Phobias

A fear becomes a phobia when it stops us from enjoying things or doing them easily.

You feel really frightened of something that is not actually dangerous and which most people do not find troublesome. The nearer you get to the thing that makes you anxious, the more anxious you get and so you tend to avoid it. Away from it you feel fine.

When someone develops a phobia, they learn that avoidance can reduce their anxiety (at least in the moment) and increase the likelihood that they will avoid the feared situation or object next time. The difficulty is that these avoidance behaviours have to keep increasing and happening even sooner to provide the same relief.

Many people cope by arranging their lives around their symptoms. This means that they (and their families) have to miss out on things they might otherwise enjoy. They can’t visit their children’s school, can’t do the shopping or go to the dentist. They may even actively avoid promotion at work, even though they are quite capable of doing a more demanding and more financially rewarding job. A significant proportion will have difficulty in making long-term relationships.

Specific phobias are an anxiety about a single object, situation or activity. These commonly include animals or insects, such as spiders or snakes, or a fear of blood, or medical interventions such as injections, or injury.

Complex phobias involve several anxieties. Agoraphobia can include a fear of open spaces, crowds, public places, entering shops or travelling alone on forms of transport. Social phobia is a fear of a social or performance situations, such as a party or speaking in public. People with social phobia fear that they will behave in an unacceptable or embarrassing way that will lead others to judge them negatively.

Simple and complex phobias may both trigger panic attacks. This is a short period, usually only a few minutes but sometimes longer, during which you feel overwhelmingly anxious, and terrified of losing control. Associated symptoms include:

• Shortness of breath
• Palpitations, pounding heart, or accelerated heart rate
• Chest pain or discomfort
• Trembling or shaking
• Feeling of choking
• Numbness or tingling sensations
• Hot or cold flushes
• Sweating
• Nausea or stomach churning
• Feeling unsteady, dizzy, lightheaded, or faint
• Feelings of unreality or of being detached from yourself
• Feelings of losing control, going crazy, or dying

How we can help

Psychological treatments can help people with phobias and a psychologist, psychotherapist, or other professional, will usually work with the person to help deal with the phobia.

Cognitive behavioural therapy (CBT) combines two types of psychotherapy: cognitive therapy and behaviour therapy. This group of therapies focuses on assisting people to modify the unhelpful patterns of thinking and reacting in order to reduce their distress and overcome phobias.

Central to our approach is to also understand anxiety and phobias as meaningful communications about the person’s life history and current circumstances. Finding and dealing with the root cause in individual therapy, and sharing experiences in group psychotherapy, further helps understanding and recovery from agoraphobia and social phobia.

Sometimes our doctors will consider it appropriate to prescribe medication for a particular psychological difficulty. If so, we will discuss this with patients first, and explain the process and possible side effects.

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