Gelotophobia is an anxiety disorder belonging to the group of social phobias. Sufferers have an abnormal fear of being laughed at by others and therefore withdraw socially.
What is gelotophobia?
Phobias are mental illnesses characterized by anxiety. Patients suffer from unnaturally extreme fears of certain situations, certain creatures or objects. In German literature, phobias are also referred to as anxiety disorders. To characterize a phobia in more detail, the Greek loanword is preceded by the fear-inducing phenomenon. Accordingly, gelotophobia is an excessive fear of laughing (gélōs – to laugh) people. Patients with gelotophobia irrationally fear being laughed at by others. Thus, gelophobia belongs to the anxiety disorder domain of social phobia. The quality of life of social phobics is limited due to social avoidance behavior. Gelotophobics have further limitations. The patients cannot use humor, cheerfulness and laughter for their life attitude, because they recognize a threat in every laughter. Michael Titze introduced the term gelotophobia in 1995, describing people who see themselves as ridiculous in a global way and therefore recognize in every laugh of their social partners a degradation of their own person.
Causes
The causes of gelotophobia can vary greatly from case to case. In principle, however, the anxiety disorder is usually based on an event that has severely affected the patient’s self-worth. Most patients of gelotophobia develop the primary type of shame underlying the disorder in their own childhood. In many cases, the feeling of shame results from disinterest or emotional coldness that a child encounters on the part of his or her caregivers. For most patients, primary shame is followed by repeated traumatic experiences of mocking, teasing, or ridiculing laughter. The more often the affected person encounters mocking laughter, the more his perception changes. Perceptual areas are fundamentally selective. Expectations shape the perception of a situation as much as previous experiences. In a way, the affected person only perceives what he wants to perceive or expects to perceive. Because patients with gelotophobia have been increasingly exposed to mocking laughter in the past, they soon expect mockery in all laughter.
Symptoms, complaints, and signs
People with gelotophobia have a fear of being laughed at. They engage in social avoidance behavior to avoid ridicule in public. They evaluate humorous remarks from their environment in a paranoid way. The patients can hardly or not at all deal humorously or cheerfully with other people. The patients evaluate themselves and their own bodies extremely critically and often also consider their verbal and non-verbal communication skills to be below average. Their negative self-esteem causes patients to develop feelings of inferiority. The tendency to compare themselves directly with others makes the sufferers feel envy. Due to avoidance behavior, the patients’ social skills degenerate further and further. Psychosomatic symptoms such as tension headaches, tremors, dizziness, blushing, or speech disorders are often added. Laughter often causes aggression in the patient, which can extend to emotional loss of control. Gelotophobia can also manifest itself in the form of Pinocchio syndrome. In this case, patients freeze whenever they hear someone laugh.
Diagnosis
The diagnosis of gelotophobia is made by psychologists. Different defining characteristics are listed in the ICD-10, including primarily social avoidance behavior and an inability to interact humorously. Gelotophobia is assessed by questionnaire. In addition to questions and answers, the corresponding questionnaires also contain pictorial instruments such as cartoons with laughing people. The subjects use these pictures to estimate what preceded the situation and what an observer might feel. The fine diagnosis of gelotophobia corresponds to a cause clarification. This cause clarification can only take place in direct conversation with the patient.
Complications
Due to gelotophobia, there are very strong psychological complaints and further depression.In the worst case, the disease can also lead to suicidal thoughts and eventually suicide. Even humorous statements that are not meant seriously are perceived as an attack or an insult by friends and acquaintances. This leads to social phobias and not infrequently to social exclusion. The patients withdraw more and more and no longer participate in social activities. Aggressiveness or increased irritability may also occur as a result of the remarks. Speech disorders or dizziness also occur. The patient trembles and often blushes. Furthermore, loss of consciousness may also occur if gelotophobia is severe. The quality of life is extremely reduced by the disease and there are significant restrictions in everyday life and social life. Treatment of gelotophobia is usually carried out by a psychologist and with the help of medication. However, it is not possible to predict how long the treatment will last and whether it will really lead to success. Likewise, taking medication can lead to addictive behavior. Gelotophobia itself does not reduce life expectancy.
When should you see a doctor?
People who suffer from increased anxiety should always see a doctor. If there is a lowered enjoyment of life or mental distress in everyday life because of the sensations, help is needed. If there is social withdrawal or isolation, a doctor should be consulted. If participation in recreational activities or athletic interests decreases, a doctor should be consulted. If there are sweating, rapid heartbeat, trembling all over the body or inner restlessness, therapeutic help is needed. If there is an increase in stress, obsessive thoughts, or avoidance behavior, a doctor should be consulted. If the emotions of guilt and shame rise sharply, this is considered worrisome. If the affected person believes that everyone around him is permanently fixated on him and his behavior, he should ask a therapist for advice. If everyday obligations can no longer be fulfilled, the normal performance level drops and the quality of life is severely reduced, it is advisable to consult a doctor or therapist. In case of sudden speech disorders in contact with other people, a strong tendency to spontaneous blushing as well as signs such as dizziness, vomiting and nausea, a doctor should be consulted. If internal aggression develops, a tendency to overreact, or if the affected person suffers from fits of rage, a visit to the doctor is necessary.
Treatment and therapy
Multimodal forms of therapy are used to treat patients with gelotophobia. Multimodal in this case means encompassing several directions. In the case of anxiety disorder, the individual directions of treatment usually correspond to depth psychology, pharmacotherapy, behavior therapy, and relaxation therapy. By means of depth psychology, the therapist clarifies the biographical cause of the phobia and provides help in coming to terms with it. The clarification of the cause takes place in conversation sessions, and trust between patient and therapist is all-important for a functioning therapy session. In behavioral therapy, the patient questions his own evaluation of the anxiety-provoking situations. He learns new evaluation possibilities and learns specific behavior and thinking patterns for coping with the situation. In conservative drug pharmacotherapy, the therapist gives the patient anxiolytics, antidepressants, beta-blockers, or St. John’s wort if absolutely necessary. This type of therapy is a purely symptomatic therapy that does not address the cause of the disease and thus, as a single procedure, cannot achieve a complete cure. Because of the side effects and addictive potential of individual tranquilizers, the drugs are generally only given for as long as they are urgently needed to work with the patient. A gentler alternative is relaxation techniques that the patient can use before and during a fearful situation. These techniques include muscle relaxation in addition to autogenic training.
Outlook and prognosis
Gelotophobia can usually be treated well. If this is done early, the complaints and symptoms can often be completely resolved over the course of months or years. Although many patients experience paranoid moments throughout their lives, these can also be alleviated by drug therapy.Through behavioral therapy, the causes of the complaints can also be remedied relatively well. In severe cases, gelotophobia persists for a lifetime. Then further psychological complaints develop, above all a pronounced paranoia as well as depressive moods. In such a severe course, which is usually due to deeper-lying mental suffering and a lack of or inadequate treatment, the prognosis is rather poor. The quality of life of those affected is considerably limited. In most cases, the sufferers are no longer able to move about in public without anxiety. They eventually withdraw completely from social life, which exacerbates the signs of the disease. A pronounced gelotophobia can only be treated symptomatically. The sufferers then receive drug treatment, which attenuates the symptoms. However, the use of antidepressants and tranquilizers is associated with serious side effects and interactions.
Prevention
Because gelotophobia is usually first consolidated by a traumatizing event in adolescence or adulthood, psychotherapeutic intervention immediately after the relevant events can prevent the full manifestation of the disorder. If a causative situation such as bullying is addressed in a timely manner with a therapist, often at least no full-blown gelotophobia develops.
Aftercare
In most cases of gelotophobia, the options for aftercare are very limited. At the same time, a complete cure for the condition can never be guaranteed, so sufferers are primarily dependent on a doctor to treat the condition to prevent further complications and discomfort. In most cases, gelotophobia is treated with the help of a psychologist and behavioral therapy. However, a complete cure cannot be guaranteed. In general, early diagnosis and treatment of the condition have a very positive effect on the further course of the disease. In some cases, patients are also dependent on taking medication. In this case, regular intake is required, and possible interactions with other medications must also be taken into account. In the case of gelotophobia, treatment through self-help options is also possible, although this treatment usually cannot guarantee a complete cure either. The support of friends and family is very important and useful in this disease. Contact with other sufferers of gelotophobia can also be useful in this regard, as it is not uncommon for this to result in an exchange of information.
This is what you can do yourself
Individuals with gelotophobia need to have their fear of being laughed at treated therapeutically. The strategies learned in behavioral therapy can be practiced in everyday life and at work, helping sufferers to slowly overcome their fears. Measures such as a change in diet, sports or a new hobby contribute to a higher quality of life and can positively influence the gelotophobia therapy. If their own child is affected by gelotophobia, parents must also look at themselves. It is possible that parenting mistakes were made in the past or that the child was not able to build up enough self-confidence for other reasons. Above all, it is important not to put pressure on the child if, for example, he or she spends little time with schoolmates or behaves unusually in everyday life. Due to the complexity of an anxiety disorder and its causes, only a specialist can answer exactly what measures should be taken. Affected children should definitely seek behavioral or relaxation therapy. After the fears have been worked through, a change of school is recommended. Although this will not alleviate the gelotophobia, it will give the child a chance to make a fresh start.
