Phobias
Chapter 16. Mental Health Conditions

A phobia is an irrational fear of a specific situation, activity, or object. The phobia compels the sufferer to avoid whatever is feared because with it comes a number of troubling symptoms such as:
Anxiety
Rapid heartbeat
Sweating
Hot or cold flashes
Choking, smothering feelings
Shaking
Dizziness, faintness
The need to flee the situation
Panic attack, sometimes. (See Panic Attacks)

Children may express their anxiety by:
Crying
Clinging
Tantrums
Freezing in place

Types of Phobias
Specific Phobias. These are sometimes called simple phobias. The irrational fear is of specific objects such as snakes, dogs, closed spaces, or heights. (See table below for some common phobias.)

Most of the time, simple phobias develop during childhood and often go away with time. Those that continue into adulthood rarely go away without treatment.

Social Phobias. The irrational fear is of being embarrassed or humiliated in public. Examples of situations leading to this include:
Public speaking (this is the most common social phobia)
Stage fright
Eating in public
Talking to coworkers
Asking someone out on a date

Agoraphobia. The irrational fear is of being alone in public places in which the person:
Feels trapped with no way to escape (or thinks it would be difficult to escape)
Would be very embarrassed or helpless when phobic symptoms occur
Fears being totally unable to take care of himself or herself if help was not around

Agoraphobia can occur with or without panic disorder. (See Panic Attacks.) It most often comes after having panic attacks because the sufferer avoids the places where panic attacks occurred. He or she fears that something about the location caused the panic attack. The fear of having another panic attack can result in avoiding going out in public. In severe cases, persons with agoraphobia don't leave their home at all.

Treatment
Treatment for phobias depends on the type of phobia and how much the fear keeps a person from normal life activities. Methods of treatment include:
Behavior therapy - one type is called exposure therapy. This type exposes the person to the feared situation or object in one of two ways:
Gradual exposure. This is called "systematic desensitization." A therapist works with the
person in gradual steps. First the person learns relaxation methods to deal with the physical
responses to his or her phobia. Second, the person imagines the source of the phobia. Next,
the person looks at pictures of the feared object or ones that depict the feared situation. Finally,
the person is gradually exposed to the situation or feared object.
Direct exposure. This is known as "flooding". The person is exposed to the feared object or
situation all at once (in the presence of a therapist). The person stays in that situation until his or
her anxiety is markedly less than its previous level. Sessions doing this are repeated until the person
can handle the phobic situation alone.
Group therapy and/or self-help support group therapy such as Agoraphobics in Motion (A.I.M.).
Medication. Types include certain antidepressants, antianxiety medicines, tranquilizers and ones known as beta blockers. These medicines block or reduce the panic symptoms that come with phobic situations. In so doing, they help a person confront the feared situation when they might have been too afraid to do so otherwise.

Medications are especially helpful for persons who have agoraphobia with panic disorder. Certain beta blockers can be useful for persons who suffer from stage fright.

Questions to Ask

Do you have all of these problems? Panic disorder (See Panic Attacks) Anxiety about being in places or situations from which escape might be difficult or embarrassing or in which you could not get help if you had a panic attack You avoid places outside of the home alone, such as ones that involve: - Being in a crowd - Standing in a line - Being on a bridge - Traveling in a car, bus or train	OR
Did you answer yes to parts 2 and 3 of the first question, but you don't have panic disorder or get panic attacks?
Are there certain objects or situations which cause you to feel intense fear or terror to the point that you lose control of yourself?
Do you avoid certain situations, objects, persons, or places to the point that doing so is interfering with tasks you want to get done?

Self-Care Tips

The following tips are ways to deal with phobias that do not disrupt your daily life. They may also be employed with or after professional treatment.
List your irrational fears. Writing them down helps you to identify them. Try to figure out why you have the fears, what you think they mean, what they might symbolize, and what you can do to deal with them. Doing these things can give you some control over your fears.
Learn and practice relaxation techniques. These allow you to feel more comfortable and show that you can control the physical symptoms which result from your phobia. They also help you remain in the situation long enough to realize that you are not in any danger. Two important relaxation techniques to use are:
Controlled Breathing. When you panic, you overbreathe or hyperventilate, which makes you
dizzy. This causes your heart to race and makes you feel weak and tremble. Take a few deep
breaths and hold each one to the count of 3, then exhale slowly to the count of 3. This will help
restore normal breathing, slow your pulse, and remedy your dizziness and shakiness.
Tension Control. When you panic, you tense your muscles, making them feel hard and
uncomfortable. Relax each muscle group (arms, legs, neck, shoulders) until you feel the tension
subside. Practice this technique until you can relax your muscles simply by thinking about relaxing
them.
If you have a fear of speaking in public, enroll in a public speaking course such as Dale Carnegie.
If you are afraid of flying, take a course designed to help people conquer this fear.
Also, see Self-Care Tips: Ways to Deal with Panic that has Limited Symptoms and Duration.
See a counselor if Self-Care Tips do not help you deal with your phobia on your own. (See also, "Places to Get Information & Help" under Anxiety/Phobias.)

HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine. 

Return to Menu

Date updated 04/20/99