DR. NEAL HOUSTON

Adult Integrative/Behavioral Health Specialist

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Monday, May 20, 2013

WHAT ARE PHOBIAS?



A phobia is an irrational fear of a specific object or situation. For instance, you may dread the sight or touch of a spider, or you may have a morbid fear of heights known as acrophobia. Such fears do not usually prevent you from leading a normal life. Fear of confined spaces also known as claustrophobia is more of a problem, because you may try to avoid cars, planes, trains, and elevators. Some phobias, however, may make normal life virtually impossible. A common example is agoraphobia, which is generally defined as fear of open spaces. For those with agoraphobia an open space may be not just a park or field but anywhere outside their own home. The phobias may also involve extreme shyness - a fear of society that is closely associated with the withdrawal symptoms of depression. If you suffer from agoraphobia or any other phobia, the need to face the situation that you fear can bring on the symptoms of anxiety, including a racing heart, sweating palms, rapid breathing, and a feeling of nausea.

What are the complications of phobias?
  •  If left untreated, a phobia may worsen to the point in which the person's life is seriously affected, both by the phobia itself and/or by attempts to avoid or conceal it. For example, a fear of flying can result in the individual being unable to travel. In fact, some people have had problems with friends and family, failed in school, and/or lost jobs while struggling to cope with a severe phobia. There may be periods of spontaneous improvement, but a phobia does not usually go away unless the person receives treatments designed specifically to help phobia sufferers. Alcoholics can be up to 10 times more likely to suffer from a phobia than those who are not alcoholics, and phobic individuals can be twice as likely to suffer from alcoholism or other addictions than those who have never been phobic. It has even been found that phobic anxiety can be life-threatening for some people, increasing the risk of suffering from heart disease in both men and women.
What are the treatment options?
  • Self-help: try to face your fear to help overcome it. See a psychiatrist or other mental health professional if you are unsuccessful after trying persistently, or if your fear interferes with everyday living or one of your goals.
  • Professional help: if your symptoms are those of a general anxiety state, treatment is similar to treatment for anxiety. For agoraphobia associated with depression, many physicians prescribe antidepressant drugs and psychotherapy.

*Alcoholics can be up to 10 times more likely to suffer from a phobia than those who are not alcoholics. And phobic individuals can be twice as likely to be addicted to alcohol as those who have never been phobic.
Two types of therapy may be used - Behavioral Therapy or psycho-dynamically oriented Psychotherapy. In the Behavioral Therapy Approach, the therapist uses desensitization, in which the therapist helps the person with a phobia to gradually increase his or her exposure to the source of fear while simultaneously teaching the individual to become deeply relaxed. As an example of desensitization, someone who is afraid of flying may be taught the process of deep muscle relaxation and then progressively shown pictures of airplanes, then asked to imagine flying in an airplane, then taken to an airport, and finally taken up in an airplane.

Ways that phobia sufferers can work toward overcoming their fears include talking about their fears, refraining from avoiding situations they find stressful, imagining themselves facing their fears (visualization), and making positive self-statements like, "I will be OK." In fact, when self-help approaches are combined with brief psychotherapy, people with phobias may achieve significant improvement in symptoms.

Psycho-dynamically oriented psychotherapy not only treats the symptoms also known as phobia but also helps the person understand and resolve the emotional conflicts underlying phobia. Phobias reflect unconscious fears, and the object of the phobia is only a symbol of the unconscious fear. Thus, agoraphobia is often linked to underlying dependency fears. Individuals with agoraphobia are afraid to leave home because of irrational fears that they will be unable to cope with life. Claustrophobia may represent a fear of being emotionally trapped. Thus the real fear may not what you think it is.

Psychologists and psychiatrists classify most phobias into three categories and, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), such phobias are considered to be sub-types of anxiety disorder. 
The three categories are:
  • Social phobia: fear of other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others. Overcoming social phobia is often very difficult without the help of therapy or support groups. Social phobia may be further subdivided into generalized social phobia (also known as social anxiety disorder or simply social anxiety).
Specific social phobia, in which anxiety is triggered only in specific situations -The symptoms may extend to psychosomatic manifestation of physical problems. For example, sufferers of Paruresis find it difficult or impossible to urinate in reduced levels of privacy. This goes far beyond mere preference: when the condition triggers, the person physically cannot empty their bladder.
  • Specific phobias: fear of a single specific panic trigger such as spiders, snakes, dogs, water, heights, flying, catching a specific illness, etc. Many people have these fears but to a lesser degree than those who suffer from specific phobias. People with the phobias specifically avoid the entity they fear.
  • Agoraphobia: a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow. It may also be caused by various specific phobias such as fear of open spaces, social embarrassment (social agoraphobia), fear of contamination (fear of germs, possibly complicated by obsessive-compulsive disorder) or PTSD (post-traumatic stress disorder) related to a trauma that occurred out of doors.
Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer relatively mild anxiety over that fear. Others suffer full-fledged panic attacks with all the associated disabling symptoms. Most individuals understand that they are suffering from an irrational fear, but are powerless to override their panic reaction.


WebMD - Phobias Slideshow: What Are You Afraid Of?