Understanding Phobia, Phobia Causes, Types, Symptoms
and How to Treat Phobias
What is Phobia?
We all have things that frighten us or make
us uneasy. New places, insects, driving over high bridges and similar
such things. And, although we sometimes try to avoid things that
make us uncomfortable, we generally manage to control our fears
and carry on with daily activities.
Fear too has two basic dimensions: Realistic and
Unrealistic.
We feel fearful when we believe we do not have
the ability to cope with something. This fear may be grounded in
reality, as when we fear being attacked by a leopard on coming face
to face with him. Or the fear may be totally unrealistic as when
we fear a cockroach.
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Difference Between Fear & Phobia
Many of our fears are a mix of reality and misapprehension
of our ability to cope. When there is a large degree of misapprehension
it is likely that it is a Phobia rather than a fear.
The essential ingredient of a Phobia is that it
has significant degree of irrationality. The person experiencing
the phobic feelings is usually well aware that their fear is irrational
but they are unable to overcome the fear. Phobias can be very long
lasting and can cause problems ranging from minor disruption to
significant disability.
People who have Phobias are often so overwhelmed
by their anxiety that they avoid the feared object objects or situations.
The causes of Specific Phobias are a complex mix
of history of negative experiences, psychological factors and biological
factors.
Learning History
Direct Learning Experiences
Specific Phobias can begin subsequent to a fearful
episode. For example if you were about to drown while swimming you
might develop a fear of water.
Observational Learning
Evidence suggests that you can learn to fear particular
situations by watching others responding fearfully in a particular
situation. For example, growing up with older siblings or parents
who fear darkness can result in you fearing darkness.
Informational Learning Experiences
This involves learning to fear a particular object
or situation by hearing or reading that the situation is dangerous.
Examples include learning to fear flying by hearing about plane
crashes in the news, or learning to fear earthquakes because someone
tells you how damaging they can be.
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Several factors may contribute to any one individual
developing a Specific Phobia after having a negative experience
that involves a particular object or situation.
One factor is your previous experience in the situation.
For example, if you have grown up with dogs you may be less likely
to develop a fear of dogs after being bitten, compared to an individual
who is bitten the first time he or she encounters a dog.
A second factor is subsequent exposure to the situation
(after the negative experience occurs). For example, if you get
right back behind the wheel following a car accident you may be
less likely to develop a Phobia of driving than someone who avoids
driving for a period of time after the accident.
Incidentally, only some individuals with Specific
Phobias report that their fear began owing to direct or observational
or informational learning. In fact, many people report that their
fear started without any obvious trigger or cause.
Some individuals say that they have always had
it or as if they were born with it. On the other side, there are
many people who have survived traumatic experiences (eg. Car crashes,
earthquakes and the like) and have not developed Phobias.
Researchers therefore are still intrigued by the
question: who develops a Phobia following one of these experiences
and who doesn’t.
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Other Psychological Factors
Attention and Memory
More often than not, if you have Specific Phobia
then you are inclined to be in a state of ‘hyper alert’
with regards to anything to do with your fear. For instance, if
you scared of snakes, then you are often the first one to spot it.
People with phobias also tend to have distortions
in their memories with respect to their encounters with the objects
and situations they fear. For example, people with an animal Phobia
may remember a particular animal that he has encountered as larger,
deadlier, or more frightening than it actually is.
Beliefs and Interpretations about Feared Objects and Situations
If you have a Specific Phobia then you tend to
believe and interpret situations in a manner that they will feed
your anxiety. If you are afraid of elevators, then you may fear
that you would be trapped in one and will run out of air.
Avoidance and other Anxious Behaviors
Avoidance of feared situations prevents people
with Specific Phobias from learning that the situations they fear
are not as “dangerous” as they feel. In addition, relying
on “safety behaviors” (e.g., climbing down the stairs
extra cautiously to avoid a fall, always wearing long pants to prevent
spiders from touching one’s legs) can also help to maintain
a person’s fears.
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Biological Factors
Unlike other Anxiety Disorders, there has been
relatively less research pertaining to the role of biology or genetics
in causing Specific Phobias. Nevertheless, there is evidence to
support that Specific Phobias can sometimes run in families and
thus genetics may have a role to play.
An individual who has a family member with a Specific
Phobia is at an increased risk for developing this disorder.
Some research indicates that the pattern of types
is similar within families. For example, a first-degree biological
relative of individuals with a situational type is likely to have
Phobias of situations.
Studies indicate that the blood and injury Phobias
have strong familial patterns.
Agoraphobia
is not, as many people believe, just the “fear of marketplace”
as it literally means. It is actually the fear of being in any place
or situation where you do not feel safe or where the you feel trapped,
and are filled by an uncontrollable urge to escape to a place of
safety which, in most cases, your house.
Social Phobia
Social Anxiety Disorder (also known as Social
Phobia) is characterized by an excessive fear of scrutiny by
other people, or by a persistent fear of humiliation or embarrassment
in social or performance situations. Exposure to any kind of social
or performance situation almost immediately provokes an anxiety
response.
Specific Phobia
Barring Agoraphobia and Social Phobia, all other
Phobias come under this category. These are very common in children,
where they are essentially thought of as normal. But some Phobias
carry on until adult life.
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These Specific Phobias can be divided up as fears
of:
1. Animals (eg. Spiders, snakes, mice, birds and
insects)
2. The natural world (eg. storms, heights, water)
3. Blood, injection and injury, seeing or undergoing
invasive medical procedures, such as blood tests or injections (Blood,
Injection, and Injury Phobias are the only Phobias that are associated
with fainting in the feared situation. For example, more than two
thirds of people with a blood Phobia, and about half of people with
a needle Phobia report a history of fainting in the situation.
The fainting response is related to an extreme
drop in blood pressure that occurs upon exposure to situations involving
blood, surgery, and needles. In fact, most people experience a slight
drop in blood pressure in these situations, but not to the degree
experienced in people with Specific Phobias of this type.)
4. Certain situations (enclosed spaces, flying,
going in tunnels or over bridges)
5. Other Phobias: These include fear of loud sounds,
fear of costumed characters, such as clowns and the like
Between these five categories are close to 350
different types commonly known Specific Phobias. Starting from something
as ordinary as ‘Cathisphobia’-fear of sitting to something
as severe as ‘Ophiophobia’ – fear of snakes.
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Please note
There are a lot of Phobia-lise circulating on the
Internet that are often copied form here or there. It is not possible
to know the exact number of Phobias that exist for the simple reason
that no things, substances, or even concepts exist that someone,
someplace may not fear, with or without reason.
The most common Specific Phobias are fears of spiders,
snakes, and heights. Specific Phobias are more common in women,
and they often begin in childhood. People who suffer from these
Phobias rarely have any other psychiatric or psychological problems.
Persistent, intense and unreasonable fear of a
specific object or situation
Compelling desire to avoid the object or situation,
or enduring it with great torment. Impaired ability to perform your
everyday tasks normally
Anticipatory anxiety is characterized by feelings
of anxiety and nervousness before being exposed to the particular
situation or object of your Phobia. (e.g, a person with a fear of
flying may become anxious at the thought of going to the airport)
Physical symptoms of an anxiety attack include
Palpitations
Trembling or shaking
Numbness or tingling
Feeling dizzy
Difficulty in breathing
Nausea and Diarrhea
Sweating
Feeling of choking
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A Specific Phobia does not always require treatment.
If the person never needs to be in the feared situation, then treatment
may not be necessary. Often, however, the Phobia may limit the person's
social activities, interfere with the person's career, or even pose
a health risk if medical appointments are avoided.
But the good news is: Specific Phobias are
one of the most treatable of the Anxiety Disorders.
They are most effectively treated by psychological
rather than biological treatments. The primary goal of most treatments
of Specific Phobias is to reduce fear, phobic avoidance, impairment,
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for Specific Phobias.
The most frequently used form of therapy for the
treatment of Specific Phobias is a type of Cognitive Behavioral
Therapy (CBT) called systematic Desensitization or Exposure Therapy.
Desensitization or Exposure Therapy
In Desensitization or Exposure Therapy, you are
exposed in a safe and controlled way to the object or situation
you fear.
The most commonly used exposure therapy involves
gradual encounters with the fear-producing object, first in the
imagination and then in reality. For example, if you have fear of
blood, you would first imagine seeing blood, then view photos of
blood, and finally look at a blood in real life.
In each of these situations, the fear is faced
long enough, with support and increasing awareness of control that
the panic and anxiety begin to go away. These exposures are combined
with relaxation techniques and a therapist or friend at your side
to provide support.
With each repeated experience facing your fear,
you begin to realize that the situation, though disagreeable, is
certainly not dangerous. Gradually, you begin to feel an increasing
sense of control over your Phobia. This sense of control over the
situation and yourself is the most important benefit of Exposure
Therapy.
Medication
Medication is rarely used in the treatment of Specific
Phobias. However, if you are too nervous to participate in Exposure
Therapy, you may benefit from a low dose of Benzodiazepines or Beta-blockers
to decrease the nervousness.
The reduction of symptoms may, on the other hand,
interfere with the treatment. Benzodiazepines are also recommended
for anticipatory anxiety prior to an individual’s entrance
into a phobic situation.
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Approximately 19.2 million American adults
have some time of Specific Phobia in a given year, making it
one of the most prevalent psychological problems.
Approximately 15 million American adults are affected by
Social Phobia in a given year.
Approximately 1.8 million American adults have Agoraphobia
without history of Panic Disorder in a given year.
Women are twice as likely as men to develop them.
Phobias are the most common psychiatric illness among women
of all ages and the second most common illness among men older
than 25.
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