All About Phobias

Heights, spiders, snakes or open spaces – these common phobias impact one in seven Australians. What causes phobias? And how can they be overcome?

Tammy Wells has a spider phobia. “It is not a rational fear or something silly that I can ‘just get over.’ It affects my life every day and the lives of everyone in my family. I am not just afraid—it is much more than that.” Tammy is not alone. About one in seven Australians is affected by one type of phobia or another.

What is a phobia?

A phobia is described as a chronic and extreme fear of an object or situation out of proportion to the danger actually presented by the feared “thing.” Common phobias may include situations such as social events, driving, heights or seeing blood and animals such as rats, snakes or dogs.

Anticipation of the danger associated with the phobia, even if it’s not in proportion to the situation, is associated with the fear, in addition to a sense of losing control and excessive anxiety, which can lead to panic attacks.

People with phobias are caught up in fears they know aren’t rational but are so strong that they avoid the situations that trigger them.

What’s the difference: fear or phobia?

Fear is a natural protective mechanism, meant to keep us from harm. Many of us have anxiety about things we’re uncomfortable with. However, when it triggers intense reactions and constantly interferes with the ability to function daily, it’s a problem.

Says psychologist Elizabeth Gilchrist, “For a fear to become a phobia, it must cause some level of impairment for the individual. As an example, spiders elicit a bit of squeamish [feelings] for many people, but when you start avoiding going into the grass in the summer because of your fear, it becomes a phobia.”

What are the different types of phobias?

Phobias are differentiated in several ways, but according to anxiety and depression group Beyond Blue, there are four main types.

Animal type: when a person is terrified of a specific animal or insect such as spiders, dogs or rodents.

Natural environment type: when a person fears natural forces such as storms, lightning or water.

Blood injury type: when a person is frightened of seeing blood (either theirs or someone else’s), getting an injection or undergoing a medical procedure.

Situational type: when a person is afraid of enclosed places, flying or driving, for example, or is excessively self-conscious in social settings, worries about being judged or avoids embarrassment from perceived poor performance or behaviour.

Who is affected by phobias?

Specific phobias are one of the most common mental health disorders. Specific phobias often begin in childhood, while panic attacks associated with phobias can develop at any age.

Age

Some phobias, such as blood injection injury or animal phobias, often develop in early childhood, with social phobias usually developing between the ages of 11 and 19. However, some specific phobias such as natural environment phobias of thunder and lightning, or fear of flying or driving, often appear in the late teens or twenties.

Sex

Although phobias affect both sexes, many types of phobias, including animal or natural environment types, are more common in women and girls. It is thought that men and boys may suffer equally from phobias, but are better at masking anxiety and are less likely to seek help.

Family

A family member who has a specific phobia, such as a fear of snakes or spiders, can influence others in the family towards similar reactions to the feared object or situation.

What causes phobias?

Many people have no idea why they possess unnatural fears of specific objects or situations. There are several ways, however, in which people can develop phobias.

Direct conditioning involves being afraid in a particular situation or by an object.

Vicarious acquisition involves witnessing a frightening event or seeing someone else react fearfully to a situation.

Informational transmission happens when someone is told about a fearful event through media or by someone they know.

What are possible complications of phobias?

Gilchrist says, “Most people do not seek help for a phobia. For example, [a] person afraid of dogs structures their walk to avoid known dogs.” However, there is a cost to avoiding the problem.

People who are troubled by phobias may experience feelings of loneliness and have trouble at work or with other relationships. Children with phobias may experience a delay or failure in developing social skills. Phobias can be devastating to people suffering from them; they can cause further complications such as social isolation, depression and substance abuse.

How do you cope with phobias?

Talk to your health care practitioner if you suspect you may have a phobia. Treatment may be easier than you think, with specific phobias being one of the easiest anxiety disorders to treat.

Gilchrist says, “Anxiety is one of the most common and treatable mental health issues, and the psychological treatment for anxiety is evidence-based and effective.” The goal for treatment is anxiety and fear reduction, so you can better manage reactions to situations that trigger them.

Exposure therapy is a behavioural treatment that “is one of the most effective behavioural methods for reducing fear and avoidance,” according to Gilchrist. She adds that in-person exposure treatment is more successful than through visual imagery, although they are both helpful.

Cognitive behaviour therapy (CBT) is a highly effective treatment, according to many studies. It includes techniques such as learning new ways to view situations and developing mastery over your thoughts.

Hypnotherapy is a treatment that focuses on the subconscious mind and deals with the emotions of phobias through memory, sensory-rich visualisations and metaphors, according to hypnotherapist Allan Clews. He adds, “Hypnosis can be particularly effective. Fears and phobias can normally be cured in four to five sessions.”

Support groups can be a helpful tool for connecting with others going through similar situations and seeking the same kind of support.

Loved ones can also be an important part of recovery, by providing support, without trivialising or requiring improvement without treatment.

Calming remedies

Dr Pamela Frank, a naturopathic practitioner, indicates that the constant fear of danger associated with phobias puts the body in chronic “fight or flight” mode, releasing adrenalin, redirecting blood flow and increasing heart rate, blood pressure, respiratory rate and sugar levels. She adds that this cycle of anxiety “further depletes your coping resources, and so your ability to deal with stress goes even lower and your anxiety level goes even higher.”

To help relieve stress, incorporate physical activity, meditation, tai chi or yoga into your schedule and avoid stimulants, such as caffeine and excess sugars and starches. Frank suggests calming supplement remedies including

• magnesium
• B vitamins
• GABA (gamma-aminobutyric acid)
• L-taurine
• valerian
• hops
• passionflower
• chamomile

You might also find comfort knowing that “what can be learned can also be unlearned,” says Clews.

What are the characteristics of a phobia?

Although the triggers of various phobias may differ, the reactions are often very similar.

• uncontrollable anxiety upon exposure to (or thinking of) the feared source
• excessive avoidance
• compromised ability to function normally in daily life
• feeling of powerlessness over fears, but awareness of the excessiveness of them
• physical reactions, such as perspiration, shortness of breath and rapid heartbeat

Glossary of common phobias