Phobias
What are Phobias?
Phobias are intense, irrational fears in the presence of, or in anticipation of, a particular object, situation or place. People who have a phobia may experience a deep sense of dread or panic when they encounter the source of their fear. Unlike general anxiety disorders, phobias are usually connected to something specific.
People can develop fears or phobias of literally anything. The largest percentage of people who seek treatment for phobias are people who have agoraphobia or social phobia. There are many identified specific phobias but the treatment approach is the same.
People with a specific phobia will go to great lengths to avoid their feared content which leads to a significant disruption in their lives. They know that the fear might not make much sense but often they describe a sense of powerlessness to stop it. The impact of phobias can range from annoying to severely disabling. Such fears can interfere with work, school, and personal relationships.
Causes of Phobias
Genetic and environmental factors can cause phobias. Children who have a close relative with an anxiety disorder are at risk of developing a phobia. Distressing events, such as nearly drowning, can bring on a phobia. Exposure to confined spaces, extreme heights, and animal or insect bites can all be sources of phobias.
People with ongoing medical conditions or health concerns often have phobias. There’s a high incidence of people developing phobias after traumatic brain injuries. Substance abuse and depression are also connected to phobias.
Types of Phobias
Agoraphobia
Adults with agoraphobia avoid situations where they think they will not be able to escape or find help. They avoid these situations due to fear of having a panic attack or other anxiety-related feelings.
The types of situations that people avoid include:
- Using public transportation (e.g. bus, train, car)
- Being in open spaces (e.g. fields, parks)
- Being in enclosed spaces (e.g. elevators, tunnels)
- Standing in line or being in a crowd
- Being outside of the home alone
People with agoraphobia are trying to avoid anxiety-related feelings including:
- Panic attacks
- Incapacitating or embarrassing panic-like sensations (e.g. loss of bowel control, feeling dizzy or falling over)
Social Phobia
Social phobia, or social anxiety disorder, is an extreme worry about social situations and it can lead to self-isolation. Social phobia can be so severe that the simplest interactions, such as ordering food at a restaurant or answering the phone, can cause panic-like symptoms. People with social phobia often go out of their way to avoid public situations.
People with social anxiety disorder usually experience significant emotional distress in the following situations:
- Being introduced to other people
- Being teased or criticized
- Being the center of attention
- Being watched while doing something
- Meeting people of authority (“important people”)
- Most social encounters, especially with strangers
- Going around the room (or table) in a circle and having to say something
- Interpersonal relationships, whether friendships or romantic
This list is not a complete list of symptoms. Other feelings have been associated with social anxiety as well.
The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling (fear of picking up a glass of water or using utensils to eat), swallowing with difficulty, and muscle twitches, particularly around the face and neck. Constant, intense anxiety that does not go away is the most common feature.
People with social anxiety disorder know that their anxiety is irrational and does not make rational (i.e., cognitive) sense. Nevertheless, “knowing” something is not the same thing as “believing” and “feeling” something.
For people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away, despite the fact that socially-anxious people “face their fears” every day of their lives.
Treatment
Treatment for specific phobias is conceptually very similar to the treatment for OCD: Exposure and Response Prevention Therapy, or ERP. No matter what subtype or particular content area the phobia takes on, the goal of treatment is to face it directly with the goal of increasing tolerance.
