Phobia Definition, Symptoms, And Treatments
Updated February 05, 2021
Medically Reviewed By: Denise Doster
Everyone fears something at some time in their lives. Being afraid can be a healthy response to the uncertainties and dangers of the world. It can help you respond appropriately when you're in a tight spot. Phobias are something different, though. Phobias can disrupt your life and cause you to avoid situations you would rather not avoid. If you question the intensity and frequency of your fear, learning the definition of a phobia may be your first step toward greater peace and freedom.
What Is A Phobia?
While it's true that everyone is afraid at some time, not everyone has a phobia. So what is the difference? What makes the one a normal reaction and the other a treatable mental illness? To find out, let’s start with some definitions.
Psychologists define a phobia as an intense, irrational, and inappropriate fear. If you have a phobia, your fear is exaggerated and overwhelming. It is a fear response to something that presents no real threat to you, at least not in your current situation.
The definition of a phobia includes an understanding of fear.
What is fear? It's a part of the fight-or-flight response. Fight or flight is a physiological response to something you perceive as dangerous. If this response happens only when there's a real threat, it's adaptive in that it prepares you to deal with the threat. Your body prepares to flee the danger or stay and fight it.
The fight-or-flight response is also called the acute stress response, referring to a type of hyperarousal that happens when you're terrified of a mental or physical threat.
This response changes the activity of your nervous system, alters your hormone levels, and increases your heart rate, muscle tension, and the intensity of your hearing and other senses.
Finally, anxiety involves a feeling of worry, nervousness, or unease, especially about an impending event or something with an uncertain outcome.
Fear can be a natural response to a real and imminent threat, but a phobia doesn't have the same basis in reality. When you experience fear even when there is nothing to be afraid of, it doesn't stop your fight or flight response from kicking in. That is why phobias are associated with irrational levels of fear.
What Does It Mean to Have a Phobia?
Having a phobia means that you structure your life to avoid the things or situations you fear. Your need to avoid what you fear is so great that your life may become limited. A phobia is considered a mental illness (a phobic disorder), because it causes distress and limits functioning.
What Is A Phobic Disorder?
As discussed above, a phobic disorder involves more than simple fear. When you have a phobic disorder, you become conditioned to experience fear in the absence of any real danger.
A phobic disorder is considered a kind of anxiety disorder because it is characterized by feelings of apprehension and dread that cause avoidance and interfere with one’s quality of life.
Phobias are thought to be caused by classical conditioning, as follows. Imagine that you are not afraid of a train (the neutral stimulus), but you are afraid of loud noises (the unconditioned stimulus). Because trains are loud, you learn to associate the train with the noise, causing a fear response (the conditioned response). Once an association has been formed, which can happen immediately or after a number of exposures, the train (which is now the conditioned stimulus) causes fear (the conditioned response), and a phobia results.
Because phobias are conditioned responses, they do not go away on their own but need therapy to extinguish or replace the conditioned response using counter conditioning.
Symptoms Of Phobic Disorder
The symptoms of phobic disorders are physical, psychological, and behavioral and are related to the fight-or-flight response.
In the absence of your phobic trigger (for example, the train in the above example), your phobic symptoms are likely to be hidden. You may feel perfectly calm and relaxed when the trigger isn’t around. However, once the phobia is triggered, you can have a panic attack. Physical symptoms of a panic attack may include:
- A choking sensation
- Chills or hot flushes
- Butterflies in the stomach
- Pain or tightness in the chest
- Rapid heartbeat
- Feeling faint
- Dry mouth
- Ringing in your ears
The panic attacks associated with phobias can also include psychological symptoms. If a phobia is triggered, you are likely to feel a sense of dread. You may feel an intense fear of losing control or feel afraid of fainting. You may even become confused or disoriented. If the fear reaction is intense enough, you may even be afraid that you are going to die. In addition, in the long term, those with phobias are more likely than others to struggle with depression.
The behavioral symptoms of phobias are a result of avoiding the fear associated with phobic triggers. Those with phobias alter their habits to live peacefully without fear. If you have a phobia, you will tend to avoid situations in which a phobic response is likely to be triggered. For example, if you have a social phobia, you may avoid places where you are likely to run into people you know. You may even be so afraid to face certain triggers that you don't leave your home at all, as in agoraphobia.
Types Of Phobia
Phobias are divided into three types: specific phobia, social phobia, and agoraphobia. Specific phobias are relatively simple phobias, while social phobia and agoraphobia are more complex phobias. With complex phobias, the triggers are harder to recognize.
A specific phobia is an irrational and persistent fear of a single object or a situation. In other words, only one stimulus triggers the fear. If you have a phobia of snakes, for example, you might be afraid when you see a snake in the wild, at a zoo, or even in a video on social media. However, when you don't see a snake (or anything resembling a snake), you are unlikely to experience fear.
Social phobia is a fear of being in social situations. Those with social phobias tend to stay away from such situations, even if this means missing out on fun activities, friendships, or career opportunities.
What individuals with social phobia fear most about social situations is being publicly judged or humiliated. As opposed to just feeling awkward or shy, those with social phobia feel scared, vulnerable, and anxious when even thinking about social situations.
Agoraphobia is complex phobia centered around being in situations from which you can't escape. Those with agoraphobia experience a number of fears related to being in public, such as:
- Fear of open spaces
- Fear of elevators
- Fear of being in a closed MRI
- Fear of being in a crowd
If you have agoraphobia, these fears may cause you to withdraw from the world. You may even stay in your home as much as possible to avoid a panic response.
What Causes Phobias?
Simple phobias can be formed anytime from early childhood to early adulthood. In the case of conditioned responses, the steps are as follows: You face a terrifying experience. Your reaction is so profound that you fear ever facing that situation again. Eventually, when you even think of being confronted with your phobic trigger, your body shifts into fight-or-flight mode and you avoid the situation.
You might also develop a simple phobia if you were present when someone else displayed panic symptoms in response to a phobic trigger. This is a learned response. Finally, some simple phobias (e.g., snake phobia) seem to have a genetic component.
It is more difficult to identify the cause of complex phobias. Studies suggest that genetics, brain chemistry, and life experience may all contribute to their development. As with many psychological conditions, these phobias seem to be caused by a combination of nature and nurture.
Treatments For Phobic Disorder
Several different treatments have proven effective in helping people with phobias. Medications can provide relief, but stronger, longer-term effects are provided by therapies, most of which have an exposure component.
Systematic desensitization is a kind of exposure therapy, which works as follows: The client is exposed to a mild example of what they fear while being prompted to relax (for example, using deep breathing). When that experience feels more familiar and less frightening, the client is guided to move on to more frightening examples of the feared object or situation, culminating in full exposure. Systematic desensitization is often done with a therapist.
For example, if you are afraid of snakes, you and your therapist might start by looking at pictures of snakes while you focus on your breathing and listen to relaxing music. Next, your therapist might accompany you to see snakes in a zoo. Finally, in your therapist’s office, you might let a nonpoisonous snake climb on your arm. Over time, this approach desensitizes you to the phobic trigger and replaces a relaxation response for the fear response.
Virtual Reality Therapy
Virtual reality therapy is another type of exposure therapy that's been gaining popularity in recent years. Virtual reality therapy consists of
viewing an image of your phobic trigger on a computer screen, in a virtual reality headset, or in a specially designed “cave,” which is a small room with a large-screen projector and powerful audio speakers. The benefit of virtual reality therapy is that you can easily control the amount of exposure to the feared image, so therapists can help clients work at their own rate. Because clients learn that no harm comes from the exposures, their fear response is eventually extinguished, meaning that it disappears.
Counter-conditioning simply means you replace your fear response with a response that is either neutral or positive. For example, you might counter-condition a response to snakes by doing deep breathing exercises while you view a snake. The goal is to replace your fear response with a relaxation response. Counter-conditioning is a component of systematic desensitization.
Biofeedback works by teaching you to reduce your physiological response to irrational fears. The doctor or therapist places electronic sensors to record your heart rate, blood pressure, pulse, and other vital signs. The results are displayed on a screen. As you're exposed to the object of your fear, you watch the screen, and images or sounds give you feedback as you focus on relaxing and lowering your stress response.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) involves identifying the thoughts behind feelings and behaviors. Once you know the thought that's causing the frightened feelings and avoidant behaviors associated with your phobia, you can work with a therapist to change the thought; this results in changing the feelings and behaviors as well. Thus, you can use CBT to decrease your fear response to phobic triggers.
Several categories of medications are used to ease the physical and emotional symptoms of phobias. These include SSRI antidepressants (such as Paxil and Zoloft), beta blockers (such as Inderal), and benzodiazapines (such as Ativan and Klonapin). Your doctor may prescribe SSRIs for steady relief and beta blockers or anti-anxiety medications to help at the moment you feel panicked.
While medications may help you face a phobia in an unavoidable situation (for example, flying in a plane for a business trip), the therapies described above are the preferred long-term treatment for phobias. One of the main advantage of therapy is that you don't have to deal with the side effects associated with many medications.
Exposure therapies are also more effective than medication in the long term.
Online Therapy for Phobias
Cognitive behavioral therapy (CBT) helps people reframe negative thoughts into positive ones, resulting in more positive emotions and healthier behaviors. CBT is considered front-line treatment for anxiety; in fact, recent studies show that online CBT (iCBT) can treat anxiety disorders just as effectively as in-person therapy. Not only is online CBT as effective as face-to-face therapy for anxiety disorders including panic disorder, social anxiety disorder, and phobias, but online treatment has been found to be cost-effective, with treatment effects maintained at one-year follow-up.
The Benefits of Online Therapy
As discussed above, CBT with a licensed therapist is an excellent way to treat phobic disorders. But social phobia and agoraphobia can make it difficult to attend in-person therapy. This is where online therapy comes in. You can access BetterHelp’s platform from the comfort and privacy of your own home. In addition, online therapy offers lower pricing than in-person therapy because online therapists don’t have to pay for costs like renting an office. BetterHelp’s licensed therapists have provided CBT for anxiety disorders including phobias. Read below for some reviews of BetterHelp therapists from people experiencing similar issues.
“I’ve only had a couple sessions with Andrea so far, but she makes me feel safe and comfortable. She listens and provides actual helpful feedback that I think about throughout the rest of the week. I would recommend her to anyone.”
“Dr. Santhouse has become a consistent source of guidance, encouragement, and support during a time of extreme uncertainty. He leaves lots of room for listening during session and shares valuable insights and questions. His empathy and non-judgmental counsel is an important piece of my own journey with mental wellness and I appreciate his work immensely”
Phobias are not just passing fears. They continue long after the real threat has passed. The good news is that you can start treatment right away on the BetterHelp.com online counseling platform with a real, licensed counselor trained in helping people with phobias. When you do, you give yourself a wonderful opportunity to have a better, happier life!
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