A Claustrophobia Desensitization Script

This is an original script for clients with claustrophobia — fear of enclosed or confined spaces. It follows the logic of systematic desensitization: pairing deep relaxation with graded imaginal exposure to increasingly confined scenarios [3]. The client remains in control throughout and can return to safety at any point.

About this script

• Purpose: graded imaginal exposure to enclosed spaces with hypnotic relaxation
• Length: about fifteen minutes at a careful pace
• Audience: practitioners trained in phobia treatment; not for unsupervised self-use
• Structure: settling, safety anchor, graded exposure (three levels), coping rehearsal, return
• Prerequisite: a full assessment of the phobia and an agreed hierarchy of feared situations

Before you read

• Build the hierarchy first. Before the first session, work with the client to create a ranked list of enclosed-space scenarios from least to most distressing (for example: a large room with one exit, a lift, an MRI scanner). This script uses three generic levels; replace them with the client’s own hierarchy.
• Establish an exit signal. Agree that raising a hand means “take me back to the safe place.” Respect it without question.
• Do not surprise the client. Describe the session structure beforehand so they know what to expect. Unexpected enclosed-space imagery can trigger panic.
• Exposure is the mechanism. Hypnosis provides the relaxation context; the therapeutic work is in the graded exposure. The meta-analytic evidence supports exposure-based treatments for specific phobias, with large effect sizes [1].

The script

Settling

Sit comfortably… feet on the floor, arms uncrossed… and let your eyes close when you are ready… [pause]

Take a slow breath in… and breathe out completely… and again… each breath a little slower, a little deeper… [pause]

You are in a place where nothing is enclosed, nothing is restricted… this room, this chair, this moment is open and spacious… [pause]

Safety anchor

Now imagine a place where you feel completely safe and open… it might be outdoors, a wide field, a beach, a hilltop… wherever you feel room around you in every direction… [pause]

Notice the space above you… the sky, the air… feel the openness… [pause]

Notice the ground beneath you, solid and wide… the horizon in every direction… there is room here… as much room as you could ever need… [pause]

Press your thumb and forefinger together gently… and as you do, let this feeling of openness and safety flow into the press… this is your anchor… you can return here at any time during this session… [pause]

Graded exposure — level one

Now, still feeling calm, let the scene shift slightly… you are in a large, comfortable room… the door is open… windows let in daylight… there is space all around you… [pause]

Notice how this feels… the room is large enough that it feels almost like being outside… the ceiling is high, the exit is clear and close… [pause]

You are breathing steadily… the room is just a room… and you are fine here… [pause]

If you feel any tension, press your anchor… breathe… and let the tension pass… [pause]

Graded exposure — level two

Now the scene shifts again… you are in a smaller space… perhaps a corridor or a car… still comfortable, still breathing… [pause]

The walls are closer now… the ceiling lower… but you are still breathing, still steady… [pause]

Notice the thought that arrives… maybe “this is too small” or “I need to get out”… let it be there… it is a thought, not a fact… the space is not dangerous, and you can leave at any time… [pause]

Breathe through it… in for four… out for eight… the long exhale loosening your shoulders, your jaw… [pause]

You are managing this… this moment, right now, you are in a smaller space and you are coping… [pause]

Graded exposure — level three

One more step… the space becomes smaller still… a lift, a narrow room, a scanner… whatever the next item on your list is… [pause]

The walls are close… the ceiling is low… and your body wants to react… that is normal… let it notice the space without deciding it is dangerous… [pause]

Press your anchor… breathe… in for four, out for eight… [pause]

You do not need to like this space… you only need to stay in it for a few moments, breathing, and notice that you can… [pause]

The anxiety rises… and it peaks… and it begins to come down… the way it always does when you stay… [longer pause]

Coping rehearsal

Now imagine yourself arriving at a real version of this situation… a lift, a tunnel, a small room… and choosing to enter it… [pause]

You press your anchor… you breathe… you notice the anxiety and you let it be there without obeying it… [pause]

You stay for as long as you need to… and when you leave, you leave because you chose to, not because fear made you… [pause]

Return

And now return to your safe, open place… the wide space, the sky, the room around you… [pause]

Press your anchor one more time and feel the safety arrive… [pause]

I will count from one to five. With each number, feel more alert, more grounded, more present.

One… returning. Two… the room around you. Three… energy in your arms and legs. Four… a deep breath. Five… eyes open, here, safe, steady. [pause]

Usage notes

Evidence context

A meta-analysis of 33 RCTs found large effect sizes for exposure-based treatments of specific phobias [1]. Hypnosis has been discussed as a way to enhance imaginal exposure — the relaxation makes the imagery more tolerable, and the hypnotic context may make the scenes more vivid [2]. The evidence for hypnosis as an adjunct to exposure specifically for claustrophobia is limited to case reports and clinical descriptions, not controlled trials.

Session progression

In the first session, stop at level one or two. Do not reach level three until the client is comfortable at the lower levels. The goal is to end each session with the client feeling they coped, not that they were overwhelmed. Over several sessions, the hierarchy items become less distressing, and the client is ready for in-vivo exposure.

Moving to real-life practice

Imaginal desensitization is the starting point. Once the client can imagine the feared scenario with moderate comfort, encourage brief real-life exposures — standing in a lift with the door open, sitting in a parked car with a window down — and gradually increasing the challenge. Hypnosis can be used before real exposures to establish calm.

Scope

This script is for specific claustrophobia — fear limited to enclosed spaces. It is not designed for:

• Agoraphobia (which involves fear of situations where escape is difficult and often co-occurs with panic disorder)
• Post-traumatic stress where the trauma involved confinement
• Panic disorder (where panic occurs unexpectedly, not only in enclosed spaces)

When to refer. If the client has panic attacks in open spaces as well as enclosed ones, avoids leaving home, has trauma related to confinement or imprisonment, or has panic disorder, refer for psychological assessment. These conditions require more comprehensive treatment than a phobia script.

Related entries

For a safety-anchor technique, see Safe Place Establishment Script. For anxiety scripts, see Letting Go of Worry Script. For general relaxation before exposure, see A Ten-Minute Relaxation Hypnosis Script.