Specific Phobia Disorder Treatment and Information: An Overview
Specific phobia disorder can be a very uncomfortable condition at the very least and absolutely disabling at its very worst. However, there are ways to cope with specific phobia disorder to prevent it from undermining an individual’s entire life. It is obviously imperative to have a good understanding of the condition as well as a recognition of when treatment is necessary. Specific phobia disorder involves a fear and avoidance of very specific circumstances or situations. It is very different from panic attacks and agoraphobia in various ways including that there are no spontaneous panic attacks or fear of panic attacks as you would experience in agoraphobia. It is also very different from social phobia in that there is no fear of embarrassment or humiliation in social situations. Direct exposure to the feared object can cause a panic reaction however. Often the fear and avoidance are significant enough to interfere with an individual’s daily functioning including working and social relationships, and frequently cause a tremendous feeling of distress. Frequently, individuals recognize the irrationality of their fear and response, but it continues to cause a considerable level of difficulty in their lives. Although there are many types of specific phobias some of the more common ones follow:
Dental or doctor phobias. Frequently these will begin with a fear of pain related to either dental or medical procedures conducted in the physician or dentist office. Later this may be generalized to anything related to or in memory of doctors or dentists. Unfortunately, this fear may cause some people to not seek medical or dental services when necessary.
Airplane phobia. Usually this phobic disorder is related to a fear of an airplane crashing. Often fears of the cabin depressurizing and not being able to breathe are part of the imagined scenario. A more contemporary version of this phobia is a fear of hijacking or a bombing of the plane Many individuals with this phobia will have an actual panic attack while flying. Some experts have concluded that approximately 10% of the population in the United States will not fly at all while an additional 20% will fly but experience tremendous anxiety.
Illness phobia. This phobic reaction is in relation to a fear of getting a specific medical condition such as cancer or having a heart attack. People with an illness phobia tend to seek constant reassurance from doctors and medical personnel and will avoid any reminder of the dreaded disease if possible. Illness phobia is also very different from hypochondriasis in that with a specific illness phobia people tend to focus on one specific illness as opposed to imagining the development of a variety of diseases or medical conditions.
Elevator phobia. This phobic reaction is usually in relation to fears of elevator cables breaking and the elevator crashing to the floor or being stopped and trapped inside. This fear frequently can cause an individual to have a panic attack although they have not previously had any history of panic disorder.
Animal phobias. The fear associated with this phobia is usually in relation to a variety of animals including rats, spiders, snakes, bats, dogs, and various other animals. This phobic disorder frequently begins in childhood where often the initial fears are considered to be rational or normal. It is only when they continue into adulthood and begin to undermine or interfere with an individual’s daily functioning that they actually develop to the point of becoming a specific phobia disorder.
Acrophobia. This phobia is often referred to as a “fear of heights”. Acrophobia can be related to a multitude of circumstances such as fear of being on the upper floors of a tall building, on top of a mountain, or even bridges. Individuals who experience this type of specific phobia disorder often say that they experience (1) dizziness or vertigo for (2) a feeling of being drawn toward the edge or an urge to jump.
Thunder and/or lightning phobias. This phobic disorder almost always starts in childhood. It is when it actually persists beyond the adolescent years that it is then defined as a specific phobia.
Specific phobias are very common and are believed to affect approximately 10% of the population. Because they do not always result in severe impairment in daily functioning, a significant amount of people who experience these fears and avoidant reactions do not seek treatment. Specific phobias seem to occur equally between men and women. Animal phobias however seem to be more common among women and illness phobia seems to be more common among men.
Development of Specific Phobia Disorder:
Specific phobias in general are usually fears about specific objects and circumstances experienced in childhood that were never really outgrown. However, in some circumstances they can be fears that are developed following the experience of a traumatic event such as an accident, illness or violent experience. Unfortunately, another precipitating factor which may lead to the possible development of a specific phobia may be the modeling of others. For example, repeated exposure to a parent who has a specific phobia can result in children developing it also.
Specific Phobia Disorder Treatment:
Specific phobia disorder treatment can be different from the usual treatment of panic disorders in that specific phobias do not generally involve spontaneous panic attacks. Therefore, they don’t often include treatments such as panic control therapy, interoceptive desensitization and medication.
Cognitive therapy. One of the more common treatments for specific phobia includes cognitive therapy which helps to recognize, challenge and replace some of the specific thoughts that perpetuate the fearful reactions and avoidance behavior. Fearful thoughts such as “What if I panic when I’m trapped on an airplane?” Can be replaced with thoughts such as “Although I’m on the plane for two hours, I will be off soon.”, or “I can get my mind on something else like reading or watching a movie.” These coping statements are usually rehearsed until they are internalized and often are accompanied with deep breathing or relaxation techniques.
Incremental exposure. This type of specific phobia treatment involves exposing the individual to the feared object or experience in incremental steps. An example of this may be when a fear of flying is incrementally approached through the use of imaginary flying experiences such as looking at pictures of people flying or even watching planes take off and land. Also, an individual may take a very short flight at first rather than a longer one. Initially they may even have a support person to accompany this individual, and eventually they may then take the flight on their own.
Relaxation training. Deep breathing and muscle relaxation can be practiced on a regular basis to reduce the general level of experienced anxiety. Relaxation training can be used to help with anticipatory anxiety as well as deep breathing while actually confronting the specific object or circumstance.
Some phobic objects and circumstances are not amenable to real-life desensitization such as earthquakes or other natural disasters. In these circumstances cognitive therapy would be used along with exposure to imaginary experiences of these natural disasters such as looking at pictures or watching movies associated with these feared catastrophes.
Specific phobia disorder conclusion:
It is always important to understand that specific phobia disorder is relatively benign initially, especially if it begins as a childhood fear. Although it has been found at times to last for many years and even decades, it will usually not get worse and sometimes will diminish over time. Fortunately, this disorder is not usually associated with other psychiatric disorders or mental health problems. People with specific phobia disorder often function at a high level in other aspects of their lives.
By Paul Susic Ph.D. Licensed Psychologist
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