We all find that certain objects or situations make us nervous or uncomfortable, but most of the time we get by without them impacting our lives. However, when a fear becomes a Specific Phobia, the fear, anxiety or avoidance related to the feared object/situation, can cause clinically significant distress and/or impairment in important areas of functioning.
Do you have a Specific Phobia?
- Do you experience marked fear or anxiety about a specific object or situation, such as flying, heights, animals, or blood?
- Does the object or situation almost always provoke immediate fear or anxiety?
- Do you actively avoid the object or situation, or endure it with intense fear or anxiety?
- Is your fear or anxiety out of proportion to the actual danger posed by the situation?
- Is your fear, anxiety, or avoidance persistent, and has it lasted roughly 6 months or more?
If you answered yes to most of these questions, you are not alone.
Specific phobias are thought to affect roughly 11% of the Australian population. Some common phobias include a fear of heights, flying, enclosed spaces, snakes, dogs, and needles. They are generally divided into five categories:
- Animal – Fear related to animals or insects such as spiders or dogs.
- Natural environment – Fear associated with the natural environment such as water, thunder or heights.
- Blood-injection-injury – Fear associated with medical procedures, such as needles, seeing blood or injury.
- Situational – Fear of a specific situation such as being in elevators, airplanes, or driving.
- Other – any other phobias, such as choking or vomiting.
Symptoms usually occur in early childhood, with the majority developing before the age of 10. However, situational phobias tend to have a later onset than other types of phobias. The degree of fear experienced can vary across different occasions due to a number of factors such as duration of exposure, presence of others, and proximity to the object or situation. Individuals with phobic reactions often experience panic attacks, or panic-like symptoms such as a pounding heart, sweating, trembling or shaking, sensations of shortness of breath, nausea, and chills or heat sensations when faced with, or thinking about the fear trigger.
What causes it?
There are several factors that are likely to increase a person’s risk of developing specific phobias.
Phobias can sometimes develop following a traumatic event (e.g. being attacked by a dog or trapped in an elevator), observing others go through a traumatic event (watching someone drown), an unexpected panic attack in a situation that hasn’t caused fear in the past but then becomes associated with panic (e.g. unexpected panic attack on a plane), or informational transmission (e.g. extensive media coverage on a plane crash).
Temperamental risk factors such as negative affectivity (the tendency to experience a variety of negative emotions across a variety of situations in the absence of an objective stressor), and behavioural inhibition (behaviour involving withdrawal, avoidance, or fear of the unknown) are risk factors for other anxiety disorders as well.
Genetic and physiological
There may be a genetic susceptibility to a certain category of specific phobia, for example, you are more likely to develop a phobia of animals if you have a parent, sibling, or child with the same phobia.
Is therapy necessary? Can’t I just avoid it?
Anxiety towards the phobic stimulus commonly involves an exaggerated fear of the probability of harm (e.g. I will suffocate because there won’t be enough oxygen in this elevator). This belief promotes your avoidance which prevents you from seeking correct information, and perpetuates the anxiety cycle. A part of therapy therefore involves challenging the beliefs about the imminent risk associated with the fear trigger. Therapy also includes psycho-education, such as discussing the effects of avoidant behaviour, and the nature of anxiety more generally. This provides the individual with the knowledge to be aware of how their body is reacting to their fearful thoughts, and how their usual methods of coping (e.g. avoidance) are not helping in the long run.
A core strategy to overcome phobias is gradual exposure therapy, which is currently considered the treatment of choice. This involves developing a hierarchy of the situations/objects you fear or avoid, and confronting them gradually. For example, someone with a fear of dogs might start with easier tasks (watching video clips of dogs, going to the pet store and looking at puppies behind the glass), then progress to slightly harder tasks (standing next to a few small dogs, standing 10 metres from a large dog on a leash) until they are able to complete their most feared task (touching a large dog). The process also includes teaching relaxation strategies, so that you have the tools required to manage your anxiety symptoms when they arise.
For those who find exposure therapy too demanding, or fail to maintain motivation for this type of therapy, exploring a combination of relaxation training and cognitive therapy can be worthwhile.
I have a strange phobia, can you still help?
All phobias are highly treatable, yet people often don’t seek help for it, usually because they are either embarrassed, or don’t realise therapy can be effective. Sometimes, their fears are not uncovered until they have started therapy, when they have sought treatment for other mental health conditions such as depression, which commonly co-occurs with specific phobia. There are many unusual or interesting phobias such as:
- Genuphobia – Fear of knees
- Botanophobia – Fear of plants
- Haphephobia – Fear of being touched by someone else
- Trichophobia – Fear of hair, specifically hair loss
- Nomophobia – Fear of being out of mobile phone contact
If your fears are impacting on your daily life, or keeping you from doing things that you enjoy, consider booking an appointment at M1 Psychology.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. DSM-V.
Hofmann, S. G., & Reineke, M. A. (Eds.). (2010). Cognitive-behavioural therapy with adults: A guide to empirically informed assessment and intervention. Cambridge, NY: Cambridge University Press.