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Lewis Psychology Services for Phobias

What is a Phobia?

A phobia is a type of anxiety disorder. A phobia is a strong, extreme or irrational fear of an animal, object, place or situation that would not normally worry the majority of people.

A phobia is an overwhelming need to avoid any contact with the specific cause of the anxiety or fear. Coming into contact, or even the thought of coming into contact with the cause of the phobia, makes you anxious or panic.

If it is unlikely that you will come into contact with the object of your phobia (for example, snakes), it will not tend to affect your everyday life too much. However, phobias such as agoraphobia and social phobia can make it very hard to lead a normal life.

Phobias are divided into two types: simple phobias and complex phobias.

Simple phobias

This type is about a single object, situation or activity. Common examples are a fear of insects, heights, snakes, enclosed spaces, dentists or flying. If you have a simple phobia you might react with mild anxiety or even with panic when confronted with the prospect of facing the source of your fear.

Complex phobias

Agoraphobia is an example of a complex phobia. It involves several anxieties, including fear of entering shops, crowds and public places, or of travelling in trains, buses or planes. It also includes anxiety of being unable to escape to a place of safety, usually home.

Social phobia is another complex phobia. Social phobia is a fear of social or performance situations, such as a wedding or public speaking. Those with a social phobia have a fear of embarrassing themselves or of being humiliated in public.

If you have a social phobia, the thought of being in public or appearing at social events will make you extremely anxious and frightened. It is because these types of situations make you feel vulnerable.

Avoiding meeting people in social situations, including parties or eating in restaurants, is a typical sign of social phobia. In extreme cases, some people are too afraid to leave their home.

It is thought that 1-2% of men and women have a social phobia, and it is usually linked to low self-esteem and fear of criticism.

Signs and Symptoms of Phobias

People with phobias experience many anxiety-related symptoms when they're exposed to the object or situation they fear. The symptoms are both emotional and physical. The symptoms of anxiety and fear can range from mild feelings of apprehension to a full-blown panic attack. Typically, the closer you are to the thing you're afraid of, the greater your fear will be. Your fear will also be higher if escape from is difficult.

Common Phobia Signs and Symptoms:

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

Confronting the Feared Situation

It is important to stop avoiding the feared situation; rather it needs confronting whilst managing the level of anxiety. Because it can be very difficult to start in the midst of the feared situation, the usual approach is by a graded exposure. This means drawing up a hierarchy of threatening situations and confronting the least feared situation first before moving on to the more threatening ones. For example, somebody with a phobia of spiders might use the following hierarchy:

  • 1. Reading about spiders
  • 2. Looking at and then touching a photograph of a spider
  • 3. Looking at/touching a plastic model of a spider
  • 4. Looking at/touching a jar with a small spider in it
  • 5. Picking the spider out of the jar
  • 6. Picking up a large spider.

To help manage the anxiety experienced during the exposure exercises, relaxation and breathing exercises can be used. It is important to stay in the situation until the anxiety has gone and not to "escape" when the anxiety is high (to do so would only reinforce the anxiety). This might take up to 20-30 minutes, but the anxiety will diminish and eventually disappear if you stay in the situation; you then start to learn that you can survive and even feel relaxed in this situation.

Dealing with Frightening Thoughts

If you can identify any threatening thoughts associated with your phobia, it is very helpful to try to write them down and "challenge" them. For example:

Frightening thoughts: This plane will crash
Rational thoughts: I've flown many times before and I've been safe. This is the safest way to travel statistically.

Frightening thoughts: I'll make a fool of myself
Rational thoughts: I've done this before and managed to cope - I can do this.

Frightening thoughts: I'll collapse and die
Rational thoughts: I have felt like this before and nothing terrible happened to me - this is just anxiety - it won't harm me.

Anxiety is normal and it won't harm you - the worst it can do is to feel very unpleasant. View each time you confront the feared situation as an opportunity to learn to overcome your anxiety in this way, rather than something to dread. When the anxiety has gone, remind yourself that you have survived, and have not gone mad, lost control or died!

If your fears are about making a fool of yourself and being judged negatively, remind yourself of your positive qualities, and of the times in the past you have coped with similar situations, got on well with people, or have had positive comments from others. You may well be much more critical of your own imagined failings than those of others; similarly, others are likely to be unaware of, or uninterested in your failings. Anyway, it is not possible to get on with or be approved of by everyone!

When and Where to Seek Further Help

  • If your phobias are interfering with your ability to lead a full, normal life and you don't make any progress in challenging them yourself
  • If you are experiencing a lot of anxiety or distress, and you seem to be feeling like this often
  • If you are avoiding situations that matter
  • If you suffer from overwhelming blushing/trembling/sweating in social situations or feel that you lack social skills

Cognitive Behavioural Therapy For Phobias

During Cognitive behavioural therapy (CBT) the therapist will collaborate with the client to identify and assess all maintaining factors; including thoughts, behaviours, emotions and physical symptoms associated with the problem and develop a working formulation which will be utilised to guide the course of therapy.

A number of techniques will be employed to test predictions and beliefs which may include behavioural strategies such as exposure and cognitive interventions aimed at identifying and challenging unhelpful thoughts and beliefs, possible thinking errors and misinterpretations. These may then be challenged through a combination of Socratic questioning and behavioural experiments.

Counselling And Psychotherapy For Phobias

Counselling and psychotherapy can help you understand what is happening to you and why you feel anxious by recognising and addressing your triggers.  You may also learn techniques to control and manage symptoms. Understanding where the phobia originated can also help you gain a new perspective.

EMDR For Phobias

The EMDR approach allows a therapist to act both in the reconstruction of the elements that may have forced the beginning of the typical symptoms of a phobia and to directly intervene at a neurophysiological level to facilitate the reworking of the elements stored dysfunctional in memory and recurrently expressed a phobia.

EMDR processing can be applied to targets such as your first and worst episodes of the phobia, life events related to the phobia and anticipated phobic situations. You would also work on current triggers related to your phobia in the present and prepare for future experiences. Using EMDR we would work towards the elimination of the phobia and avoidance behaviours, insight about symptoms and return to normal daily functioning.



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Medical disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice by a qualified doctor.