Specific Phobias and Fears Rob Shapiro
People who are highly distressed and fearful about something, and who often go to great lengths to avoid the object or situation that causes fear are often suffering from a phobia. A specific phobia is an intense, persistent, irrational fear of a specific object, situation, activity or person. Most often, the fear is perceived as greater than the actual danger or threat.
Some examples of Phobias include:
A teenager who avoids going to the homes of friends and family members who own dogs as a result of having a dog phobia.
A businessman who passes on a promotion because he is unwilling to accept the required travel due to a fear of flying.
A woman who needs getting blood work done but repeatedly delays because of a needle phobia.
A young man who refuses to use the elevator and walks up ten flights of stairs to reach his office due to a fear of enclosed spaces.
The commonality among these people is that the phobia causes marked distress in their everyday lives.
Diagnostic Criteria and Symtomatology
Therapists often turn to the Diagnostic and Statistical Manual of Mental Disorders for guidance in accurately diagnosing a phobia. The criteria includes:
A persistent fear that is excessive or unreasonable and which occurs by the presence or anticipation of a specific object or situation (such as coming into contact with a dog or a needle).
An immediate anxiety response upon exposure to the feared item or situation. Often, this response takes the form of a panic attack. In children, the anxiety may be expressed by crying, tantrums, freezing or clingy behavior.
A recognition that the fear is excessive or out of proportion to the actual threat. In children, however, this recognition may be absent.
An avoidance of the phobic situation or exposure to it that is accompanied by intense anxiety or distress.
A serious disruption in a person’s normal routine, work or school schedule, social activities or relationships because of the phobia.
A persistent fear, typically lasting for at least six months.
Another mental disorder cannot better account for the behavior. Such disorders include obsessive-compulsive disorder, post-traumatic stress disorder, separation anxiety disorder, social phobia and panic disorder.
Types of Specific Phobia
There are five different types of specific phobia:
Animal Type (such as dogs, snakes and spiders)
Natural Environment Type (heights, storms, water, etc.)
Blood-Injection-Injury Type (including a fear of seeing blood, receiving a shot or blood test and even watching a television program that depicts a medical procedure)
Situational Type (airplanes, elevators, driving, enclosed places and more)
All Other Types (loud sounds, costumed characters, clowns, activities that could lead to choking, vomiting, or contracting an illness)
Specific Phobias Versus Normal Childhood Fears
There is a big difference between normal childhood fears and Specific Phobias. According to the Child Anxiety Network (www.childanxiety.net), some research shows that 90 percent of children between the ages of 2 and 14 have at least one specific fear. Not all fears interfere with daily functioning. Nor do they necessarily merit psychological treatment. Some examples of normal childhood and early adolescent fears include:
Infants/Toddlers (up to 2 years old): loud noises, strangers, separation from parents and large objects
Preschoolers (3 to 6 years old): imaginary figures (such as ghosts, monsters and supernatural beings), the dark, noises, sleeping alone, thunder and floods
School-aged children and adolescents (7 to 16 years old): physical injury, health, school performance, death, thunderstorms, earthquakes and floods
Etiology of Specific Phobias
The etiology of Specific Phobias include learned history, past experiences and biology.
Direct Learning Experiences: A traumatic experience can sometimes trigger a specific phobia. For example, a child who is bitten by a dog might develop a fear of dogs or someone who has a car accident might develop a fear of driving.
Observational Learning Experiences: Some people develop a phobia after observing others show signs of fear in a similar situation. For example, a child growing up with a father who is afraid of heights may learn to fear heights himself.
Informational Learning Experiences: Sometimes, people develop Specific Phobias after hearing or reading about a situation that may be dangerous. For example, a person can develop a fear of flying after watching news footage of 9/11.
It is important to note that learning is not the sole cause of Specific Phobias nor a predictor of phobias to come. Many people are bitten by dogs or get into car accidents and do not go on to develop phobias.
While risk factors may include genetic susceptibilities and predisposition to phobias, more must be known about the biological factors beneath Specific Phobias. As a result of encounters with a feared stimulus, biological changes that can occur in the body include changes in brain activity, the release of cortisol, insulin and hormones and increases in blood pressure and heart rate.