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Phobias

What is a phobia?

A phobia is normally defined as a persistent and unreasonable fear of a particular situation or object. Individuals affected will try to avoid at all costs the situation or object of fear, although it might not pose an actual danger. The fear is said to be irrational. If the source of the phobia cannot be avoided, the object or situation causes severe distress and a marked effect on daily activities. In order to be classified as a phobia, the individual has to have made contact with the object or situation of fear. For example, one cannot be diagnosed with a phobia of snakes if an encounter with snakes has never occurred.

Common phobias are a fear of confined space (claustrophobia), fear of flying (aerophobia), fear of spiders (arachnophobia), fear of vomiting (emetophobia) and a fear of driving (vehophobia).

Agoraphobia is an intense anxiety regarding open or public spaces. It can be debilitating, leaving the person unable to leave the house. Agoraphobia arises as a result of the individual having suffered from recurring panic attacks in the past. It leaves the individual fearing to leave the house in case they experience panic attacks again.
 

A Blood injury phobia is a unique phobia in that there is a tendency for the individual to faint in the presence of blood as a result of a rapid fall in blood pressure. People with blood phobia are afraid of and avoid situations where they may be directly or indirectly exposed to blood. These situations cause the person to experience high anxiety and to flee where possible. They may also faint when hearing someone else talking about blood.
 

Most specific phobias in adults are a continuation of childhood phobias.
Avoidance, escape behaviours, scanning, and checking, can all be common behaviours with phobias. The fear experienced with phobias can cause physical symptoms such unsteadiness, dizziness, light-headedness or faintness, feelings of choking, rapid heartbeat, palpitations, chest pain or discomfort, sweating, shortness of breath or a smothering sensation, nausea or stomach upset, numbness or tingling sensations, trembling or shaking. Other symptoms might include feelings of being detached from your own body, fear of fainting or falling, not being in control, trapped or dying and hot or cold flushes.

How common are phobias?

Phobias are extraordinarily common. Women are more likely to be affected by phobias than men. Surveys suggest that a majority of the population (60.2%) experience “unreasonable fears”. These are generally sub-clinical, therefore they do not cause undue distress or disruption in daily life. Where the fear causes undue distress and/or is causing disruption in daily life as a result of avoidance for example, then the individual may benefit from treatment.

What is the treatment for phobias?

Cognitive Behaviour Therapy has been shown to be the most effective method of treating specific phobias. The treatment usually involves:

  • Identifying tailored, realistic and achievable goals in order to overcome your fear

  • An educational component to help you understand and normalise the experiences of fear and anxiety

  • Carrying out exposure exercises to allow for new learning and experiences to occur. Exposure can be defined as confronting agreed upon anxiety and fear-provoking triggers, normally in a graded way, therefore starting from a lower level trigger and building up to the most feared one. This is done whilst refraining from carrying out any behaviours which “mask” or distract from fear and anxiety (safety behaviours) during and after exposure, for example seeking reassurance or doing subtle things to make oneself feel better as these behaviours help to maintain the phobias.


Blood injury phobia requires a modified form of therapy due to fainting that can occur. Again CBT has been shown to be effective in working with this problem.