We are all afraid of something, be
it spiders, snakes, heights, flying or sharks. However, when a fear stops you
from enjoying life, and if you feel anxious at just the thought of coming into
contact with your fear, then you may have a phobia.
So, when does a normal fear become
a phobia? What is a phobia and what can you do about it?
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. Understandably, if an object, situation or just the thought of
something made you scared, you would avoid it!
How common are phobias?
A recent study by the National
Institute of Mental Health, found that between 8.7 per cent and 18.1 per cent
of Americans suffer from phobias, indicating that phobias are a common
Therefore, phobias can affect
anyone – estimated between 4-8 per cent of the population, including many
well-known celebrities. The comedian and game show presenter Howie Mandell is
said to be germ phobic, Jennifer Anniston is terrified of flying and Johnny
Depp is frightened of clowns.
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. For example, if as a child you were bitten by a dog, you may have
grown up feeling anxious every time a dog was near. Even though you may love
dogs, and really want one as an adult, the intense anxiety you experience when
close to even the fluffiest, friendliest dog prevents you from getting close,
let alone having a dog yourself.
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.
Why does this happen?
Our bodies are designed to respond
in specific ways to a perceived threat. 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
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 different threat – for example, if
we walk out in front of a car without looking, or someone pulls out in front of
us. In contrast, fear can be manipulated
by watching a scary or exciting film, where the director engineers this
response from the safety of your cinema seat. 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.
When to get help?
Most people can relate to a fear of
spiders, and perhaps seeing one may make most of us jump. 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 and refuse to go into a room until the place has
been checked as ‘all-clear’. The arachnophobic might also avoid certain films,
TV programmes, and spending time outdoors in case 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
How can phobias be treated?
The most effective treatment today
seems to be graded exposure (in vivo exposure) incorporating Cognitive
Behaviour Therapy. Graded exposure means slowly starting to unpick the learned
fear response. If you run away from the situation each time, you may never
learn that your anxiety does decrease in time and that there are no life
threatening consequences from having the object near you, or being in that
place. Therefore, back to our spider phobic, therapy would start with small,
gradual steps. For example, the client could start to look at a photograph of a
spider, record 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 level. The
client would move onto assignments that are more challenging and practice at
home until they could, for example be in the same vicinity as a spider, 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. This also involves
reaching a joint understanding of where the phobia may have originated and how
it is maintained. 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
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