Phobias: An Introduction

Phobias are different to simple fears we all experience day to day. Phobias are when someone starts to rearrange their lives around a specific fear, they keep away or avoiding doing things purposefully to avoid their fear. 

Phobias are an anxiety disorder. They are defined as extreme out of proportion fear about a specific object or situation. Sometimes even the thought of the object or situation triggers deep anxiety. Phobias interfere with home and work functioning. It should be persistent typically lasting 6 months or longer. 

How common are Phobias?

In a single word, very. Phobias can affect anyone, regardless of age, gender or background. It is estimated that the 1 year prevalence of phobias ranges from 6 – 10% of the population. This would mean about 2 million Australians experience a specific phobia. It is the most common anxiety disorder. 

Types of Phobias

The types of Phobias or fear change as people get older. Children tend to fear specific objects or situations, for example strangers or loud noises. Usually these fears go away as the child gets older. Social phobias or Agoraphobia, which is a fear of leaving known or safe environments develops usually in adolescence or young adulthood. 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categories Phobias into 5 specific types.

  1. Animal Type (e.g., spiders, snakes, dogs)
  2. Natural Environment Type (e.g., heights, storms, lightening)
  3. Situational Type (e.g., airplanes, elevators, cars)
  4. Blood-Injection-Injury Type (e.g., needles, invasive medical procedures)
  5. Other Type (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting an illness, loud noises, balloons popping )

Phobias affect people in different ways. We all have mild anxiety regarding specific objects or situations. A phobia is different, the fear is extreme and disabling. 

Childhood fears and phobias

Sadly phobias are even more common in children. They grow in and out of certain fears which are usually age dependent. Here are some typical childhood fears:

  • Babies and toddlers (Until 2 years old) : Separation from parents, loud noises and strangers
  • Preschool ( 3 – 5 years old) : Dark, change to routines, monsters, sleeping alone and dreams.
  • School age ( 6 years and older) : Physical Injury, school and parental illness.

Signs of Phobias

Different people experience fears in different ways. Someone with a fear of spiders might not want to touch a spider. Whereas someone else might not even want to look at a picture of one. People with phobias go to varying lengths to avoid their fear. 

People experience varying degrees of panic or heightened anxiety in relation to their fear. Signs could include:

  • Palpitations or an increased heart rate
  • Sweating, trembling, hot flushes or feeling light headed
  • Numbness or tingling
  • Dry mouth, choking or a need to go to the toilet.
  • Fear of losing control, dying or disorientation

Social phobia and Acrophobia have other quite unique signs and symptoms. 

Social Phobia

Also known as social anxiety disorder; people who experience this condition feel anxious in social situations, worry about embarrassing themselves in public and are preoccupied with what others think about them

Agoraphobia

Signs of agoraphobia could include not wanting to leave home or a safe place. Finding open or crowded spaces unsettling which then leads to avoidance. 

Causes of Phobias

There does appear to be a difference in prevalence rates of phobia depending on gender, age and background. This is understandable. Our intrinsic make up effects how we think. 

Oftentimes frightening experiences in childhood contribute to phobias. If you were bitten by a snake or a dog, especially as a child, that would stick with you. Traumatic experiences can lead to fear and avoidance. This can be protective and useful. For a fear to become a phobia it has to impact functioning. If your fear of snakes and dogs prevents you from going to a local park, play ground or even stepping into your garden; the fear is inhibiting. 

Children learn by copying adults, particularly their parents. If a parent is fearful of spiders, constantly checking crevices and ceilings a child may aware the fear through observation. Children, especially at a young age might start to imitate parental behavior around situational worries. 

The news, social media content influences our thinking. Shark attacks or crocodile attacks reports on TV, warnings at the beach stories we hear from others can leave us irrationally afraid. Such worry might prevent us attending a beachside wedding or taking a ferry. 

Whilst traumas are a separate entity; there are some overlaps seen when trying to understand phobias. Take for instance someone who witnesses a shark attack whilst walking on the beach. That person might then go onto fear; walking on the beach or the sea. In this example the person wasn’t bitten by the shark; but associated the beachside setting as frightening. 

Past experiences also matter. For instance a fear of self driving cars may come about following a road accident. If the person was riding for the first time, they are likely to be terrified and would want to keep away autonomous vehicles. However if the person involved was an engineer developing and testing self driving cars for a living, they are less likely to be put off. The engineer given their past work experience and knowledge is less likely to be fearful. 

By returning to work the next day, the engineer is likely to have ongoing corrective experiences which would help with resilience development. If the first person in the example were to stay away from self driving cars, a phobia is more likely to develop. They would miss the opportunity to learn that self driving cars are not as frightening as their first experience had them believe. 

Implications of Phobias

Phobias can be debilitating, isolating and by definition impact on functioning. Having social phobia or agoraphobia can have knock on effects on self-esteem and mood. 

There is a stigma associated with phobias, people are sometimes labelled as being “weak”. Phobias can bring about embarrassment. Imagine having to explain to a new friend that you are afraid to visit because they own a dog.

Diagnosis and Assessment

Most people who have a phobia are well aware of it. They may not have attached a label to it, but do their best to avoid the certain object or situation.

If you have a phobia and want treatment for it, speak with your GP. Often times there are underlying psychological factors which can be addressed. Your GP as part of their assessment will want to know how your phobia impacts you. They can do a Mental Health Care Plan so that a Medicare rebate can be obtained when seeing a psychologist. 

Treatment

Most people with phobias do not seek treatment, either because they are not aware of treatment availability, chose not to or avoid the feared object or situation. 

Fortunately effective treatment is available. Often it is a combination of psychological interventions and self help techniques. 

Psychology for Phobia

You can see a Psychologist using a Mental Health Care Plan done by your GP for phobic disorders. 

Exposure therapy and desensitization for Phobias

This type of therapy starts usually with learning relaxation and de-escalation techniques. Thereafter there is gradual exposure to the feared stimulus. Using calming techniques learnt, the client is better able to manage their anxiety. Sometimes therapy is started with guided imagery exercises, followed by looking at pictures, videos and then direct exposure. 

Therapy and counselling

These techniques involve working with a therapist to get to the root cause of the problem, talking though it and developing strategies to cope. 

Medication for Phobias

Medications aren’t recommended for the treatment of anxiety. Sometimes doctors prescribe medications during the early phases of treatment or when there is a co-occurring depression or other mental health concern. Antidepressants, sedatives and beta-blockers are the classes of medications if used for phobias.

Self help strategies for Phobias

Lifestyle strategies form the basis of good mental health. Regular exercise, healthy diet and adequate restful sleep can help reduce phobia and other anxiety symptoms. 

Relaxation exercises and breathing techniques can also help. They are key to working through exposure and desensitization work. Fear triggers sympathetic drive, associated increased heart and shallower breathing. Effective use of relaxation techniques can help shortcut phobic responses. 

It’s not just elite athletes who can benefit from visualizing hitting the winning goal. Visualization along with relaxation techniques can prepare us to deal better with phobic triggers. Closing our eyes and imagining being near our friend’s dog could be the first step to addressing our phobia. 

Phobias can be very distressing and disabling. They can inhibit us around others. Fortunately there are effective ways to address phobia using psychology and other talking and behavioral strategy. Our team of friendly admin and psychologists are here to help. Send us a web inquiry or call us for more information. 

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