Fear of Buttons

Why nobody agrees how common koumpounophobia is

Two figures circulate and they are not close:

• the English Wikipedia article states that it is estimated that less than one per cent of the United States has the phobia, which across that population is a ceiling of roughly three million people
• The Sun reported in April 2008 that the phobia affects one in 75,000, attributing the figure to a spokesman for the National Phobics Society, which across the same population is around four thousand

Neither has a survey behind it in the sources that carry them, and no paper reports a prevalence for the term. What can be said is that a fear widely described as bizarre is estimated by one source at a thousand times the rate the other gives, and that the gap has attracted no attention from anyone quoting either figure.

Why the clinical case treated disgust rather than fear

Jose Saavedra and Wendy Silverman published the case in the Journal of the American Academy of Child and Adolescent Psychiatry in November 2002. Their patient was a nine-year-old Hispanic American boy with a specific phobia of buttons, and the phobia had begun when a large glass container of buttons was knocked over.

Their argument is about which emotion to treat. Disgust has had limited attention in the literature on childhood phobias, and the available work suggests that going after it directly reduces phobic symptoms better, because the interaction between fear and disgust is what keeps a phobia going and can make it worse. They targeted disgust through imagery exposures inside an exposure-based cognitive behavioural intervention. The gains held at the end of treatment and at follow-up six months and twelve months later.

The word disgust appears in the description of the reaction generally, not only in the case. Exposure to a button, seen or touched, is reported as producing fear and disgust together, which places the term with Trypophobia and Misophonia rather than with the animal phobias.

Where a button shop became the exposure clinic

The most concrete account of treatment outside the case report is incidental. A button maker in Cleveland Street in Fitzrovia told the West End Extra in December 2011 that psychiatrists had asked her from time to time whether clients with koumpounophobia could visit the shop. That is graded exposure arranged by telephone with a retailer, which is what happens when a fear has no specialised service behind it.

The reported presentations are severe in proportion to the object. A parenting writer describes working with the parents of a three-year-old who violently refused to wear anything with buttons and screamed when her mother came near in a buttoned shirt. The Daily Mail in March 2012 described a thirty-year-old woman who panics at the sight of one and leaves the room if any are brought close.

Why Steve Jobs is the name attached to koumpounophobia

Steve Jobs is the name attached to the term in almost every popular account. Wikipedia records that he had an aversion to buttons, that it extended to buttons on computer hardware, and that his turtlenecks were a consequence of it. It also records the speculation that his aversion pushed Apple towards touchscreens and virtual keyboards, and marks it as speculation.

The claim is worth holding at arm's length. An aversion is not a phobia, no clinician assessed him, and a design direction that several companies were moving in has a great many other explanations. What the story does establish is how the word reached the public, which was not through the case report.

Why Coraline came with a koumpounophobia warning

The other route was a film. Neil Gaiman recorded a promotional teaser for the 2009 adaptation of his novella Coraline, in which he addressed koumpounophobia directly and warned anyone who had it about the film, whose characters have buttons for eyes. A local newspaper reviewing the film that February suggested it might give young viewers the phobia rather than merely trouble those who already had it.

A film-maker issuing a content warning for a specific phobia is unusual, and it happened for this one before the term had any presence in the clinical literature beyond a single case.

Why koumpounophobia is not built the way it looks

Modern Greek koumpi is the button and koumpono is the verb to button. Wiktionary notes that the first element of the English word is anomalous and may come from the verb rather than the noun, which is an odd way to build a term. The earliest use it can date is a Usenet post from May 2007, and every citation it holds after that is a newspaper article, a parenting book or a travel memoir. There is no scholarly one.