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Phobias can affect people of all ages, from all walks of life and in every part of the country. The National
Institute of Mental Health (NIMH) has reported that 5.1% to12.5% of Americans have phobias. They're the most common psychiatric illness among women of all ages and are the 2nd most
common mental illness among men older than 25.
By definition, phobias are "irrational fears," that interfere with one's everyday life or
daily routine. If your fear of high places prevents you from crossing necessary bridges to get to work, that fear is irrational.
If your fears keep you from enjoying life or even preoccupy your thinking so that you're unable to work, sleep or do things you wish to do, then it becomes irrational.
A phobia is something
a person fears to the point that they feel they have to change how they behave.
One key to diagnosing
a phobic disorder is that:
the fear must be excessive and disproportionate to the situation.
Most people who
fear heights wouldn't avoid visiting a friend who lived on the top floor of a tall building; but a person with a phobia
of heights would.
Fear alone doesn't distinguish a phobia; both fear and avoidance must be evident. (Lefton, L. A., 1997)
Subtypes of Phobias....
- Animal
type of phobia...
Cued or triggered by coming in contact, thought or imagination of animals or insects
- Natural environment
type of phobia...
Cued or triggered by objects in the environment, such as storms, heights
or water
- Situational type...
Cued
or triggered by a specific situation, such as public transportation, tunnels, bridges, elevators, flying, driving or enclosed
spaces
- Blood-injection-injury type....
Cued or triggered by witnessing some invasive medical procedure
- Other type....
Cued
by other stimuli than the above, such as of choking, vomiting or contracting an illness
If the object of
the fear or "phobia" is easy to avoid, people with specific phobias may not feel the need to seek treatment.
Instead, they allow
their lives to consist of making important career or personal decisions to avoid a phobic situation.
- When avoidance behavior is carried to these extreme lengths and measures, it's considered "disabling" to life.
Specific
phobias are successfully treatable much of the time, so there really is no need for those experiencing this extreme disruption in their lives to continue to do so.
When a person has
a persistent, irrational fear of an object or situation and a strong urge to avoid that object or situation, he has a "simple phobia" or "an inappropriately intense reaction triggered
by a single stimulus."
This is the point
where people begin to stay in their homes to avoid all contact with the fear inducing stressor. This behavior begins to become habit. Soon the simple phobia disorder could escalate to
include another disorder.... co-existing with the already existent phobia.
Approximately 8
% of the adult population suffers from one or more specific phobias in a single year. Much
higher rates would be recorded if less rigorous diagnostic requirements for avoidance or functional impairment were used.
Again I mention,
usually specific phobias begin in childhood. There is a 2nd peak of onset in the middle 20's of adulthood (DSM-IV). Most phobias persist for years or even decades
and very few people with phobias get better spontaneously or without treatment.
Specific
phobias generally don't develop from exposure to a single traumatic event (i.e., being bitten by a dog or nearly drowning) (Marks, 1969). Usually there's evidence of phobia in other family members and
social or vicarious learning of phobias (Cook & Mineka, 1989).
Spontaneous, unexpected panic attacks can also appear in the development of specific phobias, but the most common pattern is
that of avoidance behavior towards the object or situation of fear.
The most common
specific phobias include the following feared stimuli or situations:
- Insects (especially spiders & bees or hornets)
"Symptoms" of Simple Phobias
- Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing
blood)
- Exposure to the phobic stimulus almost invariably provokes
an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack
Note: In children,
the anxiety may be expressed by crying, tantrums, freezing, or clinging
- The person recognizes that the fear is excessive or unreasonable
Note: In children,
this feature may be absent
- The avoidance in anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or
academic) functioning, or social activities or relationships, or there's marked distress about having the phobia
- In individuals under age 18 years, the duration is at least
6 months
what causes phobias to develop?
No one knows for
sure how phobias develop. Often, there is no explanation for the fear. In many cases a person can readily identify an event or trauma, such as being chased by a dog that triggered the phobia.
What puzzles experts
is why some people who experience such an event develop a phobia and others don't. Many
psychologists believe the cause lies in a combination of genetic predisposition mixed with environmental and social causes.
Most specific phobias do not cause a serious disruption in a person's life. n these cases, individuals experiencing
a phobia, don't seek professional help as a rule. Finding ways to avoid whatever it is that triggers their panic, they simply endure the distress and try to cope with the extremely uncomfortable feelings they feel when they encounter the object or situation of their fear.
When the object
of fear or event is unavoidable, these individuals will consult their physicians, requesting medication to help them through the situation.
Simple phobias in children
Several studies have documented that mild fears are common in children of all ages. It appears that girls report fears more than boys. Several themes are consistent among children of different age groups. These fears aren't only consistent among age groups but also in various cultural groups. Simple phobias
in children are overwhelming irrational fears including:
- Falling from a high place
- Having a burglar break into a house
- Specific objects such as an animal
- Situations such as being in the dark, for which there is no logical explanation
A phobia should therefore be considered
only when the fears are excessive, persistent to a specific situation or object & result in impairment in some area of the child's functioning.
These fears are very common among young children. One study reported that as many as 43% of all children aged
6 to 12 have 7 or more fears that aren't considered "phobias."
Most common
fears of children go away w/out treatment. Few children who suffer from fears or even mild phobias ever receive treatment for them. It's important for parents to remember that if a child's fear is so extreme that they refuse to go outside in fear that "perhaps a dog may be out there," that children deserve professional attention to attend to their basic needs.
Parents can minimize fears, if educated
An example of how
a parent can help is:
If the child is
afraid of a big bad wolf, a parent can try saying, "Let's find the big bad wolf & tell him that he has to go back to the woods.
When we find the big bad wolf, we will walk him to the front door, open the door & make him leave. Then we will lock the
front door so he can't come back in."
The technique of
walking the large animal or monster to the door & making him leave is almost always effective. You can use any other technique
as long as it shows the child that you're not afraid, that you accept his/her fear, & that you're willing, ready & able to help your child achieve some control over the fear.
A parent can help minimize
the number of fears the child experiences by:
- Being careful about television shows & movies that children watch; find out before hand if the content is appropriate for their child
- Look at the
content from the perspective of the child in making this determination
- Parent can
initiate conversations about fears that children have; allowing the child to "talk about" what they're afraid of
- A good idea
for parents is to "personalize the situation" the child may state they're fearful of
- Add positive light in thinking & discussing the reasons for the fear
Parents of children who are afraid of storms i.e., should prepare their child if a storm is coming. Staying close to the child, holding the child & offering conversation about what to expect in a thunderstorm can help the child to anticipate the storm w/out being anxious or upset.
Comparing the thunder to drums or other similar sounds may help them decrease their fear for the loud sound. Teaching your child songs to sing in anticipation of a thunderstorm can also help them to build positive coping methods, by singing about the rain or thunder they have a healthy outlet to turn to instead of feeling anxious or upset.
Brontophobia
Most common in children, this phobia also affects adults. Those who have this phobia
fear thunderstorms. While thunder is usually the trigger, many brontophobes become uncomfortable at the sight of thunderclouds
gathering.
Treatment for Agoraphobia
Treatment
usually involves desensitization or exposure therapy thru which the sufferer is exposed to the source of the phobia & gradually learns to
overcome the fear.
Exposure therapy can significantly reduce or end phobic reactions for at least 7 years.
It's based
upon having the person relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.
The following methods
are helpful in controlling Agoraphobia symptoms:
- Making "dry runs" to unfamiliar places to gather info to reduce
unknown factors
- Educating ones self by reading books on the subject of anxiety
Medications Used In Treatment of Agoraphobia
Therapy is often combined with medication, such anti-anxiety & anti-depressive medications are sometimes used to help relieve the symptoms associated with phobias. Dependency on the medication is a possible side effect of this treatment.
Astraphobia, also known as Brontophobia, Keraunophobia,
or Tonitrophobia, is an abnormal fear of thunder and lightning, a type of a specific
phobia. It is quite common in humans (particularly the young),
and especially dogs and cats. Ceraunophobia is specifically the fear of thunder but not lightning.
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Social Phobia
Social phobia, also known as social anxiety disorder, involves:
People with social phobia have:
While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they're unable to overcome it. They often worry for days or weeks
in advance of a dreaded situation that involves being in the presence of people.
(perhaps you've heard the saying, "I know the facts in my head, but what
I feel in my heart - I can't overcome." It's something like that with social phobia. You know that people aren't actually
staring at you the second you walk into the grocery store - but you're afraid of people staring at you and you feel like people
are staring at you... not just one or two people - but everyone!)
Social phobia can be limited to only one type of situation - such as:
Social phobia can be very debilitating - it may even
keep people from going to work or school on some days. Many people with this illness have difficulties making and keeping
friends
Social Phobia (Now
diagnosed as Social Anxiety)
Physical
symptoms often accompany the intense anxiety of social phobia and include:
If you suffer
from social phobia, you may be painfully embarrassed by these symptoms and feel as though all eyes are focused on you. You may be afraid of being with people other than your family.
People with social phobia
are aware that their feelings are irrational. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout.
Unpleasant feelings may linger after the encounter because of worry about how they may have been judged or what others may have thought or observed about them.
Social phobia affects
about 5.3 million adult Americans or 7% of the population. Women and men are equally likely to develop social phobia. The disorder usually begins in childhood or early adolescence. There's evidence that genetic factors are involved.
Social phobia often co-exists with other anxiety disorders or depression.
Substance abuse or dependence may develop in individuals who attempt to "self-medicate" their social
phobia by drinking or using drugs.
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Agoraphobia (ag"o-rah-fo'be-ah)
Agoraphobia
is defined as a persistent, abnormal fear of open public places or public situations. It's caused by a combination of hereditary & environmental factors.
A number of experts in the
field of anxiety & panic disorder believe that there's a biological cause related to a chemical imbalance in the person's brain or body.
Other possible causes include:
Avoiding situations makes the phobic person doubt his ability ever to handle the situation. Having negative conversations with ones self, increases worry & can lead to panic attacks. These factors can multiply the person's level of distress:
ideas
Insecure
feelings
Not
being able to express feelings
Not
knowing how to relax
Dietary factors such as the caffeine in coffee or cola drinks
Marked anxiety or distress about leaving the confines of their home, being in public places, or feared situation(s). This anxiety or distress stems from the fear of being trapped or stranded w/out help, or from the anxiety these situation(s) cause.
These situation(s) may lead to a Panic Attack or a panic like symptom. Agoraphobia is often associated with Panic
Disorder With Agoraphobia or Agoraphobia Without History of Panic Attack.
Marked anxiety of being in a place or a situation that make escape difficult, embarrassing or impossible usually involves characteristic clusters of situations.
Literally agoraphobia means, "fear of open spaces or of being in crowded, public places like markets" from the ancient Greek agora or market, agoraphobia is generally understood as fear manifested in the avoidance of a cluster of situations such as:
- crowded places
- heights
- being alone
- being in a crowd
- standing in a line
- being on a bridge
- traveling in a bus, train, or automobile.
Agoraphobia can lead to:
The early treatment of anxiety helps avoid the escalation of symptoms into agoraphobic behavior. Agoraphobia
is treatable with both therapeutic & medical treatment.
Agoraphobia is a severely
debilitating psychological condition. If you have agoraphobia:
You're frightened of just thinking about being confronted by a group of people, even though you're sitting in the comfort of your own living room.
Fears simply take over & you give in to the fear often, clinging to safety.
All phobias are that way & agoraphobia
is no different. Harder to deal with maybe, but still considered a phobia, just like the
fear of spiders, snakes, thunder & airplane rides. The fear can be overpowering & debilitating.
Those experiencing
agoraphobia generally develop the disorder after first suffering a series of panic attacks in public places. The attacks seem to occur randomly & w/out warning, making it impossible for a person to predict what
situation will trigger such a reaction.
The unpredictability
of panic attacks, "trains" the victims to anticipate future panic attacks resulting in the fear of any situation an attack could occur. Avoiding going out in public, Agoraphobics also are likely to develop depression, fatigue, tension, spontaneous panic & obsessive disorders.
Symptoms of agoraphobia may include:
- Extreme anxiety & fear when leaving home - Agoraphobics fear being in groups of people where there seems to be nowhere to escape
- Those w/this
disorder spend an enormous amount of time planning on ways to avoid being confronted w/other people, or groups of people; making excuses for not joining in w/family outings & faking illness for an excuse to stay home
much of the time
- Agoraphobia's symptoms of feeling extreme helplessness in groups of people & the ongoing fear of being judged or watched by others' can ruin their lives. Individuals may become short of breath, sweaty, feel faint or dizzy upon being
confronted by groups of people.
- Agoraphobics
tend to feel stranded & w/out help when faced w/public siutations.
There
are only two feelings,
yet one of which is true,
love, composing all that is,
and fear, the opposing view.
They
cannot exist concurrently,
they fluctuate in the mind,
choose love for all-creation,
or fears to be blind.
To rid your-Self
of any fear,
offer Self-truth and trust,
present it to be transmuted,
for disappearance into dust.
These fears
are merely veils,
that disguise the loving mind,
by sending love into them,
eternal joy you'll find.
Eric M. Brodsky
10 Tips to Help You Overcome Dentist Phobia
1. Tell the dentist
about your fears. This information will help the dentist determine how to best manage and address those fears. By letting
the dentist know exactly why the experience is difficult for you, you will feel more control in the examination chair.
2. Remember that
dental procedures have greatly improved in the past few years. Modern dentistry offers new methods and treatment options to
make you feel comfortable.
3. Your dentist
can explain the entire procedure to you beforehand, as well as walk you through step-by-step while the procedure is being
performed. You always have the right to fully understand the work being done on your teeth.
4. Consider additional
medication to relax. Many dentists recommend nitrous oxide, sedation or anti-anxiety medicine for extremely nervous patients.
Find a dentist who offers these options to help you get through the visit.
5. Find a dentist
you are comfortable with and establish a trusting relationship. There are many personalities in the dental profession. Find
a dentist who makes you feel at ease and is willing to work with you on your fears.
6. Breathe deeply
and try to relax. Some dentists recommend practicing relaxation techniques before and during the appointment. Other dentists
find that listening to music, or scheduling an appointment first thing in the morning, before the stresses of the day add
up, also help patients to relax.
7. Talk to the
dentist about stopping if you're uncomfortable. Many of the dentists surveyed said they establish a signal to "stop" with
their patients. This puts you in control of the procedure and alerts the dentist if you're uncomfortable or need to take a
break during the appointment.
8. Visit the dentist
regularly to prevent problems. For fearful patients, just going for a check up can be nerve-wracking, but the more you go
to the dentist for routine cleanings, the more likely you are to avoid larger problems that result in extensive procedures.
9. Visit the office
and talk to the staff before your first appointment. You should feel free to meet with the dentist and to ask questions before
scheduling your appointment. Meeting the dentist and his or her staff first will help you find a dentist you like and trust.
10. Go slow. Dentists
are happy to go slow with nervous patients. If possible, make sure your first visit is a simple one, such as a cleaning. This
will help you build your relationship with the dentist before going in for a more difficult procedure.
Last reviewed: On 17 Nov
2005 By John M. Grohol, Psy.D.
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