Fear, a concept everyone is most familiar with yet, the response varies in its composure, texture, nature and many other aspects. It is a very primary reaction to many things we encounter in daily life. And, it is a very fundamental biological reaction in certain scenarios. This fear ranges into the severe spectrum when it turns into what healthcare professionals call PHOBIA. Phobia, according to Harvard Health, is “a persistent, excessive, unrealistic fear of an object, person, animal, activity or situation”.It is an excessive and irrational fear reaction and may further cause a sense of dread or panic when you encounter the source of your fear.
Phobia is a fear that sticks around in various forms and which gets triggered as the person is subjected to that particular thing, person, animal, activity or situation. Phobia can be very specific, severe, irrational and can cause various kinds of drastic problems in one’s daily life.
The impact of a phobia can range from distractingly annoying to severely disabling. People with phobias often realize their fear is irrational, but they’re unable to do anything about it. Such fears can interfere with work, school, and personal relationships.You know you are having an intense fear of something when you get subjected to it and feel breathless, dizzy, increased heart rate, fear of dying, nausea and have a sense of unreality. Now, these are just basic symptoms one experiences. Don’t use these to rule out anything!
When you have a phobia towards something or someone, these symptoms become prominent and intervening with your normal lives. A diagnosis can only be done by a professional, who would further devise an intervention for you.
Types of Phobias
Phobias are basically categorized into three different types by The American Psychiatric Association and these are:
• Agoraphobia – Fear of being trapped in a place or a situation where one cannot escape. The word itself refers to “fear of open spaces”. Normally, the phobic individual avoids the situation in order to stay safe.
• Specific Phobias – This category involves fear of a particular subject and typically falls into one of four different categories: medical, situational, animals or environmental.
• Social Phobias – This category consists of an extreme and pervasive fear of social situations. In some cases, this fear may centre on a very particular type of social situation such as public speaking. In other situations, people might fear performing any task in front of other people as they fear being somehow publicly embarrassed.
Phobias are what we generalise into a particular category or spectrum of fear. For example, when I was 10, three dogs chased me while I was walking on the road and since then I have this acute fear of dogs and I generalise each dog into a potential harm.
And, many such instances happen with people where they generalise a situation they feared and apply it to every other situation or thing. The way our brains work when we get subjected to a phobia element is what makes us generalise that reaction and develop it more.
Studies have shown that those who suffer from anxiety disorders, including phobias, have trouble with the regulation of serotonin levels in their brains. Serotonin is a chemical that acts as a neurotransmitter which modulates the signals between neurons and other cells.
Serotonin acts in the brain and, among other things, moderates mood. A serotonin level that is too high or too low can cause both depression and anxiety. Consequently, phobias are often treated with a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Normally serotonin is released from a nerve cell into the synaptic gap between cells. It is recognized by the second nerve cell, which then transmits a signal to the brain. The serotonin is then recaptured by the first nerve cell.
An SSRI prevents some of the serotonin from being reabsorbed. It stays in the synaptic gap in order to further stimulate the second nerve cell. SSRIs are not the only medications used in the treatment of phobias but are among the most effective. They must be used with caution, however, particularly in young people, as there can be serious side effects.
Let’s take an example, If I go and see a dog from my window inside my neighbour’s house chained, I don’t feel as scared as I would feel if I see it in front of me. The hippocampus and the prefrontal cortex process the contextual information and the pathways dampen amygdala fear response and it downplays the result at the end. This shows how our “thinking” circuit of the brain assures our “emotional” circuit.
If we take the above example of my life, when I was standing on the road, if the three dogs passed by normally, it wouldn’t have caused that much fear inside me because I have control of the situation. I am still in my place and they just casually went by. They instead chased me and I lost my edge, I had to run as they bared their teeth and that gave me intense fear of being bitten. That’s how my fear accumulated and turned into a phobia. That’s how I generalised it thinking all dogs are wild and dangerous.
When we think of the ‘why’ aspect of phobias, it can be due to various causes. Genetic and environmental factors play a role in development though I think more so environmentally.
Classical conditioning is used both in understanding and treating phobias. A phobia is an excessive, irrational fear to something specific, like an object or situation. When you develop a phobia, classical conditioning can often explain it.
For example, if you have a panic attack in a certain place — like an elevator — you may begin to associate elevators with panic and begin avoiding or fearing all elevator rides. Experiencing a negative stimulus can affect your response. The important thing to remember is that phobias are based on irrational fears. Just as classical conditioning may have played a part in “learning” that phobia, it can also help treat it by counterconditioning.
If someone is exposed to the object or situation they fear over and over without the negative outcome, classical conditioning can help unlearn the fear. Once you’ve gone in 100 elevators and experienced no panic, you should no longer associate it with panic.
A lot of people with a phobia don't need treatment, and avoiding the object of their fear is enough to control the problem. However, it may not always be possible to avoid certain phobias, such as a fear of ants. In this instance, you may decide to get professional help and advice to find out about treatment options. Most phobias are curable, but no single treatment is guaranteed to work for all phobias. In some cases, a combination of various treatments may be recommended.
We have seen what phobia is and how it can be formed or caused and now we dive into the topic of how phobias are or can be treated. There are many techniques a mental health professional can use stems from several schools of psychology and neuro-linguistic programming. Some of these techniques are:
Cognitive behavioural therapy (CBT) - CBT can be used to develop practical ways of dealing with your phobia. One part of the CBT treatment process that's often used to treat simple phobias involves gradual exposure to your fear, so you feel less anxious about it.
For example, if you have a fear of snakes (ophidiophobia), your therapist may start by asking you to read about snakes. They may later show you a picture of a snake. They may then arrange for you to visit the reptile house of your local zoo to look at some real snakes. The final step would be for you to hold a snake. Exposure therapy works by gradually increasing the level of exposure to your fear, which allows you to gain control over your phobia. As the treatment progresses, you should begin to feel less anxious about your phobia.
• Exposure Therapy – In cases of phobia, people tend to avoid the source they are fearing from and that’s what this therapy helps them face. In this type of therapy, a professional creates a safe space for the phobic individual to expose them to stimuli they fear gradually.
This works as the professional overseeing the case identifies the patient’s triggers, causes and exposes them gradually to a situation, person or object. They make a plan on how to expose them going from low to high or high to low depending on the patient.
This will in turn help the person slowly to reduce fearing and get used to the thing they initially feared.
Exposure therapy has many types given in it and depending on the patient’s state and diagnosis a type is chosen for them. Some types of exposure therapy are imaginal exposure, graded exposure, flooding, systematic desensitization, virtual reality exposure and more.
• Rewind Technique – Richard Bandler, co-founder of NLP talks about how this particular technique helps people with overcoming their phobias. The rewind technique is done when someone is in a deep state of relaxation. To get to the state of relaxation, the client is taken through guided visual imagery into their ‘safe place’ and from there, the patient is asked to visualise a screen.
Let’s take an example of a boy having fear of rats. He is taken to a safe place through visualisation and is asked to imagine a screen there like a theatre screen in his ‘safe place’. Then, he is guided through a visual of themselves rising out of their body. Like how they show in the movies and are asked to instead, watch themselves from a far. By watching themselves watching the screen, they won’t be able to see the picture on the screen and this creates a double dissociation. The individual will watch themselves as they are subject to a screening of the traumatic memory that is affecting them and their daily life.
They go on and imagine returning to their body and experiencing themselves ‘rewinding’ through the trauma they faced as if they were a character in the film. At the end, the individual will watch the same images in fast forward (dissociation). This cycle is repeated multiple times with each traumatic memory. As we keep dissociating with the trauma it gets better and we slowly can feel the fear leaving us.
Not only these but meditation, yoga, mindfulness, muscle relaxation techniques also help one in recovering and controlling one’s phobias and fears. Several studies have been done on phobia and within the fields of psychology, NLP and many have discovered techniques that can help with eradicating phobia. Key is to see that it can be dissociated.
Fast phobia cure as NLP Practitioners say is real. There is a saying that mental health disorders are not cured easily and will take a long time to disappear but, I beg to differ as I see facts of how we can easily face the problem.
Reading different materials on phobia got me thinking of how what I thought as a phobia is something so related to my perception and cognitive thinking. When we are faced with a stimulus providing an imbalance between emotions and ranges up to fear, there is always a chance to make it dissipate. But we are accumulating that fear, within us making a stem grow.
The fact that we are perceiving something as a phobia can be changed because perceptions change every time as we learn. The key is within us itself. Once going back to where we talked about how the hippocampus and prefrontal cortex and the thinking circuit’s work. Our thinking circuit is always on whether we are ready to go to war or we are ready to flee from the horror show. The way we try interpreting threats helps us gain mindfulness. And the key to not develop a phobia towards something or someone also lies in the interpretation.
We can change the way we interpret it by changing our beliefs on phobia. About how we learn and differentiate between fear and generalising it. We can change the way we think about it by communicating better about it. We can also change our views regarding phobias by trying to accept them as something serious. Because often phobias are disregarded on the basis of irrational fear. Letting them grow off the branch will make it difficult to maintain a healthy life
Fear is an inevitable emotion but eradicating it from our life just takes effort. The fact lies in whether we hold onto it tighter or want to let it go.
After all, as Nelson Mandela wisely stated, "The brave man is not he who does not feel afraid, but he who conquers that fear."
This article on 'Phobia-Accumulation or Dissipation' has been contributed by Parinitha Kodali who is a student of Clinical Psychology, from Amity University, Mumbai. and peer reviewed by Ishita Vashisht who is a psychology student from Keshav Mahavidyalaya, Delhi University
Parinitha and Ishita are both part of the Global Internship Research Program (GIRP), which is mentored by Anil Thomas.
Parinitha's future plan is in gaining knowledge from various fields including research. Fascinated with human behaviours and space and ancient mythologies.
Ishita hopes to pursue a doctoral degree in psychology and understand human behaviour, their attachment styles and clinical disorders through her own lens.
GIRP is an initiative by (International Journal of Neurolinguistics & Gestalt Psychology) IJNGP and Umang Foundation Trust to encourage young adults across our globe to showcase their research skills in psychology and to present it in creative content expression.