Phobias

A phobia is an intense and often irrational fear of something that in fact poses little or no real threat. When you have a phobia, even though you realise that your fear is unfounded, you are unable to control your feelings. Merely thinking about the object or situation you fear may make you anxious and upset. And if you are physically exposed to your phobia, you are likely to automatically experience overwhelming terror. ?
Common phobias include enclosed places, heights, spiders, snakes, needles and flying – but it’s possible to develop a phobia about virtually anything. Most phobias originate in childhood, but they sometimes develop in adults.
Many sufferers find their phobia so disturbing that they are prepared to take extreme measures to avoid it, even to the extent of greatly inconveniencing themselves, or making significant lifestyle changes. Someone who fears heights, for example, may be happy to drive an extra ten miles to and from work each day, simply to avoid driving over a high bridge. Or a claustrophobic person would be unable to unable to travel in the cramped confines of a lift, or even an underground train.

What are the symptoms of phobia?

A phobic person experiences both physical and emotional symptoms of anxiety or fear when they think about, or are exposed to, the object of their phobia.
The symptoms can range from mild apprehension to a severe panic attack. The fear normally increases as the person gets closer to the object of their phobia and becomes increasingly heightened if escape seems difficult.
Common signs of a phobic reaction include:
• Shortness of breath or the sensation of air being restricted
• A choking feeling
• Palpitations, a pounding heart or a rapid heartbeat
• Chest discomfort or pain
• Numbness or tingling sensations
• Trembling or shaking
• Sweating
• Hot or cold flushes
• A sick feeling or stomach distress
• Feeling unsteady, dizzy, lightheaded or about to faint
• Feelings of unreality or of being detached from yourself
• Fear of losing control or going crazy
• Fear of dying

What causes a phobia?

It’s not entirely clear how phobias originate, but it’s widely believed that the potential to develop a phobia is increased by certain genetic, cultural and experience factors.
Genetic factors
Research has shown that some phobias may run in families. For example, twins sometimes develop the same phobias despite being brought up in different locations. However, many people with phobias have no relatives at all with the same phobia.

Cultural factors

Some phobias only occur in certain cultural groups. A good example is a social phobia syndrome that is almost exclusive to Japan, called taijin kyofusho. This is a fear of offending or harming others in social situations – which differs from the more common phobia in which an individual is afraid of being embarrassed on humiliated in a social situation.
Life experience
It is believed that many phobias originate from a past event that might not even be consciously remembered. For example, claustrophobia may result from being shut in a cupboard, while a phobia of dogs may stem from being attacked as a small child.

What treatments are there for a phobia?

Systematic desensitisation
The most frequently used (and most effective) phobia treatment is a type of cognitive behavioural therapy (CBT) called systematic desensitisation, or exposure therapy.  Research figures suggest that about 75% of people overcome their phobia through exposure therapy. The treatment centres upon exposing the phobia sufferer in a safe and controlled way to the object or situation they fear. Gradually increasing encounters with the fear-producing object are used, initially in the imagination and then in reality.
For example, for a dental phobia, the person might first sit in the dentist’s waiting room, then talk with the dentist, and then sit in the dentist’s chair. These exposures are combined with relaxation techniques, plus support provided by a therapist or friend. Repeated exposures to the fear develop a realisation that although the situation maybe unpleasant, it is not harmful. Each exposure gives the patient an increasing sense of control over their phobia, so that the phobia gradually becomes weaker. Feeling in control of the situation is the most important benefit of exposure therapy.
Participant modelling
This is an alternative type of exposure therapy in which the therapist models healthy ways to interact with the object of the phobia. So for a computer phobia, the phobic person would watch while the therapist uses a computer in a calm and relaxed manner. Then the phobic person would be encouraged to do the same.

When is it right to seek help for a phobia?

Although phobias are common, they don’t normally cause much disruption to everyday life. A snake phobia, for example, rarely causes anxiety for a city dweller – whereas someone with a severe phobia of crowded spaces would find city life extremely challenging.
If your phobia doesn’t affect your lifestyle much, there’s probably no need for concern. But if avoiding the source of your phobia interferes with your everyday life or stops you doing things you enjoy, you should probably seek help, especially if:
• Your phobia causes intense fear, anxiety and panic
• You recognise that your fear is irrational and excessive
• You avoid certain situations and places because of your phobia
• Avoidance interferes with your normal life or causes significant distress
• You’ve been badly affected by the phobia for at least six months

How long does phobia treatment take?

Some phobias, such as fear of flying, are so common that there are therapists who specialise in their treatment. Minor phobias can be treated in as few as two or three short exposure-based therapy sessions or even a single long session. But overcoming a severe phobia may require a number of treatment sessions.