Understanding phobias and exposure therapy

The facts:  

• A phobia is an irrational or excessive fear of a particular object or situation
• Common phobias include heights, flying, spiders, injections and enclosed spaces
• Just under ten percent of people in Australia have a phobia
• Phobias can be regulated and extinguished through treatments including exposure therapy
• The psychologists at Seed Psychology can help you manage and move past fears and phobias

Fears vs phobias

As human beings, we are all afraid of something. Throughout history it has been advantageous for people to fear certain animals and environments. Those who were more cautious and avoidant of genuine threats were more likely to survive. Even today, a certain amount of fear at times is rational and healthy – even useful.

A fear only becomes a phobia when it inhibits normal function and daily routines. People with phobias tend to understand their fear is irrational and disproportionate to the true threat, but this does not diminish the fear. The situation or object is avoided or endured with great distress, anxiety or panic.

Common phobias

Some phobias are relatively common, perhaps for evolutionary reasons. The most common phobias include heights, flying, elevators, storms, snakes, spiders, rats, injections, vomiting and choking. Common phobic situations include dentist appointments, social engagements, claustrophobia (enclosed spaces) and agoraphobia (fear of leaving familiar, safe environments – usually the person’s home).

Most people with phobias have more than one. In Western countries, almost one in ten people have a phobia. Numbers tend to be lower in Africa, Asia and Latin America (approximately 3%). Phobias are approximately four times more common in women than men.

Why do some people have phobias while others do not?

There are numerous theories about the causes of phobias. Freud proposed that phobias are displaced fears from other, unrelated aspects of life. The best current research suggests a complex combination of biological, environmental and social factors.

There is still much to be learned about the psychological mechanisms which underlie phobias, but many researchers believe social conditioning plays a part. This means that fears can be learned by witnessing or even hearing about the negative experiences of others. According to conditioning theory, if a fear can be acquired or learned, then it can be extinguished, or unlearned.

Fear extinction and exposure therapy

Avoidance is most people’s main method of coping with fears and phobias. Unfortunately, it is also the biggest maintaining factor. In order to move past them, phobias must be tested in safe, controlled environments.

Exposure therapy requires the client to overcome their avoidant behaviours and confront the feared object or situation. This is done gradually, in small, manageable steps so as not to overwhelm the client. By seeing repeatedly that the feared outcome does not match reality, we essentially unlearn the phobia. The process varies depending upon the phobia, but the underlying mechanism of fear extinction is the same.

Exposure therapy can be a long and slow process, as it requires a major shift in thinking. Exposure therapy has been shown to reduce fear over time. Research has found that most people who undergo exposure therapy have positive results. This psychotherapeutic approach can also be used to treat other anxiety disorders and Post-Traumatic Stress Disorder (PTSD).

How Seed Psychology can help

Several psychologists at Seed Psychology have extensive experience and training in helping people with anxiety, fears and phobias. We can use evidence-based therapeutic approaches including exposure therapy, Cognitive Behavioural Therapy (CBT) and psychoeducation to help you move past your fears and phobias, to regain your mental health and wellbeing.

Contact us now to book an appointment.

Reference:

Ressler KJ, Rothbaum BO, Tannenbaum L, et al. Cognitive Enhancers as Adjuncts to Psychotherapy: Use of D-Cycloserine in Phobic Individuals to Facilitate Extinction of Fear. Arch Gen Psychiatry. 2004;61(11):1136–1144.