We are all wary or afraid of something, so when does a normal fear become a phobia? What is a phobia and what can you do about it? This article tries to answer these questions and demystifies this common disorder.
First, a quiz, what are the following phobias a fear of? Pair the terms together, for example, Aviophobia is the fear of flying (answers at the end of this article).
1. Aviophobia a. Flying
2. Alektorophobia b. Frogs and toads
3. Icthyophobia c. Beards
4. Acrophobia d. Vomit
5. Emetophobia e. Heights
6. Cynophobia f. Speaking in public
7. Pogonophobia g. Fish
8. Hematophobia h. Blood
9. Batrachophobia i. Dogs
10. Glossophobia j. Chickens
It is thought that about 10% of people develop a phobia.
What is a phobia?
The word ‘phobia’ comes from the Greek word ‘phobos’ meaning ‘fear’ or ‘morbid fear’. It is an extreme fear related to an object or situation that is out of proportion to the actual threat posed. If something or the idea of something made you scared you would avoid it! Most people can understand a fear of spiders and perhaps seeing one might make us jump, and therefore we’d rather not see one. But, for the person with a phobia of spiders (arachnophobia) not only would they avoid spiders at all costs , they might also avoid places where there might be the slightest possibility of seeing a spider. The arachnophobic might also avoid certain films, TV programmes, and spending time outdoors on the off-chance that a spider might be lurking. Therefore, daily activities and things we would take for granted become fearful and complicated to the person with a phobia, remember the phobic person isn’t just anxious, they are terrified! So, if you were living in a landlocked country, then a fear of the sea (thalassophobia) would not be an issue, but here in Cayman, that would be difficult to cope with!
However, not all situations can be avoided or planned for. When the phobic person anticipates or comes into contact with the feared situation or object, he/she will experience anxious symptoms. The physical symptoms may include shortness of breath, palpitations, nausea, sweating and a strong desire to escape the situation. Only when the situation has been successfully avoided, or an escape has been made, will the person start to calm down. Not to be confused by the level of anxiety we all experience at times, the person with a phobia will describe the feeling as terror.
When confronted with a perceived danger, our bodies respond in specific ways. These physical sensations are the result of high adrenaline levels, commonly known as the ‘flight or fight’ response, in which the body prepares itself to either engage in combat, or run away. This biochemical reaction is thought to be an evolutionary response; for example when ancient man came across a tiger, this response enabled him to take quick action, an automatic response crucial to survival. In the absence of tigers, we may feel this rush of adrenaline in the presence of a real threat .However, the person with a phobia will have this exaggerated response in the absence of what most of us would perceive as a real threat.
Where do phobias come from?
There is debate regarding how a phobia develops. Some may stem from a particular incident with an object or situation and that becomes the basis of the phobia, which is reinforced as time goes by. Ivan Pavlov in the 1890’s and 1900’s famously demonstrated this by training his dogs to salivate in the presence of food when he rang a bell then salivate on hearing the bell in the absence of food; i.e. the behaviour was learned and Classical Conditioning was born. The behaviourist John Watson in the 1920’s, conditioned an 11 month boy known as ‘Little Albert’ to be fearful of a white rat by associating the experience of being with the rat and a loud noise which scared the boy. The boy became afraid of the rat and would no longer play with it. This was later repeated by Mary Jones in1924 with a slightly older boy, producing the fear anxiety response in not only rats, but a rabbit, white fur and cotton wool. So, some phobias may be learned, and it’s easy to see how anxiety can spread from specific object, to related objects and situations.
How can phobias be treated?
Years ago, treatment would include ‘flooding’, where the client would be in a room with the feared situation until their anxiety level went down. For example, if the fear was chickens, they would be placed in a room full of chickens and kept there until they were calm! Obviously, this is highly unethical and does not motivate the person with the phobia to continue with treatment !
The most effective treatment today seems to be graded exposure (in vivo exposure) incorporating (CBT) Cognitive Behaviour Therapy. Graded exposure means slowly starting to unpick the learned fear response. If you run away from the situation each time, you never learn that your anxiety does go down in time and that there are no life threatening consequences from having the object near you, or being in that place. So, back to our chicken phobic, therapy would start with small gradual steps. The client would start to look at a photograph of a chicken, note their anxiety level, and continue to look (without distraction or running away), until they felt calm again. This is done in session with the therapist encouraging the client at intervals to rate their anxiety. The client would move onto more challenging assignments and practice at home until they could, for example be able to hold a chicken, or have them scratching on the ground and feel reasonably relaxed. The cognitive bit of treatment (cognitive simply means ‘thoughts’) is about helping the client to modify their thoughts and beliefs about the phobia, and chip away at the imagined negative consequences that the person believes the object holds. Thus also involves reaching a joint understanding of where the phobia may come from and how it is maintained, for example by avoiding or seeking reassurance. Treatment can be daunting, as the therapist is asking the client to face the very thing they have avoided for years! However, for the motivated client, the results are positive and long lasting.
So, if you have a phobia and are fed up with how it affects you and your family, get some help now, what are you afraid of?!
Emma Roberts is a Cognitive Behavioural Therapist and Counsellor with the Employee Assistance Programme of the Cayman Islands. Telephone 949-9559 for a confidential appointment or visit our website, www.eap.ky
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