Understanding Specific Phobias and How to Manage Them

Did you know that specific phobias are an intense and unreasonable fear or anxiety about an object or situation? You can treat it with cognitive-behavioral therapy or exposure therapy.
Understanding Specific Phobias and How to Manage Them

Last update: 22 July, 2021

Have you ever heard about specific phobias? Concern or fear about certain situations, activities, animals, or objects isn’t uncommon. Many people feel anxious when faced with a snake or spider, heights, or traveling by plane. Fear is a rational response to situations that can pose a threat to our safety. However, some people react to objects, activities, or situations (the phobic stimulus) by imagining or irrationally exaggerating the danger. 

Their feelings of panic, fear, or terror are completely out of proportion to the actual threat. Sometimes, the mere thought of the phobic stimulus is enough. Other times, the sight of the phobic stimulus on TV is enough to cause a reaction. These types of excessive reactions may be indicative of a specific phobia. People with this type of phobia are well aware that their fears are exaggerated or irrational.

Even so, they feel that their anxious reaction is automatic or uncontrollable. Specific phobias are often associated with panic attacks, during which the person experiences overwhelming physical sensations. These sensations may include a pounding heart, choking, nausea, faintness, dizziness, chest pain, hot or cold flashes, and perspiration. 

Phobias affect about 19 million adults worldwide. Women are two times more likely than men to have a specific phobia. Some people experience multiple specific phobias simultaneously. Sadly, approximately 75 percent of people with a specific phobia fear more than one object or situation.

What are specific phobias?

The term “phobia” refers to a group of anxiety symptoms certain objects or situations bring. A specific phobia, formerly called a simple phobia, is a lasting and unreasonable fear. It’s an anxiety disorder. The presence or thought of a specific object or situation causes it. Still, the object or situation usually poses little or no actual danger. Exposure to the object or situation brings about an immediate reaction. 

It causes the person to endure intense anxiety (nervousness) or to avoid the object or situation entirely. The distress it associates or the need to avoid it significantly interferes with the person’s ability to function. Adults with a specific phobia recognize that the fear is excessive or unreasonable, yet are unable to overcome it. There are different types of specific phobias, based on the object or situation feared, including:

  • Animal phobias. Examples include the fear of dogs, birds, snakes, insects, or mice. Animal phobias are the most common specific phobias.
  • Situational phobias. These involve a fear of specific situations, such as flying, riding in a car or on public transportation, driving, going over bridges or in tunnels, or of being in closed spaces, like elevators.
  • Natural environment phobias. Examples of phobias include the fear of storms, heights, or water.
  • Blood-injection-injury phobias. These involve a fear of being injured, seeing blood, or of invasive medical procedures. For instance, blood tests or injections.
  • Other phobias. These include a fear of falling down or a fear of loud sounds. Furthermore, a fear of costumed characters, such as clowns.

A person can have more than one specific phobia.

Criteria for diagnosing a specific phobia

A fear and a phobia aren’t the same, as it’s important to know the difference. Many people experience fears or aversions to objects or situations. This doesn’t necessarily mean that they would develop a phobia. Therapists can’t use a lab test to make this diagnosis. Therefore, they and other mental health professionals consult the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). This guide provides diagnostic criteria for specific phobia from the American Psychiatric Association:

  • Unreasonable, excessive fear. The person exhibits excessive or unreasonable, persistent, and intense fear triggered by a specific object or situation.
  • Immediate anxiety response. The fear reaction must be disproportionate to the actual danger. It should appear almost instantaneously along with the object or situation.
  • Avoidance or extreme distress. The individual goes out of their way to avoid the object or situation or endures it with extreme distress.
  • Life-limiting. The phobia significantly impacts the individual’s school, work, or personal life.
  • Six months duration. In children and adults, the symptoms must last for at least six months.
  • Not caused by another disorder. Many anxiety disorders have similar symptoms. A doctor or therapist will first rule out similar conditions before diagnosing a specific phobia. For instance, agoraphobia, obsessive-compulsive disorder (OCD), and separation anxiety disorder.

Prevalence and causes

How common are phobias? The National Institute of Mental Health estimates that around 12-15 percent of Americans have phobias. Specific phobias affect an estimate of about seven million adult Americans. Although phobias first appear in adolescence and adulthood, they can occur in people of all ages. Besides, they’re slightly more common in women than in men. Specific phobias in children are common and usually disappear over time. 

When it comes to adults, this type of phobia generally starts instantly and is more lasting than childhood phobias. Only about 20 percent of specific phobias in adults go away on their own (without treatment). What exactly causes phobias? Science still doesn’t know the exact cause of specific phobias, though most seem to be associated with traumatic experiences. Learned reactions cause other types of phobias. For example, a person who suffered a frightening or threatening experience with an animal in childhood. 

If an animal attacks or bites you, you can develop a specific phobia. Witnessing a traumatic event in which others experience harm or extreme fear can also cause it. Receiving information or repeated warnings about potentially dangerous situations or animals may develop it. Fear can be learned from others, as well. A child whose parents react with fear will likely respond to the objects with fear. Likewise, a student whose teacher responds with anxiety to certain situations will surely also respond with anxiety.

Treatment options

While specific phobias can be serious and debilitating, effective treatments are available. These can help reduce or even eliminate symptoms:

  • Cognitive-behavioral therapy (CBT). Psychotherapy is the cornerstone of treatment for specific phobias. Treatment often involves a type of cognitive-behavioral therapy, called systematic desensitization. CBT helps people learn to identify and then change the automatic negative thoughts that contribute to phobic reactions.
  • Exposure therapy. This type of therapy involves gradual and progressive exposure to the feared object or situation. In fact, therapists pair such exposure with relaxation strategies until the patients’ fear is reduced or utterly extinguished. This form of behavioral therapy is the best treatment for this type of phobia.
  • Medication. Doctors may sometimes prescribe it to help people manage the physical and emotional reactions that come with phobias. For instance, short-acting sedative-hypnotics, antidepressants, and beta-blockers. Medications are more successful when paired with psychotherapy.
  • Relaxation techniques. Relaxation techniques like deep breathing and progressive muscle relaxation may also help reduce anxiety symptoms. Other people calm down by practicing yoga or visualization techniques. Additionally, meditation also helps soothe their nerves.

Risk factors

Many factors may increase your risk of specific phobias:

  • Your age. Specific phobias can first appear in childhood, usually by age ten. However, they can occur later in life.
  • Your relatives. If someone in your family has a specific phobia or anxiety, you’re more likely to develop it as well. This could be a tendency you inherited. Children may learn phobias by observing a family member’s phobic reactions.
  • A negative experience. Experiencing a frightening traumatic event triggers the phobia to develop. For example, when people get trapped in an elevator.
  • Your temperament. Your risk of developing the phobia increases if you’re more sensitive, more inhibited, or more negative than the norm.
  • Learning about negative experiences. Hearing about negative information or experiences, such as plane crashes, can lead you to develop certain phobias.
An image of a man on plane with fear of flying.

Complications

Specific phobias may seem silly to others. Nonetheless, they can be devastating to the people who have them, causing problems that affect many aspects of life.

  • Social isolation. Avoiding places and things you fear can cause academic, professional, and relationship problems. Children with these disorders are at risk of academic problems and loneliness. They may also have trouble with social skills if their behaviors significantly differ from their peers.
  • Mood disorders. Many people who suffer from phobias may also suffer from depression and other anxiety disorders.
  • Substance abuse. The unbearable stress of living with a severe specific phobia may lead to abuse of drugs or alcohol.
  • Suicide. Some individuals with this type of phobia may have an elevated risk of suicide.

In short, specific phobias are common and rooted in the primal, instinctual fears people experience and understand. If you have a phobia, get psychological help, especially if you have children. Although genetics likely plays a role in developing phobias, repeatedly seeing someone else’s phobic reaction triggers it in children. By dealing with your own fears, you’ll teach your children excellent resiliency skills. You’ll also encourage them to take brave actions just like you did.

“The psychological condition of fear divorces from any concrete and true immediate danger. Besides, it comes in many forms: unease, worry, anxiety, nervousness, tension, dread, phobia, and more. This kind of psychological fear is always of something that might happen, not of something that  happens now.”

-Eckhart Tolle-

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  • American Psychiatric Association –APA- (2014). DSM-5. Manual diagnóstico y estadístico de los trastornos mentales. Madrid: Panamericana.
  • Capafons Bonet, J. I. (2001). Tratamientos psicológicos eficaces para las fobias específicas. Psicothema, 13(Número 3), 447-452. Recuperado a partir de https://reunido.uniovi.es/index.php/PST/article/view/7898