Anxiety, Fears, and Phobias

Specific Phobias

Millions of people have a specific phobia. Unlike agoraphobia, which may be a fear of many situations, specific phobias are defined as a fear of one living thing, object or situation.

Among the most common phobias are fear of:

• Spiders, insects
• Flying
• Enclosed spaces (claustrophobia)
• Sex
• Snakes, dogs, cats
• Blood, injury, medical and dental procedures
• Heights (acrophobia)
• Driving

To others, certain types of phobia may seem quite trivial and even funny. But to those who have them, phobias are not funny at all. Indeed, they can often be quite limiting in their effects.

• A fear of snakes may be so strong that people cannot hike in the country.
• A fear of elevators or of flying may be crippling to business people who need to attend meetings on the 20th floor or fly to other cities.
• A fear of injections may keep people from important medical or dental treatment.

The good news is that these specific phobias are usually very easy to treat.

One of the symptoms of a specific phobia is avoidance. For example:

• People who are afraid of elevators may get around the problem by always booking hotel rooms on the lower floors so they can take the stairs.
• People who are afraid of blood may avoid visiting friends in the hospital.

Sometimes, people can’t avoid the object or situation they are afraid of. And if they must come face to face with it, they may have symptoms similar to those experienced during panic attacks:

• Tense muscles
• Heart palpitations
• Anxiety
• Shortness of breath

In some cases, phobias may produce panic. Then, symptoms may include:

• Dizziness
• Fear of going crazy
• Feelings of unreality
• Fear of dying

There’s nothing unusual about being nervous around barking dogs, or insects. But people who are truly phobic are afraid even when there is no threat. Some people with a spider phobia break out in hives when shown pictures of spiders.

How Do Specific Phobias Start?

Certain fears are a normal part of human development. For example, preschool children usually go through a period of being afraid of small animals. But in some people, these fears last into adulthood. In other cases:

• A dramatic event (like being stuck in a subway) may mark the beginning of a phobia.
• A fear may be learned. When one member of the family becomes phobic, others may develop the same fear.
• A mild phobia may become more severe as a result of illness or pregnancy.

Most often, however, there is no apparent reason for the beginning of a specific phobia.

You should consider therapy if you are suffering a great deal from your phobia. For example:

• Your circumstances may have changed so that you must now face the object or situation you are afraid of more frequently that before. For example, someone who is afraid of flying may have a promotion that requires more air travel.
• The phobia may be starting to dominate your thoughts and dreams.

Different therapists take different approaches. But treatment usually involves exposure therapy to help people get used to the object or situation that causes their fear.

Medication is usually not needed for specific phobias, though the doctor may prescribe it for use on special occasions.

• For example, people who are afraid of flying may be helped by a tranquilizer to keep them calm for a few hours. If they don’t fly often, this may be all the treatment they need.
• In some cases, the therapist may find that a person has more than a simple, specific phobia. For example, a sex phobia may be part of a more complex social phobia. Or a driving phobia may be a sign of agoraphobia – the fear of public places.

Sometimes, a course of treatment for a specific phobia can be extremely short. For example, it may be possible to overcome the fear of spiders through exposure therapy in less than one hour – like this:

• Looking at small, black and white pictures of spiders.
• Seeing larger pictures of spiders, some of them quite big and hairy.
• Seeing color pictures of large tropical spiders.
• Seeing a dead spider in a jar.
• Holding the dead spider.
• Holding a jar with a live spider.
• Watching a live spider released a few feet away.
• Touching the live spider

Although exposure treatment of other phobias may require more time and may be spread over several sessions, the principles are the same. This type of treatment has a very high rate of success.