Specific phobia is a fear of a particular object, animal, or situation. The fear is great enough that you wish to avoid the situation or experience it only with considerable anxiety. Fears and phobias are very common. In a recent national survey, 60% of the people interviewed reported that they feared some situation or thing. The most common fears were fears of bugs, mice, snakes, bats, heights, water, public transportation, storms, closed spaces, tunnels, and bridges. Many people reported that they feared several things and that they consciously avoided them. In fact, over 11% of the people indicated that their fears qualified as specific phobias. That is, their fears were persistent and associated with intense anxiety; they avoided or wanted to avoid certain situations; they realized that their fears were excessive or unreasonable; and their fears resulted in distress and difficulty in their normal lives.
There are several causes of specific phobia. Psychologists make a distinction between how you learned to fear something and why you still fear that thing even years later.
Some theories suggest that people tend to develop phobias about objects, animals, or situations that were dangerous in prehistoric times. For example, bugs, mice, snakes, many other animals, heights, strangers, bridges, and water were all potentially dangerous for early humans. In a wild environment, these fears were very adaptive and useful. People with these fears were better prepared to avoid contamination, poisonous bites, falling off cliffs or bridges, being murdered by strangers, or drowning. But in today's technological world, these fears are no longer as accurate as they once were.
A second origin of phobias is through learning - either connecting a bad experience with the thing you are afraid of (for example, perhaps you were bitten by a dog and developed a fear of dogs) or observing someone who is afraid and learning from their fear (for example, perhaps other family members had a fear of flying and you learned that fear from them). A third reason for phobias may be distortions in thinking. For example, a phobia may be based on incorrect information, on a tendency to predict the worst, on a tendency not to use evidence that challenges the phobia, or on a belief that you cannot tolerate anxiety.
Once you learn a fear or phobia, there are a number of ways in which it is maintained. The most important reason is that you avoid the situation you fear. If you fear flying, you feel less anxious every time that you decide to avoid getting onto a plane. Each time you avoid flying, you teach yourself that “the way to reduce my fear is to avoid” - that is, you learn to avoid. This is like taking a drink every time that you are anxious - you learn to drink more because it temporarily reduces your anxiety. But by avoiding the thing you fear, you never learn that you can overcome your fear. Another way you may maintain your fear is by engaging in “safety behaviors.” These are things you do or say that you think will protect you. For example, in an elevator you may hold onto its side, or in an airplane you may hold onto your seat. Or you may repeat prayers or otherwise seek reassurance when you are in a feared situation. You can come to believe that these safety behaviors are necessary for you to overcome your fear.
Your fear and anxiety will begin to fade when you learn, from experience, that your phobia is unfounded.
Cognitive-behavioral therapy for specific phobia is about helping you face what you fear rather than avoiding it. In order to overcome your fear, your therapist will have you make a list of the objects or situations that you fear, describe how intense your fear is, and indicate what your beliefs are about each object or situation (for example, do you think that you will be contaminated, die, be attacked, or go insane?).
You will be taught how to relax when you are feeling tense. Your therapist may ask you to form images in your mind about a feared situation and hold these images in mind until you feel less anxious. You may observe your therapist doing the things that you fear, and later you may imitate him or her. Your exposure to the things that you fear will be gradual: Your therapist will explain everything before you do it; you are free to refuse to do anything; there will be no surprises sprung on you; and you will determine the pace at which you make progress.
Most patients using these techniques find that they feel much less tense, become able to do things that they feared, and feel more effective in their lives. Many patients are able to improve rapidly with a few prolonged sessions (for example, 2- to 3-hour sessions) that allow intense exposure to the feared objects or situations. Depending on the fear, between 74% and 94% of patients improve when they use these techniques. Although some patients may use antidepressants or antianxiety medications for these fears, the treatments that we have described do not require these medications.
Overcoming fears may require you to gradually put yourself into situations that make you anxious. You should let your therapist know which situations or things make you most anxious, what kinds of thoughts you have about those things, and whether you are willing to experience some anxiety in order to overcome your fears. Your therapist will help guide you through gradual exposure to these situations. You will have to carry out some self-help homework between therapy sessions, with which you will practice many of the same things that you are learning in the sessions with your therapist.
The information on this page is provided for informational purposes only and does not replace in any way a formal medical or psychiatric evaluation or suggest a diagnosis. If you suspect you may be experiencing any of the above symptoms we would recommend you seek an evaluation by a psychiatrist or medical practitioner. All therapy should begin with seeking any medical reasons for the presenting problem.