Fears/Phobias

What is Fear?

Emotions are transient reactions to particular cues, such as cues relating to the environment, the body and mind. Though they are transient, meaning short-in-duration, if prolonged, these emotions can become dominant emotional states. Extremities of these emotional states can fester and grow into more serious disorders (see depression and anxiety).

Fear is a strong transient emotion. Fear can be defined as an unpleasant emotion or feeling caused by either real or perceived threats of danger or harm, which if prolonged can develop into dominate states of anxiety or anxiety related disorders such as phobias.

What is the biological basis of fear?

Fear is a product of evolution that developed as a survival mechanism when our ancestors were more likely to be in immediate threat from a predator.  The primary goal of fear is to evoke a response to perceived threats, commonly known as the ‘fight or flight’ response. This response is usually performed by the body’s autonomic nervous system (ANS), which is responsible for the regulation of unconscious body processes, such as the heart muscle. The ANS comprises of two sub divisions: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), which have complementary roles.

The SNS is activated when an individual is presented with an immediate or perceived threat, it is responsible for preparing the body for either a confrontational response (fight) or running response (flight). The SNS activates parts of the adrenal gland, releasing adrenaline into the bloodstream. This then activates specific muscles and glands which tense and constrict the muscles as well as speed up bodily systems, making the individual feel more alert. To conserve energy, unessential body systems such as the immune and digestive systems begin to shut down.  Because of the activation of the ‘fight or flight’ response a person may notice that they have an increased heart rate; their lungs have become enlarged, making it easier to breathe; their muscles become tight; they produce less saliva; and experience a loss of appetite.

Opposing the SNS is the PNS, also known as the rest and digest’ system. It is responsible for bringing the body back to a state of homeostasis or balanced functionality. The PNS regulates activities such as digestion, sexual arousal, salivation, the production of tears, urination, and defecation.

In modern society, there are a lot of situations that people fear and where the ‘fight or flight’ response becomes activated. However, if an individual is unable to react to the threat, he or she begins to feel helpless and the ‘fight or flight’ response is prolonged. The longer it is in activation the higher the chances are for that person to develop a feeling of hopelessness and an anxious dominant emotional state or a severe anxiety disorder.

What is a phobia?

One such anxiety disorder is phobia or specific phobia (DSM-5). A phobia can be defined as an intense fear to a specific object or situation.

To be diagnosed with a specific phobia, a person must display pronounced fear, anxiety or avoidance towards a stimulus, persistently for at least 6 months, resulting in severe distress or interference with one’s daily life. The level of fear experienced is out of proportion to the level of actual danger. Whilst a person can develop a specific phobia at any time in their life, on average, onset occurs in childhood. The development of a specific phobia mostly follows a traumatic event. Despite this, an affected individual usually cannot recall the triggering event.

Types of Phobias:

There are two recognised classifications of phobias: social phobia and specific phobia.

Social phobia or Social Anxiety Disorder is marked by a fear or anxiety of one or more social situations where the individual may be scrutinised by others. Individuals with social phobia will often feel anxiety from simple social interactions such as answering the telephone. These intense social discomforts can lead individuals to lead very isolated confined lives.

There are more than 100 types of specific phobias that have been identified. These include phobias to particular animals, insects, situational fears, environmental factors, or other specific objects. Below is a table with some of the most common specific phobias.

What causes a phobia?

There are many potential causes that may lead an individual to develop a phobia, these include:

• Classical conditioning: This is when individuals learn to associate an object or situation to negative feelings, creating an aversion. An example is when a child experiences a traumatic event in their lives such as drowning and learns to associate water with the feeling of death and drowning. Another way an individual might develop a phobia is through observational learning. In this case a child might observe their parent react fearfully in a specific situation.
• Genetics: Studies have found that individuals who have family history of phobias are more likely to develop phobias themselves than individuals who do not have a family history.

Who is at risk of Phobias?

There are many possible risk factors for the development of a phobia, this includes:

• Medical conditions: Research has found that individuals with ongoing medical conditions or health concerns are at an increased risk of developing phobias. This may be due to prolonged anxiety associated with their health outcomes.
• Trauma: As mentioned above, individuals who have experienced some form of traumatic event in their lives are at an increased risk of developing a phobia. This is usually due to conditioning the brain to associate an object or situation to that traumatic experience.
• Pre-existing mental disorders: Individuals with a history of mental illness or substance abuse are at an increased risk of developing phobias.
• Low Socio-economic Status: Individuals who come from households with a low income are at an increased risk of developing phobias. This may be due to observational learning or exposure to an anxious atmosphere that is usually associated with financial stress.

In Australia it has been estimated that approximately 11% of the population will be affected by a specific phobia, this is based only on cases that have been formally diagnosed.

 What are the signs or symptoms of having a phobia?

A phobia can have adverse effects on an individual’s wellbeing and functioning. The following table shows both emotional and physical symptoms an individual with a phobia might experience:

If the phobia is experienced by a child look for symptoms such as crying, tantrums, freezing, or clinginess.

How can Psylegal help with phobias?

Psylegal Melbourne provides anxiety treatment that helps you learn how to control your anxiety so it doesn’t control you. Some common treatments for anxiety include:

• Cognitive Behavioural Therapy (CBT) has been reported as one of the most effective in treating individuals with various mental health problems, including anxiety. It involves teaching individuals how to identify the automatic negative thoughts and beliefs that cause their anxiety. Thoughts are messages generated automatically and randomly from our brain. We cannot stop and control our thoughts, but we can choose how we react to them. By becoming more aware of our thoughts, feelings, and body sensations, we give ourselves the possibility of not getting into the same old “mental ruts” that may have caused problems in the past. It also teaching individuals how to challenge negative thinking styles and change entrenched behavioural patterns.

• Systematic desensitisation is a therapeutic technique effective in treating anxiety disorders, particularly phobias. It involves exposing an individual to their fear whilst they practice relaxation techniques, in a safe environment. It is a gradual, step-by-step process, sometimes referred to as ‘hierarchy therapy’ or ‘graduated exposure therapy’. Treatment begins by presenting the individual with their fear in a way they consider least threatening (e.g. an image of a spider at 10ms away), once they are able to cope with the stimulus, they are presented with a slightly more threatening stimulus (e.g. an image of a spider 5ms away). Slowly, slowly, the individual is able to overcome the pattern of avoiding their feared stimulus, and realise the stimulus is not as frightening as it once seemed!

• Flooding also known as “exposure therapy” or “prolonged exposure therapy” is similar to systematic desensitization. However, rather than it being an incremental process, the anxious individual is presented with their fear in the most threatening way they could imagine. For example, a person fearful of spiders may be left in a room alone with a spider. Whilst this may technique is quick and still effective, it can be fairly traumatizing for the patient.

• Relaxation techniques such as practicing deep breathing, meditation and mindfulness. Deep breathing can be extremely beneficial for calming individuals, especially those experiencing symptoms such as heart palpitations, as it will bring back their usual heart rate. Mindfulness and meditation is effective in helping an individual focus on the here and now, improving their self-awareness, and accepting negative feelings and thoughts without letting them take over. Relaxation techniques can be extremely effective in helping an individual cope with the symptoms of anxiety, in turn, making them feel more in control.

The psychologists at Psylegal are very experienced and knowledgeable. They are aware that each anxiety disorder is different, and therefore are effective in providing you with treatment tailored to your needs.

If you feel you may be suffering from anxiety and would like help, give us a call today on 1300 79 22 09.

The sooner you seek treatment, the better!