Toxophobia (fear of poisoning): symptoms, causes and treatment

This anxiety disorder appears by means of terror crises before the possibility of being poisoned.

The presence of intoxicants is not uncommon, poisoning being one of the main reasons for the death of a large number of people throughout history. Poisons such as arsenic were used during antiquity and the Middle Ages to commit murder, and even today there are chemical weapons used in military conflicts. We also use poisons to kill other creatures, such as rat poison or insecticides.

The existence of a certain fear of being poisoned at any given moment may therefore be quite rational. But most of us will never actually get poisoned. Maybe some food poisoning, or drug poisoning, but death by poisoning is not that common. However, for some people this fear exists in a persistent manner and transforms into an uncontrollable panic, which leads them to avoid situations and stimuli and greatly limits their life. It is what happens to those subjects with toxicofobia..

The toxicofobia like specific phobia

It is considered toxicofobia, toxiphobia or toxophobia to the irrational or exaggerated fear to the poison or to the fact of being poisoned (generally accidentally). (usually accidentally). It is one of the so-called specific phobias, in which an intense fear or anxiety is generated before a specific stimulus. These sensations provoke in the sufferer the intense need to flee from the stimulus, as well as the avoidance of both exposure to it and situations in which it could appear.

This panic is persistent, not disappearing on its own and occurring every time there is an exposure to the stimulus in question. Such fear is generally triggered by the presence of the stimulus itself, but the mere imagination or thought of the fear-causing element can trigger reactions of distress and physiological symptoms.

Among the most common symptoms, we find tachycardia, hyperventilation, sweating and trembling, which can lead to an anxiety crisis.. At a cognitive level, attention is focused on the stimulus and on avoiding it, reducing cognitive capacities and judgment and planning abilities. In extreme cases, even hallucinations may appear, such as nervous paroxysm, in which they may perceive the taste of poison or something toxic in the food.

Although seeing and recognizing some type of poison is not common, toxicophobia can become a serious limitation for the life of the person who suffers from it. If it occurs in a mild degree, a fear of the poisons themselves may appear, avoiding the use or exposure to poisons such as rat poison. But depending on the degree, this panic can extend to the consumption of cleaning products, solvents, drugs and practically any type of chemical product with harmful potential. It can also generate suspicion towards the manipulation of drinks or food or, in extreme cases, towards contact with other people who could poison us.

Link with other psychopathologies

An interesting aspect of the toxicofobia that it is worth emphasizing is its possible linkage or confusion with elements of other psychopathologies and symptomsIt can also be confused with the persecutory delusions or gustatory hallucinations in different conditions and psychotic states, such as schizophrenia, delusional disorder or substance intoxication (in this case, we would be talking about a real intoxication). It can also sometimes be confused with obsessive-compulsive disorder, in those subjects with obsessions linked to germs and with cleaning and washing compulsions.

In this sense it should be noted that toxicophobia involves a disproportionate fear of the idea of being poisoned or the presence of poisons and can lead to avoidance of situations where toxic elements may be present or the perception of a high possibility of being poisoned.

The disproportionate fear of being poisoned is also common in people with persecutory delusions, but in this case we would not be talking only about a fear but of the persistent and fixed belief that somebody is trying to kill us by this way (sometimes with gustatory hallucinations that they interpret as confirmation of this belief). Or in people with OCD linked to germs, diseases and cleanliness, the idea that these elements appear can cause deep anxiety.

The idea that they are trying to kill us, the worry about the germs and diseases they may cause or the thought that some kind of misfortune may happen if we do not perform the compulsion can generate the emergence of a deep aversion and dread to exposure to elements such as poison or toxins, seeking their avoidance through compulsions (although usually cleaning OCD is linked to germs to be cleaned and not to toxins as a chemical product).

However, it must be taken into account that for us to be talking about a phobia it is necessary for the fear to be irrational or disproportionate. In these cases, the fear would be coherent with the presence of repetitive and intrusive thoughts or the belief that someone is actually trying to kill or harm us. The different diagnostic classifications stipulate in this regard that a phobia such as toxicophobia is only diagnosed in the absence of other disorders that better explain the fear and reactions to the feared stimulus.

Causes: a fear with adaptive significance

The causes of toxicophobia, as with other mental disorders, are not completely known. However, there are several highly plausible hypotheses regarding its origin.

One possible hypothesis is the existence of conditioning: throughout our lives we have seen and received news of people who have died of poisoning, either accidentally or voluntarily provoked. It is even possible that we have seen or experienced a situation in which we or a loved one has been poisoned. In this sense, the person with toxicophobia may have acquired a fear conditioned by past experiences. a fear conditioned by past experienceseither lived in their own flesh or vicariously through the visualization of a case of poisoning (either through direct observation, reading or audiovisual media).

Another quite plausible hypothesis is the same that is usually held for the fear of different animals and plants: Seligman's preparedness theory. This theory proposes that intense fear to some stimuli would be phylogenetically prepared, being inherited from our ancestors when they had to face life and death situations. For example, the attack of a predator, the bite of a spider or the consumption of certain herbs can cause death. Thus, our species would have learned to avoid a series of stimuli and to feel an innate fear or repugnance towards them.

Although in the case of toxicophobia, the element in question is very generic (in nature we do not find poison in the wild, but rather it comes from animals or plants), we could be dealing with a generalization of this kind, we could be dealing with a generalization of these fears linked to the idea of dying or becoming ill due to an external agent that is not directly visible. Evidently, avoidance of toxic elements is adaptive and allows us to survive, so the fear of being poisoned could be explained to a large extent by this theory.

Treatment of this disorder

One of the most common treatments to combat phobias is exposure therapy. It involves placing the subject in situations in which he/she has to face his/her fear, generally in a graduated way after having carried out a hierarchy with feared situations between therapist and patient. In the case of toxicophobia, the subject will obviously not be exposed to being actually poisoned, but it is possible to work with avoided situations related to this fear.

For example, the subject can be exposed to drinking in a group or in a discotheque if this situation generates the fear of being poisoned. The subject can also be exposed to the use of chemicals such as cleaning products. Another possible item would be to get to handle commonly used vials or poisons, such as insecticides or rat poison.

Discussion of beliefs and fears, as well as the meaning attributed to poison and the beliefs that may lie behind the fear of poisons or of being poisoned, may also be useful. Generally, the following would be employed cognitive-behavioral therapy procedures, such as cognitive restructuring.such as cognitive restructuring.

Likewise, it is essential to make a good differential diagnosis, due to the high probability of confusing the phobia to toxics or to be poisoned with the belief of being poisoned typical of some subjects with some type of psychotic pathology or the obsession with cleanliness of some types of Obsessive-Compulsive Disorder.

Bibliographical references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.