The presence of toxins is not uncommon, with 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 ancient times and in the Middle Ages to commit murder, and even today there are chemical weapons used in warfare. We also use poisons to kill other creatures, such as rat poison and insecticides.

The existence of a certain fear of poisoning at a given time can therefore be quite rational. But most of us will never actually be poisoned. Perhaps some food poisoning, or drug poisoning, but death by poisoning is not so common. For some people, however, such fear exists persistently and turns into an uncontrollable panic, which leads them to avoid situations and stimuli and greatly limits their life. This is what happens to those subjects with toxicophobia .

Toxicophobia as a specific phobia

Toxicophobia, toxophobia, or toxinophobia is considered to be an irrational or exaggerated fear of poison or of being poisoned (usually accidentally). This is one of the so-called specific phobias, in which an intense fear or anxiety is generated when faced with a specific stimulus. These sensations cause the sufferer to have an intense need to escape from the stimulus, as well as avoid exposure to it and situations in which it could appear.

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

Among the most common symptoms, we find tachycardias, hyperventilation, sweating and tremors, which can lead to an anxiety crisis . At a cognitive level, attention is focused on stimulus and avoidance, reducing cognitive abilities and the capacity for judgement and planning. In extreme cases, hallucinations may even appear, such as nervous paroxysm, in which they may capture the taste of poison or something toxic in the food.

Although seeing and recognizing some type of poison is not common, toxicophobia can be a serious limitation to the life of the person who suffers it. If it occurs to a slight degree, a fear of the poisons themselves can appear, avoiding the use or exposure of poisons such as rat poison. But depending on the degree, this panic can extend to the consumption of cleaning products, solvents, drugs and virtually any type of chemical 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 toxicophobia that is worth highlighting is its possible link or confusion with elements from other psychopathologies and symptoms , such as persecutory delusions or gustatory hallucinations in different conditions and states of a psychotic type, such as schizophrenia, delusional disorder or intoxication by substances (in this case, we would be talking about real intoxication). It can also sometimes be confused with obsessive-compulsive disorder, in those subjects with germ-related obsessions and with cleaning and washing compulsions.

In this regard, it should be noted that toxicophobia involves a disproportionate fear of being poisoned or of the presence of poisons and can lead to the avoidance of situations in which there may be toxic elements 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 wouldn’t be talking only about a fear but about the persistent and fixed belief that someone is trying to kill us by this means (sometimes there are taste hallucinations that are interpreted as confirmation of this belief). Or in people with OCD linked to germs, illness and cleanliness, the idea that these elements are appearing can cause deep anxiety.

The idea that they are trying to kill us, the concern about the germs and diseases that they may cause, or the thought that some kind of misfortune may occur if we don’t perform the compulsion can lead to the emergence of a deep aversion and dread of exposure to elements such as poison or toxins, seeking to avoid them through compulsions (although cleaning OCD is usually linked to germs to be cleaned and not to toxins as a chemical).

However, we must bear in mind that for us to be talking about a phobia, the fear must be irrational or disproportionate. In these cases, the fear would be consistent with the presence of repetitive and intrusive thoughts linked to the subject or to the belief that someone is trying to kill us or really hurt us. The different diagnostic classifications stipulate in this sense that a phobia is only diagnosed as toxicophobia in the absence of other disorders that better explain the fear and the reactions to the feared stimulus.

Causes: a fear with adaptive meaning

The causes of toxicophobia, as with other mental disorders, are not completely known. However, there are several highly plausible hypotheses as to 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. It is even possible that we have been able to see or experience a situation in which we or a loved one has been poisoned. In this sense, the person with toxicophobia could have acquired a fear conditioned by past experiences , whether lived in their own flesh or in a vicarious way through the visualization of some case of poisoning (either through direct observation, reading or audiovisual media).

Another quite plausible hypothesis is the same one that is usually held towards the fear of different animals and plants: Seligman’s theory of preparation. This theory proposes that the intense fear to some stimuli would be prepared phylogenetically, being inherited of our ancestors when these had to face situations of life or death. For example, the attack of a predator, the bite of a spider or the consumption of certain herbs can cause death. In this way, 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 loose poison but rather it comes from animals or plants), we could be facing a generalization of these fears linked to the idea of dying or becoming ill because of an external agent not directly visible. Obviously, avoiding toxic elements is adaptive and allows us to survive, so the fear of being poisoned could be explained to a great extent by this theory.

Treatment of this disorder

One of the most common treatments for phobias is exposure therapy . This involves placing the subject in situations in which they have to face their fear, generally in a graduated manner 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 real poisoning, but it is possible to work with avoided situations related to this fear.

For example, the subject may be exposed to drinking in a group or in a discotheque if such a situation creates a fear of having his glass poisoned. He may also be exposed to the use of chemicals such as cleaning products. Another possible item would be to manipulate bottles or poisons that are usually used, such as insecticides or rat poison.

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

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

Bibliographic references:

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