What is a phobia?
A phobia is an excessive and irrational fear caused by exposure to a specific phobic stimulus.
Anxiety about phobias is mainly the anticipation of exposure to the phobic stimulus in question, even the slightest verbal mention of it. In addition, negative thoughts about these stimuli are stirred more in the mind of the phobic person. As a result, patients with phobias will try to avoid the stimulus that causes them fear in any way.
Phobia is essentially fear except that it is more focused, more intense and chronic. Someone who suffers from a specific phobia may generally be a person who does not get scared easily in other aspects of their life.
Phobias have a frequency of approximately 5-15% in the general population with a predominance in the female sex.
What types of phobias exist?
Specific phobias usually begin in childhood and persist into adulthood. The most common are:
- Animal phobias: phobias about any kind of animal, most often for mice, spiders, cockroaches, snakes.
- Environmental-weather phenomena: storms, heat, water, floods, fires, earthquakes, darkness.
- Situational phobias: hypsophobia (acrophobia), claustrophobia (e.g., in elevators, airplanes), phobia of swallowing, driving, going to the dentist, etc.
- Needles-Blood-Injuries: A classic case in which people with this specific phobia have a fainting tendency to the sight and ingestion of blood. Studies have found that 4% of the US population has this phobia and that 20-50% of teenagers and 20-30% of young adults are afraid of needles.
- Drug phobia.
- Sexual phobias: such as sexual acts or fear of nudity.
- There are also many other rarer types that are not classified somewhere, such as phobias for specific places, mirrors, for sounds, etc.
- Agoraphobia and social phobia are also phobias, but they usually develop later in life, e.g., from adolescence or into adulthood. Agoraphobia is associated with the fear of being outside, while social phobia concerns places where other people are, regardless of whether they are inside or outside.
To talk about the existence of a phobia, the following conditions must be met:
- The specific object or situation almost always causes immediate fear or anxiety.
- The phobic object or situation is actively and persistently avoided for 6 months or more.
- The fear or anxiety we experience is disproportionate to the actual danger posed by the particular object or situation.
- There may be marked discomfort or impairment in social, occupational, or other important areas of functioning.
- The symptoms cannot be explained by another psychiatric disorder such as hypochondriasis , obsessive-compulsive disorder (OCD) , post-traumatic stress disorder (PTSD) , separation anxiety, social anxiety disorder, or substance abuse.
The most common symptom of a phobia is a panic attack. Characteristics of a panic attack include:
- shortness of breath
- rapid speech or inability to speak
- dry mouth
- stomach disorders
- motion sickness
- increased blood pressure
- chest pain or tightness
- profuse sweating
Why we have phobias
The exact causes are not known. However, some theories suggest that a specific phobia may develop due to associating a specific object or situation with feelings such as fear and panic. Two theories dealing with ways of learning have been proposed to show this connection.
The most common theory is called classical sensitization and states that a phobia is established when an event that causes fear or anxiety is paired with a neutral event . A simple example is when an activity such as driving is combined with an intense emotional/traumatic experience such as an accident. As a result, the individual becomes prone to a chronic emotional association between driving and anxiety and develops behavioral avoidance of driving in order not to experience the anxiety.
Another relevant case is the place and time one will experience a feeling of panic. For example if someone has a panic attack on a ship, then they may fear ships because their brain has misinformed them that the ship is the cause of the panic.
Another bonding mechanism is imitation, in which one person observes a reaction in another person and internalizes the other person’s fears or warnings about the dangers of a particular object or situation. This is the formal process through which we receive and adopt various characteristics from our parents, but also from other people in our immediate environment.
Finally, a hereditary dimension is recognized in some phobias such as e.g. for blood/needles. This particular phobia has a separate mechanism from the others. The tendency to faint is caused by a sudden firing of the parasympathetic system, which follows the initial activation of the sympathetic nervous system.
Coping with phobias
“How can I overcome my phobias?” many people ask, but they are not always willing to follow the appropriate approach. A phobia needs management and treatment if it causes you a problem in everyday life.
Avoidance or escape is the best way that the phobic patient will adopt to manage the problem by themselves. The problem is that avoidance does not defeat phobias, instead it perpetuates and worsens them. This is because :
- It prevents learning that situations are not threatening.
- It increases sensitivity to threatening elements.
- The temporary relief facilitates the repetition of this behavior.
- Guilt and shame, frustration and low self-confidence are created for the problem that won’t go away.
One of the most effective treatments for specific phobias is cognitive behavioral therapy (CBT). CBT aims to strengthen the awareness that the phobic stimulus is safe, a perception that will gradually prevail over the problematic learning that, as we mentioned above, has brought about the phobia. This is done through systematic desensitization and exposure.
It must be said, of course, that a phobia in someone with a depressive or narcissistic personality is a different phenomenon than a phobia in a characteristically phobic person (phobic neurosis). The same applies to the way to deal with it.
Antidepressants and anxiolytics do not treat the phobia itself but only reduce anxiety and physical symptoms, such as palpitations or dizziness that occur due to stimulation of the autonomic sympathetic system. It is the fight-flight response that is ingrained in humans to deal with danger.
Phobias are highly treatable, and people who have them are nearly always aware of their disorder. This helps diagnosis a great deal. Speaking to a psychologist or psychiatrist is a useful first step in treating a phobia that has already been identified.