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Fears and Phobias

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Phobias, a type anxiety disorder is evidently different from normal fear. Normal fears have a minimal effect on day to day life. Phobias, however are defined as fear or anxiety that is persistent, excessive and out of proportion to the actual danger posed by the object of the phobia. 

When a person is phobic they will recognise non-dangerous objects or situations as imminent threats and experience excessive fear and anxiety.

Phobias are characterized by:

  • The fear or anxiety is about a specific object or situation which is Irrational and unreasonable fear

  • The object of the phobia nearly always causes immediate anxiety or panic

  • The phobia causes avoidance of the object or situation, or they are endured with great discomfort

  • The fear or anxiety occurs at levels excessive for the actual danger posed by the phobic object or situation

  • Powerlessness to control the intense fear

 

The  difference between a fear and a phobia can be blurred. Fears  are a normal part of development. However, unlike phobias, fears involve an ordinary fear response, have a minimal effect on daily function and resolve with time.

There are three types of phobia:

  • Specific Phobias

  • Social Phobia (now known as social anxiety disorder)

  • Agoraphobia

 

The clinical characteristics of phobias depend on the type of phobia, the degree of severity in a particular individual and the amount that it interferes with the individual’s ability to function normally. However, common to all three types of phobias is extreme fear or anxiety in response to a particular object or situation.

 

 

Specific Phobias

 

The DSM-5 outlines criteria for a specific phobia diagnosis:

  • The fear or anxiety is about a specific object or situation

  • The object of the phobia nearly always causes immediate anxiety or fear

  • The phobia causes avoidance of the object or situation, or they are endured with great discomfort

  • The fear or anxiety occurs at levels excessive for the actual danger posed by the phobic object or situation

As well, the diagnostic criteria for specific phobias specify that the fear, anxiety and avoidance behaviour must last more than six months, cause significant distress or impairment in functioning and not be due to another mental health disorder or substance use.

There are nearly limitless possible phobias, but some common specific phobia examples are:

  • Animals, especially snakes, spiders and dogs 

  • Seeing blood, receiving or seeing an injection

  • Loud sounds 

  • People, such as clowns 

  • Situations, including enclosed spaces (claustrophobia), heights (acrophobia) and flying (aerophobia)

  • Environmental, such as water (aquaphobia), thunderstorms (astraphobia), darkness (nyctophobia), tunnels and holes 

 Specific phobias can involve virtually anything. 

Specific phobias are the most common of the three types of phobias and are the most common type of anxiety disorder

 

 

 

 

 

Social Phobias

 

Social phobia, is also known as social anxiety disorder, is not a specific phobia but is classified as an anxiety disorder in the DSM-5. 

Social phobia symptoms are based on a persistent, irrational fear of embarrassment in social situations, particularly being negatively judged by others due to visible anxiety symptoms. People with social phobia typically experience intense fear or anxiety about:

  • Specific social situations, especially those where they may be scrutinized by others

  • Humiliation, embarrassment, and rejection due to their anxiety symptoms

  • Almost any social situation

Although most people are afraid of being singled out or embarrassed in public, people with social phobia experience fear or anxiety out of proportion to the actual situation and cannot function well because of their avoidance behaviors.

 

Agoraphobia

 

Agoraphobia is an excessive fear of having a panic attack in situations that would be embarrassing and from which escape is not possible. Agoraphobia symptoms vary from obsessively avoiding certain situations (such as crowded rooms or public transport) to the complete inability to leave home.

Agoraphobia is listed as an anxiety disorder in DSM-5 and is therefore not considered to be a specific phobia, despite its name. Because agoraphobia is set off by the fear of having panic attacks, it is closely associated with panic disorder.

 

 

Treating Phobias

Seeking treatment for Phobia becomes more likely when the phobia starts affecting the life of the person concerned. For example, someone who suffers from claustrophobia and suddenly finds that they cannot use lifts and find it hard to travel on trains or fly on planes. 

The treatment plans that I create for my clients will involve looking into cognitive distortions and using systematic desensitisation in hypnotherapy to overcome the fear and reduce the phobic avoidance behaviours through imagery. 

In some cases where possible the person will be advised to expose themselves to the phobic object gradually until the situation or object no longer elicits the excessive fear response. They are taught techniques for relaxing, calming themselves and dealing with anxiety.

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