A phobia is an excessive or unreasonable fear of an object, place or situation. Simple phobias are fears of specific things such as insects, infections, flying. Agoraphobia is a fear of being in places where one feels 'trapped' or unable to get help, such as in crowds, on a bus, or standing in a queue. A social phobia is a marked fear of social or performance situations.
What causes phobias?
Phobias are extremely common. Sometimes they start in childhood for no apparent reason; sometimes they emerge after a traumatic event; and sometimes they develop from an attempt to make sense of an unexpected and intense anxiety or panic (for example, 'I feel fearful, therefore I must be afraid of something').
When the phobic person actually encounters, or even anticipates being in the presence of the feared object or situation, s/he experiences immediate anxiety. The physical symptoms of anxiety may include a racing heart, shortness of breath, sweating, chest or abdominal discomfort or trembling and the emotional component involves an intense fear - of losing control, embarrassing oneself, or passing out.
Commonly, people try to escape - to avoid the feared situation wherever possible. This may be fairly easy if the feared object is rarely encountered (e.g. fear of snakes) and avoidance will not therefore restrict the person's life very much. At other times (e.g. agoraphobia, social phobia) avoiding the feared situation limits their life severely. Escape and avoidance also make the feared object/situation more frightening, and reinforce the fear.
With some phobias the person may have specific thoughts which attribute some threat to the feared situation. This is particularly true for social phobia where there is often a fear of being negatively evaluated by others, and for agoraphobia when there may be a fear of collapsing and dying with no one around to help, or of having a panic attack and making a fool of oneself in front of other people.
With other types of phobias there may be accompanying frightening thoughts ('This plane might crash'; 'I'm trapped'; 'I must get out'). Yet, it is more difficult with some phobias to identify any specific thoughts which could be associated with the anxiety (e.g. it is unlikely that a spider phobic is afraid of making a fool of themselves in front of the spider). With these phobias the cause seems to be explained more as a conditioned (learned) anxiety response which has become associated with the feared object - more likely an automatic 'body' response to a stimulus.
There are several counselling and hypnotic approaches to helping a phobic person. Traditional treatments involving the use of 'Systematic Desensitization' techniques are very effective and can generally be completed in relatively short periods of time (several weeks in some cases).
Clients can learn powerful relaxation techniques and begin to gradually desensitize themselves, under instruction, to an increasing range of (previously) stressful stimuli. Someone with a fear of snakes may begin treatment by first learning to associate a relaxation response with viewing pictures of snakes and gradually progress, as each hierarchical stage is managed, to perhaps handling a snake. The stages may for example involve:
Firstly, reading about snakes
Then viewing and touching a photograph of a snake
Looking at and touching a plastic model of a snake
Looking at and touching a jar with a small snake in it
Picking the snake out of the jar
Picking up and handling a large snake.
This technique is based on replacing the previously learned and automatic stressful or panic response with a newly learned response of relaxation.
Cognitive behavioural approaches will also involve some level of exposure or confrontation with the feared situation, and will emphasize some new, 'rational' methods of examining and dealing with stressful and frightening thoughts.
Other useful treatments, discussed elsewhere on this website could involve the use of hypnosis, biofeedback and neuro-feedback techniques, a range of relaxation strategies, and other forms of energy therapies.
You may need to seek professional help if:
Your phobias are interfering with your ability to lead a full, normal life and you don't make any progress in challenging them yourself
You are experiencing a lot of anxiety or distress, and you seem to be feeling like this often
You are avoiding situations that matter
You suffer from overwhelming blushing/trembling/sweating in social situations or feel that you lack social skills.
Listed alphabetically, our approach to treating phobias includes: