Carol has had an intense fear of spiders for as long as she can remember. The fear seems to control her entire life. She refuses to go camping, sit on the verandah by herself or lie on the grass. She frequently sprays her entire house with insect repellant. She cannot even look at a picture of a spider without experiencing a full-blown panic response.
Carol is not alone. Surveys in the USA suggest that between 10 to 11 percent of individuals suffer from a phobia in any given year. Three quarters of those with the worst phobic symptoms are women.
We all have common fears that play on our minds sometimes, but a phobia is a far more persistent and unreasonable fear of a particular object, activity or situation. Sufferers will do anything to avoid their fear, and such distress often interferes noticeably with personal, social or occupational functioning.
The DSM-IV distinguishes between three main categories of phobias, namely agoraphobia, social phobia and specific or simple phobias.
Agoraphobia is a pervasive and complex disorder in which sufferers have an intense fear of any public places or situations in which escape might be difficult – for example, crowded streets or supermarkets, tunnels and bridges. If agoraphobics find themselves in these kind of dreaded situations, they develop panic-like symptoms such as dizziness, palpitations, diarrhea or nausea. Often the condition becomes so severe that agoraphoics are afraid to leave their own houses.
Social phobic sufferers have an irrational fear of scrutiny by other people in social situations, as well as a marked and persistent fear of performance situations in which they may become embarrassed or humiliated. Social phobics can be fearful of a wide range of social situations or their fear can be limited to specific activities eg: public speaking. The most common feared events include being introduced to others, meeting people in authority, being watched doing something, writing in front of others, eating in front of others and speaking in public.
If an individual has a persistent fear of a specific object or situation – excluding that of being in public places (agoraphobia) or in socially embarrassing situations (social phobia) – then he/she is classified as suffering from a simple/specific phobia. Carol, for example, has a specific phobia because when she is exposed to, or anticipates being exposed to, spiders she develops immediate fear. Women are twice as likely as men to develop specific phobias.
There are 320 registered phobias – some of them more unusual than others. A sample of the more common specific phobias include: fear of spiders (arachnaphobia); birds (ornithophobia); fluing (aerophobia); thunderstorms (tonitrophobia); heights (acrophobia); blood (hematophobia); dirt (mysophobia); injections (trypanophobia) and snakes (ophidiophobia).
On the other hand, here are some specific phobias that you probably haven’t heard of: fear of beards (pogonophobia); being buried alive (tapophobia); children (pediophobia); England and things (anglophonbia); horses (hippophobia); human beings (anthropophobia); marriage (gamophobia); shadows (sciphobia) and swallowing (phagophobia).
Unlike social phobics and agoraphobics, specific phobics generally are not anxious or depressed, nor do they score high on neuroticism measures except when confronted with the phobic object or situation. Thus, the impact that a specific phobia can have on a sufferer depends largely on what exactly it is that the sufferer fears. Some phobias are easier to avoid than others, for instance aeroplanes and dogs can be avoided far more easily than water and dirt can be. Specific phobias can develop at any time in life. Childhood phobias seem to pass more often, whereas phobias that last until adulthood or begin during adulthood are more likely to be more persistent.
Although many sufferers are aware that their fears are excessive, they often have no idea where their phobias originated from. In most cases, the cause of phobias is complex involving the interaction of genetic, developmental and environmental factors.
With proper treatment, the vast majority of phobic patients improve significantly or completely overcome their fears. The most effective method for treating phobias is a behaviour therapy called exposure which involves exposing the sufferer to the feared object or situation. There are two variants of this method, namely “flooding” and systematic desensitization.
During “flooding” therapy, the sufferer is exposed directly and immediately to the feared object or situation, and is required to stay in that situation until his/her anxiety is noticeably reduced. Recently, technological advancement in the form of virtual reality has resulted in phobics being treated in simulated real-life settings. Researchers boast that this method is simple, low cost and very effective.
Systematic desensitization is a more gradual from of exposure therapy in which the phobic confronts his/her fear in a series of steps. The sufferer first learns relaxation techniques to control the anxiety, and then works from imagining the feared object or situation to looking at pictures of it, to finally confronting it in reality.
Self-help groups have also proved to be effective in fighting phobias. The Depression and Anxiety Support Group, a non-profit privately funded support group with a membership of over 8 000, has established over 75 regional support groups country-wide. Mutual help is a vital element of the groups – who better to give support to a phobic sufferer than a recovered phobic sufferer? The Support Group can be contacted on (011) 884-1797 / 783-1474/6.
Finally, medication can also be used to control the panic experienced during a phobic situation as well as the anxiety aroused by anticipation of the event. Social phobics and agoraphobics, in particular, tend to find medication such as antidepressants very helpful.