Phobia

A phobia is a type of anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (IV), a phobia is an irrational fear that results in the deliberate avoidance of the feared object, activity or situation. Actual exposure to the feared object or situation is not necessary; just thinking about it can cause severe anxiety.

While it is common for people to say that they have a phobia, the psychological definition of phobia is very different than how it is commonly used. People with phobias have irrational fears so severe that the fears actually disrupt their lives.

Types of Phobias

  • Social Phobia (also known as Social Anxiety Disorder): Social phobia causes an overwhelming fear of being humiliated or embarrassed in social settings. A social setting can be anywhere such as school, church or the grocery store. The notion of public speaking or even raising your hand in class can bring on panic symptoms like nausea, shortness of breath and sweating. One survey showed that many people were more afraid of addressing a group than they were of death.
  • Specific Phobias: Specific phobias are the most common types of phobias. They typically consist of a fear of animals, storms, heights, illness, injury and death. Symptoms commonly associated with specific phobias include: irrational fear, anxiety, accelerated heartbeat and/or excessive perspiration. Specific phobias consists of: Aichmophobia (a fear of needles or pointed objects), Arachibutyrophobia (the fear of peanut butter sticking to the roof of your mouth), and Gerontophobia (a fear of old people).

You may think that you can prevent phobia-related anxiety attacks simply by avoiding the phobia trigger, but in reality this is not the case. The criterion that separates clinical phobia from a normal fear is that a phobia disrupts your life. For example, if you have a fear of heights, you will more than likely live in a one-story building as a way to avoid the fear of being off the ground. In some cases, your fear of heights may be so severe that you refuse to take a much-desired job on the top floor of a skyscraper because the thought of being that far off the ground terrifies you. When your fears interrupt or disrupt your life then you have a phobia.

How Many People Are Affected By Phobias?

Approximately 5% of the general population suffers from at least one phobia, although there are large differences amongst countries. In the United States, nearly 9% of the population has been diagnosed with a specific phobia while, for example, that number drops to .2% in Northern Ireland. Approximately 4.6% of the world’s population suffers from a social phobia.

What Causes a Phobia?

Phobias are caused by a combination of biological, genetic and environmental factors. When you have a phobia, you develop a mental connection between an object or a situation and the emotions of fear and panic. For example, during childhood, you may have witnessed a lightning strike very close to home – a terrifying event. For the rest of your life, you associate any violent storm with the emotions felt during that particular childhood experience. You know that there is a very small chance that lightning will strike in your vicinity, but the fear paralyzes you to the point where you are afraid to venture outside your home when it rains. Just the thought of lightening causes you to hyperventilate, break into a sweat and experience accelerated heartbeats.

You can still have a phobia even when you do not have direct contact with the object or situation. For example, you can live in a geographic area where storms are rare, but still fear storms to the point that it paralyzes you with fear.

In addition, there appears to be a genetic factor in the development of phobias; as many as 75% of those diagnosed with a specific phobia have a close relative with the same type of phobia. Of course, it should be noted that you can develop a phobia as the result of just observing the emotional reactions of others. In other words, if your mother hid under the bed during storms, you may find that you model the same behavior as an adult.

What Treatments are Available for Phobias?

With the exception of severe social phobia, medication is rarely prescribed for the treatment of phobias. If medication is needed, it is often for treating the panic symptoms associated with confronting a phobia. These medications can include tranquilizers or beta blockers.

Exposure therapy, also called systematic desensitization, incorporates the use of imagery, has shown very effective in treating phobias. The therapist asks the client to recall an event and confront the thoughts and feelings that occurred during that event, but this time in a safe environment. Gradually, the patient is introduced to the fear. For example, a patient with a fear of water may first look at pictures of water then work his/her way up to touching water and finally being submerged in water. Hypnosis can also be helpful at reducing anxiety caused by a phobia.

Flooding uses the same approach as exposure therapy but does so rapidly rather than gradually. While it has the benefit of being much faster than exposure therapy, flooding can in some cases worsen phobias rather than alleviate them. In order to control the physical symptoms associated with phobia exposure, the patient may be given a low dosage of a sedative before the treatment.

References:

American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.

Morrison, J. (2002). Straight talk about your mental health: Everything you need to know to make smart decisions. New York: Guildford Publications.

Somers, J. M., Goldner, E .M., Waraich, P., & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 51 (2), 100-115.

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