This page was clinically reviewed by Barbara Morgan (BA, BACP), Psychotherapist and CBT specialist at Priory Wellbeing Centre Harley Street in July 2022.
What are phobias?
A phobia is characterised by an overwhelming and debilitating fear of objects, situations, places, feelings or animals. It is not necessary for the affected individual to recognise that their anxiety is excessive or unreasonable although often they acknowledge that it may be an irrational response.
This is associated with a sense of uncontrollable anxiety and avoidance behaviours. There is an inability to function normally when exposed to the trigger.
Whilst it is normal for all of us to have ‘fears’ of particular objects or situations, these fears reach the threshold of becoming a phobia when:
- The imagined threat is out of proportion to the actual danger, accompanied by loss of control when exposed to the source of the fear
- The behaviour lasts for more than 6 months
- It affects the ability to function ‘normally’, impacting significantly on the life of the individual
- It is not directly caused by another disorder
What to look out for
The following physical symptoms may be experienced by those affected, when in contact with the source of their fears:
- Dizziness and /or light-headedness
- Sweating or hot flushes
- Palpitations or an increased heart rate
- Chest pains
- Shortness of breath
- Pins and needles in peripheries of fingers and toes
- Nausea, churning in stomach, stomach ache, diarrhoea
- Dry mouth
Types of phobias
There are many types of phobias, including situational phobias (lightning, enclosed/open spaces, darkness, flying and heights), animal phobias (spiders and snakes), mutilation phobias (injections, dentists, injuries) and agoraphobia (fear of places seen as dangerous, uncomfortable or unsafe, leading to a desire to escape). There is also social phobia which focuses more on cognitive than behavioural responses.
Fears are very prevalent and phobias occur in up to 13% of the population. They are also twice as common among women. Phobias all come about from a classic conditioning model; they are involuntary reactions which are physiologically driven.
Treatment for phobias
When receiving treatment for a phobia at Priory, visiting one of our nationwide UK hospitals or wellbeing centres across the country on an inpatient, day care or outpatient basis, gives you access to a tailored treatment plan for your phobia.
Using evidenced-based therapy techniques, you will learn to control your emotions relating to the disorder, and when you are ready, take part in ‘graded exposure’ to your fears, thereby reducing avoidance and life limiting behaviours associated with the condition.
What is the best treatment for phobias?
Most treatment for phobias at Priory involves a variation on what is known as ‘graded exposure’. This involves trying to tackle the fear of a situation by acknowledging how it could be approached, even at first using imagination, before trying to tackle the feared situation in reality.
Interoceptive exposure is used to expose bodily sensations. Exposure to feared bodily sensations is necessary to learn how dangerous they truly are. The aims of interoceptive exposure are:
- To elicit the feared bodily sensations
- To activate any unhelpful beliefs associated with the bodily sensations
- To maintain the feared bodily sensations without distraction or avoidance
- To allow new learning about the bodily sensations to take place
It is important to note that your therapist will work through interoceptive exposure with you.
This involves carefully and systematically learning to face the fear in a gradual and controlled way, thereby reducing the avoidance, which is known to worsen the problem. Safety behaviours that have been put in place in order to attempt to avoid the problem will be identified and challenged. These techniques may, at first, involve imagining exposure to the feared situation rather than in a real life situation.
Cognitive behavioural therapy
Treatment for ‘complex phobias’ may take longer and cognitive behavioural therapy is mainstay of treatment at present. It aims to address the dysfunctional thought processes that underpin the person’s anxiety and evaluate more realistic ways of viewing situations and developing healthier thinking processes.
Before that can be undertaken, it is often necessary to be able to learn techniques for managing symptoms of anxiety and improving coping techniques before the procedure begins.
Priory can offer specific treatments, including talking therapies such as cognitive behavioural therapy (CBT) and other evidence-based treatments in order to help you understand more about why your phobia exists and how you can reduce associated symptoms.
CBT is widely used across the world to treat a range of mental health conditions, as it helps identify the relationship between your thoughts, feelings and behaviour, before pro-actively challenging any negative thoughts associated with your phobia by learning practical methods of managing patterns of negativity.
It is also very important to properly assess a phobia, as they it could form part of a wider issue involving symptoms of anxiety and depression, or could be exacerbated by these co-existing conditions, in which case these conditions would need to be treated independently of your phobia.
While exposure therapy and talking therapies such as CBT are the main treatments used to relieve symptoms of phobias, taking medication alongside therapy sessions can help with any severe symptoms of anxiety you may be experiencing, which in turn can make your therapy sessions more effective.
If anxiety linked to your phobia is severe, or if you have co-existing mental health conditions such as anxiety or depression, then the most commonly prescribed drugs which can help improve symptoms include a type of anti-depressants known as selective serotonin reuptake inhibitor (SSRI) antidepressants.
Further drugs which may be recommended for severe anxiety that is impacting your day-to-day life include those with tranquilising effects such as a benzodiazepine, for example Valium. These drugs should only be taken for a short time, as they can be highly addictive.
For physical symptoms of anxiety, beta-blockers such as propranolol can help reduce the rapid-heartbeat, tremors and palpitations associated with intense anxiety and panic attacks, although they won’t help cure the psychological symptoms underpinning your phobia. If you have a specific or complex phobia that only arises occasionally, such as having to go on an aeroplane, then these drugs can be particularly effective.
How can Priory help?
Priory’s consultant psychiatrists and therapists are able to deliver a comprehensive and collaborative approach to achieve patient-centred care, taking into account:
- Other possible factors such as co-morbidities of drugs and alcohol substance misuse
- Complicating co-morbid mental health disorders
- A bio-psycho-social approach for an inclusive understanding of the individual’s issues, appropriate risk management and the appropriate treatment required
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