Specific/Simple Phobias
Overview
Phobias are the most common type of anxiety disorder and can affect anyone, regardless of age, sex and social background.[1] Phobias are overwhelming, unreasonable, uncontrollable and lasting fear of objects or situations that pose little real danger but provoke anxiety and avoidance. They cause intense physical and psychological reactions, and can affect your ability to function normally at work, at school or in social settings.[2,3]
If someone does not come into contact with the source of their phobia very often, it may not affect their everyday life. While someone may not experience any symptoms until they come into contact with the source of their phobia, others can feel anxious or panicked even thinking about the source of their phobia (i.e., anticipatory anxiety). If a phobia becomes very severe, a person may organize their life around avoiding the thing that's causing them anxiety. As well as restricting day-to-day life, this disorder can also cause a lot of distress.[4]
About 19 million Americans have one or more phobias that range from mild to severe (inducing panic attacks). While phobias can happen in early childhood, they are often first seen between ages 15 and 20. Although they affect both men and women equally, men are more likely to seek treatment for phobias.[5]
Types of Phobias
Phobias can be divided into 2 main categories: Specific/Simple and Complex (i.e., Social Phobia and Agoraphobia.)
Specific/Simple Phobias center around a particular object, animal, situation or activity. They often develop during childhood or adolescence and may become less severe as you get older.[6]
Examples may include a fear of:[7]
Flying (e.g., fearing the plane will crash)
Dogs (e.g., fearing the dog will bite or attack)
Closed-in places (e.g., fear of being trapped)
Tunnels (e.g., fearing a collapse)
Heights (e.g., fear of falling)
Signs and Symptoms
Regardless of phobia type, common symptoms those with phobias exhibit include:[8]
An immediate feeling of intense fear, anxiety and panic when exposed to or even thinking about the source of your fear
Awareness that your fears are unreasonable or exaggerated but feeling powerless to control them
Worsening anxiety as the situation or object gets closer to you in time or physical proximity
Doing everything possible to avoid the object or situation or enduring it with intense anxiety or fear
Difficulty functioning normally because of your fear
Physical reactions and sensations, including: sweating, trembling, shaking, rapid heartbeat, tight chest or difficulty breathing
Feeling nauseated and/or upset stomach
Dizzy, lightheadedness or fainting
Children present: tantrums, clinging, crying, or refusing to leave a parent's side or approach their fear
Causes
Research suggests that both genetic and environmental factors contribute to the start of phobias.[9] While phobias do not have a single cause, there are a number of associated factors.[10,11]
A phobia may be associated with a particular incident or trauma
A phobia may be a learned response that a person develops early in life from a parent or sibling (brother or sister). This is particularly the case for Specific Phobias.
Genetics may play a role – there's evidence to suggest that some people are born with a tendency to be more anxious than others
Diagnosis
While phobias are often not formally diagnosed, the majority of people with a phobia know their fear is extreme. Sometimes, a person will choose to simply live with a phobia, taking great care to avoid the object or situation they're afraid of. However, as a phobia cannot be overcome in this manner, the continual avoidance tends to result in a worsened situation.[12,13]
A physician or mental health professional (e.g., psychiatrist or psychologist) can make a formal diagnosis of a phobia based on specific criteria in the DSM-5. This typically occurs when the specific fear interferes with one’s daily activities of school, work, or home life or is excessively upsetting.[14]
Complications
Phobias can be devastating, leading to problems that affect many aspects of life. If untreated, phobias can cause:
Social isolation - Avoiding places and things one fears can cause academic, professional and relationship problems. Children with phobias are at risk of academic problems and loneliness, and may have trouble with social skills if their behaviors significantly differ from their peers.
Mood disorders - Many people with specific phobias have depression as well as other anxiety disorders.
Substance abuse - The stress of living with a severe specific phobia may lead to abuse of drugs or alcohol.
Suicide - Some individuals with specific phobias may be at risk of suicide.[15]
Treatment
The majority of phobias can be successfully treated and cured.[16] Generally, cognitive behavioral therapy (CBT) is the primary treatment for phobias and is usually considered a short-term treatment. CBT focuses on teaching a person the specific skills to better tolerate anxiety, directly challenge their worries and gradually return to the activities they've avoided due to their anxiety. Through this process, symptoms improve as one builds on their initial success.[17] While medication is not usually used to treat phobias, it may be prescribed to help people cope with the effects of anticipatory anxiety.[18]
For specific phobias, CBT with exposure and response prevention (ERP) is advised. In exposure therapy, people are gradually exposed to what frightens them until the fear starts to fade. Relaxation and breathing exercises also help to ease symptoms.[19]
Self-Help Techniques
In addition to cognitive behavioral therapy (and medication at the direction and supervision of one’s physician), a person suffering from phobias may wish to incorporate the following self-help techniques into their routine:[20]
Relaxation Techniques – A series of physical exercises that can help someone relax and have better control over their breathing, particularly during an anxiety or panic attack.
Visualization – This the combines relaxation and breathing techniques mentioned above with the mental visualization how one will successfully deal with a situation that could cause anxiety.
Self-Help Groups and/or Group Therapy – Meeting others with similar experiences and sharing ways of coping can provide enormous support for those suffering from phobias.
Contributed by: Jennifer (Ghahari) Smith, Ph.D.
References
1 “Overview – Phobias,” NHS. (accessed 2-23-2022). www.nhs.uk/mental-health/conditions/phobias/overview/
2 “Specific Phobias,” Mayo Clinic. (accessed 2-22-2022). www.mayoclinic.org/diseases-conditions/specific-phobias/symptoms-causes/syc-20355156
3 “Phobias,” Johns Hopkins Medicine. (accessed 2-22-2022). www.hopkinsmedicine.org/health/conditions-and-diseases/phobias
4 “Overview – Phobias,” NHS.
5 “Phobias,” Johns Hopkins Medicine.
6 “Overview – Phobias,” NHS.
7 “Phobias,” Johns Hopkins Medicine.
8 “Specific Phobias,” Mayo Clinic.
9 “Phobias,” Johns Hopkins Medicine.
10 Ibid.
11 “Overview – Phobias,” NHS.
12 Ibid.
13 “Phobias,” Johns Hopkins Medicine.
14 Ibid.
15 “Specific Phobias,” Mayo Clinic.
16 “Overview – Phobias,” NHS.
17 “Agoraphobia,” Mayo Clinic. (accessed 2-23-2022). www.mayoclinic.org/diseases-conditions/agoraphobia/diagnosis-treatment/drc-20355993
18 “Overview – Phobias,” NHS.
19 “Phobias,” Johns Hopkins Medicine.
20 “Self Help – Phobias,” NHS. (accessed 2-23-2022). www.nhs.uk/mental-health/conditions/phobias/self-help/