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When You're Embarrassed of Being Embarrassed, You Have 'Erythrophobia'

Some people resort to surgery to prevent their bodies from blushing.
Ashwin Rodrigues
Brooklyn, US
December 18, 2014, 10:00am

​Aside from sociopaths and people who are in certain breeds of cults, everyone experiences some level of social anxiety. Some get sweaty palms right before it's their turn to speak in public. Others will overshoot their bus stop because they were too afraid to yell to the driver. And others blush.

If you're mortally terrified of blushing, you have erythrophobia, which is not only associated with the act of blushing, but with the negative social aspects of blushing. Erythrophobes also have an exaggerated self-perception of blushing (meaning they think they're blushing even when they're not), which just becomes one horrible, self-fulfilling loop.

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Most cases of erythrophobia aren't completely debilitating, but in at least one case, a 20-year-old committed suicide at least in part because of his extreme erythrophobia.

In 2012, Brandon Thomas, of Washington state, ​wrote in his suicide letter that he wanted to raise awareness for the condition.

"I blush several times a day. It doesn't have to be when I am embarrassed, either," he wrote. "I am tired of blushing … it is exhausting to wake up every day and have to find little ways to avoid blushing situations."

Thomas's case was obviously extreme, but the symptoms he notes aren't uncommon. In a 2007 paper in the Polish Journal of Surgery, surgeon Tomasz J. Stefaniak wrote that symptoms of erythrophobia are "closely associated with social support and fear of losing that support."

if you're one of those people who always points out when someone is blushing, maybe you shouldn't

He notes that it is not just the reaction to one's blushing, but also "high focus on one's own symptoms and higher level of negative feelings [towards those symptoms.]" Stefaniak delves into the purpose of blushing in the first place, which is supposed to "stimulate compassion in the other person and to obtain help or trust despite unsuccessful interaction."

When you think of blushing as a sign on your face saying "I fucked up," it's easy to see how someone would go to great lengths to avoid it.

The usual feedback loop of "I am embarrassed, and now I will blush," for someone with the condition, is more like, "I am terrified of blushing, given its social implications, so I will avoid situations that will make me blush, or feel embarrassed."

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It's easy to see how socially debilitating this fear can be, given how much of life has the potential for embarrassment and shame.

While most people would describe an erythrophobia sufferer as simply "overly shy" or "reclusive," earlier studies preferred the term "neurotically bashful," which is a phrase that never gained widespread acceptance.

Academic Wilhelm Stekel, in his book Conditions of the Nervous Society and Their Treatment came to the probably incorrect conclusion that "everyone who suffers from erythrophobia has a bad conscience," way back in 1923. For that reason, his assessment should be taken with a grain of salt, considering it was a time when mental illnesses and anxieties were treated even more callously than they are today.

Stekel goes on to describe "erythrophobist" blushing as a "genitalisation" of the face, essentially calling the innocent act of blushing a face-boner. This wonderful document goes on to say "every phobia hides the old infantile criminal phantasy [sic]." This diagnosis is not considered valid or remotely scientific today, but you must know history in order to not repeat it, etc.

Erythrophobia is suffered across all walks of life. Like with many phobias, internet forums prove to be a safe haven for erythrophobia sufferers. The diversity of discussion boards that erythrophobia spans is incredible. The Bodybuilding.com forums are mostly devoted to all things getting shredded, but there's a few people who would rather drop a class than give a spoken presentation, due to the intense anxiety suffered from the prospect of blushing.

a hole is made in the chest and the nerve associated with facial sweating, near your spine, is destroyed with a laser or severed with a knife

IBSgroup.org, a place where irritable bowel syndrome sufferers get together to discuss effective treatments, has a post from a "former blusher" named Sam.

SocialAnxietySupport, a safe haven for those suffering from all types of discomfort brought on by the outside world, has a girl who says she's unable to get a job due to her condition. More strangely, on Twitter, hundreds of people have posted the definition of erythrophobia in Indonesian, a phenomenon I cannot immediately understand or explain at this time.

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Treatment for erythrophobia can be approached at both the physical and psychological levels. As with most anxieties, therapy and slow exposure to blushing more often in safe settings are the most common treatments.

But more extreme interventions include surgeries, such as the Endoscopic Thoracic Sympathectomy. This procedure does not involve removing the all blood vessels from your face, which is what I hypothesized. Instead, a hole is made in the chest and the nerve associated with facial sweating, near your spine, is destroyed with a laser or severed with a knife. A little extreme, but, hey, it works.

Finally, an anecdotal proof of cure comes from the Bodybuilding.com forum, where one user claims, "Many people say that it has disappeared once they fell in love," though he is "not sure about this."

Whether you have this condition or not, you should be aware of the difficult journey erythrophobia-sufferers face in their daily lives. If you don't suffer from it, you're able to enter social situations and get embarrassed without a heightened physical and psychological terror response. Maybe that's a sign that you should take more risks.

And if you're one of those people who always points out when someone is blushing, maybe you shouldn't—you could be making someone's worst fears come true.

Psyched Out is a new, weekly series in which Motherboard will explore little known, but somewhat common psychological disorders. Previously on Psyched Out: People Who Chew on Their Own Skin Have a Disorder Called Dermatophagia.