By Yiing Tan – Registered Psychologist

Fear is a natural human emotion, however when it becomes irrational or exaggerated, it transforms into phobia, an intense fear that can negatively impact a person’s life. From the common fear of heights to more peculiar aversions like butterflies or seashells, this blog offers some general insights into phobias that may help in recognizing them within ourselves or others.

So, what exactly are phobias?

A phobia is defined as an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity. This fear can be so overwhelming that a person may go to great lengths to avoid the source of this fear. This fear can also be found in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5-TR, known as Specific Phobia, that falls under the category of Anxiety Disorders.

People sometimes wonder if the fear that they are experiencing is actually a phobia, or a ‘usual’ kind of fear. Let’s have a look at this example of Charlie and his fear of heights:

• Usual fear: Charlie stands on a balcony and feels somewhat uneasy looking down from the height. He steps back, feels a little nervous, but is able to enjoy the view and carry on without further challenges.
• Phobia: Charlies stands on a balcony, and the feelings of fear and anxiety becomes overwhelming. His heart races, he feels dizzy, and even just the thought of heights would trigger a panic. He avoids high places at all costs, as the fear feels uncontrollable and paralyzing.

In a nutshell, phobias tend to be intense, specific, irrational, highly avoided, impairs functioning, and can last for long periods if left untreated.

Common types of Phobias and Their Impacts on Daily Life

Animal related, e.g., snakes, spiders, dogs

• People with animal related phobias may go to great lengths to avoid places or situations where they may encounter the specific animal(s), or constantly be checking if the animal(s) are present in their environment.

Health-related, e.g., needles, medical procedures

• Individuals undergoing medical treatment or those who are required to do medical testing may avoid receiving treatment due to their intense fear towards e.g., needles, making treatment or assessments difficult. Children may exhibit strong negative reactions when a doctor visit is warranted, interfering with the child’s overall well-being and medical compliance.

Situational-related, e.g., elevators, airplanes, crowded places or places where escape might be difficult (agoraphobia)

• Adults and children with agoraphobia may avoid leaving home altogether, leading to social isolation and difficulties engaging in everyday activities. Individuals with fear of elevators may avoid buildings with elevators, preferring to take stairs, and again, in extreme cases – avoid going out altogether if they are expected to use an elevator.

Apart from the physical, emotional, social and daily functioning impacts, phobias may also negatively impact the individual’s relationships with others, particularly if their closed ones do not understand the severity of the fear, leading to disagreements or everyday challenges. These impacts should not be underestimated, as the far can be deeply distressing and overwhelming, and for us to make a mental note to approach those experiencing phobias with understanding and empathy, offering support rather than judgement.

How are Phobias Treated?

Following great amounts of studies and research poured into studying phobia and its treatment after all these years, psychologists can confidently say that phobia is treatable with evidence-based interventions. The most commonly used interventions are:

Cognitive Behavioral Therapy (CBT)

CBT is based on a concept that our thoughts, feelings, physical sensations, and behavior (actions) are interconnected, such that they influence each other, and having an unhelpful or irrational thought can trap us into a negative cycle. CBT aims to help identify our irrational thoughts through thought tracking and cognitive restructuring to challenge the unhelpful negative thoughts and beliefs.

In the case of Charlie (with fear of heights) from earlier, the process of CBT can help Charlie in identifying any irrational thoughts about heights, challenging these thoughts, and later realizing the risk is much smaller than he anticipated. CBT is often used in combination with Exposure Therapy, which is what you will read about next.

Exposure Therapy

Exposure therapy, just like it sounds, involves exposing the individual to the source of fear (e.g., bugs, needles etc.). While it does sound scary, CBT is typically implemented in the initial stages to help the individual to feel more prepared for this exercise. Additionally, the individual does not face with their fear immediately, as this is rather a gradual process (gradual exposure), starting with exposure to very similar fear but of lower intensity, and gradually moving up the stepladder of fear.

Following CBT interventions, Charlie may be asked to stand on the balcony of a first-floor building, starting with a manageable height to reduce anxiety. Through repeated exposures and practicing techniques like deep breathing to stay calm, he can gradually work his way up to higher floors. Over time, as he becomes more comfortable, Charlie can move up another level, slowly building confidence and reducing his fear of heights with each step.

Ending note..

While the intervention process sounds easy to some, the experience of facing your fears can be really daunting for these individuals, thus patience and empathy is highly important while supporting your family or friends who are going through similar processes.

I hope this article helps deepen your understanding of what phobias are like and how they can be treated, as well as prepare you in case you need to seek support. If you or someone you know is struggling with a phobia and requires support around this, Spencer Health is equipped with skilled clinicians who are ready to provide the support you need. Any questions, you can reach us at support@spencerhealth.com.au.