Phobias

What is a phobia?

The NHS define a phobia as an anxiety disorder involving an overwhelming, debilitating fear of something (NHS, 2018).  The word ‘fear’ here is used to mean an irrational, extreme, disproportionate response to a usually harmless object, place, situation or living being, consisting of some or all of the following:

  • Breathlessness/hyperventilation
  • Dizziness
  • Increased heart rate
  • Light-headedness
  • Nausea
  • Palpitations
  • Sweating
  • Trembling or shaking
  • Unsteadiness
  • Upset stomach

(NHS, ibid.)

Everybody feels fear; it is an inbuilt survival mechanism that keeps us safe from harm.  However, a phobia can make us behave in ways that put us at more risk of harm; for example, in arachnophobia (phobia of spiders), a person might open their sun visor, only to see a spider come flying out and scuttling across the dashboard; in the ensuing panic, they might end up crash their car.  NoPanic define a phobia as getting ‘frightened at the wrong times or in the wrong places’ (NoPanic, 2019); a car crash is a lot more dangerous than a small arachnid an eighth of an inch across! 

Who do phobias affect?

Phobias affect people of all genders, backgrounds and age groups, and make up 2.4% of all common mental disorders (CMDs) (Baker, 2020).  However, Baker (ibid.) identifies that significantly more women (65% of total referrals in England) seek NHS psychological therapy for mental health issues than men.  Attitudes and behaviours relating to masculinity might preclude men from admitting they have any mental health issue (ManHealth, 2020), and the gender gap for CMDs (including phobias) has remained consistent since 1993, despite an overall increase of 20% in CMDs in the same period (Baker, 2020).

What phobias do people have?

If something exists, someone somewhere can be afraid of it (TOP UK, 2020).  Arachnophobia is specific to one object: a spider.  TOP UK (2020) refer to such phobias as ‘simple phobias’.  This is as opposed to a complex phobia, such as a social phobia, that exists in many situations.  This can make specific phobias less disruptive and life-limiting than their complex brethren, as it is possible to avoid or escape specific triggers (such as spiders) most of the time.  Nevertheless, the symptoms can be incapacitating or even dangerous, as demonstrated in the car example discussed previously. 

There is no evidence to show that people with specific phobias show more general anxiety away from the object of their phobia; it is only when, in this example, a spider is present (or in some cases might be present, for example in an attic or garage) that the arachnophobic will show apprehension or fear (NoPanic, 2019).  That said, people with co-existing generalised anxiety can feel anxious at any time, regardless of the absence or presence of triggers (Padesky and Greenberger, 1995).

What causes phobias?

Research has identified multiple potential causes of phobias (Kennerley, 2014).  Potential influences are as follows:

  • A trauma or incident directly related to the phobic object; for example, a person might have been bitten by a poisonous spider, read sensationalist media yarns about ‘killer false widows’ or watched a horror movie about them, and their survival mechanism has ‘learned’ that spiders are dangerous.
  • A trauma or incident associated with (but not directly related to) the phobic object.  For example, if a spider was in the room while the person was being physically assaulted, the spider became associated with the trauma and will henceforth trigger a phobia response.
  • A learned response from older people; for example, if a young child sees their mother constantly panicking when she sees a spider, they can thusly learn that spiders are dangerous.
  • Genetic individual differences; some people could be more genetically predisposed to anxiety than others.
  • Collective genetic influences; one theory speculates that we are born with a rogues’ gallery of potential phobic objects that might have been dangerous in our evolutionary past, such as snakes, swooping birds and spiders, or that remain potentially dangerous today (such as heights, fire and water).  These collective influences could be amplified or attenuated by the other items in the above list.

What can I do about my phobia?

Phobias rarely, if ever, go away on their own unless we are regularly exposed to the object of our phobia to the extent that we ‘unlearn’ the fear response (Kennerley, 2014) .  Therapy can help people identify ‘hot thoughts’ and cognitive distortions that accompany the object of their phobia (such as “the spider will jump up and bite me”) and devise an action plan for managing the situation.  For example, you might examine the worst than can happen when you encounter a spider and then break it down into its component parts before addressing each one in detail (Padesky and Greenberger, 1995).  Over time, this can reduce or eliminate the neural escalation that happens when we meet (or anticipate meeting) a spider.  Therapy can also help rationalise our thoughts and perceptions about spiders as, for example, useful little housemates that clear up flies, cockroaches and other health hazards.

Conclusion

Phobias are common anxiety disorders that affect people of all ages and walks of life; the good news is that phobias respond very positively to a range of therapy tools and techniques.  Therefore, there is hope for many people currently living with a phobia.

References

Baker, C.  (2020) Mental health statistics for England: prevalence, services and funding.  House of Commons Briefing Paper Number 6988, 23 January 2020.

Kennerley, H. (2014) Overcoming Anxiety, Robinson, London

ManHealth (2020) About [ONLINE]Available at: https://www.manhealth.org.uk/ [Accessed 3rd September 2020].

NHS (2018) Phobias [ONLINE] Available at: https://www.nhs.uk/conditions/phobias/ [Accessed 18 August 2020].

NoPanic (2019) What is a Phobia?  [ONLINE]  Available at: https://nopanic.org.uk/phobia/ [Accessed 3rd September 2020].

Padesky, C.A. and Greenberger, D. (1995) Clinician’s Guide to Mind Over Mood, The Guilford Press, New York/London.

TOP UK (2020) What is a phobia? [ONLINE] Available at: https://www.topuk.org/what-is-a-phobia/ [Accessed 19 August 2020].