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Phobia Counseling in Broken Arrow for Tulsa Area Residents

By Alina Morrow, LPC

Disclaimer: The article below is for informational purposes only and should not be considered as direct advice, a personal diagnosis, or as an individual treatment plan. Always consult with a mental health professional or medical doctor if you have concerns.

Introduction and Overview

Phobia is a common anxiety disorder and refers to a group of conditions characterized by fear-related symptoms triggered by certain objects or situations. It can take different forms: social phobia, agoraphobia, and specific phobia.

Specific phobia (formerly known as simple phobia) is an anxiety disorder characterized by an intense, irrational, and involuntary fear of specific objects, living beings, and situations that present little or no real threat. Some of the objects, living beings, and situations (known as phobic stimuli) that can be the source of a specific phobia include: animals, insects, reptiles, storms, heights, water, escalators, tunnels, bridges, highways, enclosed places, public transportation, driving, flying, seeing blood, receiving injections, undergoing invasive medic procedures, and fear of choking, vomiting, or contracting an illness.

When individuals with specific phobia anticipate or encounter the phobic stimulus, they experience an intense level of anxiety. In some individuals, the anxiety response may take the form of a panic attack. A panic attack is an episode of intense, out-of-proportion fear in the absence of a real danger that is usually perceived as suffering a heart attack or stroke, as death is imminent, as losing control over emotions and behavior, or going crazy.

Individuals with specific phobia recognize that their fears are excessive and unreasonable, and the anxiety caused by the phobic stimulus uncontrollable. This typically leads to an avoidance behavior towards the phobic stimulus itself and situation where it can occur.

Every person may have things that frightens them or makes them feel uncomfortable and uneasy (such as new places, driving on bridges, insects, elevators), but they manage to control their fears and carry on with daily activities. Specific phobia becomes a problem when the avoidance behavior, the fear, and the anxiety are so severe that they interfere with the person's daily routine, occupation and social life.

The onset age for specific phobia can vary. Some specific phobias develop during childhood, while most seem to develop during early adolescence and young adulthood. Specific phobia seems to be more common among women than men.

According to the National Institute of Mental Health, 5 to 12 percent of the population suffers from a form of phobia. Approximately 19 million people in the United States and 2.5 million people in the UK suffer from specific phobia.

Types of Phobias

There are five types of specific phobia:

1. Animal Type
Animal phobia is one of the most common forms of specific phobia. Individuals with animal phobia fear animals, insects, reptiles, or birds. This type of phobia usually develops during childhood.

2. Natural Environment Type
This type of specific phobia is triggered by objects or phenomena in the natural environment, such as water, heights, or storms. In most cases, this phobia develops during childhood, but there are cases when it can develop in early adulthood (such as height phobia). Natural environment type is the second most common form of specific phobia.

3. Situational Type
Individuals with this type of phobia fear specific situations such as public transportation, tunnels, bridges, elevators, flying, driving, enclosed places. This type has "a bimodal age-at-onset distribution, with one peak in childhood and another peak in the mid-20s".

4. Blood-Injection-Injury Type
Individuals with this type of phobia fear seeing blood or injuries, receiving injections or other invasive medical procedures. It usually develop during childhood. Characteristic for this type of phobia is the vasovagal response (fainting), which can lead to detrimental effects on the individual's health.

5. Other Type
In this category are included phobias triggered by other stimuli (that do not belong to the other types) such as: the fear of choking, vomiting, falling down ("space phobia"), fear of loud noises and fear of costumed characters (common among children), or fear of contracting an illness.

Signs & Symptoms of Phobia

Individuals with specific phobia can display slightly different symptoms according to the type of phobia they suffer from. However, the main symptoms include:

Intense, Irrational Fear
Individuals with specific phobia experience intense and unreasonable fear when anticipating or encountering a specific object, living being, or situations that poses little or no real threat. The fear is limited to the phobic stimulus and focuses on the anticipated harm that can be caused by some aspects of the feared object or situation. For example, an individual with dog phobia experiences marked distress and fear when in the presence of a dog due to their concern of being bitten or attacked.

Anxiety
When encountering the phobic stimulus, individuals with specific phobia immediately experience anxiety. The intensity level of the anxiety response can be influenced by two factors:

(1) the proximity of the phobic stimulus (when the phobic stimulus is in the near proximity the anxiety tends to increases), and

(2) whether a potential escape is possible or not (the anxiety increases when the individual cannot escape the situation). The somatic (bodily) signs of anxiety are: palpitation, tremor, sweating, gastrointestinal discomfort, diarrhea, muscle tension, blushing, confusion.

In some cases, the anxiety response can take the form of a panic attack. The somatic (bodily) signs of a panic attack include: palpitations, sweating, chills or hot flashes, trembling or shaking, sensation of shortness of breath, sensation of choking, chest pain or discomfort, nausea or abdominal discomfort, dizziness or lightheadedness, tingling sensations.

Avoidance Behavior
Individuals with specific phobia deliberately avoid the phobic stimulus and/or situations where it can occur. The purpose of the avoidance behavior is to prevent the anxiety response triggered by the presence of phobic stimulus.

Other Symptoms
Individuals with blood-injection-injury phobia experiences slightly different symptoms. When exposed to blood, individuals experience fear and disgust. Also, the body's first reaction is to increase the heart rate and blood pressure, which is immediately followed by a quick drop causing nausea, dizziness, and fainting.

Causes and Risk Factors

The exact cause of specific phobia is not known, but the etiology (causes) of specific phobia is extensively studied. However, the mechanism that lies behind the development of specific phobia is extremely complex and involves a combination of several factors (genetic tendencies, brain chemistry, biological, psychological and environmental factors).

Environmental Factors
Specific phobia can develop as the result of a traumatic experience. This can include three situations:

1). Direct exposure to a traumatic event (known as direct learning experience). Some individuals develop a specific phobia as the result of a direct experience to a traumatic event. For example, an individual that was bitten by a dog can develop a dog phobia.

2). Witnessing a traumatic event (known as observational learning experience). Some individuals can develop a specific phobia by witnessing others experiencing a traumatic experience or displaying fear and anxiety in certain situations. For example, an individual that grows up with parents who fear height or witnesses a tragic accident when someone falls from a building can develop a phobia of high places.

3). Hearing or reading about dangerous situations (known as informational learning). An individual can develop a specific phobia when hearing and reading about situations that can be dangerous. For example, a flying phobia can be triggered by frequently hearing of plane crashes. A child can develop an animal phobia if their parents repeatedly warn them about the danger of certain animals.

Specific phobia can develop as the result of the association between a neutral stimulus and an anxiety response. For example, when an individual drives on the highway and experiences an intense anxiety response or panic attack, they can associate the highway with the anxiety/panic attack. When the avoidance behavior occurs (the individual avoids the highway), the individual can learn to become phobic.

However, experiencing a traumatic experience does not always result in the development of a specific phobia, and some individuals with specific phobia do not recall any obvious trigger, cause, or source of their phobia.

Psychological Factors
Researchers that study phobias noticed that individuals that suffer from a specific phobia tend to pay more attention to threatened information than individuals without specific phobia. Individuals with a spider phobia tend to notice the presence of a spider in a room before anybody else. Also, it is common for individuals with specific phobia to have distortions regarding memories that involve the phobic stimulus. They recall the phobic situation as more dangerous than it really was, or the feared animal larger, faster, or more aggressive than it was in reality. The memory distortions can be supported by impaired beliefs and interpretations attributed to feared objects or situations. The anxiety response experienced during a phobic situation can be maintained or increased by these impaired beliefs and interpretations.

Biological Factors
Although there is relatively little research conducted on the biological factors of specific phobia, there is evidence that specific phobia tends to run in the family. First-degree relatives of individuals with specific phobia, animal type are more likely to have an animal phobia themselves, but they may not necessary fear the same animal. First-degree relatives of individuals with specific phobia, situational type, are likely to develop situational phobias. However, individuals with specific phobia, blood-injections-injury type "have a particularly strong family pattern." (2)

Counseling & Treatment

Suffering from a specific phobia can affect the quality of life by limiting the individual's social interactions and activities, interfering with their occupational and career goals, and in some cases, even affecting their health. Treatment is the only option for individuals with specific phobia to regain control over their life.

Specific phobia can be effectively treated if the individual seeks professional help. Fortunately, specific phobia is the only anxiety disorder that is effectively treated with psychological approaches rather than medication. There are no controlled trials that can support the efficacy of medication for specific phobia.

The most effective forms of psychotherapy are: cognitive behavioral therapy and behavioral therapy.

Cognitive behavioral therapy has proven to be effective in treating specific phobia. However, this form of psychotherapy is employed more efficiently when the phobia has a significant cognitive component. Cognitive behavioral therapy combines two components (cognitive and behavioral component) for a better outcome. The cognitive component targets the individuals dysfunctional thinking patterns that supports and maintains the anxiety response, replacing them with more adaptive and realistic cognitions.

The most effective technique is cognitive restructuring which challenges the irrational beliefs. This method is based on the theory that the unrealistic beliefs built when exposed to fear stimuli generate, maintain, and increase dysfunctional emotions and behaviors. The behavioral component targets the individual's reaction to the phobic stimulus. The most effective behavioral approach is exposure therapy where in a safe setting the individual gradually gets exposed to their feared stimulus, first using the imagination and then by direct confrontation.

Behavioral therapy is another effective form of therapy that can treat specific phobia. The goal of behavioral therapy is to modify the fear-related behaviors and gain control over the dysfunctional behaviors. Two of the most effective behavioral techniques used to treat specific phobia are:

  1. learning a relaxation technique which allows the individual to control the anxiety, and
  2. exposure technique which gradually exposed the individual to feared stimuli.

Medication can be another treatment approach for individuals with specific phobia. However, medication has a limited utility in the treatment of specific phobia. In some cases, antidepressants (such as selective serotonin reuptake inhibitors - SSRIs) and tranquilizers (to reduce the anxiety) can be prescribed for individuals with specific phobia. Medication seems to be more effective when the individual with specific phobia has another coexistent anxiety disorder.

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Do you suffer with a phobia? Want to overcome your fears? Contact Tulsa Therapist Alina Morrow, LPC, today to make an appointment and get the help and relief you deserve. You can reach me by texting or calling 918-403-8873 or by Email.

Page Last Updated: October 30, 2016

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