What is Catoptrophobia?

Catoptrophobia is an extreme and overwhelming fear of mirrors. Although this is a relatively unknown phobia, with few diagnoses in the UK, a phobia of mirrors can be extremely debilitating and have a significant impact on someone’s day-to-day life and their well-being.

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

What is catoptrophobia?

Catoptrophobia is the extreme, irrational, overwhelming and persistent fear of mirrors. Also commonly known as spectrophobia or eisoptrophobia, a phobia of mirrors is a type of specific phobia which is characterised by an enduring, overwhelming and irrational fear of a specific object, situation, place or person; in this case, an extreme fear of mirrors. Catoptrophobia is also a type of anxiety disorder.

Someone with catoptrophobia will have an abnormal and irrational fear of mirrors that results in fear, anxiety, panic and distress if they see a mirror or think about seeing a mirror. Negative thoughts and feelings are likely to be further exacerbated if they see their own reflection in the mirror.

The negative thoughts and feelings associated with mirrors are likely to be overwhelming and can have a significant impact on a person’s day-to-day life, their mental and emotional health and their overall well-being. They may also experience anticipatory anxiety in the lead-up to situations where they could encounter a mirror.

Catoptrophobia is a highly individualised phobia that manifests differently in different people. It can be connected to several specific fears relating to mirrors, such as:

• Self-image issues – In the majority of cases, a phobia of mirrors is connected to body image issues, which are perpetuated by excessive self-criticism and the need to conform to unhealthy beauty standards held in society. An individual may begin refusing to look in the mirror in case they dislike their own reflection. Their low self-esteem or distorted body image may cause them to excessively criticise their appearance and begin to find faults or flaws, even if these flaws don’t exist in reality; for example, they may look in the mirror and see themselves as being fat, even though they are a healthy weight in reality. The dislike of their own reflection can result in them avoiding mirrors to prevent the negative thoughts and feelings they know a mirror will create. Catoptrophobia often occurs alongside an eating disorder or body image issue.
• The fear of objects being distorted in the mirror – Many objects can appear distorted in a mirror, particularly if they are being viewed from an angle or the mirror is magnifying the image. There are also special mirrors, often found in places such as funhouses or fairs, that purposefully distort reflections, for example, by making images appear elongated or squashed. Seeing something that is different to reality can provoke fear or anxiety in some people.
• The fear that mirrors are connected to the supernatural – Mirrors have long been connected to the supernatural, with many stories being widely known that have created an association between mirrors and supernatural beings, for example:
  – Vampires and witches have no reflection as they have no soul.
  – Speaking Bloody Mary’s name into a mirror a specific number of times summons her bloody ghost.
  – Mirrors attract malevolent spirits.
  – Demons can enter the human world through mirrors.
  Being aware of and fearing the supernatural can result in someone avoiding any connection to the supernatural. Mirrors in particular are portrayed negatively, often as a way for supernatural beings to attack you or reveal themselves.
• Myths and superstitions relating to mirrors – There are many myths and superstitions connected to mirrors; some well-known examples are:
  – That a person’s soul can become trapped in a mirror.
  – If a corpse is carried past a mirror, they instantly become a ghost.
  – If you see the reflection of someone who has died, you will be the next to die.
  – If you break a mirror you will receive seven years of bad luck.
  – Sleeping opposite a mirror causes your negative energy to be reflected back at you.
  The many negative superstitions that are attached to mirrors can promote the idea that mirrors are evil, supernatural or dangerous items that can bring harm to a person or their home.

Mirrors are found on a variety of objects and in a variety of places and situations. This can make functioning normally in everyday life very difficult for someone with catoptrophobia. For example, they may be unable to travel by car, because of the multiple mirrors found in cars.

They may even have difficulties in medical settings, as mirrors are often found in a GP’s office, in dental surgeries and in opticians. Some people with catoptrophobia may only fear actual mirrors, whereas other people fear any mirrored objects that show their reflection.

Although disliking mirrors isn’t uncommon and some people avoid mirrors because of superstition or body image issues, this doesn’t mean that everyone who dislikes mirrors is experiencing a phobia.

To be classified as a phobia, your fear of mirrors will include:

• Feelings of intense fear, panic or anxiety that are difficult to manage.
• Fear or anxiety that is out of proportion to the true risk.
• A fear of mirrors that lasts for at least six months.
• Engaging in avoidance behaviours to prevent encounters with mirrors.
• A fear of mirrors that interferes with your day-to-day life, overall well-being or sense of safety.
• Experiencing anticipatory anxiety or worry when thinking about seeing a mirror.

Someone with catoptrophobia may experience difficulties functioning normally or concentrating in certain places or situations because of the fear that they could encounter a mirror. For example, they may find it difficult to walk down the street in case they see a mirror on a car or be unable to go into a shop because of the likelihood that a mirror is present.

They could become consumed with the thought of mirrors and find themselves constantly looking around them to check there are no mirrors close by or that they cannot see their reflection. The fear, anxiety and panic that they feel can have a significant impact on their mental and emotional well-being and their behaviour.

If you have catoptrophobia, the fear and anxiety you feel if you see a mirror can result in avoidance behaviours, whereby you go to extreme lengths to avoid mirrors and places and situations where you could encounter a mirror.

For example, you may refuse to go close to cars, go into shops and cafes and enter other people’s homes. However, because mirrors and mirrored objects are extremely common and are used for both functional and decorative purposes, it can be extremely difficult to avoid mirrors completely.

Avoidance behaviours can also negatively impact your life and make it difficult for you to perform everyday tasks or function normally in society. Although avoidance behaviours are designed to help you avoid mirrors and prevent you from experiencing negative thoughts and feelings and adverse symptoms, they can actually have a paradoxical effect and instead reinforce your fear and result in more severe symptoms in the future.

Avoidance behaviours can also negatively impact your social life and professional life, your relationships and your ability to function normally.

Someone with catoptrophobia may be aware that their fear of mirrors is irrational and that mirrors don’t actually pose a risk to them. However, they may still find that they are unable to control their fear or anxiety and are unable to manage or prevent their psychological, behavioural or physiological responses to mirrors.

Catoptrophobia is connected to and can occur in conjunction with other phobias, such as:

• Atelophobia: An extreme fear of imperfection.
• Cacophobia: An extreme fear of ugly things or looking ugly.
• Obesophobia: An extreme fear of gaining weight.
• Demonophobia: An extreme fear of evil supernatural beings.
• Phasmophobia: An extreme fear of ghosts.

Because of the association with body image, catoptrophobia may also be more likely to occur in people with eating disorders or body image disorders.

Such as:

• Anorexia Nervosa: A type of eating disorder that is characterised by abnormally low body weight, an extreme fear of gaining weight, restrictive eating and body image disturbance.
• Bulimia Nervosa: A type of eating disorder that includes a pattern of eating characterised by binge eating followed by purging (making yourself vomit or taking laxatives) to prevent weight gain.
• Body Dysmorphic Disorder (BDD): A mental health condition involving excessive worrying or obsessing about your perceived defects or flaws (which are often not noticeable to others).

How common is catoptrophobia?

Because catoptrophobia is a type of specific phobia, any diagnoses of this condition will fall under the specific phobia umbrella. This means there are no individual statistics available that show how many people have a phobia of mirrors.

Approximately 5 million people in the UK are diagnosed with a specific phobia and there are currently more than 400 specific phobias. However, it is thought that many specific phobias, including catoptrophobia, go undiagnosed and that the true figures could be significantly higher than 5 million.

There are many possible reasons why individuals experiencing a phobia of mirrors never receive a diagnosis, such as:

• Many people have never heard of catoptrophobia so someone who has a phobia of mirrors may not realise they are experiencing a diagnosable medical condition.
• Many people are unaware that there are effective treatment options available for phobias, including catoptrophobia.
• If the individual experiencing catoptrophobia is an adolescent (the most common age for developing this phobia) they may not inform adults around them of their phobia or they may be expected to grow out of it.
• Someone with this phobia may not discuss their thoughts and feelings with others so may not realise that what they are experiencing is abnormal.
• Someone with this phobia may successfully implement avoidance behaviours which minimise their contact with mirrors, making their phobia easier to ignore.
• Someone with catoptrophobia may be embarrassed about their negative thoughts and feelings so may not want to tell their doctor.
• This phobia may occur alongside another condition, such as an eating disorder, and the symptoms may be misinterpreted as symptoms of another condition.

It is also important to consider that not everyone who dislikes or avoids looking in mirrors is experiencing catoptrophobia.

Negative thoughts and feelings concerning mirrors and your reflection can occur on a spectrum, ranging from mild anxiety to severe fear, panic and anxiety that can impact your day-to-day life, affect your decision-making and result in changes in your behaviour. It can sometimes be difficult to differentiate between a dislike of mirrors and a phobia of mirrors.

Who is at risk of catoptrophobia?

Although anyone can develop catoptrophobia, there are certain risk factors that can increase the likelihood of someone developing a fear of mirrors, such as:

• Having an eating disorder, such as anorexia nervosa or bulimia nervosa.
• Having another mental health condition relating to the way you look, such as body dysmorphic disorder.
• Having another related phobia, such as obesophobia or atelophobia.
• Having an obsessive compulsive disorder (OCD), an anxiety disorder or another mental health condition.
• Having an unhealthy body image or being exposed to an unhealthy body image at a young age.
• Having low self-esteem.
• Having a previous negative, traumatic or scary experience involving mirrors.
• Believing in superstitions relating to mirrors.
• Having a close family member, for example, a parent or sibling, with catoptrophobia.
• Having a close family member, for example, a parent or sibling, with another phobia.
• Currently or previously being a victim of physical, sexual or emotional abuse or assault or bullying.
• Being exposed to catoptrophobia during childhood or adolescence.
• Going through a significant life stressor, having higher than usual stress levels or being in a heightened mental state (particularly if you are exposed to the fear of mirrors or have a negative experience involving mirrors during this time).
• Having a substance use disorder, such as an addiction to drugs or alcohol.

It is important to note that although the risk factors listed above can increase the likelihood that someone could develop catoptrophobia, they do not guarantee this. Someone with none of the above risk factors may develop a phobia of mirrors unexpectedly, whereas someone with several risk factors may never develop catoptrophobia.

Although catoptrophobia can develop at any age, it may be more prevalent in adolescents. This could be because diagnoses of eating disorders and other related mental health conditions are higher in adolescence.

Catoptrophobia is also more prevalent in females, compared to males. However, as with any mental health condition, it is dangerous to think that catoptrophobia is associated with one particular gender or age group, as mental health difficulties do not discriminate and can affect people of all ages, genders and backgrounds.

How to deal with catoptrophobia

Although medical treatments have proven to be extremely effective in treating specific phobias, such as catoptrophobia, there are certain coping and calming strategies you can implement to help you successfully manage your phobia and the symptoms of your phobia.

These coping and calming strategies can be combined with lifestyle changes to help reduce negative thought patterns related to mirrors, and any connected behaviours, alleviate the symptoms of your phobia and reduce the impact your fear has on your mental health and well-being.

Some of the strategies are most effective when they are implemented long term. This means you should engage in them regularly and incorporate them into your daily or weekly routine. Long-term strategies can help to reduce the frequency and severity of your phobia symptoms over time and reduce the likelihood that encountering a trigger or gaining weight will result in a negative response.

Other strategies are most effective when used in triggering situations, or when you can feel the symptoms of your phobia beginning. These are known as short-term strategies and minimise or prevent any physiological, psychological or behavioural symptoms and prevent an anxiety-inducing situation from escalating.

Some of the long-term and short-term coping and calming strategies you can implement to help you deal with your phobia of mirrors are:

• Understand your phobia – Thinking about your phobia in more detail, particularly the root cause, your triggers and your symptoms, can help you to successfully address the root cause of your fear and any negative patterns of thought, beliefs, feelings and behaviours that are attached to your fear. By rationalising and understanding your phobia, you can reduce your automatic fear response, and reduce the frequency and severity of your symptoms.
• Desensitisation – Desensitisation draws on aspects of exposure therapy. The process involves gradually exposing yourself to mirrors and other things that trigger your fear or anxiety. The more exposure you get the less intense your automatic fear response will be, meaning you will be less likely to experience negative symptoms if you see a mirror. This can reduce the impact your phobia has on your day-to-day life. Ensure desensitisation happens gradually in an environment where you feel calm and safe.
• Visualise yourself overcoming your fear – You can utilise visualisation techniques to help you overcome your mirror phobia by imagining yourself successfully confronting and overcoming your fear and anxiety. You can do this by visualising situations that you find triggering, such as looking in a mirror, and imagining how you would successfully overcome your anxiety. Positively visualising encounters with mirrors can help to reassure your brain that mirrors don’t pose a threat to you and make it less likely that you will experience an automatic fear response.
• Join a support group – In order to deal with your phobia, you can join a support group where other people have gone through the same experiences as you. Support groups are usually led by experts and are comprised of people who have faced or overcome similar challenges. As well as providing you with information and advice, the sessions can validate your thoughts and feelings and provide reassurance and empathy. You can choose from in-person or online support groups.
• Create a support network – Finding support from people you trust and who care about you can be a great way of helping you deal with your phobia. Being aware of your phobia also ensures that people around you are more conscious of your fear and don’t accidentally trigger your anxiety. Having a support network also gives you someone to talk to and lean on if you are struggling. Your support network could be made up of your family, your friends, your colleagues or anyone else you trust.
• Create a fear ladder – A fear ladder can help you to analyse and understand your fear of mirrors and can also help you to identify which of your triggers creates more severe fear, anxiety and panic than others. When creating your fear ladder, your triggers will be organised from least severe to most severe. Because phobias are highly individualised, everyone’s fear ladder is different. Although your fear ladder may look different, an example is shown below:
  – 1 = Looking directly in a mirror.
  – 2 = Being in the same room as a mirror.
  – 3 = Being in the same house or building as a mirror.
  – 4 = Seeing a mirror reflecting in the distance.
  – 5 = Watching a film or TV show about mirrors.
  – 6 = Looking at a picture of a mirror.
  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 mirrors long term.
• Challenge negative thoughts and feelings – You may find yourself constantly thinking about mirrors or considering what will happen if you look in a mirror. If you find yourself thinking about mirrors negatively or experiencing negative emotions, try to disrupt your thoughts and feelings to prevent your fear from escalating. Remind yourself that mirrors don’t pose a risk to you and that your fear is unfounded. If you begin to experience negative symptoms, remind yourself that the feelings will soon pass and that your fear is disproportionate.
• Avoid negative superstitions or negative portrayals of mirrors – Negative superstitions and supernatural beliefs and negative portrayals of mirrors, for example, in a horror film, can reinforce your fear and validate any negative beliefs and negative thoughts you have already attached to mirrors. They can also result in you becoming hyperaware or paranoid that there is a mirror somewhere nearby or that something bad is going to happen if you see a mirror. This can exacerbate your phobia and result in more severe phobic symptoms. Try to avoid any triggering portrayals or superstitions about mirrors to prevent your phobia from escalating.
• Practise mindfulness – Mindfulness is an effective calming strategy for a number of mental health difficulties, including phobias. Mindfulness teaches you how to focus your breathing and attention and reduce your chances of experiencing high levels of anxiety or a panic attack if you see a reflection in a mirror or are faced with your triggers. In addition to managing stress and anxiety, mindfulness can help you explore the connection between mind and body, as well as reduce the impact of the symptoms of catoptrophobia.
• Practise yoga and meditation – People who practise yoga and meditation consistently can achieve a meditative state of mind that can help manage the symptoms of catoptrophobia. The practice of yoga and meditation helps you achieve a highly relaxed state and decreases your stress levels, which reduces your chances of being in a fight-or-flight situation. You can also learn how to control your breathing and manage your body’s negative reactions to your triggers. Daily practice can help reduce the impact of your phobia and improve your symptoms over time.
• Practise deep breathing exercises – Stress levels can be reduced, tensions in the body can be relieved, and anxiety and panic can be reduced through deep breathing. The act of deep breathing sends a signal to your brain to relax and calm down. In addition, it can help you control your nervous system, which controls your phobic responses. Regularly practise deep breathing and use the strategies you have learned when you are faced with your triggers in the future.
• Make lifestyle changes – Lifestyle factors such as lack of sleep, high levels of stress and a poor diet can exacerbate the symptoms of your phobia and increase your anxiety. By making lifestyle changes, you can reduce the impact your phobia of mirrors has on your life. Some lifestyle changes you can make include:
  – Implement a successful sleep routine.
  – Reduce your daily stress.
  – Eat a healthy, balanced diet.
  – Implement an exercise routine.
  – Avoid caffeine, sugar and other stimulants.
  – Avoid alcohol and recreational drugs.
  – Stop smoking.

What triggers catoptrophobia?

A trigger, also known as a stressor, is an object, person, place, situation or thought that triggers an adverse reaction and negative thoughts and feelings, such as fear, panic, anxiety or distress. A trigger can also lead to physiological, behavioural and other psychological symptoms. Your brain perceives triggers as a threat to your physical or mental safety or well-being and will react accordingly.

Because catoptrophobia is an individualised condition, it can manifest differently in different people. Different objects, places and situations can act as triggers for catoptrophobia, and the triggers can vary from person to person. Some people only have one or two triggers, whereas other people have many different triggers.

The types of triggers and the number of triggers experienced by different people can vary depending on what initially caused their phobia of mirrors to develop, their perception of the potential risk, the severity of their symptoms and their current mindset and mental health.

The most common triggers for people with catoptrophobia are:

• Seeing your own reflection in a mirror.
• Seeing a reflection of something else in a mirror.
• Seeing a reflection in another type of mirrored object.
• Seeing a body of water or another reflective surface.
• Seeing a mirror from a distance, even if you cannot see any reflection.
• Seeing something that typically has a mirror, such as a car or a make-up case.
• Going into a clothes shop or another place that typically has mirrors.
• Watching a film or TV show that features a mirror.
• Seeing a picture of a mirror.
• Thinking about a mirror or your own reflection.
• Remembering what your reflection looks like.
• Hearing a smashing sound.
• Talking about a mirror.
• Knowing you are in close proximity to a mirror, even if you cannot see it.
• Needing to buy new clothes.
• Going into someone else’s house.
• Driving a car.

What are the symptoms of catoptrophobia?

The symptoms of catoptrophobia are very varied and often differ significantly from person to person. The symptoms can differ in the way they manifest, their severity and the type of symptoms a person experiences. Some people with catoptrophobia only experience a few mild symptoms whereas other people experience more severe symptoms.

Some people also experience different symptoms in different situations. For example, you may experience more severe symptoms if you look directly into a mirror, compared to if you watch a film about a mirror. Differences in the severity of symptoms, how frequently they occur, and their manifestation can also occur for other reasons, such as how acute your phobia is, your triggers, your perception of the situation and your current mental health and mindset.

The symptoms of catoptrophobia can occur at any time, including when you encounter a mirror, if you think about or talk about a mirror, or if you anticipate seeing a mirror. The symptoms of phobias are often automatic and uncontrollable. It may feel like you are unable to control or manage your thoughts or feelings and that your phobia is taking over your body. To be classified as catoptrophobia, you will need to experience symptoms for a minimum of six months.

Symptoms of catoptrophobia can be physiological, psychological and behavioural. The most common symptoms of catoptrophobia are:

Psychological symptoms:

The psychological symptoms of catoptrophobia are the cognitive and emotional symptoms your experience as a result of your phobia.

The most common psychological symptoms of catoptrophobia are:

• Intense, overwhelming persistent, excessive and unreasonable fear, anxiety, panic or dread if you see a mirror or another reflective object.
• Feelings of fear, anxiety or panic that are out of proportion to the risks.
• Being unable to control your fear, anxiety or panic even if you are aware that they are out of proportion to the risk.
• Catastrophising what will happen if you see a mirror.
• Anticipatory anxiety in the lead-up to potentially triggering situations.
• Depersonalisation or derealisation (where you feel like you no longer understand what is happening around you or you have lost touch with reality).
• Feeling like you are immobilised or frozen by your fear.
• Feeling vulnerable or defenceless.
• Having difficulties concentrating or functioning normally in triggering situations.
• Feeling like you are losing control or are out of control.
• Experiencing frequent or distressing nightmares about mirrors.
• Feeling like you are in danger or having a sense of impending doom.
• Feeling like you are dying or are going to die.

Behavioural symptoms:

Behavioural symptoms refer to changes in your behaviour that occur as a result of your phobia. They are usually characterised as negative, damaging, unusual or abnormal behaviours that differ from your typical behaviour or from expected behaviour in society.

The most common behavioural symptoms of catoptrophobia are:

• Avoiding mirrors.
• Refusing to have any mirrors in your home and not buying objects that have mirrors already attached.
• Refusing to drive a car or travel in a car because of the need to use the car’s mirrors.
• Refusing to enter clothes shops and other places that commonly have mirrors.
• Refusing to seek medical help or treatment in case there are mirrors in the medical setting.
• Avoiding going to any new or unfamiliar places in case there are mirrors.
• Being unable to eat or having a lack of appetite during or in the lead-up to a potentially triggering situation.
• Difficulties sleeping or insomnia in the lead-up to a potentially triggering situation.
• Refusing to talk about or think about mirrors.
• Refusing to watch a TV show or film about mirrors.
• Feeling like you want to run away or hide if you see a mirror.
• Becoming socially withdrawn.

Physiological symptoms:

The physiological symptoms of catoptrophobia are the physical symptoms, physical disturbances or physical changes that you experience in your body as a result of your phobia. Because mirrors induce feelings of fear and anxiety in people with catoptrophobia, encountering a mirror can result in a fight-or-flight response.

This is an automatic physiological reaction where the perception of a threat or danger from mirrors results in a sudden release of hormones that activate your sympathetic nervous system. Your body then releases catecholamines, such as adrenaline and noradrenaline, to help you fight or flee from the perceived danger.

This can result in physiological symptoms such as increased heart rate and blood pressure, rapid breathing and muscle tension. When someone with catoptrophobia encounters a mirror, this can trick their brain into thinking they are in danger and can cause or worsen the symptoms of their phobia.

The most common physiological symptoms of catoptrophobia are:

• Feeling dizzy or lightheaded.
• Feeling confused or disorientated.
• Unusual or excessive sweating or clamminess.
• Trembling or shaking.
• Chills.
• Difficulties breathing, rapid breathing or hyperventilation.
• Feeling like you cannot catch your breath.
• A fast heart rate, heart palpitations or feeling like your heart is pounding.
• Elevated blood pressure.
• Chest pains or feeling like your chest is tight.
• Experiencing a choking sensation, finding it difficult to swallow or feeling like something is stuck in your throat.
• Stomach pain, nausea, vomiting or feeling like you need to go to the toilet.
• Feeling like you have butterflies in your stomach.
• Unusual headaches or other pains.
• Pins and needles, particularly in your hands, feet, arms or legs.
• A dry or sticky mouth.
• Feeling unusually or unexplainably tired or fatigued.
• Muscle tension or stiff muscles.
• An unusual sensitivity to hot or cold temperature or feeling unusually hot or cold.
• Having pale or flushed skin.
• Having a panic attack.

Some people with catoptrophobia only experience a few of these symptoms and may not experience symptoms from all three categories (psychological, behavioural and physiological). For example, they may feel fear and anxiety when they encounter mirrors but may not experience any physical symptoms of their phobia. Other people experience many different symptoms.

It is also possible to experience different types and severity of symptoms at different times, depending on the trigger. For example, you may experience physiological symptoms, such as a racing heart, shaking, breathing difficulties and panic attacks if you see your reflection in a mirror but not if you see a mirror on the TV.

Because a phobia of mirrors is so closely connected with body image, some people with catoptrophobia also show symptoms that are consistent with eating disorders or body image disorders. Because there is some cross-over between the symptoms of different conditions, it is recommended that you always seek the advice of your doctor or primary healthcare physician if you are experiencing any of the above symptoms.

What causes catoptrophobia?

There are many possible causes of catoptrophobia and, often, someone develops this phobia because of several different factors. It could also be that your phobia of mirrors has one clear cause that you can easily identify.

Other people find it difficult to pinpoint exactly when and why they began to fear mirrors and what contributed to them developing a phobia. This is particularly likely if your phobia of mirrors developed a long time ago, such as during childhood, or if your symptoms developed slowly over time.

Identifying the root cause or causes of your phobia can be extremely beneficial, as it allows you to address your initial triggers and any negative patterns of thought or feelings that are attached to your initial triggers. This can make it easier to manage your symptoms and reduce the impact your phobia has on your life.

The causes of catoptrophobia can be psychological, environmental, societal or genetic. The cause often varies from person to person.

The most common causes of catoptrophobia are:

• Societal pressure and beauty standards – People whose phobia of mirrors is connected to their self-image or body issues often report that society overfocusing on the importance of looking good and the societal pressure to be slim and attractive were major contributors to their issues surrounding looking at themselves. Society often discriminates against people who are overweight or don’t fit traditional beauty standards, whilst simultaneously celebrating people who are slim and attractive. The pressure to conform to size and beauty standards can come from the media, pop culture, social media, your family and friends and even yourself. If you feel like you are not conforming to these standards, or you dislike your own appearance, you may begin avoiding mirrors and your reflection, which can develop into catoptrophobia.
• Being in an industry or activity that focuses on image – Being involved in an activity or industry that focuses primarily on the way you look can be damaging and put a lot of pressure on someone to look perfect all the time. For example, modelling, competing in beauty pageants or bodybuilding, and acting or dancing on stage can all require you to be a specific size or look a specific way. People who engage in activities such as these are more likely to develop catoptrophobia or an eating disorder, particularly if they engage in them during childhood and adolescence. They may receive pressure from other people in the industry, their families and themselves. They may begin avoiding mirrors in case what they see doesn’t match up to what they believe is required of them and this can lead to catoptrophobia.
• Currently or previously experiencing sexual, physical or emotional abuse or violence – Someone who has been abused, assaulted or bullied (either physically, mentally or sexually) may go on to develop catoptrophobia and other body image issues for several reasons. They may feel ashamed of what happened to them and may feel unable to look at themselves or see any damage to their bodies, such as bruises. In some cases, catoptrophobia occurs alongside an eating disorder as the individual may be trying to regain control of their body.
• A negative, traumatic, painful or scary experience involving a mirror – Also known as traumatic conditioning or a direct learning experience, a previous traumatic experience involving a mirror is a common cause of catoptrophobia. The traumatic experience may or may not have involved real danger or risk. However, as long as the individual experienced significant fear, distress or trauma, this could have led to the development of a phobia. A traumatic experience is more likely to lead to a phobia if it happened during childhood or during a particularly vulnerable time in your life. Examples of traumatic experiences include:
  – A mirror falling on you and hurting you.
  – A mirror smashing close to you and scaring you.
  – Seeing a reflection or distortion in a mirror that scared you.
  – Encountering a scary mirror in a funhouse or haunted house.
  Following the traumatic experience, you may begin to have intrusive and negative thoughts or memories of the trauma and begin to avoid trauma-related triggers, for example, by avoiding mirrors. This can cause the fear or anxiety you felt at the time of the experience to linger or worsen and can lead to you developing a phobia.
• Superstitions and supernatural beliefs relating to mirrors – As mentioned earlier, there are multiple well-known superstitions and supernatural beliefs relating to mirrors, the vast majority of which are negative. Many of the superstitions are specifically designed to scare people (e.g. Bloody Mary) and have been around for a long time – in fact, the belief that smashing a mirror brings seven years of bad luck can be traced back to the ancient Romans! The negative stories and connotations that people learn about mirrors can cause them to think of mirrors as being scary, dangerous or evil. This can then develop into catoptrophobia.
• Fear rumination – This is a common cause of phobias and usually occurs following a negative encounter with a mirror or your reflection. Fear rumination involves engaging in repetitive negative thought processes and persistently and repeatedly recapping a traumatic, scary, negative or painful experience involving a mirror. Over time, these thoughts and memories can become increasingly upsetting and intrusive and can make you remember the event as being more negative or scary than it was in reality. Fear rumination reinforces your natural fear responses, creates additional anxiety and can result in you developing catoptrophobia.
• Negative portrayals of mirrors – There are many examples in popular culture where mirrors are depicted negatively or where superstitions and supernatural beliefs about mirrors are used to create feelings of fear, for example, in horror films. This includes depictions of demons or spirits coming out of mirrors or the audience seeing the reflection of an evil character in the mirror before they attack someone. Being exposed to these negative depictions, particularly during childhood and adolescence, can cause a person to attach negative connotations to mirrors and associate them with danger, death and fear.
• A learned phobia – Also known as an observational learning experience, a learned phobia usually means you observed a phobia of mirrors in another person and learnt to be scared of them yourself. You may have learnt to associate mirrors with fear, superstitions or danger or may have learnt that looking at yourself in a mirror can be stressful. You are more likely to learn a phobia if you are exposed to it during childhood or adolescence – children who grow up with a close family member, such as a parent or sibling, with catoptrophobia are more likely to develop the condition themselves. However, a learned phobia can also develop during adulthood.
• Experiencing significant or higher than usual stress levels – 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, such as catoptrophobia, particularly if you have a negative experience involving mirrors or are exposed to the fear of mirrors while experiencing higher levels of stress. A stressful or distressing event, such as a death, can also trigger a phobia, as you may be less able to manage your emotions and thought processes when experiencing grief, which can result in a disproportionate fear response to otherwise non-scary situations.

How is catoptrophobia diagnosed?

If you think you may be experiencing catoptrophobia, your first step should be to make an appointment with your GP. Because some of the symptoms of catoptrophobia are similar to other mental health conditions, you may be unsure whether you are experiencing a phobia of mirrors.

You should, therefore, ensure you see your GP if you experience:

• Fear, anxiety, panic or distress when looking in a mirror or thinking about looking in a mirror.
• Difficulties with self-image, self-confidence or an obsession with the way you look.
• Avoidance of mirrors or places or situations where you could encounter mirrors.
• An obsession with superstitions or supernatural beliefs relating to mirrors.

Your GP will ask questions about your symptoms and look at your medical history, including whether you have previously experienced a phobia, a mental health condition, an eating disorder or a body image disorder. They may also ask about any medications or supplements you take to ensure your symptoms cannot be attributed to another source. If your GP thinks you could be experiencing catoptrophobia, they will refer you to a psychologist or another mental health professional.

To gain more insight into the symptoms you experience and your thoughts and feelings surrounding mirrors, the psychologist will conduct a phobia questionnaire.

 They will also ask for information about your phobia of mirrors, such as:

• The type of symptoms you experience, how frequently they occur and how severe they are.
• The initial onset of your phobia, including when your symptoms first began and what initially triggered your fear of mirrors.
• Your medical history, including whether you are currently or have previously had any anxiety disorders, panic disorders, phobias or other mental health conditions.
• Whether you have a family history of phobias.
• How much your fear interferes with your day-to-day life, your well-being and your behaviour.

Because catoptrophobia is a type of specific phobia, in order to make a diagnosis, your symptoms will be compared to the seven key criteria listed in the diagnostic criteria for specific phobias.

1. The fear must be persistent, excessive and unreasonable. It can occur either when the individual is close to a mirror or when they are not.
2. Exposure to a mirror or another 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 the individual.
4. The individual avoids places or situations where they could be exposed to a mirror. If they are exposed to a mirror, the individual will experience extreme fear, anxiety or distress.
5. The anticipation of encountering a mirror and the avoidance behaviours associated with avoiding mirrors can have a significant impact on the individual’s 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 a phobia, specifically catoptrophobia. Depending on the severity of your symptoms, you may be offered treatment.

How is catoptrophobia treated?

There are multiple treatment options that are effective in treating catoptrophobia. However, not everyone with a phobia requires treatment. If your symptoms are mild, your fear of mirrors doesn’t impact your daily life or well-being or you have already implemented successful coping strategies, then formal treatment may not be required. However, you should always consult your doctor before making any treatment decisions.

However, many people with phobias find medical intervention to be successful. Treatments for specific phobias work successfully in approximately 90% of cases. If your phobia is frequently triggered, if you find yourself changing your behaviour to avoid mirrors, if your symptoms are severe or if your phobia negatively impacts your life, then treatment will likely be recommended.

Because there are multiple different treatment options, your psychologist will create a personalised treatment plan that is specifically designed to treat your phobia.

Your treatment plan will be based on several factors, such as:

• The severity of your symptoms.
• The frequency of your symptoms.
• The root cause of your phobia.
• How significantly your phobia impacts your life.

The most common treatment options for catoptrophobia are:

Exposure Therapy:

Also known as gradual desensitisation or gradual exposure, exposure therapy is one of the most successful treatment options for catoptrophobia. It involves gradual exposure to your triggers in a safe and controlled environment.

You will work to change any negative patterns of thoughts and harmful beliefs surrounding mirrors through exposure to your triggers. Exposure will happen gradually over multiple sessions, with the number of sessions required depending on the severity of your phobia.

As part of the therapy, you will be asked to visualise and talk about your fear and experience your triggers in real life. This will happen gradually, in escalating phases, starting with the least anxiety-provoking trigger; for example, you may begin by looking at pictures of a mirror. Once you are comfortable with this level of exposure, you will move on to the next exposure, such as visualising yourself looking into a mirror. With each exposure, you should experience progressively lower anxiety with the aim that you can eventually look in a mirror without experiencing a negative response.

By creating realistic thoughts and beliefs surrounding mirrors, unlearning negative associations and patterns of thought, decreasing negative reactions and feelings towards mirrors long term, and learning relaxation techniques and coping and calming strategies, exposure therapy can help you overcome your phobia.

Cognitive Behavioural Therapy (CBT):

Also known as talk therapy, CBT helps you to explore, understand and address any negative or harmful thoughts and feelings you have associated with mirrors. It helps you to deconstruct negative thoughts and feelings into smaller pieces and replace them with healthier, more positive alternatives.

If you have a phobia of mirrors, you will likely hold the belief that mirrors are dangerous or will cause you some harm (whether physically or emotionally). These beliefs lead to automatic negative thoughts and related behavioural reactions. CBT works to gradually change the way you think. Because your thoughts, beliefs, feelings and behaviours are all interconnected, changing the way you think will help all aspects of your phobia.

CBT takes place over multiple sessions and depending on the severity of your phobia, it may be recommended that you engage in CBT long term. Sessions may be conducted individually or as part of a group.

During the sessions you will work to:

• Understand your triggers and what initially caused your fear of mirrors.
• Recognise distorted patterns of thinking.
• Change any unhealthy beliefs surrounding mirrors.
• Learn positive habits and positive body image.
• Learn coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.

Clinical Hypnotherapy:

Clinical hypnotherapy uses a combination of guided relaxation techniques and focused attention to help change your beliefs, thought processes and overall perception of and response to mirrors.

Hypnotherapy can help you to identify and understand the root cause or causes of your fear of mirrors and work on any unprocessed trauma surrounding the root cause of your phobia. You will also focus on negative patterns of thought and try to replace them with positive thoughts. You will also learn how to overcome any negative beliefs and feelings about mirrors, both long term and short term. To help you manage your phobia more effectively, you will also learn calming techniques.

Medication:

Although medication is not often used as a sole treatment for phobias. It may be helpful if your phobia is particularly severe or as a temporary solution to help you get through a challenging time. For example, if you need to drive but using the rear-view and wing mirrors creates too much anxiety.

In this situation, you may be prescribed medication such as anti-anxiety medication or anti-depressants. However, these will likely only be offered in conjunction with another type of treatment, such as CBT or exposure therapy.