Phobia
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A phobia (from Greek: φόβος, phobos, "fear"), is an irrational, intense, persistent fear of certain situations, activities, things, or persons. The main symptom of this disorder is the excessive, unreasonable desire to avoid the feared subject. When the fear is beyond one's control, or if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made. [1]
Phobias
Phobias (in the clinical meaning of the term) are the most common form of anxiety disorders. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. [2] Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25.
Causes
It is generally accepted that phobias arise from a combination of external events and internal predispositions. In a famous experiment, Martin Seligman used classical conditioning to establish phobias of snakes and flowers. The results of the experiment showed that it took far fewer shocks to create an adverse response to a picture of a snake than to a picture of a flower, leading to the conclusion that certain objects may have a genetic predisposition to being associated with fear[3]. Many specific phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age. Social phobias and agoraphobia have more complex causes that are not entirely known at this time. It is believed that heredity, genetics, and brain chemistry combine with life-experiences to play a major role in the development of anxiety disorders and phobias.
Other uses of term
Phobia is also used in a non-medical sense for aversions of all sorts. These terms are usually constructed with the suffix -phobia. A number of these terms describe negative attitudes or prejudices towards the named subjects. See Non-clinical uses of the term below.
The anatomical side of phobias
Phobias are more often than not linked to the amygdala, an area of the brain located behind the pituitary gland in the limbic system. The amygdala secretes hormones that control fear and aggression, and aids in the interpretation of this emotion in the facial expressions of others. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, in which they are ready to move, run, fight, etc.[4]
Studies have shown a difference between the response cycles of those facing an object of a phobia and those facing a dangerous object that does not trigger phobia-like responses. In one case, patients with arachnophobia were shown pictures of a spider (the object of fear) and a snake (a control picture, intended to induce the normal response). When flashed up, the arachnophobe responded with brief fear to the snake, but the amygdala quickly shut down when the logical areas of higher thought analyzed the threat and ruled it out as unimportant. However, when shown the spider, the arachnophobe's amygdala reacted, and then did not stop secreting 'alarm' hormones, even after they had rationalized the situation they were in.[4]
For this reason, a phobia is generally classified as a panic disorder by most psychologists, since it involves an unnatural or illogical functioning of the brain.[4]
Clinical phobias
Most psychologists and psychiatrists classify most phobias into three categories: [2] [3]
- Social phobia, also known as social anxiety disorder - fears involving other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Social phobia may be further subdivided into
- generalized social phobia, and
- specific social phobia, which are cases of anxiety triggered only in specific situations. [5] 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. That goes beyond mere preference. If the condition triggers, the person physically cannot empty their bladder.
- Specific phobias - fear of a single specific panic trigger such as spiders, snakes, dogs, elevators, water, flying, catching a specific illness, etc.
- Agoraphobia - a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), social phobia, specific phobia, and agoraphobia are sub-groups of anxiety disorder.
Many of the specific phobias, such as fear of dogs, heights, spiders and so forth, are extensions of fears that a lot of people have. People with these phobias specifically avoid the entity they fear.
Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer only relatively mild anxiety over that fear. Others suffer fully-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 initial panic reaction.
Phobias in children
Severe fears are present in about 10-15% of children and specific phobias are found in about 5% of children. Children with specific phobias experience an intense fear of an object or situation that does not go away easily and continues for an extended period of time. Children often have specific phobias of the dark, varieties of insects, spiders, bees, heights, water, choking, snakes, dogs, birds, and other animals. For many children, these fears and phobias interfere with their participation in and enjoyment of various activities. It may also interfere with their education, family life, or their social life. However, effective treatment is available for children who experience phobias.
Treatments
Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitization therapy.
Cognitive behavioral therapy (CBT) can be beneficial. Cognitive behavioral therapy lets the patient understand the cycle of negative thought patterns, and ways to change these thought patterns. CBT may be conducted in a group setting. Gradual desensitisation treatment and CBT are often successful, provided the patient is willing to endure some discomfort and to make a continuous effort over a long period of time.
Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction.
Anti-anxiety or anti-depression medications can be of assistance in many cases. Benzodiazepines could be prescribed for short-term use.
Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, considered to be pseudoscience by the mainstream medicine, is allegedly useful.
These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.
Non-psychological conditions
The word "phobia" may also signify conditions other than fear. For example, although the term hydrophobia means a fear of water, it may also mean inability to drink water due to an illness, or may be used to describe a chemical compound which repels water. Likewise, the term photophobia may be used to define a physical complaint (i.e. aversion to light due to inflamed eyes or excessively dilated pupils) and does not necessarily indicate a fear of light.
Non-clinical uses of the term
It is possible for an individual to develop a phobia over virtually anything. The name of a phobia generally contains a Greek word for what the patient fears plus the suffix -phobia. Creating these terms is something of a word game. Few of these terms are found in medical literature. However, this does not necessarily make it a non-psychological condition.
Terms indicating prejudice or class discrimination
A number of terms with the suffix -phobia are primarily understood as negative attitudes towards certain categories of people or other things, used in an analogy with the medical usage of the term. Usually these kinds of "phobias" are described as fear, dislike, disapproval, prejudice, hatred, discrimination, or hostility towards the object of the "phobia". Often this attitude is based on prejudices and is a particular case of general xenophobia.
Class discrimination is not always considered a phobia in the clinical sense because it is believed to be only a symptom of other psychological issues, or the result of ignorance, or of political or social beliefs. In other words, unlike clinical phobias, which are usually qualified with disabling fear, class discrimination usually have roots in social relations.
Below are some examples:
- Chemophobia, prejudice against artificial substances in favour of 'natural' substances.
- Christianophobia, fear or hatred of Christians or Christianity.
- Ephebophobia, fear of youth or adolescents
- Islamophobia, fear-induced prejudice against Muslims or Islamic culture.
- Xenophobia, fear or dislike of strangers or the unknown, sometimes used to describe nationalistic political beliefs and movements. It is also used in fictional work to describe the fear or dislike of the space aliens.
- Mailophobia, fear-induced by having to check/get mail.
See also
References
- ↑ Edmund J. Bourne, The Anxiety & Phobia Workbook, 4th ed, New Harbinger Publications, 2005, ISBN 1-57224-413-5
- ↑ Kessler etal, Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication, June 2005, Archive of General Psychiatry, Volume 20
- ↑ Phobias: Causes and Treatment in AllPsych Journal
- ↑ 4.0 4.1 4.2 Winerman, Lea. "Figuring Out Phobia," American Psychology Association: Monitor on Psychology, August 2007.
- ↑ Crozier, W. Ray; Alden, Lynn E. International Handbook of Social Anxiety: Concepts, Research, and Interventions Relating to the Self and Shyness, p. 12. New York John Wiley & Sons, Ltd. (UK), 2001. ISBN 0-471-49129-2.
- Lynne L. Hall, Fighting Phobias, the Things That Go Bump in the Mind, FDA Consumer Magazine, Volume 31 No. 2, March 1997 [4]
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