What is phobia?
A phobia is an overwhelming and irrational fear of an object, place, situation, feeling or animal which can cause physical or psychological symptoms. Phobias are more prominent than fears and can also be complex which makes everyone’s experience of them unique.
Whilst there are things in life that we may feel scared of and warrant a fearful response, phobias arise when the individual’s fear is significantly larger than what the perceived threat should trigger. Phobias can affect a person’s day to day life as they may change their routine in order to avoid situations that would trigger anxiety.
Anxiety may rise when in contact with the cause of the phobia and in some cases, this may also prompt panic attacks. It may be useful to think of phobia like many other mental illnesses on a spectrum. Hence people with mild phobia may be unaffected in their day to day lives whereas the mental wellbeing, social life and day to day functioning of individuals that experience severe phobia may be greatly impacted.
Phobia is a form of anxiety and can be thought of on a spectrum ranging from mild to severe. It is therefore important to seek out help when the person experiencing phobia notices that it is having a detrimental impact on their mental wellbeing, social functioning or daily life.
Signs that it may be impacting ones life may be not doing things you otherwise would have done and have previously enjoyed doing, or using adverse coping mechanisms to cope with the anxiety caused by phobia such as alcohol, drugs or self harming behaviours.
Phobia, anxiety and panic attacks
Often the response to a phobia may be anxiety, however individuals with severe phobia may feel anxious even when they are not exposed to the specific object or situation that involves the phobia. What may also cause anxiety is the fear of being scared.
There may be cases where the phobia contributes to such increased anxiety that it leads to a panic attack. For some the panic attack itself may become a traumatic event and may cause a phobia of panic attacks. Hence once a person starts to feel a bit anxious they may start to become fearful of having a panic attack which in turn may increase their anxiety further.
Phobia or fear?
Distinguishing between phobia and ordinary fear may appear difficult but there are ways to differentiate the two. A phobia is defined by a disproportionate response of anxiety and fear of an object or situation, whereas ordinary fear is a natural response that protects us from harm when we face real danger.Phobias are characterized by a persistent fear even when there is evidence that the fear is unfounded.
How does phobia develop?
Phobia cannot be attributed to a single causal factor. However, research suggests that a combination of genetic and environmental factors may contribute to someone developing phobia. For example, children with a close relative that experiences severe anxiety are more likely to develop phobia than children who don’t. Traumatic events such as drowning accidents or encounters with snakes may also contribute to developing phobia. The traumatic event could also not be dangerous but may be perceived as dangerous by the child, which may in turn cause the person to have similar feelings when they remember the object or situation that initially prompted them. Hence when something similar occurs it may prompt the traumatic feelings to arise. A phobia is therefore an assimilation of feelings that are developed reflexively when the perceived traumatic incident recurs.
Another common attribute to phobia is comorbidity. Therefore, individuals that experience ill mental health may also have phobias. Phobias have been associated with anxiety, depression, substance abuse, brain injury and schizophrenia.
Common types of phobias
According to the Diagnostic and Statistical Manual of Mental Disorders specific phobias are typically split up into five categories. These categories are fears related to animals, natural environment, injury, situation, or other types that do not fit into the four aforementioned categories.
Phobias related to animals are centred around insects or animals and may include cynophobia (fear of dogs), ophidiophobia (fear of snakes) and arachnophobia (fear of spiders).
Phobias related to the natural environment involve weather and environmental events, these can be astraphobia (fear of lightning) or aquaphobia (fear of water).
Phobias related to injury encompass a fear of physical harm, blood, or medical issues, such as injections, falls or broken bones. Phobias of the injury type can be dentophobia (fear of going to the dentist) or trypanophobia (fear of injections).
Phobias related to specific situations may involve flying, driving, or riding in an elevator. These may include claustrophobia (fear of enclosed spaces).
The last category includes all the phobias that do not fit into the category and involves phobias like choking, vomiting or loud noises.
How is phobia treated?
The treatment can include changes in lifestyle, psychoeducation, self-help materials and programs, psychological therapies, and medication.
The most prevalent psychological treatments for phobias are Cognitive Behavioural Therapy (CBT) and exposure therapy. Nevertheless, other therapies and medication can also be used to treat phobias. Although it may be important to understand the cause of the phobia, the breadth of treatment focuses on any avoidance behaviours that have developed because of the phobia. Avoidance tends to reinforce negative thoughts about the fear, hence trying not to avoid feared objects or situations is important.
The aim of the treatment is for the individual to no longer be limited by their phobia and to consequently improve their mental wellbeing and quality of life.
The focus of exposure therapy is to change the reaction to the situation or object that triggers the phobia. Exposure therapy involves understanding the thoughts, feelings and physical symptoms that arise when you are exposed to the route of the phobia and how to manage the anxiety. The process involves progressively and gradually exposing the individual to the specific phobia. For example, if an individual fears spiders, the therapy may start by asking the individual to think about spiders, then look at photos of spiders, look at videos of spiders and then look at spiders in an enclosure.
Cognitive behavioural therapy (CBT) encompasses exposure alongside other ways in which to cope with the phobia. CBT can also involve changing an individual’s beliefs about the phobia and focuses on understanding one’s thoughts, feelings, behaviours and physical sensations so as not to feel overwhelmed by them. CBT also allows the individual to recognise the short and long term consequences of their behaviours, as for example avoidance of a difficult situation or object may contribute to short term relief but may lead to long term changes in one’s routine and debilitating phobia.
Other treatments may involve self help materials or group therapy where one can share their experience of the phobia with others that may be experiencing something similar.
In most cases psychotherapy using exposure therapy is effective in treating phobia. Nevertheless, medication can also be prescribed to decrease the anxiety that may be experienced by thinking about or being exposed to the phobia.
Other tools that can be helpful for treatment of phobias can be mindfulness, relaxation techniques and physical activity. Mindfulness involves bringing your attention to the present moment on purpose, one may try to practice having their cup of tea mindfully, like focusing on how their body may be feeling, what the texture and warmth of the cup feels like and the taste of the tea. By bringing one’s attention to the here and now one may notice that they are no longer worrying about the future or the past, or feeling overwhelmed by their thoughts. Relaxation techniques could be various breathing exercises and progressive muscle relaxation which can also help with anxiety.
Along with the strategies there are things individuals can also try to do to help with their phobia. Finally taking care of oneself, getting enough rest, eating well and getting some form of movement can be beneficial to mental wellbeing and make an individual feel better prepared to face situations that can be anxiety provoking.