Ally, Sarah Paulson's character in the latest season of American Horror Story, lives with a wide and ranging assortment of phobias (agoraphobia, coulrophobia, and trypophobia) which only intensify following the 2016 election. While it is fitting for a show like AHS to feature a character living with intense fears of her own, it's important to note that phobias are more complicated than simply identifying a source of anxiety and slapping its Greek root on the word.
Franklin Schneier, MD, co-director of the Anxiety Disorders Clinic and special lecturer in psychiatry at Columbia University Medical Center, tells Refinery29 that not all phobias are created equal — especially when it comes to the three that Ally faces.
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First, let's define those aforementioned Greek roots. "Coulrophobia" and "trypophobia" refer to very specific trigger points: clowns and (as you may have seen in AHS: Cult's promotional material) clusters of tiny holes, respectively. Where coulrophobia normally stems from the fear that something safe and childlike could suddenly become dangerous and evil, trypophobia is borne out of a sense of vague disgust.
For the record, Dr. Schneier says neither of these fears tend to be majorly impairing, since it's pretty easy to avoid clowns and tiny holes in your everyday life. And, unless they cause "significant distress" or impact your ability to work and form relationships, they might not even qualify as technical phobias. Trypophobia, he says, "is not a major public health problem." (But it can be a nuisance if you have an Apple Watch or are Kendall Jenner.)
Agoraphobia, on the other hand, describes intense anxiety triggered by being in an unfamiliar or unsafe place, far from home, or even feeling trapped. Dr. Schneier explains that agoraphobia is one of the most common — and severe — phobias. It can have a major impact on sufferers' lives and even incite a vicious cycle, where they avoid work, social settings, or public places out of fear, which only increases their fear of those situations. From what we see in the trailer for this season, Ally is about to experience this pattern for herself.
She becomes more and more reluctant to leave her house and even experiences hallucinations of evil clowns. This is one more thing that AHS gets right about phobias. "Any stressor can trigger re-emergence of a phobia," Dr. Schenier says. A "stressor" could be anything from drugs and alcohol to a panic attack. Judging by Ally's reaction to the election results, it's safe to say that the latter is what causes her phobias to return.
We doubt that Ally will adopt a constructive coping mechanism for her fears (gradually exposing herself to her stressors and practicing relaxation techniques, for example). Though, to be fair, she does seem to be seeing some sort of therapist in the preview, played by Cheyenne Jackson. Given AHS' mile-wide morbid streak, a character seeking a healthy course of treatment for a mental illness might be the biggest twist in the show's run. American Horror Story: Cult premieres tonight on FX.
If you think you might have a phobia and want to seek help, click here for more resources.