The possibility of insects can affect where you sit, whether you open a window and which invitations or outdoor activities feel comfortable. You may still take part while spending much of the time watching for movement or listening for a sound.

Other people may see only the brief reaction when an insect appears. They do not necessarily see the checking and anticipation surrounding it.

A sight or sound may bring:

• A racing heart, trembling or muscular tension
• Nausea or recoiling at the thought of contact
• An urge to move away or protect your face
• Freezing while trying to track where the insect is

These describe a fear response.

After an actual sting, sudden breathing difficulty or swelling of the mouth or throat needs emergency medical help rather than being assumed to be anxiety.

The concern may involve injury, but it does not have to. You may worry about:

• An insect landing on you
• Something entering your clothing
• Crawling or fluttering movement
• Contact with food
• Losing sight of it and being unable to settle

Someone who knows perfectly well that an insect cannot sting may still find its movement intensely uncomfortable.

That helps explain why factual reassurance sometimes has very little effect. The information may answer a danger question while the automatic response is reacting to contact, unpredictability or disgust.

You may:

• Inspect a room again after already checking it
• Avoid outdoor activities you would otherwise enjoy
• Keep windows closed because insects might enter
• Wait for somebody else before continuing after a sighting
• Monitor the insect continuously until it has gone

Having an insect removed is not automatically a phobic behaviour. The important feature is whether you can make an ordinary choice about the situation or feel unable to carry on until complete certainty has been restored.

Anticipation can turn a future activity into something you rehearse long beforehand. Afterwards, you may replay how the insect moved or begin wondering where another one might appear.

The encounter can therefore occupy far more time in thought than it did in reality. That leaves less attention for the meal, conversation, garden or evening you actually wanted to enjoy.

A meaningful improvement is not necessarily wanting insects nearby. It is having them take up much less of your day.

You may already understand the situation and know exactly what you would prefer to do. The automatic feeling is the part that has not yet caught up.

That provides a useful direction for therapeutic work: less automatic alarm, more choice and more attention available for the life happening around the insect.

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