How can talking treatments help me with my phobia?
If your fear of something – whatever that ‘something’ may be – causes you significant problems and anxiety, then it may well be a phobia. A phobia is defined by the National Institute of Mental Health as: “an intense, irrational fear of something that poses little or no actual danger.” The definition goes on to explain that even though adults with phobias may understand their fears are irrational, it still provokes severe anxiety [1].
If this is you, take comfort in the fact you are not alone and that most phobias are treatable [2]. In the UK, the NHS estimates that around 10 million people have phobias [3]. Phobias affect people regardless of social background, age or gender, although research suggests women are affected at a higher rate [4]. According to Medical News Today [5], the most common phobias include:
- Acrophobia (fear of heights)
- Aerophobia (fear of flying)
- Agoraphobia (fear of public spaces or crowds)
- Arachnophobia (fear of spiders)
- Aichmophobia (fear of needles or sharp-pointed objects).
- Hemophobia (fear of blood).
- Claustrophobia (fear of tight or crowded spaces)
- Glossophobia (fear of public speaking)
- Mysophobia (fear of dirt and germs)
- Zoophobia (fear of animals)
In addition, emetophobia (which is the fear of vomit), and school phobia, are both common in children. These can be distressing for both the child and their parents. However, there are options available to help your child reduce their distress and improve their ability to function.
The DSM-5 outlines the following criteria to make a diagnosis of phobia [6]:
- Marked fear or anxiety about a specific object or situation.
- The phobic object or situation almost always provokes immediate fear or anxiety.
- The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
- The phobic object or situation is actively avoided or endured with intense fear or anxiety.
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
- The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms; objects or situations related to obsessions; reminders of traumatic events; separation from home or attachment figures; or social situations.
There are three main categories of treatment for phobias, which are: self-help techniques, medication and talking treatments. All of these have their pros and cons. Self-help techniques include self-help books and online programmes, relaxation techniques and support groups [6]. The positive with this approach is that it can be done on your own timescale, but that is also the negative – because it’s easier to avoid facing the phobia than pro-actively dealing with it alone. Self-help techniques therefore may not be sufficient, but certainly some of these elements can be very useful when used in conjunction with other treatments.
Medications are not used for phobias themselves but rather to treat the effects of the phobias. Antidepressants are used to reduce anxiety, whereas tranquillisers are used for severe anxiety, and only in the short-term [2]. Beta-blockers are used to treat heart issues such as high blood pressure or heart palpitations caused by the phobia [2].
Major medical bodies, such as the NHS, prefer individuals to use talking treatments rather than medications because they are usually effective and do not have side effects [2]. The most common technique for phobia treatment is cognitive behavioural therapy (CBT), although graded exposure therapy and clinical hypnotherapy are often used independently or alongside this [7]. At My Family Psychologist we specialise in CBT and will utilize other techniques to create a tailored treatment plan for each client. There is no one-size-fits-all when it comes to phobias, so expert knowledge is required to create this positive experience for each individual client.
Cognitive behavioural therapy (CBT)
CBT has been called the “gold standard” of treatment because of its high levels of effectiveness [8]. It involves looking at thoughts, feelings and behaviours and where changes can be made to help an individual manage their issue [9]. CBT helps people learn alternative beliefs about their phobias and encourages a sense of confidence and control over the phobia [9].
The process is taken step-by-step and at a pace suitable for the client. At the heart of the process is the belief that changing unhelpful thinking to more helpful thoughts can change unhealthy behaviours to healthier ones [10]. Many former phobia sufferers will testify to its effectiveness.
Graded exposure therapy is often used within this technique because it helps desensitize an individual to the stimulant. Research shows a larger positive effect for individuals when CBT and graded exposure therapy are used together, rather than each on its own (11).
It’s easier to explain graded exposure therapy with an example, so let’s say you have a fear of trains. Using CBT and graded exposure therapy you could: start with discussing this with your psychologist, then simply think about getting on a train, then visit a train station coffee shop and just hear the trains in the background, then sit on the platform and watch the trains come and go, and then get on a train yourself.
If this sounds like a long process, don’t be dissuaded. Often, when people begin CBT they find it so empowering and supportive they can move through these steps efficiently.
Clinical hypnotherapy may also be used to complement the CBT. When undertaken by a qualified and experienced practitioner, it is safe and effective. Forget about tacky hypnosis stage shows because they are simply entertainment, whereas clinical hypnotherapy is a valid and powerful approach [12]. It is used commonly with phobias and will feel relaxing and reassuring.
As you can see, talking therapies are regarded as the most effective treatment for phobias and offer a world of freedom to anyone who is currently suffering. At My Family Psychologist we can help you with your phobia, whatever it is.
Some phobias are very common, others are less so, and some can even feel embarrassing. We understand that asking for help can be a big step, but it can be a step that leads you towards a more free and spontaneous life. Call today on 07801 079 555 or email luisa@myfamilypsychologist.com and together we can find a happier future for you.
References
- https://www.nimh.nih.gov/health/statistics/specific-phobia
- https://www.nhs.uk/mental-health/conditions/phobias/treatment/
- https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias#:
- https://www.sciencedirect.com/science/article/abs/pii/0005796795000483
- https://www.medicalnewstoday.com/articles/list-of-phobias#treatment
- https://pro.psycom.net/assessment-diagnosis-adherence/phobia
- https://www.mind.org.uk/information-support/types-of-mental-health-problems/phobias/treatment/
- David D, Cristea I, Hofmann SG. (2018) Why cognitive behavioral therapy is the current gold standard of psychotherapy. Front Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004
- https://www.bacp.co.uk/about-therapy/types-of-therapy/cognitive-behavioural-therapy/
- https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162
- Priyamvada, R., Kumari, S., Prakash, J., & Chaudhury, S. (2009). Cognitive behavioral therapy in the treatment of social phobia. Industrial Psychiatry Journal, 18(1), 60–63. https://doi.org/10.4103/0972-6748.57863
- Häuser, W., Hagl, M., Schmierer, A., & Hansen, E. (2016). The Efficacy, Safety and Applications of Medical Hypnosis. Deutsches Arzteblatt international, 113(17), 289–296. https://doi.org/10.3238/arztebl.2016.0289