Specific phobias

Most of us have things we are afraid of, things that make us nervous. Heights, spiders, or small dark spaces are all things that can make many feel uneasy and things that we may try to avoid. However, having a specific phobia is very different and is characterised by having an extreme and persistent fear of a specific object or situation that is out of proportion to the actual danger or threat.

Phobias can develop around a wide range of contexts such as flying, going to the dentist, being in spaces that are difficult to exit, encountering specific animals, and also in response to a wide array of objects, such as needles, vomit or blood, including less obviously provoking, seemingly harmless, objects too.

Different types of specific phobia

There are 5 different types of specific phobias:

  • Situational phobias, e.g. fear of flying, being in enclosed spaces
  • Animal phobias, e.g. dogs, spiders
  • Natural Environment Phobias, e.g. swimming in the sea, heights, large spaces
  • Blood-Injection-Injury Phobias (e.g., fear of blood, receiving an injection )
  • Other Phobias (e.g., situations that may lead to choking, vomiting, or contracting an illness; avoidance of loud sounds or clowns)

Symptoms of specific phobias

People with a phobia will experience an intense sense of dread or panic when faced with the subject of their fear. These fears can become all-consuming and have a big impact the way someone functions in their everyday life, whether this is at work or in personal relationships.

  • Physical
    • Racing heart
    • Trembling or shaking
    • Numbness or tingling
    • Sweating
    • Nausea
    • Dry mouth
    • Diarrhoea
    • Feeling dizzy or lightheaded,
    • Feeling like you are choking
    • Faster breathing
    • Chest pain or tightness
  • Cognitive
    • The consistent overestimation of the risk of harm and associated sense of threat presented by a specific situation or object
    • The underestimation of the ability to cope with the identified threat
    • Feeling overwhelmed by anxiety or fear of a specific object or situation
    • Knowing that your fear is not logical, but not being able to control it
  • Emotional
    • Anticipatory anxiety; becoming nervous ahead of time about being in certain situations or coming into contact with the object of your phobia
  • Behavioural
    • Avoiding the object or situation or enduring it with great distress

Causes of specific phobias

No one knows one specific cause of phobias but it is often associated with a traumatic event or a learnt reaction to the object or situation. For example, it might be that if you have a phobia of dogs, it might have been caused by a frightening experience you had with a dog, such as being chased or bitten. It can also occur from having witnessed a traumatic event happening to someone else. A phobia can also be learnt. For example if a child grows up with a mother who is very fearful of needles, it might be that the child grows up with a related fear. However, many people will not know how their phobia first began. This is normal and makes no difference in terms of the effectiveness of CBT for a specific phobia

How to deal with a specific phobia

Experiencing a phobia can have a huge impact on your day-to-day life, self-esteem and relationships, especially if you feel consumed by having to avoid the feared subject.

It can be difficult to know when to seek treatment for a phobia. If avoidance of the object, activity or situation that triggers your phobia does interfere with your everyday life, or keeps you from doing things you would otherwise enjoy, it may be time to seek help.

Even if you have experienced a phobia for a long time, the good news is, it is treatable. The most evidence-based treatment being cognitive behavioural therapy. CBT for a specific phobia will involve noticing and understanding the thinking and behaviour that maintains the anxiety. Once this is well understood by you and your therapist, therapy progresses into testing out potentially helpful new thinking and behaviour. This will involve gradual steps towards the feared object or situation, always at your own pace and in a manner that ultimately reduces anxiety.

How to support a loved one going through a specific phobia

If you are close to someone who is suffering with a phobia there are a number of things that you can do to help them.

  • Take their phobia seriously

    It is important to take their phobia seriously. Even if you don’t understand the fear, it is likely causing them a lot of distress and anxiety.

  • Learn as much as you can about their phobia

    Read online resources about what it is and other people’s experiences will help you understand what they are going through. Listen to the person about their personal experience too.

  • Try not to pressurise

    It can be important, even with the best of intentions, not to pressurise your friend or loved one into phobic situations or encounters with phobic objects before they decide they are ready to. It is often the case that the best way forward is to encourage them to access psychological therapy, on their own terms, such that they can take a structured approach to dealing with the phobia that they are in control of.

  • Encourage them to seek help

    Support them to seek help. Help them arrange a GP appointment and go with them if they would like you to. The GP will help refer them to a therapist who will be able to help them.

  • Reassure

    Reassure them that help is available and it is absolutely possible to live a life free of any and all phobias.