batman, Spiderman or Zorro.
• Going to a place where you are likely to see someone wearing a mask or costume, such as a circus, theatre show or a children’s party.
• Seeing someone’s nose and mouth covered by a medical mask, including at a hospital, clinic or dental surgery.
• Thinking about masks or costumes.
• Remembering a traumatic or negative event involving masks or costumes.
• Seeing a picture of a mask or costume.

What are the symptoms of masklophobia?

The symptoms of masklophobia can vary significantly in frequency and severity from person to person and situation to situation. This could be because some people experience more severe masklophobia than others. It could also be because certain triggers result in more severe symptoms; for example, your symptoms may be more severe if a person wearing a mask or costume approaches you suddenly, compared to if you see someone wearing a mask on TV.

The severity of your symptoms can also change depending on your current mental health and overall wellbeing, the effectiveness of any coping and calming strategies you have implemented and the proximity of the perceived threat. Masklophobia can cause you to perceive a person wearing a mask or costume as being larger, scarier and more threatening than they actually are. This can cause your symptoms to escalate.

The symptoms of masklophobia can be similar to the symptoms of anxiety and panic attacks. The symptoms can be both physiological (related to your body) and psychological (related to your mind) and can include:

Physiological Symptoms

• Difficulties breathing, including shallow breathing and rapid breathing.
• A rapid heart rate, heart palpitations or feeling like your heart is pounding.
• Tightness in your chest, chest pains or feeling like something is stuck in your chest.
• A choking sensation, difficulties swallowing or feeling like something is stuck in your throat.
• Shaking, trembling or chills.
• Unusual or excessive sweating or clamminess.
• Unusual flushing or paleness, particularly in your face.
• Nausea, vomiting, upset stomach or a nervous feeling in your stomach (commonly referred to as butterflies).
• Feeling dizzy or light-headed.
• Feeling confused or disorientated.
• Having a dry mouth.
• Muscle tension.
• Unusual or severe headaches.
• Feeling like you are unusually hot or cold or having an unusual sensitivity to hot or cold temperatures.
• Numbness or tingling, particularly in your hands or feet.
• Unusual fatigue or tiredness.
• A lack of appetite when in triggering situations or in the lead-up to triggering situations.
• Insomnia in the lead-up to triggering situations.

Psychological Symptoms

• Overwhelming fear, anxiety or panic when faced with masks or costumes.
• Feelings of fear, anxiety or panic that are out of proportion to the risks.
• Being unable to control your negative thoughts or feelings, even if you are aware that they are out of proportion to the true danger.
• Anticipatory anxiety in the lead-up to encountering masks or costumes.
• Difficulties concentrating or functioning normally in triggering situations.
• Experiencing frequent or distressing nightmares involving people wearing masks or costumes.
• Finding certain times of the year, such as Halloween or Christmas, to be triggering and experiencing feelings of dread in the lead-up to or during these times of the year.
• Feeling like you are out of control of the situation.
• Feeling like you are about to lose control.
• Engaging in avoidance behaviours, such as avoiding places, situations or social events where you might encounter masks or costumes.
• Feeling vulnerable or defenceless when faced with masks or costumes.
• Having a sense of impending doom.
• Feeling like you are going to die.

Symptoms of Masklophobia in Children

Although children can experience the same or similar symptoms as adults, the symptoms of masklophobia can differ, particularly in young children who may be unable to rationalise or understand their own thoughts and feelings, may be unable to explain to an adult what they are feeling and may be less constrained when experiencing fear, panic or anxiety.

Some symptoms of masklophobia in young children can include:

• Crying, screaming or having a tantrum.
• Lashing out by hitting or kicking people or objects that are close to them.
• Trying to run away or hide.
• Clinging to a parent, guardian or another safe person.
• Shaking or trembling.
• Showing extreme anxiety, fear or panic.

What causes masklophobia?

There are many different causes of masklophobia, and these causes could be genetic, psychological and environmental. Different people’s phobias can have different causes. Some people can pinpoint one clear cause of their fear of masks and costumes, whereas, for other people, multiple factors contributed to them developing masklophobia.

It may be that you cannot pinpoint exactly what caused your phobia to develop. However, identifying the root cause of your phobia can be extremely beneficial and can help you to address your initial trigger and any negative patterns of thought or negative feelings that are attached to the initial onset of your phobia. This can make it easier to treat your phobia and for you to develop coping strategies. Being aware of the cause of your masklophobia can make your phobia easier to manage.

Some of the most common causes of masklophobia are:

A negative or traumatic experience involving masks or costumes

In many cases, masklophobia originates from a negative or traumatic experience, which is known as a direct learning experience or traumatic conditioning. The event that caused the traumatic conditioning may not actually have involved real danger or real risk. However, as long as the individual experienced significant fear, distress or trauma, this could have led to the development of masklophobia. A traumatic experience may include being scared by a character in a mask, someone in a mask jumping out at you, or being kidnapped by a person wearing a mask. Following the negative event, you may experience intrusive and negative thoughts or memories of the trauma and begin to avoid trauma-related triggers, for example, by avoiding places and situations where you could encounter someone wearing a mask or costume. This can cause the fear or anxiety you felt at the time of the experience to linger or worsen.

Experiencing an attack, sexual or physical assault or abuse, violence or bullying

A traumatic experience such as assault or rape, whether in childhood or adulthood, can result in a person developing masklophobia. This could have been a one-off experience or a repetitive cycle of abuse. The traumatic experience can result in a fear of losing control, a fear of people you don’t know or a fear of being vulnerable or defenceless. It could also cause someone to view things as being more threatening than they actually are. In some cases, the abuser or attacker may have worn a mask or tried to hide their identity, which can result in someone being afraid of all masks.

Negative depictions of masks in popular culture or the media

Masks and costumes are frequently used in horror movies or in popular culture to indicate who the villain is. Being unable to see a character’s face can cause the audience to feel uncomfortable, anxious or scared. Additionally, news stories involving kidnappers, burglars and other offenders wearing masks can cause people to view masks as being threatening. Negative connotations that are frequently attached to masks in popular culture and the media can result in someone associating them with fear and anxiety and developing a phobia as a result.

A learned phobia

Phobias can develop because of an observational learning experience, meaning you observed a fear of masks and costumes in another person and learnt to associate them with fear or danger yourself. You are more likely to learn a phobia if you are exposed to it during childhood or adolescence. In fact, children who grow up with a close family member, such as a parent or sibling, with masklophobia are more likely to develop a fear of masks and costumes themselves.

Fear rumination

Fear rumination is when you engage in a repetitive negative thought process and persistently and repetitively recap a traumatic, scary or negative experience involving masks or costumes. Over time, these thoughts and memories can become increasingly upsetting and intrusive and can make you remember the experience as being more traumatic, painful or scary than it was in reality. Fear rumination reinforces your natural fear responses and can result in you developing a phobia.

Experiencing significant stress

Significant, long-term stress can result in a disproportionate fear response or an inability to manage intense situations, which can make it more likely that you will develop a phobia. A stressful and distressing event, such as a bereavement, can also trigger a phobia, as it can result in some people being less able to manage their emotions and thought processes. If you are exposed to masklophobia or have a negative experience with masks and costumes while experiencing significant stress, this is more likely to develop into a phobia.

How is masklophobia diagnosed?

If you think you might have masklophobia, your first step will be to visit your GP. Some people who experience fear, anxiety or panic when faced with masks or costumes are unsure whether their symptoms meet the criteria for a phobia.

If you are unsure whether you are experiencing masklophobia, consider whether your symptoms include:

• Fear, anxiety or panic that are out of proportion to the actual risks.
• Fear, anxiety or panic that impact your ability to function in your everyday life or in certain situations.
• Thoughts and feelings surrounding masks and costumes that negatively impact your quality of life, your mental health or your wellbeing.
• Symptoms that occur when faced with your triggers or when thinking about your triggers.
• Fear or anxiety that results in avoidance behaviours.

During your appointment, your GP will ask about a variety of things relating to your phobia, such as:

• Your symptoms, including what your symptoms are, how frequently they occur and how severe they are.
• Your medical history, including any anxiety disorders, panic disorders, phobias or other mental health conditions you have experienced.
• Any medication or supplements you take.
• Whether you have a family history of phobias.

Although GPs don’t usually make a formal diagnosis, they will refer you to a psychologist or phobia specialist who will spend more time discussing your symptoms. The psychologist will ask some of the same questions as your GP, such as when your symptoms began, what caused the initial onset and how much your fear interferes with your everyday life or your decision-making. The psychologist will also conduct a phobia questionnaire.

Masklophobia is a type of specific phobia, which means it is a lasting, overwhelming and unreasonable fear of a specific object, situation, activity or person; in this situation, an overwhelming fear of masks and costumes. Because the diagnostic criteria for phobias do not list every phobia separately, your symptoms will be compared to the general diagnostic criteria for specific phobias.

Your symptoms will need to correspond to the seven key criteria in the diagnostic criteria, listed below:

1. The fear must be persistent, excessive and unreasonable. It can occur either when your triggers are present or when they are not present.
2. Exposure to a trigger leads to an immediate anxiety response in the majority of situations.
3. The fear is excessive and disproportionate to the threat, and this is recognised by you.
4. You avoid places or situations where triggers could be present. If a trigger is present, you will experience extreme fear, anxiety or distress.
5. The anticipation of a trigger and the avoidance behaviours associated with avoiding your triggers can have a significant impact on your day-to-day life.
6. The fear has lasted for a minimum of six months.
7. The phobia is not associated with another disorder or mental health condition.

If your symptoms fit the diagnostic criteria, you will receive a diagnosis of masklophobia. Depending on the severity of your phobia, you may be offered treatment.

How is masklophobia treated?

There are multiple treatment options available for masklophobia. However, not every person with a phobia requires treatment. If your symptoms are mild, you have implemented successful coping strategies or your phobia doesn’t impact your day-to-day life or wellbeing, you may not require formal treatment.

However, if the symptoms of your phobia occur frequently or are severe, if your phobia results in avoidance behaviours or it is impacting on your daily life, treatment will likely be recommended.

Your psychologist will work with you to create a personalised treatment plan based on what is most likely to effectively treat your phobia.

To create your treatment plan, the following factors will be taken into consideration:

• How severe your symptoms are.
• How frequently your symptoms occur.
• What the root cause of your phobia is.
• How significantly your phobia impacts your life.
• Your overall health and wellbeing, including your mental health.

The most common and effective treatments for masklophobia are:

Exposure Therapy

Exposure therapy is an important psychological treatment that was designed specifically to help people overcome their fears and anxieties. It aims to break the patterns of fear and avoidance. It involves gradual and repeated exposure to your triggers in a safe and controlled environment to help eliminate the fear and negative patterns of thought you have associated with masks and costumes and reduce your fear and anxiety responses.

As part of your sessions, the psychologist will assess your phobia and create a fear ladder of scenarios and situations that are the least to the most triggering. Your exposure will begin gradually, with a situation that creates the least phobic response. Once you are comfortable with this level of exposure, you will move on to the next level. The aim is that through systematic desensitisation, you will eventually be comfortable with the most triggering situations.

Exposure therapy helps you to overcome your fear in four ways.

1. Emotional Processing: It helps you to create realistic thoughts and beliefs about your triggers.
2. Extinction: It helps you to unlearn any negative associations or negative patterns of thought associated with masks and costumes.
3. Habituation: Because exposure is repetitive over time, this can help to decrease your reactions to your triggers.
4. Self-Efficacy: It will show you that you are able to overcome your fear and reduce your anxiety, making this seem more achievable in the future.

Cognitive Behavioural Therapy (CBT)

CBT is a type of psychotherapy often referred to as talk therapy. It aims to change the way you think and behave by focusing on existing negative thought patterns and any harmful thoughts, feelings and behaviours related to your triggers. During the sessions, you will address the root cause of your phobia and will gradually change the way you think about masks and costumes, reduce any negative emotions and change the way you behave in response to your triggers.

During your CBT sessions, you will:

• Discuss your triggers and symptoms.
• Explore what caused your fear of masks and costumes.
• Explore your fears in more detail.
• Learn how to recognise your negative thoughts and change the way you are thinking.
• Learn coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.

Clinical Hypnotherapy

Clinical hypnotherapy is a type of hypnosis that is used to treat a range of phobias. It aims to help you unlearn your fear response, build up your comfortable exposure to your triggers and reduce the associated fear and anxiety. Hypnotherapy uses guided relaxation techniques and focused attention to help you reduce your stress, fear and anxiety responses.

It helps you to identify the root cause of your fear and helps you change your thought patterns and any negative feelings you have about masks and costumes. Hypnotherapy helps you to change your perception of your triggers and reduce your phobic response. This is done by putting you in a deeply relaxed state while you discuss your phobia and your triggers.

Hypnotherapy sessions also aim to repattern your thoughts, memories and feelings towards masks and costumes. It can also teach you calming strategies, such as deep breathing and relaxation techniques which can help you to reduce your symptoms in the future.

Medication

Medication is not a common treatment choice for phobias and will likely not be offered to treat the symptoms of your phobia alone. Medication may only be used if you are also experiencing anxiety, depression or another mental health difficulty alongside your phobia.

In this case, some of the medications you may be offered include:

• Beta-blockers.
• Selective serotonin reuptake inhibitors (SSRIs).
• Sedatives.
• Anti-anxiety medication.