Understanding Pistanthrophobia, or The Fear of Trusting People

We all move at different speeds when it comes to trusting another person, especially in a romantic relationship.

For some, trust comes easily and quickly, but it can also take a long time to trust someone. And yet for another group of people, being able to trust another person romantically may seem like an impossible task.

What is pistanthrophobia?

Pistanthrophobia is a phobia of getting hurt by someone in a romantic relationship.

A phobia is a type of anxiety disorder that presents as persistent, irrational, and excessive fear about a person, activity, situation, animal, or object.

Often, there’s no real threat or danger, but to avoid any anxiety and distress, someone with a phobia will avoid the triggering person, object, or activity at all costs.

Phobias, regardless of the type, can disrupt daily routines, strain relationships, limit the ability to work, and reduce self-esteem.

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There’s not much research specifically on pistanthrophobia. Rather, it’s considered a specific phobia: a unique phobia related to a specific situation or thing.

Specific phobias are quite common. According to the National Institute of Mental Health, an estimated 12.5 percent of Americans will experience a specific phobia in their lifetime.

“Pistanthrophobia is the fear trusting others and is often the result of experiencing a serious disappointment or painful ending to a prior relationship,” says Dana McNeil, a licensed marriage and family therapist.

As a result of the trauma, McNeil says the person with this phobia possesses a fear of getting hurt again and avoids being in another relationship as a way to guard against future similar painful experiences.

But when you avoid relationships, you also end up keeping yourself from experiencing the positive aspects of one.

When this happens, McNeil says you’re unable to have a future relationship that may help you gain perspective or understanding as to why the prior relationship may not have been a good fit to begin with.

What are the symptoms?

The symptoms of pistanthrophobia will resemble those of other phobias, but they’ll be more specific to relationships with people. In general, the symptoms of a phobia can include:

• panic and fear, which is often excessive, persistent, and irrational to the level of threat
• urge or strong desire to get away from the triggering event, person, or object
• shortness of breath
• rapid heartbeat
• trembling

For someone with this phobia, McNeil says it’s also common to see the following symptoms:

• avoidance of conversations or deep interactions with a person who could be a potential love interest
• being guarded or withdrawn
• unreceptive to attempts by another person to engage them in flirtation, dating, or romantic relationships
• anxiety or an appearance of wanting to get away or out of conversations that are becoming uncomfortable, especially as they relate to intimacy, dating, or a prospective romantic partner

“These behaviors are all considered unsafe to a pisanthrophobe, and they are hypervigilant about letting themselves participate in behaviors that have a potential to lead to vulnerability out of a fear that the connection could lead to a deeper relationship,” McNeil says.

What causes it?

Like other phobias, pistanthrophobia is typically triggered by a person or event.

“Many people have had a bad experience with a past relationship where they feel extremely hurt, betrayed, or rejected,” says Dr. Gail Saltz, associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine.

As a result, they live in terror of a similar experience, which Saltz says causes them to avoid all relationships.

Saltz also says that some people with this phobia may not have experience with a bad relationship. Still, they do have tremendous anxiety, low self-esteem, and a fear that if anyone gets to know them, they’ll be rejected or betrayed.

Ultimately, the feelings that occur because of a bad experience or traumatic relationship result in being plagued with thoughts of rejection, betrayal, hurt, sadness, and anger.

Or, as Saltz says, really any and all negative feelings that can arise from getting involved with someone else.

How is it diagnosed?

Pistanthrophobia, or any phobia, needs to be diagnosed by a mental health professional.

That said, pistanthrophobia isn’t included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an official diagnosis.

Therefore, your doctor will likely consider the DSM-5’s diagnostic criteria for specific phobia, which lists five different types of specific phobias:

• animal type
• natural environment type
• blood-injection-injury type
• situational type
• other types

Your doctor or therapist may ask you several questions related to your current symptoms, including how long you’ve had them and how severe they are. They’ll also inquire about family history, other mental health conditions, and past trauma that may have set off the phobia.

“Anything that is considered a phobia in the psychology world meets the definition of a diagnosable mental health issue when it interferes with a client’s ability to fully participate in one or more aspects of life,” McNeil says.

When your personal, professional, or academic worlds are affected by an inability to concentrate, function, or produce normally expected outcomes, McNeil says you’re considered impaired by the phobia.

A phobia is diagnosed when it has lasted more than 6 months and affects you in several areas of your life; pistanthrophobia isn’t specific to one relationship, but all your romantic relationships.

How is a phobia treated?

Therapy, in particular, can help treat all types of phobias. Therapies can range from cognitive behavioral therapy (CBT), like exposure and response prevention, to psychodynamic psychotherapy, according to Saltz.

“Just like we do for clients who have a fear of spiders or heights, we work with a pistanthrophobic client to slowly develop exposure and tolerance to the stimulus they fear,” McNeil says.

When clinicians work with people with phobias, McNeil explains they often focus on behavior modification as a way to rewire the way a person views or thinks about a particular situation or object associated with fear or catastrophe.

“The clinician working with a pistanthrophobic client will likely start small by asking them to visualize what it would be like to be in a romantic relationship and encouraging them to talk through the experience with the clinician present,” McNeil explains.

By doing this, the clinician can help the client develop coping skills or ways to self-soothe when the anxiety or fear kicks in.

Other methods of treating a phobia may include medications if you have other mental health conditions, such as anxiety or depression.

Help for a phobia

If you or someone you love is dealing with pistanthrophobia, support is available.

There are many therapists, psychologists, and psychiatrists with expertise in phobias, anxiety disorders, and relationship issues. They can work with you to develop a treatment plan that’s right for you, which may include psychotherapy, medication, or support groups.

Not sure where to start? Here are a few links to help you locate a therapist in your area who can treat phobias:

• Association for Behavioral and Cognitive Therapies
• Anxiety and Depression Association of America
• Psychology Today

What’s the outlook for people with pistanthrophobia?

Treatment for this phobia can be successful with time and work. Getting the right treatment and support for a specific phobia like pistanthrophobia not only helps you learn to trust again, but it’s also critical for your overall health.

A 2016 study found that people with a specific phobia have an increased probability for certain diseases, such as:

• respiratory disease
• heart disease
• vascular disease

That said, the outlook for a phobia like pistanthrophobia is positive, as long as you’re willing to commit to regular therapy and work with your healthcare providers to treat any other conditions that may accompany this diagnosis.

The bottom line

Phobias like pistanthrophobia can interfere with your ability to romantically connect with other people.

While addressing the underlying issues that are triggering the phobia may be uncomfortable, in time you can learn new ways to trust people and enter into a healthy relationship.

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