Persistent fears: Exploring the science behind phobias

phobias and fears

What is a phobia? Merriam-Webster it as “a persistent, irrational fear of a specific object, activity, or situation that leads to a compelling desire to avoid it.” Although fears are something everyone experiences, a phobia goes beyond everyday worries and can lead people to take extreme actions to avoid the cause of their terror. Phobias can significantly impact sufferers’ daily lives and have a crippling effect on their health and happiness.

What Is a Phobia?

As explained, a phobia is a persistent fear that leads to sufferers avoiding the fear at all costs. But beyond the common meaning is a deeper psychological understanding. In clinical psychology, a phobia is considered a type of anxiety disorder and can lead to marked distress in social and occupational activities. For centuries, humans have been trying to understand and treat phobias.

The Difference Between a Fear and a PhobiaDifference between fears and phobias

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the primary diagnostic tool for psychiatric disorders, phobias can only be diagnosed if the object or situation that invokes fear is present in a person’s life. For example, an individual who has a fear of spiders (arachnophobia) will not be diagnosed as phobic if they live in a climate with no spiders present. Although the thought of spiders may cause that person distress, if they do not have to experience it regularly, it isn’t a true phobia.

Types of Phobias

The DSM classifies phobias into two distinct categories:

Specific Phobias

These phobias are a fear of particular objects or social situations that immediately result in anxiety. The distress can grow so large that sufferers experience panic attacks and other medical issues. Specific phobias typically fall into one of five subcategories: animal type, natural environment type, situational type, injury type and other.

Agoraphobia

This phobia is a generalized fear of leaving home or a similar “safe” area, and usually is accompanied by panic attacks. Although agoraphobes have a specific fear of leaving this area, there are a variety of things they may fear once leaving including: open spaces, social embarrassment, contact with germs, or any other kind of trauma that occurs outside the home. Agoraphobia is sometimes related to post-traumatic stress disorder or obsessive-compulsive disorder.

It’s important to note that phobias vary in severities among individuals. If a sufferer can simply avoid the subject of their fear throughout their life, they will likely suffer little anxiety over that fear. However, some experience phobias bring full-fledged panic attacks and other disabling symptoms. Most victims understand that their fear is irrational, but are unable to override the panic reaction.

Epidemiology

Phobias are among the most common of anxiety disorders and their distributions are heterogeneous by both age and gender. The National Institute of Mental Health has found that between 8 and 18 percent of Americans suffer from phobias. It is the most common mental illness among women of all ages and the second most common among men. A Swedish study found evidence that women have a higher incidence than males (26 percent for females and 12 percent for males), but this is not yet a widely agreed upon fact.

What Causes Phobias

Although the study of phobias has always been linked with the study of fear, psychologists have long wondered how a fear can evolve from normal to persistent and, potentially, debilitating. There are a number of theories involving both how our brain works and what we experience throughout life.

Rachman’s Fears

Dr. Stanley Rachman is one of the leading figures in the research and treatment of anxiety disorders, including phobias. He proposed that there are three pathways to acquiring fear responses that lead to phobias:

Classical Conditioning

Like the Pavlovian model, Rachman felt that fear acquisition could occur when a previously neutral stimulus is repeatedly given a negative reaction, thus turning the stimulus negative. For example, when an electric shock is given in a specific room, the subject can not only fear the shock but the room itself.

Vicarious Fear Acquisition

Rachman also believed that it is possible to learn to fear something not by experiencing it, but by seeing others react. For example, if a child sees a parent reacting to an animal fearfully, the child could also become afraid of that animal, or all animals.

Informational and Instructional Acquisition

Similar to vicarious acquisition, informational instructional involves learning fear from someone else. However, this fear is not acquired by observation but merely by receiving information; for example, when told that electric wires can cause shocks and electrocution, people can begin to fear them, even without experiencing or seeing other experience those effects.

These fear responses do not always evolve into phobias, but they certainly can. Once there are symptoms of impairment and avoidance, it is believed that fear has become a phobia.

Brain Mechanisms Behind PhobiasBrain mechanisms behind phobias; the insular cortex and amygdala

Located behind the brain’s cerebral cortex, the insular cortex is the center of the limbic system, which processes emotions, detecting and interpreting stimuli and then sending out responses we interpret as emotion. Studies have linked the insula directly with anxiety, meaning that the insula may have a significant part of how phobias are developed.

The amygdala, located inside the brain’s medial temporal mode, also plays a part in fear and phobias. It processes the events that are associated with fear and has been linked to anxiety disorders like phobias. The amygdala responds to fearful stimuli via the process of fear conditioning. It learns to associate a conditioned stimulus with either a negative or avoidant response.

Treatments for Phobias

There are a variety of methods that are used to treat phobias. These treatments have evolved with the advent of technology, including the use of digital imagery to desensitize patients. Here are some common treatments:

Therapy

Cognitive behavioral therapy has been beneficial for those suffering from phobias. The therapy gives patients tools to challenge dysfunctional thoughts or beliefs, including being mindful of their own feelings with the goal of labeling their fear as irrational. This type of therapy is especially helpful to children developing social phobias.

Eye movement desensitization and reprocessing is another type of therapy that has shown success in treating phobias. EMDR uses an eight-phase approach to help process distressing memories, including having clients recall distressing images while receiving one of several types of bilateral sensory input, including side-to-side eye movements. Although typically used to treat posttraumatic stress disorder, EMDR can help alleviate phobias, especially those related to specific incidents of trauma.

Systematic Desensitization

The theory behind systematic desensitization explains that by helping patients slowly become accustomed to a phobia, they are likely to overcome it. For example, someone who fears spiders would begin the process by viewing pictures of spiders. Then they could move on to videos of spiders, and seeing spiders in a cage. Eventually the person could touch the spider and hopefully hold it without fear. This treatment is so common that friends and family of the affected may try to perform it. This is, of course, not recommended; all therapy should be conducted by a trained professional.

The same process is performed for those with social phobias, with therapists slowly but steadily introducing the behavior into the sufferer’s life. Using this technique for social phobias is far more controversial, especially to agoraphobics whose fear may be caused by a traumatic event. These individuals may need traditional counseling or therapy.

Medications

In some cases, pharmaceutical medication may be helpful in treating phobias. Benzodiazepines may be used in the acute treatment of severe systems, but most experts do not recommend this drug regimen for long-term use to deal with phobias.

Overcoming the Fear

There’s a good chance that you or someone you know is suffering from some kind of phobia. Although the effects vary, there is no doubt that it can have a negative influence on their life and well-being. Not all phobias need curing, but there is help out there for those looking for it. With the proper therapy and guidance, everyone can live phobia-free.

As mentioned above, trained professionals are the best way to treat phobias. The first step to learning how to help those with mental illness is with a bachelor’s degree in psychology. Notre Dame College offers a fully online program that will help you get started on your path to helping others. Learn more today.