Phobia is a Greek word meaning fear and is used as an umbrella term describing social phobias, specific phobias, and agoraphobia. Many unusually named phobias exist. For example, omphalophobia describes the fear of belly buttons, and pupaphobia is the fear of puppets.
There are several types of phobia, all defined by two characteristics: excessive and unrealistic fears of actual or anticipated objects or situations, coupled with a dysfunctional way of managing that fear. Phobia sufferers may realize their fears are irrational, yet they are unable to successfully manage or reduce their fears through their own efforts. The physical symptoms of distress upon exposure to the feared object/ situation may reach that of a classic panic attack, with racing heartbeat, sweating, shortness of breath, bowel dysfunction, nausea and feelings of freezing or fleeing in terror. A study by the National Institute of Mental Health found that between 8.7 to 18.1 percent of Americans experience phobias.
Social phobias are an extreme fear of being scrutinized, leading to humiliation and embarrassment, in either social or evaluative situations. It is an incapacitating fear of being negatively judged. Social situations include dating or meeting authority figures or strangers. Evaluative or performance situations include public speaking and job interviews, although eating, drinking or writing in public also fall into this category. Individuals with social phobias may decline job promotions that require public speaking or social entertaining. They may not date for fear of rejection. In more mild cases, they may experience sweaty hands and difficulty speaking. Individuals with social phobias were often shy children with lifetime patterns of nervousness.
Specific phobias, formerly called simple phobias, are fears of specific things such as spiders, tunnels, clowns, injections, and so on. Specific phobias are arranged in five categories:
- Animals and insects
- Natural environments (such as deep water and heights)
- Blood, disease, injections
- Situations (such as elevators, tunnels, and airplanes)
As with social phobia, there is a great deal of fear and avoidance around the feared object or situation. Individuals may know their terror is unwarranted yet they are unable to control it. With specific phobias, there is a clear distinction between mild, tolerable anxiety, and anxiety that causes extreme distress and impacts functioning. Researchers have found that nearly 50 percent of the population lives with some condition of fear, yet only a fraction will develop a phobia that impacts daily living. Several effective treatment options for specific phobias are available, and most include some form of gradual exposure to the feared object or situation.
Agoraphobia, extreme anxiety in situations which are deemed difficult and embarrassing to escape, is closely related to panic attacks. The sudden and powerful nature of a panic attack, which can be accompanied by several unpleasant physical symptoms such as shortness of breath, racing heart, dizziness and a feeling of unreality, can lead individuals to believe they are dying, going crazy, otherwise losing control. However, individuals are never in danger of losing control or dying, and the panic attack usually passes within 10 to 30 minutes.
Individuals with agoraphobia fear having a panic attack in a place where they cannot attain help or where they can’t escape. That could be a bridge, tunnel, or even a grocery store. Agoraphobia is, therefore, a reaction to repeated panic attacks and the fear of more panic attacks. Subsequently individuals avoid situations where a panic attack could or has occurred. Panic attacks and agoraphobia sometimes stop without treatment, but they can reoccur again in the future without warning.
Individuals who experience distressing anxiety symptoms without full-blown panic attacks may be diagnosed as having “agoraphobia without history of panic disorder.”
Avoidance Doesn't Work
One of the least productive and most common methods of dealing with phobias is to try and avoid the object or situation at whatever cost. This unproductive method of managing fear frequently causes disturbances in work, school, and social functioning. Avoidance behaviors can render individuals homebound, if fear of leaving their home is too great. The avoidance behavior doesn’t help individuals develop personal resources for managing their fear, and once avoidance behaviors begin, the can be very difficult to overcome. Individuals with phobias also experience anticipatory anxiety; meaning, they become highly distressed as they await a feared event or situation that may be months away from occurring.
Most treatment strategies for phobias incorporate some form of exposure therapy. Exposure to the feared object or situation may be gradual, although some researchers believe that prolonged and intensive exposure, called flooding, can be beneficial. In either case, the individual is taught to manage the anxiety generated by the feared object without the use of medications. Exposure can either be in a treatment setting, perhaps though photos or video, or sometimes in an outside, physical location such as a shopping center. Virtual reality is sometimes used to recreate the feared setting in a safe place. While treatment for specific phobia will be tailored to the individual’s needs, group treatment may be used for social phobias and agoraphobia.