SPECIFIC PHOBIA

Specific Phobias involve intense and inappropriate fears of a specific object or situation. Thoughts or confrontation with the fear-inducing stimuli results in symptoms of anxiety. People with Specific Phobias often avoid the feared object or situation. In order to be diagnosed with a Specific Phobia, there are a number of criteria that need to be met. Several of these criteria include:

  • You recognize that your fear is over and above what the situation calls for
  • The phobic reaction, anticipation, or avoidance interferes with your relationships, routine, or causes significant distress
  • Your phobia has been present for 6 months or longer
  • Your symptoms are not connected to another mental health issue

Specific Phobias fall into several different categories, including Environmental Phobias (Example: fear of storms, lightning, water, etc.), Animal Phobias (Example: fear of spiders, dogs, rodents, etc.), Situational Phobias (Example: fear of enclosed places, of flying, of driving, etc.), and Bodily Phobias (Example: fear of seeing blood, getting a needle injection, having a medical procedure, etc.).[1] Phobias that do not fit into these four categories fall into a fifth category referred to as Other Types (Example: fear of choking or fear of vomiting).2

Common Types of Specific Phobias:

  • Vehophobia: fear of driving
  • Glossophobia: Performance anxiety, or the fear of speaking in front of an audience
  • Acrophobia: The fear of heights
  • Claustrophobia: The fear of enclosed or tight spaces
  • Aviatophobia: The fear of flying
  • Dentophobia: Fear of the dentist or dental procedure
  • Hemophobia: Fear of blood or injury

Canadian Statistics

  • Phobias are very common and are found in 1 out 10 Canadians.[2]
  • Many people do not seek treatment because they may think that they can work it out on their own or that may be able to successfully avoid the feared stimulus/context.[3]
  • According to statistics from 2015, research suggested that roughly twice as many women compared to men experience Specific Phobias.[4]
  • Bodily and Animal Phobias typically begin in early childhood whereas Situational and Environmental phobias begin later in life, usually in the late teens and in the early twenties. Approximately 75% of individuals with a Bodily Phobia report a history of fainting in response to the phobic situation.2
  • Specific Phobias are the most treatable of the anxiety disorders.2

Behaviours associated with Specific Phobias:

  • Avoiding going out to dinner with your friends because you are afraid of the germs on restaurant cutlery and glasses
  • Refusing important vaccinations due to your fear of needles
  • Missing a destination family reunion because you are too afraid of flying in an airplane
  • Not going on your child’s nature field trip for fear of seeing a spider
  • Avoiding amusement parks because even seeing the rides gives you unbearable anxiety
  • Missing out on accepting a prestigious award because you will have to make an acceptance speech

Feelings associated with Specific Phobias:

  • Anxious
  • Fearful
  • Apprehensive
  • Tense
  • Depressed
  • Vulnerable

Thoughts associated with Specific Phobias:

  • “I can’t even cope with the thought of a needle entering my arm. There’s no way I am going to my doctor’s appointment.”
  • “I can’t go to that park. If I go, a dog might get loose and attack me.”
  • “I can’t get on this airplane because I have a bad feeling about it. It’s going to crash and I’m going to die.”
  • “I can’t go to that party because there’s going to be too many people.”

Specific Phobias and the Body:

Specific Phobias fall under the category of anxiety disorders, and therefore produce the bodily symptoms associated with anxiety. Some of these sensations include:

  • Muscle tension
  • Heart palpitations
  • Difficulty being still
  • Shortness of breath
  • Cold or sweaty hands and/or feet
  • Lightheadedness or dizziness

With a Specific Phobia, the onset of these symptoms occurs when you are confronted with the object or situation of which you are afraid.

Specific Phobias and the Brain:

When people with phobic anxiety are introduced to fear-inducing stimuli, two parts of the brain become the most active: the amygdala and the insula.[5] Although the exact function of the insula is unknown, there is ample evidence that it is involved in perceiving and processing feelings, pain, and self-awareness.[6] The other area of the brain associated with panic disorder is the amygdala. This part of the brain is strongly linked with recognizing and responding to fear.[7]

Does Psychology Work?

There are several psychological interventions that are effective in the treatment of Specific Phobias.

  • Exposure Therapy: This treatment is one of the most successful psychological interventions for Specific Phobias. Your improvement and recovery can happen in as little as one session of guided exposure to the feared situation or stimulus lasting for 2-3 hours.2 Treatments involve repeatedly confronting a feared object or situation in a highly controlled and paced setting. Over time, exposure to the feared stimuli usually results in less of an intense response. One of the reasons why this treatment is often successful is because it stops people from avoiding the object of their phobia. Avoidance of the fear-provoking object or situation perpetuates the phobia; and exposure-based treatments can help you realize that you can tolerate the fearful and anxiety-producing situation, and that nothing bad will happen to you. Exposure-based treatments have been statistically shown to effectively treat phobias better than other types of therapies.[8]
  • Virtual Reality Therapy (VRET): is a type of exposure therapy used in treating Specific Phobias. This type of therapy involves systematically exposing someone with a phobia to a virtual world that presents them with their fear. Using these virtual worlds in a therapeutic setting creates an opportunity for Psychologists to help you regulate anxious responses in a safe space. Virtual reality therapy has shown to improve the behaviours associated with Specific Phobias. These behaviour changes extend beyond virtual reality exposure into real-life situations.[9]
  • Eye Movement Desensitization and Reprocessing (EMDR): is another effective strategy for working with Specific Phobias. The process of EMDR involves exposure to an image of a fear-provoking stimulus while engaging in bilateral stimulation. Phobias brought on by traumatic experiences are especially responsive to EMDR.[10]

Tips to Manage Specific Phobias!

  • Mindfulness: can help reduce the anxiety associated with your phobia. Mindfulness is a scientifically proven method to help reduce anxiety;[11] and involves an open and non-judgemental awareness of your internal and external states. Paying attention to your thoughts, bodily sensations, and external surroundings are all strategies for practicing mindfulness.[12] More formal mindfulness practices can involve meditations, which are widely available as free resources on the internet.
  • Breathing: is another strategy for managing phobia-related anxiety. Breathing into the abdomen rather than the chest is a useful breathing technique that you can practice in preparation for facing the object of your phobia. It can help slow down your heart rate and trigger a relaxation response in your body. Timing out the pace of your breathing to make it more consistent is another way of managing the anxiety related to your phobia. Although it may feel nearly impossible to get rid of your panic with breathing, simply practicing awareness of the breath can help you recognize when your breathing is worsening the symptoms of anxiety.[13]
  • Relaxation exercises: such as progressive muscle relaxation, have also been shown to help reduce anxiety.[14] There are several forms of progressive muscle relaxation. One version encourages you to relax different areas of your body, while another suggests both tensing and relaxing the muscles throughout your body.[15] Over time, this practice will help you notice when your muscles are tense versus when they are relaxed. Progressive muscle relaxation can help you reduce your anxiety by bringing awareness to the tension in your body and releasing it during times of stress.

The category of Specific Phobias includes various types of phobias. Phobias do not typically go away without treatment and it often worsens over time. You may require psychological treatment if the phobia is severely interfering with your life. Your experience of a phobia is unique and you may also be experiencing multiple psychological issues at the same time. Hopewell Psychological will customize a treatment plan just for you. We offer a wide range of therapies to suit all your needs. There is hope for your recovery from a phobia, and we will ensure that you receive top quality, evidence-based treatment.

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*Psychologists are covered under Insurance Companies in Canada. You will need to check with your insurance company about the specific details regarding your coverage.

References

[1] Fleming, Kevin, Ph.D. “Specific Phobia DSM-5 300.29 (ICD-10-CM Multiple Codes).” Theravive (2017).

[2] “Psychology Works.” Canadian Psychological Association. Fact Sheet: Phobia.

[3] Healthwise staff, Healthlink BC 2016. https://www.healthlinkbc.ca/health-topics/zd1121

[4] “Section B – Anxiety Disorders.” Statistics Canada. 2015 http://www.statcan.gc.ca/pub/82-619-m/2012004/sections/sectionb-eng.htm#a1.

[5] Ipser, Jonathan C., Leesha Singh, and Dan J. Stein. “Meta-analysis of functional brain imaging in specific phobia.” Psychiatry and clinical neurosciences 67.5 (2013): 311-322.

[6] Stephani, C. et al. “Functional neuroanatomy of the insular lobe.” Brain Structure and Function 216.2 (2011): 137-149.

[7] Smoller, Jordan W. et al. “The human ortholog of acid-sensing ion channel gene ASIC1A is associated with panic disorder and the amygdala structure and function.” Biological Psychology 76.11 (2014): 902-910.

[8] Hood, Heather K., Antony, Martin M. “Evidence-Based Assessment and Treatment of Specific Phobias in Adults.” Intensive one-session treatment of specific phobias. New York: Springer, 2012. 19-42.

[9] Morina, Nexhmedin, et al. “Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments.” Behaviour research and therapy 74 (2015): 18-24.

[10]  Hood, Heather K., Antony, Martin M. “Evidence-Based Assessment and Treatment of Specific Phobias in Adults.” Intensive one-session treatment of specific phobias. New York: Springer, 2012. 19-42.

[11] Khoury et al. “Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review 33.6 (2013).

[12] Hofmann, Stefan G. et al. “The effect of mindfulness based therapy on anxiety and depression: a meta analytic review.” Journal of consulting and clinical psychology 78.2 (2010): 169.

[13] Meuret, Alicia E. et al. “Coping skills and exposure therapy in panic disorder and agoraphobia: latest advances and future directions.” Behavior Therapy 43.2 (2012): 271-284.

[14] Francesco, Pagnini, et al. “The efficacy of relaxation training in treating anxiety.” International Journal of Behavioral Consultation and Therapy 5.3-4 (2010): 264.

[15] Feldman, Greg, Jeff Greeson, and Joanna Senville. “Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on de-centering and negative reactions to repetitive thoughts.” Behavior research and therapy 48.10 (2010): 1002-1011.img_01122016_164943

 

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