What is Merinthophobia?

Merinthophobia, an extreme fear of being bound or tied up, is a type of specific phobia that is not as well-known as other types of phobias.

Although many people may feel fear, anxiety or panic if faced with being tied up, less than 1% of the population are currently diagnosed with merinthophobia. However, this could be because of a lack of awareness about this phobia.

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

What is merinthophobia?

Merinthophobia is the extreme and overwhelming fear of being bound or tied up. Merinthophobia is often related to the fear of losing control or being out of control. A person with merinthophobia experiences overwhelming and irrational fear, anxiety or panic when they are being tied up or in places where they might encounter things that can bind them.

A person with merinthophobia may physically avoid being tied up or physically and visually avoid objects that can bind them, including rope, string, seatbelts, handcuffs, netting, cord, wire, thread, tape and chains.

Although many people dislike being restrained and it is rational to be afraid of situations where you are restrained and there is a genuine threat of danger, for example in a kidnapping situation, a person with merinthophobia will fear situations where there is no real danger. They may even be afraid of situations where they are being restrained or tied up to keep them safe or where there is no real threat of them being tied up.

Determining whether you are experiencing merinthophobia or just have a low level of fear relating to being tied up can be difficult. However, there are some key differences.

To be classified as a phobia, your merinthophobia must:

• Include feelings of intense fear, panic or anxiety that are irrational and difficult to control or manage.
• Include fear that is out of proportion to the potential danger.
• Last longer than six months.
• Negatively impact your day-to-day life.

Some people think of merinthophobia as the fear of being bound or tied up with objects such as rope or cord.

However, merinthophobia can be connected to a number of other fears, including:

• A fear of being restrained with a seatbelt.
• A fear of being arrested and put into handcuffs.
• A fear of the lap bar and harness that are used on rides in fairgrounds and theme parks.
• A fear of wearing a safety harness, for example, if working at height.
• A fear of restraints, such as those used in mental health hospitals.
• A fear of wearing a blood pressure monitor or the arm belt a doctor uses to take blood.
• A fear of getting tangled or stuck in netting, ropes, string or webbing.

The fear and anxiety a person with merinthophobia experiences may be related to the fear of being trapped and unable to escape, a fear of being confined, a fear of being defenceless and a fear of being unable to breathe.

Even if the thing that is binding them is necessary to their health and safety or is required by law, such as wearing a seatbelt in a car or having their blood pressure checked by their doctor, the individual’s irrational fear of being tied up and bound can mean they refuse to engage in these practices, even if they are aware that their fear is irrational. This could result in extreme avoidance behaviours, such as refusing to travel in a car or on an aeroplane or avoiding visiting the doctor.

Merinthophobia can be related to and occur in conjunction with other phobias, including:

• Capiophobia: An extreme fear of getting arrested.
• Cleithrophobia: An extreme fear of being trapped.
• Thanatophobia: An extreme fear of dying.
• Claustrophobia: An extreme fear of confined spaces.
• Coasterphobia: An extreme fear of roller coasters.
• Aerophobia: An extreme fear of flying. (link to aerophobia article when published).

How common is merinthophobia?

Merinthophobia is not as well-known and frequently diagnosed as other phobias. Negative thoughts and emotions about being restrained can 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.

There are no accurate statistics available that show how many people experience merinthophobia. In fact, merinthophobia is one of the least well-known specific phobias. If people are not aware of merinthophobia, they may not be aware that they are experiencing a phobia. This could make it unlikely that they ever seek a diagnosis, making merinthophobia one of the least diagnosed specific phobias.

It is thought that less than 1% of the population has merinthophobia, although these figures may not be accurate as people with the condition often do not receive a formal diagnosis.

Who is at risk of merinthophobia?

Although anyone can develop merinthophobia, there are certain risk factors that can increase the likelihood of you developing a fear of being tied up.

These can include:

• Having another related phobia, such as claustrophobia or cleithrophobia.
• Having a history of anxiety, depression, panic attacks or another relevant mental health disorder.
• Having a close family member, such as a parent or sibling, with merinthophobia.
• Having a close family member, such as a parent or sibling, with another phobia.
• Being exposed to the fear of being tied up during childhood or adolescence.
• Having a negative, scary or traumatic experience involving being tied up or bound.
• Experiencing physical, mental or sexual assault or abuse, bullying or violence.
• Being a naturally more anxious or fearful person.
• Experiencing high levels of stress or a significant life stressor.
• Having a substance use disorder.

However, just because you have one or more of the above risk factors, this does not necessarily mean that you will develop merinthophobia. Some people with this phobia have no risk factors and cannot associate their phobia with a specific source.

Other people may have several risk factors but never develop merinthophobia; for example, even if you have a previous scary experience involving being tied up and you have an anxiety disorder, you may not develop merinthophobia.

How to deal with merinthophobia

Many people with merinthophobia think that the best way to deal with their phobia and reduce the likelihood of them experiencing symptoms is to avoid being tied up or bound and any objects, places or situations which could result in them being tied up. However, although avoidance behaviours may seem like they are effective, it may not be possible to avoid your triggers at all times.

Failure to address your phobia could result in your symptoms becoming more severe in the future. If you haven’t learned any coping strategies, this could result in a more severe phobic reaction, which could be particularly problematic if a situation arises in the future where you need to be restrained in some way, or if you see triggering objects, such as a rope or handcuffs.

Coping strategies can help you to reduce and alleviate the symptoms of your merinthophobia and reduce the impact it has on your day-to-day life and overall wellbeing. They can also help you to reduce avoidance behaviours and manage your phobia more successfully.

Some long-term and short-term coping strategies you can implement include:

• Learn about your phobia
  Thinking about what initially caused your phobia and what your triggers are can help you to understand your phobia and rationalise your thoughts and emotions. This can help you to manage your symptoms more effectively.
• Educate yourself
  Learning about triggering objects and situations can help you to view them as less of a threat and less dangerous. This can help you to feel more comfortable and less fearful. Many triggering objects are statistically highly unlikely to harm you and instead may be beneficial to you. Focusing on information such as why seatbelts are necessary and how few people are harmed or injured from being tied up can help you to rationalise your thoughts and disrupt your negative thought patterns.
• Create a fear ladder
  A fear ladder can help you to analyse your phobia and determine whether certain scenarios or objects related to being tied up create more severe fear and anxiety than others. A fear ladder organises your triggers from least severe to most severe.For example, your fear ladder can look like this:– 1 = Being tied up with a rope or a similar object.
  – 2 = Getting arrested and put into handcuffs.
  – 3 = Being restrained by a lap bar or safety harness.
  – 4 = Wearing a seat belt in a car or on an aeroplane.
  – 5 = Watching a video, film or TV show where someone is tied up.
  – 6 = Touching objects that you associate with being tied up or bound, such as a rope or chains.
  Once you have created your fear ladder, you can then tackle your triggers one at a time, starting at the bottom of the ladder (the situation that results in the lowest phobic response). This can help you to build up the tolerance of your triggers gradually.
• Challenge negative thoughts
  Negative thoughts can exacerbate your symptoms and worsen your phobia. Remind yourself that the risks are minimal and that you are not in danger. If you begin to experience symptoms of merinthophobia, remind yourself that the feelings will soon pass and that your fear is irrational.
• Implement distraction techniques
  If you are in a triggering situation or need to be restrained in some way, implementing distraction techniques can help to reduce your physiological and psychological responses to your trigger. Some distraction techniques you could implement include listening to music, engaging in conversation, reading, playing a game or focusing on something external, such as other people.
• Implement visualisation techniques
  Visualisation has been found to be an effective coping strategy for reducing the symptoms of phobias. When faced with your trigger, visualising a place or memory that keeps you calm or elicits positive emotions can help to alleviate your symptoms.
• Practise deep breathing techniques
  Deep breathing is an effective way of lowering stress and relieving tension in your body. This is because it sends a message to your brain to relax and calm down. It can help to reduce anxiety and can help you to control your nervous system, which is central to your phobic responses.
• Practise yoga, meditation or mindfulness
  Yoga, meditation and mindfulness teach you how to control your breathing and your body’s physiological responses. The skills you learn can help you to feel more in control and calm and help to reduce the physiological and psychological responses you may have when faced with your triggers.
• Implement lifestyle changes
  Phobias can be made worse by factors such as lack of sleep and excessive stress. Take steps to reduce stress in your everyday life, eat a healthier, more balanced diet, exercise regularly and ensure you have a good sleep routine. These lifestyle changes can help to reduce the symptoms of your phobia long term. This is because these lifestyle factors can impact your anxiety levels, your stress levels and your feelings of depression. Avoiding caffeine, sugar and other stimulants can also be beneficial, as these can increase your heart rate and blood pressure and worsen your physiological symptoms.
• Avoid negative stories
  Reading or listening to frightening or negative stories about someone being tied up or watching negative stories on the news, for example about a kidnapping, can worsen your phobia and reinforce your negative thought patterns. Avoid negative stories to prevent your phobia from worsening.

What triggers merinthophobia?

Merinthophobia can have different triggers for different people. Your triggers can vary, depending on what initially caused you to develop a phobia, your perception of danger, the severity of your symptoms and your current mental health and mindset.

Some of the most common merinthophobia triggers are:

• Being tied up or bound or feeling like you are about to be tied up.
• Seeing objects that are commonly used to bind people, such as rope, string, netting, cords, zip ties, wire, thread, tape or chains.
• Feeling restrained by necessary objects, such as seatbelts.
• Being told that you need to be bound, tied up or restrained.
• Getting arrested.
• Seeing a picture or video of someone being tied up.
• Seeing an escape artist, an illusionist or another performer who is tied up and has to escape.
• Hearing stories about someone being kidnapped and tied up.
• Hearing a sound you associate with being tied up, such as the closing of zip ties.

What are the symptoms of merinthophobia?

The symptoms of merinthophobia can differ from person to person and situation to situation. It may be that some situations create a stronger phobic response than others. For example, you may experience more severe symptoms if someone approaches you with a rope, compared to seeing a picture of someone else being tied up.

In some situations, your symptoms may be mild, and you may be able to effectively manage them. At other times, your symptoms can be more severe and can be similar to the symptoms of anxiety or panic attacks, which can be overwhelming, difficult to manage and have a serious impact on your wellbeing.

Your triggers and the proximity and danger you associate with the perceived threat can affect the severity of your symptoms. The severity of your symptoms can also change depending on your current mental health and overall wellbeing and the effectiveness of your coping strategies.

The symptoms of merinthophobia can be both physiological and psychological and can include:

Physiological Symptoms:

• Increased heart rate, heart palpitations or feeling like your heart is pounding.
• Increased rate of breathing, shortness of breath, difficulty breathing or hyperventilating.
• Increased blood pressure.
• Muscle tension.
• Trembling or shaking.
• Excessive sweating.
• Feeling dizzy or light-headed.
• Chills, hot flushes, unusual paleness or redness in your face.
• Nausea, vomiting or stomach distress.
• A dry mouth.
• A choking sensation, feeling like you are unable to swallow or like something is stuck in your throat.
• Insomnia or difficulty sleeping (particularly in the lead-up to being restrained or when thinking about being restrained).
• A loss of appetite.
• Numbness or tingling, particularly in your extremities.
• Unusual or severe headaches.

Psychological Symptoms:

• Intense feelings of fear, anxiety or panic.
• Avoiding being tied up or bound, objects that could be used to tie you up or any place or situation where you could be restrained.
• Feeling defenceless.
• Feeling like you have lost control or are going to lose control.
• Feeling like you are trapped and cannot escape.
• Feeling like you want to run away.
• Feeling confused or disoriented.
• Feelings of irritability.
• Feeling detached from reality.
• Experiencing anticipatory anxiety.
• An inability to function normally when faced with your triggers.
• An inability to control your fear, panic or anxiety, even if you are aware that they are out of proportion to the threat.
• A sense of impending doom.
• Feeling like you are going to die.

What causes merinthophobia?

There is not one specific cause of merinthophobia. Instead, there are several reasons why someone might develop merinthophobia. It could be that your phobia has one single cause or that multiple factors contributed to you developing a phobia of being bound or tied up.

Some of the most common causes of merinthophobia are:

• A traumatic experience involving being tied up
  Traumatic events that occurred either accidentally or on purpose could result in you developing merinthophobia, particularly if this experience occurred during childhood or adolescence. If you were tied up and felt fear, pain or anxiety or tried to escape and couldn’t, this could create trauma and could result in you developing merinthophobia. This experience could be direct, meaning it happened to you, or indirect, meaning you witnessed the experience happening to someone else.
• Fear rumination
  Fear rumination is when you engage in a repetitive negative thought process and persistently and repetitively recap a negative experience where you were restrained or think about being tied up in a negative way. Over time, these memories can become increasingly distressing and intrusive and can make you remember being tied up as being more painful and scary than it actually was. Fear rumination reinforces your fear responses and can result in you developing a phobia.
• A learned phobia
  Phobias can be learned in what is known as an observational learning experience. This is more likely to happen if you are exposed to merinthophobia during childhood or adolescence. A family history of merinthophobia increases the likelihood of you developing the same fear.
• Previously experiencing sexual or physical assault, rape or violence
  A traumatic experience such as assault or rape, whether in childhood or adulthood, can result in a person developing merinthophobia. The traumatic experience can result in a fear of losing control, being unable to escape and a fear of being defenceless.
• Exposure to information that scares you
  An informational learning experience can happen if you are exposed to information about being tied up that scares you. For example, learning facts about deaths or accidents that occur when someone is restrained or tied up or information about knots that are difficult to escape from can cause you to associate being restrained with fear and danger, which can develop into a phobia.
• Media portrayal
  There are a huge variety of negative or traumatic stories portrayed in the media that involve someone being restrained or unable to escape. This includes the death of George Floyd while in handcuffs, serial killers that tied up their victims and even crashes that have occurred involving aeroplanes, cars or rollercoasters. It can be impossible to avoid the traumatic stories, pictures and videos that are shown in the media, and this can contribute to someone developing merinthophobia.
• Significant stress
  Significant, long-term stress can result in a disproportionate fear response or an inability to manage intense situations. This can make it more likely that you will develop a phobia. A stressful and distressing event, such as a death, can also trigger a phobia, as people may be less able to manage their emotions and thought processes when experiencing grief.

How is merinthophobia diagnosed?

Merinthophobia is not a frequently diagnosed phobia. Many people are unaware of merinthophobia, meaning they may be unaware of the characteristics, symptoms and triggers typically associated with merinthophobia. This could mean that many people with a phobia of being tied up or bound may not realise they are experiencing a phobia and may never seek a diagnosis.

Because being tied up often has negative connotations, with it often being associated with being trapped, kidnapped, held ransom or imprisoned, you may think that experiencing fear, anxiety or panic when thinking about or facing being tied up is normal.

However, your fear of being tied up may classify as a phobia if it:

• Impedes your ability to function in your everyday life.
• Has a negative impact on your quality of life.
• Causes you to avoid certain situations or places.
• Has a negative impact on your mental health or wellbeing.
• Occurs even if there is minimal to no risk or danger involved.
• Occurs when you are faced with your triggers directly or indirectly.

If you think you may be experiencing merinthophobia, you should first visit your GP. Your GP will look at your medical history, including whether you have previously experienced an anxiety disorder, panic disorder or another phobia or extreme fear and any other medical conditions you are diagnosed with, including other mental health conditions.

Your GP will also ask about any medications or supplements you take to ensure your symptoms cannot be attributed to anything else. Your GP may also ask whether you have a family history of phobias.

If your GP thinks you may be experiencing merinthophobia, they may then refer you to a psychologist or another mental health professional.

The psychologist will conduct a phobia questionnaire and a psychological evaluation and ask questions about:

• What triggers your fear or anxiety.
• The type of symptoms you experience.
• The frequency and severity of your symptoms.
• How much your phobia interferes with your everyday life.
• When your phobia began and what caused the onset of symptoms.

When conducting your evaluation, the psychologist will compare your symptoms to the diagnostic criteria for specific phobias. A specific phobia is a lasting, overwhelming and unreasonable fear of a specific object, situation, activity or person, in this case, an overwhelming fear of being tied up or bound.

To receive a diagnosis of merinthophobia, your symptoms must fit into the seven key criteria listed below:

1. The fear must be persistent, excessive and unreasonable. It can occur either when you are being tied up or restrained or when you are not, for example, if you see an object typically used to bind people or you see a video of someone being tied up.

2. Exposure to your triggers 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, situations or objects where you could be tied up, bound or restrained. If you encounter a trigger, you will experience extreme fear, anxiety or distress.

5. The anticipation of being tied up or restrained and the avoidance behaviours you may implement 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 merinthophobia. Depending on the severity of your phobia, you may be offered treatment.

How is merinthophobia treated?

There are several different treatment options for merinthophobia. Once you receive a diagnosis of merinthophobia, your GP or psychologist will discuss your different treatment options and determine the best treatment plan for your phobia.

The best type of treatment for you will depend on:

• The frequency and severity of your symptoms.
• The root cause of your phobia.
• How significantly your phobia impacts your life.
• Your overall health and wellbeing, including your mental health.

Some people with merinthophobia may not require formal treatment. This could be because their phobia doesn’t have a significant impact on their day-to-day life or their wellbeing or they have learned and implemented effective coping strategies which reduce the need for formal treatment.

If your symptoms are severe or occur frequently or your phobia negatively impacts your life, treatment may be recommended. In this case, your doctor will create a treatment plan that is personalised to you.

The most common types of treatments for merinthophobia are:

Exposure Therapy:

Also known as systematic desensitisation, exposure therapy is one of the most common treatment options for merinthophobia. In a safe controlled environment, you will be exposed to your fear and your triggers in a systematic way over a period of time.

Being exposed to your fear gradually in a safe environment allows you to feel safe and in control. During your sessions, you may be asked to create a fear ladder of situations, places, objects and triggers to determine which causes the biggest phobic response. The psychologist will then create a collection of exposures for you to face.

The exposure will be gradual and once you are comfortable with each level of exposure, you will then progress to the next level of exposure. You may be encouraged to look at pictures, watch videos, use virtual reality (VR), handle objects typically used for tying people up and may even be (safely and ethically) encouraged to be restrained or tie yourself up.

Exposure therapy can address the negative thoughts and emotions you experience in relation to being tied up or bound and can help you to change your physiological and psychological responses.

Cognitive Behavioural Therapy (CBT):

Cognitive behavioural therapy (CBT) is another popular treatment option for merinthophobia. It can help you explore and understand why you think, feel and behave the way you do when faced with your triggers.

CBT is a type of talking therapy that can be done individually or as part of group sessions with other people with merinthophobia. It can help you to address any harmful, flawed or negative thought patterns associated with your phobia and address the feelings and behaviours you experience and exhibit in relation to your triggers.

As part of your CBT sessions you will:

• Discuss your triggers and symptoms.
• Explore the root cause of your merinthophobia.
• 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 uses guided relaxation techniques and focused attention to help you to identify the root cause of your fear and help you change your thought patterns and any negative feelings you have about being tied up or bound, thus reducing your physiological and psychological reactions to your triggers.

Hypnotherapy sessions often involve the therapist putting you into a relaxed, hypnotic state. A combination of techniques will then be used to re-pattern your negative thoughts and memories. Hypnotherapy 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:

Although medication is not a common treatment option for someone with a phobia, it may be recommended if other treatment options fail, if your phobia is particularly severe or whilst you are waiting for psychotherapy to work. You may also be prescribed medication if you experience anxiety or depression alongside your phobia.

Some medications that may be used to treat merinthophobia include:

• Anti-anxiety medication: These can be used to prevent a panic attack or if you experience anxiety as part of or alongside your phobia.
• Anti-depressants: Antidepressants may also be prescribed to people who are experiencing depression, anxiety or low mood alongside their phobia.