Fear is a part of everyday life. Although it may be unpleasant, it is a perfectly normal and natural response to threats or danger. However, sometimes fear can become uncontrollable and develop into a disabling phobia. Fortunately, many fears and phobias can be effectively treated by psychotherapy and other techniques.
If you believe someone is following you down the street at night, your body starts to show the typical fear response: your heart speeds up, you breathe faster, your palms sweat, your mouth becomes dry and blood pressure rises. All of these changes divert blood to the muscles so that you have more energy either to get away from or confront the pursuer.
‘FIGHT OR FLIGHT’
This ‘fight or flight’ response to danger has obvious survival value in helping us to deal with all manner of threats, not just imagines stalkers on the street. Our emotional and physical responses to situations that we fear can also help us to take practical steps. For example, if your home has been burgled, you are more likely to find the time and money to fit secure locks to doors and windows or install a telephone in the bedroom in case you need to call for help. While such practical action can assure, it is natural to feel a sense of anxiety that takes a while to dissipate.
But fear and anxiety can get out of hand. Roughly one person in ten suffers from a phobia – an irrational fear of an object or situation that may be harmless in itself. Phobias are nothing new: the ancient Greek physician Hippocrates described patients disabled by irrational fear more than 2000 years ago. King James I of England was terrified by the sight of unsheathed swords, and Henry III of France was scared of cats.
Sigmund Freud, the founder of psychoanalysis, believed that phobias stemmed from childhood trauma. In some cases, this is true: one woman with a fear of feathers traced the problem back to a large feather in the hat of an unknown woman who learn over her pram when she was a baby, causing her to scream with fear.
Fears and phobias vary in severity. Some people just feel mildly uncomfortable when talking about their phobia, and will avoid it if possible. Others will go to any lengths to avoid the object or situation because it produces such intense fear – so bad that they feel they might be about to die. In these cases, a phobia can seriously disrupt everyday life. People with a fear or phobia usually have a clear insight into their problem and know their fear is exaggerated, so in addition, they often feel ashamed of their weakness.
THE THREE CLASSES OF PHOBIA
- Simple Phobia – These are fears of specific objects or situations, and include Acrophobia (heights and high places), Arachnophobia (spiders), Astraphobia (thunderstorms), Bacillophobia (germs), Claustrophobia (enclosed spaces, e.g. small rooms or lifts), Haematophobia (the sight of blood), Hydrophobia (water, such as rivers and oceans), Nyctophobia (the dark or darkness), and Zoophobia (animals).
- Social Phobia – This is a feeling of insecurity or fear in specific social situations, coupled with a fear of being publicly embarrassed. Social phobia may include a reluctance to eat and drink if anyone is watching.
- Agoraphobia – This is one of the most common phobias, and involved the fear of being alone in public places or in an unfamiliar setting.
TREATING FEARS AND PHOBIAS
Behaviour therapy can help people overcome mist phobias and fear, and sometimes antidepressant drugs can be effective. Behaviour therapy exposes the sufferer to the object or situation they fear.
There are two ways of doing this: through fantasy, which is a useful approach in situations that cannot easily be reproduced, such as thunderstorms, or by directly confronting the phobia. Fantasy involves the person imagining the phobia object or viewing it via video slides or computer stimulations while being repeatedly told to relax. Fear and relaxation cannot be present in the mind at the same time, so the fear should begin to fade and be replaced by a relaxed feeling.
For direct confrontation, there are two main approaches. Systematic desensitisation exposes a fear gradually. If, for example, a person fears going out at night after being mugged, the victim might begin by going out for short periods with friends, gradually reducing reliance on others until confident enough to walk alone.
The alternative approach, called ‘flooding’, is like jumping straight into the deep end of a swimming pool. The person is exposed to the full extent of their fear – with agoraphobia, for instance, they might go to the shopping centre for a few hours. Flooding demands more of the patient but it yields quicker results. However, the patient must agree to see it through – fleeing halfway would reinforce the phobia.
REAL LIVES: A FEAR OF HOLES
Shirley, 24, a magazine editor, has an unusual fear – she cannot bear to look at objects, such as natural sponges, that contain irregular holes. ‘It is really just when I look at sponges or those yeasty bread things called crumpets. It’s as if the holes might have something horrible living inside them.
They make me feel very uncomfortable and nauseous, and I want the holes to be closed up. I’ve eaten crumpets in the past but I can’t stand looking at them – it really freaks me out. I can’t explain how I feel, it’s a kind of disgust. I get the same feeling with certain stones with holes in them – even the word “pitted” makes me feel queasy. It’s the idea that things could be inside and creep out the holes. I put it down to an over-active imagination.
It’s silly, I know, and I’ve never consulted anyone about it, because it’s not that important, although my friends do laugh at me. If I’m in a shop or somewhere and I see a big, holey sponge, I’ll just turn away quickly. I’ve never met anyone else with this phobia, so I don’t normally tell people about it.”