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What are phobias?

Phobias are characterised by feelings of intense fear or anxiety triggered by particular situations, places, animals or objects that are disproportionate to the actual threat or danger a situation poses, after taking into account all the factors of the environment. These situations do not cause anxiety to everyone, although it is little help to sufferers in realising that others do not regard the situation as being threatening. Symptoms of phobias typically last for at least six months and may or may not be accompanied by panic attacks.

While a phobia may appear irrational or unusual to those that don’t have one, they are a type of anxiety disorder. This means that the anxious feelings associated with the phobia can be activated just by thinking or talking about the situation or object, which can be debilitating. 

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?

Graded exposure

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.

Psychotherapy

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.

Medication

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.

This page was clinically reviewed by Barbara Morgan (BA, BACP) in July 2022.

Treatment for phobias at Priory
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What is a phobia?
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What causes a phobia?
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