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Clowns often appear at places of joy and entertainment, such as a circus or children’s birthday party.
There are even medical clowns who visit patients in the hospital to lift their spirits and spread the healing power of humor. Yet, some people don’t feel joy or happiness when they see a clown. Instead, they react with fear and panic.
What is coulrophobia?
Coulrophobia is the fear of clowns. This fear is different from a general dislike of clowns or finding them disturbing. With coulrophobia, clowns cause immediate and intense anxiety, causing those with the phobia to avoid places where clowns might be present (Meiri, 2017).
Coulrophobia is a type of specific phobia—a condition characterized by fear or stress caused by a particular object or situation. Examples of common specific phobias include arachnophobia (fear of spiders) and acrophobia (fear of heights).
What causes coulrophobia?
Like many specific phobias, clinicians don’t know why some people have an extreme fear of clowns, but here are a few theories.
Parents pass down many traits to their children––fears and phobias included. Researchers typically see coulrophobia as a learned trait.
For example, people whose parents are afraid of dogs are more likely to fear dogs themselves, and people who see their parents demonstrate a fear of clowns may be more likely to be scared of clowns, too. There are some theories that a person might even have a genetic predisposition to developing a specific phobia (Fredrikson, 1997).
Other possibilities include having a traumatic experience with a clown and seeing scary or evil clowns portrayed in movies and popular culture.
Exposure therapy: a proven therapy for anxiety and PTSD
Symptoms of coulrophobia
If you have coulrophobia, you probably steer clear of any location a clown could appear. But of course, sometimes clowns can’t be avoided.
Children with coulrophobia might react with crying, anger, panic, or clinging to a caregiver (Meiri, 2017).
Some people may also experience panic attacks. Symptoms of a panic attack include (Cackovic, 2020):
- Fast, pounding heartbeat
- Shaking or trembling
- Feeling like you can’t breath
- Nausea or upset stomach
- Dizziness, or feeling lightheaded or faint
- Sudden chills
- Chest pain
- A feeling of impending doom
Can you be diagnosed with coulrophobia?
If your fear of clowns is beyond reason or affecting your quality of life, it might be best to see a mental health specialist who can help determine if you have coulrophobia.
They will ask how you feel when you see a clown, when your fear of clowns started, and if you always respond this way. They’ll also ask if you actively avoid clowns and how behaviors related to the phobia affect your life.
Your provider will also want to rule out any other possible medical conditions that could explain your symptoms, such as paranoid personality disorder and panic disorder (SAMHSA, 2016).
How is coulrophobia treated?
There are different types of psychotherapy commonly used to treat specific phobias like coulrophobia.
What is behavioral therapy and who is it for?
Cognitive behavior therapy (CBT) is a well-studied, effective form of treatment. CBT teaches strategies to help change how your brain reacts to seeing whatever it is that triggers your fear. A therapist will work with you to identify why you fear clowns and cultivate a more rational perception.
Another component of CBT is exposure therapy. With exposure therapy, you’d likely be shown pictures of clowns. The aim of this is to get you familiar with clowns by exposing you to them. Once you see them more regularly, the idea is you won’t be as anxious when encountering a clown in real life (Thng, 2020).
There aren’t any medications that will treat the underlying cause of coulrophobia. However, if you experience panic attacks, anti-anxiety medications and propranolol (which lowers blood pressure) can help.
If medications are part of your treatment regimen, carry them with you if you’re going somewhere you might be triggered. You might feel dizzy or drowsy from the medication, so plan accordingly (Samra, 2021).
Coping with coulrophobia
As part of your therapy, you’ll be taught techniques to help you cope with your fear.
Deep breathing is a type of relaxation technique that alleviates anxiety. Practice inhaling for four seconds through your nose, and then exhale through your mouth for six seconds. We don’t usually breathe that slowly, so it may help to use a timer if you’re first starting (Shiban, 2017).
There are lots of other relaxation methods to explore. For example, you might have specific songs or sounds that you find soothing (Seinfield, 2016). Other effective de-stressors include taking a hot shower, going for a walk, or finding a distraction.
- Cackovic, C., Nazir, S., & Marwaha, R. (2020). Panic Disorder. In StatPearls. StatPearls Publishing. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28613692/
- Fredrikson, M., Annas, P., & Wik, G. (1997). Parental history, aversive exposure and the development of snake and spider phobia in women. Behaviour Research and Therapy, 35(1), 23–28. doi:10.1016/s0005-7967(96)00076-9. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0005796796000769
- Meiri, N., Schnapp, Z., Ankri, A., Nahmias, I., Raviv, A., Sagi, O., … Pillar, G. (2016). Fear of clowns in hospitalized children: prospective experience. European Journal of Pediatrics, 176(2), 269–272. doi:10.1007/s00431-016-2826-3. Retrieved from https://link.springer.com/article/10.1007/s00431-016-2826-3
- Samra, C. K., & Abdijadid, S. (2021). Specific Phobia. In StatPearls. StatPearls Publishing. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29763098/
- Shiban, Y., Diemer, J., Müller, J., Brütting-Schick, J., Pauli, P., & Mühlberger, A. (2017). Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study. BMC Psychiatry, 17(1), 29. doi: 10.1186/s12888-016-1181-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28100203/
- Seinfeld, S., Bergstrom, I., Pomes, A., Arroyo-Palacios, J., Vico, F., Slater, M., & Sanchez-Vives, M. V. (2016). Influence of Music on Anxiety Induced by Fear of Heights in Virtual Reality. Frontiers in Psychology, 6, 1969. doi: 10.3389/fpsyg.2015.01969. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26779081/
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2016). Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (US). Retrieved from https://pubmed.ncbi.nlm.nih.gov/30199183/
- Thng, C., Lim-Ashworth, N., Poh, B., & Lim, C. G. (2020). Recent developments in the intervention of specific phobia among adults: a rapid review. F1000Research, 9, F1000 Faculty Rev-195. doi: 10.12688/f1000research.20082.1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32226611/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.