Specific phobias involve persistent and irrational fears of a specific situation or object that is out of proportion to the actual risk. This strong fear makes a person avoid the objects or animals that cause these specific phobias. People suffering from specific phobias not only avoid the objects or animals itself, but often also video’s or images. The thought of a specific animal or object can already make people feel sick, nausea, and scared. In other words: if someone suffers from arachnophobia (fear of spiders) then that person will avoid direct contact, and in severe cases even a picture of a spider or talking about a spider (movie), because it can trigger signs of fear and discomfort. Here are a few examples of common specific phobias: fear of dogs, fear of heights, fear of spiders, fear of snakes, fear of blood, fear of flying.
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There are so many different specific phobias that I’ve categorized them into 5 categories. For interesting facts about these specific phobias go to: interesting specific phobias facts.
(1) Situations – fear of air planes or enclosed places.
(2) Nature – fear of heights or thunder.
(3) Animals or insects – fear of spiders or horses.
(4) Blood, injection or injury – fear of needles or blood.
(5) Other phobias – fear of clowns or men or blushing.
Many people experience intense and irrational fear, anxiety and distress when they are exposed to their phobic situation, object or animal. The intensity of the fear is out of proportion to the actual risk. For example: fear of heights is a common fear people tend to have. Looking down from approximately 10 meters can make people a bit dizzy and afraid (‘I might fall down’). But for some people it is already too much to cross a small bridge because they might get a panic attack. Fear of heights is called acrophobia and is one of the many specific phobias. Here are the DSM-5 criteria for Specific Phobia:
Persistent and irrational fear for the situation or object, cued by its presence or anticipation.
The fear is persistent and lasts at least 6 months.
Exposure to phobic object/situation provokes an acute anxiety response (sometimes a panic attack).
The fear or anxiety is out of proportion to the actual danger posed by the object/situation.
The fear or anxiety is not a typical response in the person’s social or cultural context.
Phobic situations/objects are avoided or else are endured with intense anxiety or distress.
The avoidance, distress and fear interferes significantly with someone’s daily routine.
The fear, distress or avoidance cannot be explained by another mental disorder.
Specific phobias usually develop in early childhood, between 4 and 8 years of age. But phobias can also develop during the teenage years or early adulthood. Rarely phobias develop after the age of 30. Specific phobias are more likely to develop in people with a predisposition for anxiety. If you have biological relatives with anxiety disorders or who suffer from a phobia, then there is a higher risk for you to develop a phobia as well. However, just genetics is not sufficient enough to explain what causes people to develop specific phobias. You need to experience something bad in order or develop a phobia.
An example to illustrate the situation: A four year old sees how a dog approaches her. The dog wants to play with the girl, but the girl thinks the dog will attack her. The girl runs away from the dog and towards her parents. Her parents pull her up and sooth her (and thus take her away from the dog). By taking the girl in their arms they learn the girl that being afraid of dogs is normal. In the future the girl may misinterpret the dog’s behaviour and in this way a phobia can develop. As a result the girl is afraid whenever she sees a dog. Whenever a dog approaches her the girl experiences anxiety and this anxiety becomes bigger and bigger. (In this example it is possible that the parents won’t sooth the little girl, bun instead, dismiss her fear and her fearful experience with the dog. In this case the girl can’t talk about her fear and she can’t get over her anxiety for dogs).
In case the parents have either a phobia or an anxiety disorder, it’s possible that the parents will respond fearfully when they see the dog. In this case the girl can (1) inherited the genes for anxiety disorders and phobia, and (2) learn from her parents’s behaviour that you should be afraid of certain things. In case of the latter, the girl doesn’t need to inherit the anxiety genes to develop an anxiety disorder or a phobia.
To make things even more confusing: specific phobias also develop naturally. Every child has phases in which he or she is afraid of ‘the dark’, ‘ghosts’, ‘strangers’ or ‘Santa Claus’. Usually these fears fade away over time. However, sometimes these fears develop into more persistent fears and eventually the child develops a phobia.
There are several ways to treat specific phobias. Here are the most commonly used and most effective treatments:
Cognitive behavioural therapy (CBT): this therapy focuses on identifying their own anxious and irrational thoughts and replace them with more realistic thoughts. Eventually the patient will be ‘exposed’ to the feared object/situation/animal in a safe and ethical way.
Eye movement desensitization and reprocessing (EMDR): Recent studies show that EMDR is a very effective way of treating people who suffer from specific phobias. Phobias may develop after a traumatic event with the feared object/animal/situation. And the majority of the people who suffer from a phobia have very detailed images of what will happen to them if they get to meet with the phobic object/animal or situation. EMDR focuses on image you have of the traumatic event or the feared image in the mind of a future encounter and desensitizes the image.
Exposure therapy: this therapy gradually exposes you to the feared situation until the situation no longer triggers the fear response. This can be done by imagining the feared situation or by confronting yourself with the feared situation in real life. A combination of both is recommended.
Relaxation: learning breathing techniques can help you cope with the feared situation.
Medication: for some people medication is effective, especially when people do not have time to go to a therapist, or when you only have to endure the phobic situation for a while (such as with flying). Medication usually does not solve the phobia, but takes away the fear for a while.