Wearing a face mask is perhaps our most important tool to limit spread of COVID-19. However, some people truly fear face coverings. And we’re not talking here about just mask discomfort or inconvenience. We’re talking about fear that can be profound: even the thought of wearing a mask can provoke anxiety, and attempting to do so could provoke panic. It doesn’t matter that the mask is harmless. Phobias are often irrational. What do such people do during this pandemic?

There’s good news that many former “mask-o-phobics” already know. Phobias, including claustrophobia from masks, may be overcome through a process called desensitization. Desensitization may be professionally facilitated or in some cases self-guided. It involves controlled exposure to the source of fear, in this case mask wearing, until the fear is gone.

Steps in the process may include:

· Reading stories about how others overcame phobias.

· Researching types of masks, how they work, and their importance in controlling the pandemic.

· Just having masks laying around to see and think about.

· Holding and studying a mask.

· Holding a mask up to the face for increasing amounts of time, but not putting it on. Accompanying relaxation exercises such as deep breathing or meditation can help.

· Putting a mask on, even briefly, again with relaxation measures as needed.

· Wearing a mask for increasing amounts of time.

It helps to push but stay within comfort limits. Distractions such as reading or watching TV can help. Progress depends on diligence. The person who works with the mask several times per day will be wearing it without fear sooner than someone who is less engaged.

Desensitization works. In sleep medicine, severely claustrophobic people commonly and successfully desensitize to use of a CPAP mask over their nose and mouth. They learn to sleep all night every night wearing it. Their motivation for doing so is to improve their sleep quality, quality of life, and overall health by treating their sleep apnea.

Motivation is important, and this pandemic provides a very strong motivator. Fear of a mask is indeed irrational, but fear of COVID-19 is justified.

A mask can’t kill anyone, but going out without a mask can.