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Fears and Phobias

Fears and phobias limit our ability to get the most from life. In some cases they can prevent us living even a relatively normal life. In all cases we can overcome them through learning how to manage our own thoughts and feelings.

What is fear?

We feel fearful when we believe we do not have the ability to cope with something. This fear may be grounded in reality, as when we fear being knocked down by a car when trying to cross a busy road. Or the fear may be irrational as when we fear a tiny harmless spider. Many of our fears are a mix of reality and misinterpretation of our ability to cope. When there is a large degree of misinterpretation it is likely that it is a phobia rather than a fear.

What is a phobia?

The essential ingredient of a phobia is that it involves a significant degree of irrationality. The person experiencing the phobic feelings is usually well aware that their fear is irrational but they are unable to overcome the fear. The irrational fear is driven by emotions, which is why will-power, facts and reassurance tend to have little impact.

What is a specific phobia?

Specific phobias are characterised by an extreme and unreasonable fear of a specific object or situation such as dogs, heights, thunder, darkness, flying, escalators, tunnels, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, the sight of blood or injury, and the fear of exposure to specific diseases.

Once the phobia starts to interfere with normal daily functioning, then it is problematic. Generally specific phobias can be categorised as follows:

Animal type - cued by animals or insects. Natural environment type - cued by objects in the environment, such as storms, heights, or water. Blood-injection-injury type - cued by witnessing some invasive medical procedure. Situational type - cued by a specific situation, such as public transportation, tunnels, bridges or elevators. Flying, driving, or enclosed spaces.Other types - cued by stimuli other than the above, such as of choking, vomiting, or contracting an illness.

How is a specific phobia diagnosed?

One key to diagnosing a phobic disorder is that the fear must be excessive and disproportionate to the situation. Fear alone does not distinguish a phobia; both fear and avoidance must be evident. The phobic situation is avoided whenever possible. Examples include: agoraphobia, animal phobias, claustrophobia and examination phobia.

What is agoraphobia?

An abnormal and persistent fear of public places or open areas, especially those from which escape could be difficult if help was not immediately accessible. Panic disorders frequently accompany agoraphobia. As such, suffers not only avoid certain public places but they also avoid the situations which bring them anxiety or panic.

What causes agoraphobia?

The disorder tends to be triggered by a traumatic event, and generally starts in the mid to late 20s and affects women twice as often as men. Modern learning theory suggests that agoraphobia may develop because people avoid situations they have found painful or embarrassing.

What are the symptoms of agoraphobia?

People with agoraphobia become anxious if they even think about being trapped in a situation where it might be difficult to leave. People with agoraphobia also characteristically avoid the situations which bring them anxiety or panic. In the most severe cases, victims may be incapacitated and be homebound.

What are social phobias?

Social phobias are characterised by excessive fear of embarrassment in social situations. Such fears are extremely intrusive and can have a damaging affect on personal and professional relationships. The can interfere with any activity that takes place in public, including, public speaking, eating in public, interaction with colleagues and asking for directions. Although sufferers recognise that their fear is excessive and unreasonable, they are unable to overcome it.

What are the symptoms of social phobia?

The symptoms and signs of social phobia include blushing, sweating, trembling, rapid heartbeat, muscle tension and stomach discomfort, light-headedness, and other symptoms of anxiety.

Why should social phobia be treated?

If not treated, social phobia can be extremely disabling to a person's work, social and family relationships. In extreme cases, a person may begin to avoid all social situations and become housebound.

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