Phobias – What Are They and How Do We Deal With Them?

A phobia is a “marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood)”.

Exposure to the phobic stimulus provokes anxiety even though the person recognizes that the fear is excessive, unreasonable or uncommon.  People avoid situations where the fear stimuli might be present even though avoiding it might have negative social consequences (avoiding flying even though your job calls for travel).

Specific types of phobias are:
Animals and insects, natural environment (heights, storms, water), blood-injection-injury (runs in families and is characterized by fainting) and situational (elevators, crowds, bridges, clowns).

How are phobias treated?  While it may be helpful to the individual to understand the origins of the phobia, the treatment of choice is cognitive behavioral therapy which helps the person to “desensitize” from the stimuli.  If a child is scared of dogs the steps might be to look at pictures of dogs and talk about them, then watch programs of dogs on TV, the look at dogs while in a car or from the house window, then slowly decrease the distance between the child and a very well behaved and safe dog until the child can be in the same room with one and tolerate it.  The goal is not to become best friends with a dog, just co-existence.

For those who are fearful of flying, find out the aerodynamics of how planes work.  (Note: Gripping the seat arm does NOT keep a plane in the air).  Talk with the airlines about getting a tour of the plane.  Meet the pilot and copilot of your flight.  Tell the crew how scared you are and ask that they check in with you from time to time.  See if there is an airline crew member who might be off-duty but traveling on the plane whom you might sit next to.  Ask your doctor for an anti-anxiety medication to help you with the flights.  Remember to breathe – a lot!

As with many things, the reaction of fear or anxiety to a phobic stimuli can trigger shame due to the judgments of people in our lives.  While “Just don’t look down” might work for people without a phobia of bridges, it is not useful to those who do.

Men have a high rate of the blood-injection-injury phobia and are often embarrassed about it and sometimes avoid the medical care they need in order to avoid their shame and fear of fainting.  It is the only phobia where the blood pressure goes down involuntarily instead of going up for fight or flight.  Some of the treatment for this is to lie down before any treatment, tell the medical person that you have this phobia, and get up very slowly when done.

If you suffer from a phobia, I encourage you to seek help and not suffer in silence with this most treatable problem.

The information on the definition and types of phobias in this article is taken extensively from the DSM-IV of the American Psychiatric Association, copyright 1994.