Cacophobia: Symptoms, Causes and Treatments

The cacofobia is irrational, excessive and unjustified fear of ugliness, covering both people and objects or ugly elements. It is one of the strangest and least prevalent specific types of phobia that exist today.

Individuals suffering from cacophobia experience high sensations of fear when exposed to this type of stimulus. Likewise, the feelings of fear suffered cause a remarkable response of anxiety.


Despite being a psychopathology very little prevalent in society, research shows that it shares multiple characteristics with the other types of specific phobia.

In this way, despite not having specific research about their characteristics, the information that is available today about the cacophobia allows the development of an adequate diagnosis and treatment.

The objective of this article consists of exposing the main defining aspects of the cacophobia, commenting on its symptoms and causes, specifying the diagnosis and explaining the treatments with which the alteration can be intervened.

Characteristics of the cacophobia

The main characteristic of this disorder lies in the experimentation of a persistent, abnormal and unjustified emotion towards the ugly.

It consists of an anxiety disorder in which fear is the main element that causes the symptomatology.

Likewise, the fear caused by the stimuli related to ugliness are so high that they lead the person to avoid all contact with this type of elements.

Obviously, it deals with a highly subjective type of phobia. The characterization of ugly made an object, person, situation or infrastructure is done individually and personally.

Thus, it is unlikely that two people suffering from cacophobia would be afraid of the same stimuli. The detection of an ugly aspect is subjective, so that the determination of the feared elements is individualized and varies in each subject.

Difficulties of cacophobia

The main difficulty posed by the diagnosis and treatment of the cacophobia lies in the little specificity of the feared elements.

While in other specific phobias such as spider phobia or blood phobia, the stimuli that provoke fear to the person are easily identifiable, in the cacophobia this process is much more ambiguous.

In order to determine which stimuli a subject with cacophobia fears, it is necessary to detect which categorization and cataloging patterns he uses when interpreting elements as ugly.

In other words, what a person perceives as ugly may not be different and vice versa. The feared element of the cacophobia responds to individual cognitive processes and, therefore, little specific.

This characteristic of the cacophobia motivates a greater work for its diagnosis, as well as a greater evaluation and examination of the elements to be treated in its intervention.

To be able to intervene properly this alteration is necessary to establish a pattern that allows to determine the element feared by the subject. Task that is not always easy.

The fear

People suffering from cacophobia fear a series of elements that are subject to the subjective assessment of ugly. That is, they present emotions of fear every time they are exposed to a stimulus perceived as ugly.

However, to properly understand the disorder is not only necessary to establish what elements the person fears, but also to determine how he fears those elements.

In this sense appears the specification of fear that is experienced in the cacophobia. This is classified as phobic fear towards ugliness and presents a series of characteristics.

It is excessive

For fear to do the ugly can be categorized as referring to the cacophobia it is necessary that this is excessive.

Specifically, the person with this alteration will present sensations of fear that are excessively high in situations in which there is no reason to be afraid.

Ugly people, objects or situations do not constitute a threat to the individual. However, the subject with cacophobia reacts to these elements in an exaggeratedly intense manner.

It is irrational

Ugly people or objects are not a threat to human beings. However, people with cacophobia perceive it as such.

This fact responds to the irrationality of fear. That is, the fear of ugliness is not based on congruent thoughts.

The fear of cacophobia is totally irrational and the person who suffers from the disorder is totally unable to justify the reason for their fears.

It is uncontrollable

Despite being irrational and having no reason to fear ugly people and objects, the fear of these elements also appears in individuals with cacophobia.

This fact is explained through the uncontrollability of fear. This appears automatically without the subject can do anything to control or manage it.

It is persistent

Finally, fear of the ugly is characterized by being persistent in time. Fear is experienced permanently and does not respond to specific stages or moments of the person.

The subject with cacophobia will always experience high sensations of fear when exposed to ugliness.


Cacophobia is considered an anxiety disorder due to the manifestations produced by the alteration.

When an individual with cacophobia is exposed to their feared elements responds immediately with a series of symptoms of anxiety.

These symptoms are caused by phobic fear of ugliness and generate high discomfort in the individual.

Likewise, the symptomatology can seriously affect the functioning and behavior of the individual, limiting their quality of life and well-being.

The anxious manifestations of the cacophobia can be divided into: physical symptoms, cognitive symptoms and behavioral symptoms.

Physical symptoms

The sensations of fear experienced by the person with cacophobia when exposed to his feared stimulus immediately causes a series of alterations in the functioning of his body.

These alterations correspond to an increase in the activity of the central nervous system and appear as a physical response to the perceived threat.

The physical symptoms produced by cacophobia can vary relatively in each case. Nevertheless, the experienced manifestations will always be some of the following:

  1. Increase of the cardiac and respiratory rate.
  2. Palpitations, tachycardias or feelings of drowning.
  3. Increase in muscle tension that can lead to headaches and / or stomach.
  4. Excessive sweating throughout the body.
  5. Pupillary dilation
  6. Sensation of dizziness, nausea or vomiting.
  7. Dry mouth.
  8. Feeling of unreality

Cognitive symptoms

In order to establish the diagnosis of cacophobia, it is not only necessary for the subject to experience physical symptoms when exposed to his feared stimulus, but a series of thoughts must also appear.

These thoughts are based on the fear of ugliness, the interpretation of the damage that these elements can cause to oneself, and the null capacities that are had to face such threats.

In the case of cacophobia, cognitive symptoms are mainly based on irrational thoughts about people and / or ugly objects.

These manifestations are fed back with the physical symptoms and make the feelings of fear and anxiety are increasing, and are uncontrollable for the person.

Behavioral symptoms

Finally, the cacophobia presents a series of alterations and manifestations in the individual’s behavioral area. In other words, this disorder manages and modifies the behaviors carried out by the person.

In this sense, the two main symptoms that psychopathology produces are avoidance and escape.

Avoidance refers to a series of behaviors that the individual carries out in order not to come into contact with ugly elements.

Due to the low specificity of the ugliness aspect, this behavior can be complex and seriously affect the person.

That is, the individual with cacophobia will have difficulty detecting in what situations or at what times he may come into contact with an ugly person or object. Reason why it will be difficult to carry out avoidance behaviors.

On the other hand, the escape behavior constitutes all those behaviors that the person with cacophobia performs when he comes into contact with his feared stimuli.

This behavior is very common in the cacophobia since often the individual will be exposed to people or objects that he interprets as ugly and that therefore produce fear and anxiety.


From the elements exposed in the previous sections, the main criteria for the diagnosis of cacophobia can be extracted.

According to the diagnostic and statistical manual of mental disorders (DSM-V), to determine the presence of cacophobia the following criteria must be met:

  1. Fear or intense anxiety for a specific object or situation that is interpreted as ugly (phobic element).
  2. The phobic element almost always causes fear or immediate anxiety.
  3. The phobic element is actively avoided or resisted with fear or intense anxiety.
  4. Fear or anxiety is disproportionate to the real danger posed by the phobic element and the sociocultural context.
  5. Fear, anxiety or avoidance is persistent, and typically lasts six or more months.
  6. Fear, anxiety or avoidance causes clinically significant discomfort or deterioration in social, occupational or other important areas of functioning.
  7. The disturbance is not better explained by the symptoms of another mental disorder, such as fear, anxiety and avoidance of situations associated with panic symptoms or other disabling symptoms (as in agoraphobia ); objects or situations related to obsessions (as in obsessive-compulsive disorder ); memory of traumatic events (as in post-traumatic stress disorder ); leaving home or separation of attachment figures (as in separation anxiety disorder ); or social situations (as in social anxiety disorder ).


The etiological factors of cacophobia are little studied today. However, it is postulated that the causes of this disorder could be related to the elements that condition the development of phobic fear in a general way.

In this sense, some factors have been ruled as especially important in the acquisition of cacophobia. These are:

Traumatic or unpleasant experiences

It is postulated that the fact of having been exposed to media images of people with unusual or unpleasant facial expressions in relation to violent crimes or other traumatic events could be a factor that motivated the development of cacophobia.

Educational style

On the other hand, having received an education during childhood in which there was a special rejection towards ugly people or elements that are not aesthetically pleasing could also contribute to the development of the pathology.

Genetic factors

In general, in specific phobias, the presence of genetic factors is postulated. In the case of cacophobia, it is not well established which genes could be related to the development of the disease.

However, having a family history of anxiety may increase the risk of developing an anxiety disorder, including cacophobia.

Cognitive factors

Certain elements related to the thinking and cognition of people are related to the maintenance of phobias and irrational fears. The main ones are:

  1. Unrealistic beliefs about the damage that could be received if exposed to the feared stimulus.
  2. Attention bias towards threats related to phobia.
  3. Low perceptions of self-efficacy.
  4. Exaggerated perception of danger.


The treatment of first choice of the cacophobia is the psychotherapy, which has been much more effective the intervention with drugs.

In this sense, the cognitive behavioral treatment incorporates techniques and therapeutic tools that have been shown to be very useful for reversing and overcoming phobic fears.

Also Read: Astrophobia: Symptoms, Causes and Treatments

The main interventions that are carried out in this type of treatments are:

  1. Exposure to the phobic element in a gradual way with the aim of getting used to it and learning to manage the sensations of fear.
  2. Relaxation techniques to mitigate the impact of anxiety symptoms.
  3. Cognitive techniques to modify irrational thoughts about ugliness.