Facing up to phobias
You have likely experienced a moment of terror, but for those living with phobias, this overwhelming fear is a part of daily life. We explore the origin of phobias and how to overcome them.
When Zoe landed her dream job the day after she graduated from university, she was over the moon. That is until she discovered her new office with a view would be on the 25th floor. Zoe had a phobia of heights and reluctantly turned the job down.
Phobias aren’t as uncommon as you might think. Beyond Blue estimates that around 11 per cent of Australians will experience a phobia at some point in their lives.
Phobias are classed in the same family as anxiety disorders including generalised anxiety disorder, panic disorder, post-traumatic stress disorder and obsessive-compulsive disorder. Phobias differ from some other types of disorders in that they’re generally about something quite specific. Did you know there is a thing called genuphobia, for example? It’s a fear of knees.
There are other phobias which might seem quite bizarre — like papyrophobia (fear of paper) or alektorophobia (fear of chickens). Some are enough to tickle your funny bone, but for many who suffer from phobias it is no laughing matter.
Psychologist Corrie Ackland from Sydney Phobia Clinic says there is a common misconception that phobias are just little quirks. “Some phobias can have far-reaching consequences; they can have a big impact on important life choices people make,” she says.
One of the most common phobias at Ackland’s clinic is a fear of vomit. “People think it’s unusual, but it isn’t,” she says. “I’ve had enquiries for fear of buttons, hair, belly buttons and dead fish.”
Whether it’s being fearful of spiders or giving a speech to a room full of people, everyone has fears and anxieties. Our fears are often a way to keep us safe from potential harm: it’s a learned response, one which increases our heart rate and pumps adrenaline throughout the body. We know it’s risky to stand at the edge of a mountaintop or to walk across a busy road without checking for traffic.
You might feel anxious or fearful before taking an exam or your first big stage performance, or perhaps when meeting your partner’s family for the first time. Anxiety is a manifestation of fear, but it’s not the same as a phobia.
Fee-fi -fo-fum, fear or phobia?
The difference between a fear and phobia is fairly clean-cut. Fear is a normal, adaptive response to something that can be potentially dangerous, but a phobia is an avoidance and irrational fear around something that either poses no threat,
or the level of fear is inappropriate to the potential threat.
Australian Psychological Society president and practicing clinical psychologist Tamara Cavenett says if a phobia is limiting your life choices and ->
-> adding unreasonable stress, then it needs to be dealt with. “For example, you have developed a phobia about spiders, and just the thought of them or watching a movie with a spider in it is quite distressing for you,” she says. “You might repeatedly check your room or under your bed for spiders before you go to sleep.”
Cavenett says if you do suffer from a phobia, don’t lose hope; there are ways to overcome it. “Your brain isn’t stuck, you can change the way it thinks, feels and functions, in incremental exposures — we see firsthand how quickly it can change,” she says.
According to Cavenett, those most at risk of developing phobias are people who are anxious. “There’s a definite correlation between anxiety and phobias, and if you have one phobia, there’s also the potential to develop multiple phobias,” she says.
A phobia is a definitive pattern of apprehension and/or avoidance. You won’t visit an outdoor café you know has harmless lizards because they creep you out, or use a public restroom for fear of germs because you might get sick and never recover.
Phobias are complex; sometimes they seem unreasonable and maybe even a little silly to others. But here’s the kicker. Those with a specific phobia know and recognise their fear is inappropriate. They know they shouldn’t feel the way they do, but they feel impotent — they are powerless to stop those feelings. The good news, however, is there are positive steps you can take to overcome a phobia.
Fear is a normal, adaptive response to something that can be potentially dangerous, but a phobia is an avoidance and irrational fear around something that either poses no threat, or the level of fear is inappropriate to the potential threat.
Your body’s response
But first, let’s look at the physiological effects of what occurs when a person is faced with the object of their phobia. It often begins with signs of physical distress: your heart might feel as though it’s galloping in your chest, you could begin to sweat and shake and your mouth might go dry, sometimes there’s feelings of nausea. Ackland says if left unchecked, your body’s response escalates. “For some it can turn into a full-blown panic attack,” she says.
There are measures that those who experience phobias implement to cope. Safety-seeking behaviours is one. These behaviours are employed to prevent the event the person fears from occurring. It also helps them to feel more comfortable in a particular situation if it can’t be avoided. For example, if you have social phobia, wearing headphones on public transport will discourage strangers from striking up a conversation.
You might think these behaviours are helpful, but according to Ackland the reverse is true. “We consider safety behaviours unhelpful as they prevent you from directly confronting your fears; it maintains the notion that what we are afraid of is inherently dangerous or bad for us,” she says.
Avoidance is not a strategy
Unhelpful thoughts about the phobia, and overrating the potential harm it can inflict, can also perpetuate irrational fears. They can deepen the feelings of distress associated with the phobia. For example, “If I go to the party, no one will talk to me. I’ll sit there nibbling on carrot sticks looking like a fool.”
You might also underestimate your ability to cope with the situation. If you are afraid of something, it’s important not to avoid it, because on a deeper level you cognitively know it’s not potentially harmful to you, so it’s vital to try to work through it.
Cavenett says avoidance can sometimes inadvertently increase the anxiety or phobia. “Your body learns there definitely is something to fear,” she says. “The more experiences it has of fear around something, the stronger it will embed the connection between the object and the phobia.”
From dogs to birds, lightning, storms, dark spaces and walking through tunnels: there are many different types of phobias people can experience. Cavenett says phobias are very specific to one person. “What one person develops a phobia about might not affect another at all; that’s why some phobias seem puzzling to some people — they are very unique,” she says. However, there is a commonality to some phobias, with spiders, snakes, heights, injections, the dentist and flying among the most widespread.
A phobia can develop in a number of ways. If someone in your family has a phobia, there is a stronger chance you will too. Research by CMHH van Houtem and colleagues who assessed twin studies showed a definite genetic link. Among the most prevalent phobias shared genetically are blood, injury and injection phobias, as well as a fear of certain animals.
Cavenett says phobias can also develop if you have a negative experience associated with something. “A fear of dogs can develop as a direct response to being bitten by a dog,” she says.
Phobias can be learned by proxy, too. You might watch a parent show a strong fear response around large barking dogs, so as a young child you indirectly learn that big barking dogs are something to fear and avoid.
You’ve probably heard of claustrophobia (fear of enclosed spaces), arachnophobia (fear of spiders) or even pteromerhanophobia (fear of flying). Here are some other less well-known phobias:
- Botanophobia — Fear of plants
- Chromophobia — Fear of colours
- Ephebiphobia — Fear of youth
- Koumpounophobia — Fear of buttons
- Trypophobia — Fear of holes
- Chronomentrophobia — Fear of clocks
- Bibliophobia — Fear of books
- Arithmophobia — Fear of numbers
- Heliophobia — Fear of the sun
If you experience phobias, working on relaxation strategies can help. Take calming deep breaths, pull your thoughts back to the moment and try to create a sense of calm to still your body and mind.
One of the most successful ways to deal with a phobia, however, is by exposure to it. This is done in very small measured increments. A common phobia is fear of needles, and since COVID-19 it’s a phobia that Ackland says is on the rise. With more and more Aussies set to receive a double jab, she offers the following as an example of exposure therapy.
“Someone with a needle phobia commonly can’t even look at pictures of someone receiving an injection or watch medical shows,” she says. “So we begin with early practice tasks of looking at pictures of needles, and when the person can master that, to watch videos of injections.”
After that step, Ackland suggests visiting a pathology lab waiting room and then, if possible, watching someone you know having an injection. The idea is to work your way through each step until you reach the point where you can have an injection yourself.
The premise behind exposure therapy is that by gradual measured and controlled steps, a person can eventually overcome their phobia.
Supporting someone with a phobia
A phobia can cripple an otherwise calm, confident human and its impacts can have
far-reaching consequences. The child who can’t go to his best mate’s birthday party because there’s a “scary” clown, the young mum who can’t take her kids to play group because she has to drive on the highway to get there.
You probably know people who have phobias, but some suffer in silence. Many will keep quiet about their fears for fear of ridicule. A well-intentioned friend might say, “Oh come on, you’ll be right — that puppy looks friendly.” Or even, “That’s nuts to be afraid of riding on an escalator, it’s totally safe.”
The problem, says Ackland, is that the person with the phobia has probably tried themselves to “get over it”, but despite their best efforts they have not been able to.
A better strategy, she explains, is to offer empathy and understanding and to accompany the person to one of their early exposure tasks. “Champion their efforts and be congratulatory when they’ve achieved those first steps,” she says. “Let them know you understand how tough it was, and even offer a reward too — ‘This is a really tricky thing for you to do — how about you do it and then we will go out for afternoon tea?’”
Social phobia is an often crippling anxiety disorder that can prevent people from making positive connections with others, limiting their social and work life opportunities. It’s one of the most prevalent but least talked about phobias.
Cavenett says it impacts around 15 per cent of the population. “It’s incredibly common and is characterised by worrying more than the average person about what other people think of them,” she says. As a result, they avoid social situations for fear of negative scrutiny. It can be incredibly debilitating, but Cavenett says it’s very treatable.
“We can help people to discover ways to let those unhelpful thoughts go and to be less self-critical,” she says. “We get them to go out into the world and socialise, to challenge the predictions they’ve made that others would judge and reject them. We get some great results in therapy.”
Cavenett says it’s not just about facing your fears: “There is a lot we can do with the way you think — change both and we get some great results.”
If fear or a phobia is ruling your life, reach out. There are many organisations that can offer assistance, as well as tools and strategies to help you take positive and achievable steps to overcome your phobia.