Understanding Phobias: What They Are and How They Develop

What is a Phobia?

Specific phobia is an anxiety disorder recognized by the DSM-5. It is classified by excessive or unreasonable fears brought on by the presence or anticipation of specific objects or situations. Examples of some common phobias include heights, flying, seeing blood, or needles.

Phobias can greatly impact a person’s life and potentially lead them to organize their daily activities to avoid the experiences causing them anxiety. A fear is excessive or unreasonable when the reaction to an object or situation is not proportionate to the actual danger, threat, or risk.

For example, someone without a phobia of injections might experience a bit of anxiety prior to getting a vaccine at the doctor’s office. However, someone with a phobia of injections may avoid the doctor altogether, refuse the vaccine when suggested, or become faint/panicked at the sight of the needle.

How Do Phobias Develop?

The research on specific phobias is limited and therefore there is little known about what causes this anxiety disorder to develop. However, even though there isn’t one specific cause for the development of a phobia, there are some known risk factors.

Risk factors for developing a phobia include:

• Negative Experiences. Prior negative experiences, or even learning about negative experiences, related to a specific object or situation can cause disproportionate fears to develop.
• Genetics. If a family member has an anxiety disorder or phobia, there may be a genetic link.
• Age. A phobia is typically more prevalent if it shows up in childhood, before the age of 10.
• Temperament. There is a higher risk for developing an anxiety disorder if you have a more cautious or inhibited temperament.

The Benefits of Seeking Therapy for Phobias

Specific phobia is thought to be the most common of all anxiety disorders. It is a disorder that exists on a spectrum of severity. Some individuals struggling with phobias will not require treatment. However, for many people phobias can cause intense psychological suffering that affects their ability to function normally.

If a phobia is impacting your daily life, therapy can be a great option for treatment. Therapy can help you understand, work through, and even overcome your fears, allowing you to live a more whole and fulfilling life.

Common Phobia Therapy Techniques

Cognitive behavioral therapy (CBT) with exposure therapy is most commonly recommended for individuals experiencing phobias.

Exposure therapy may include the following steps:

1. Learning relaxation techniques to use when exposed to fearful stimuli.
2. Sitting with the therapist and imagining the fearful stimuli while practicing relaxation techniques.
3. Looking up pictures or watching videos of the fearful stimuli while practicing relaxation techniques
4. Exposing yourself to the feared stimuli outside of session while using relaxation techniques.
5. All exposure steps will include processing the experience with the therapist afterward.

The Therapeutic Process: Outcomes to Expect from Phobia Treatment

Taking the step to seek out therapy for a phobia may feel challenging or scary because it forces you to confront an overwhelming fear. Knowing what to expect from treatment for a phobia may help therapy feel more manageable.

The most commonly recommended therapeutic intervention for phobias is exposure therapy alongside cognitive behavioral therapy. Exposure therapy can feel like a scary intervention because it involves exposing yourself to your phobia. But research suggests that this is the most effective method to decrease and potentially eliminate the fear altogether.

Exposure therapy is known to help in several ways, including:

• Decreased reaction to the feared object or situation.
• Weakened learned associations between the feared object or situation and bad outcomes.
• Learned self-efficacy. Exposure therapy shows individuals that they are capable of confronting their fear and managing their anxiety during the exposure.
• Develop realistic beliefs. Client’s who participate in exposure therapy report they learn more realistic beliefs about feared objects or situations. This helps clients become more comfortable with experiencing fear in their life and less likely to avoid situations in the future.

Conclusion

Though it can be scary to consider reaching out for help regarding a phobia, research shows that undergoing exposure therapy can decrease and even eliminate unrealistic fears altogether. By decreasing the impact of your phobia on your day to day functioning, you can begin to feel in control of your life again.

References

Botella, C., Fernández-Álvarez, J., Guillén, V. et al. Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review. Curr Psychiatry Rep 19, 42 (2017). https://doi.org/10.1007/s11920-017-0788-4

Garcia R. (2017). Neurobiology of fear and specific phobias. Learning & memory (Cold Spring Harbor, N.Y.), 24(9), 462–471. https://doi.org/10.1101/lm.044115.116

Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.11, DSM-IV to DSM-5 Specific Phobia Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t11/