Phobias: Excerpt from Professional Guide to Diseases (Eighth Edition)

Defined as a persistent and irrational fear of a specific object, activity, or situation, a

phobia results in a compelling desire to avoid the perceived hazard. The patient recognizes
that his fear is out of proportion to any actual danger, but he can’t control it or explain it away.
Three types of phobias exist: agoraphobia, the fear of being alone or of open space; social,
the fear of embarrassing oneself in public; and specific, the fear of a single, specific object,
such as animals or heights.

A social phobia typically begins in late childhood or early adolescence; a specific

phobia usually begins in childhood. Most phobic patients have no family history of
psychiatric illness, including phobias.

Agoraphobia and social phobia tend to be chronic, but new treatments are improving
the prognosis. A specific phobia usually resolves spontaneously as the child matures.

Causes and incidence

A phobia develops when anxiety about an object or a situation compels the patient to
avoid it. The precise cause of most phobias is unknown. Psychoanalytic theory holds that
the phobia is actually repression and displacement of an internal conflict. Behavior theorists
view phobia as a stimulus-response reflex, avoiding a situation or object that causes
anxiety.
Ten percent of Americans suffer from a phobic disorder. In fact, phobias are the most
common psychiatric disorders in women and the second most common in men. More men
than women experience social phobias, whereas agoraphobia and specific phobias are
more common in women.

Signs and symptoms

The phobic patient typically reports signs of severe anxiety when confronted with the
feared object or situation. A patient with agoraphobia, for example, may complain of dizziness,
a sensation of falling, a feeling of unreality (depersonalization), loss of bladder or bowel
control, vomiting, or cardiac distress when he leaves home or crosses a bridge. Similarly, a
patient who fears flying may report that he begins to sweat, his heart pounds, and he feels
panicky and short of breath when he’s on an airplane.
A patient who routinely avoids the object of his phobia may report a loss of self-esteem
and feelings of weakness, cowardice, or ineffectiveness. If he hasn’t mastered the phobia, he
may also exhibit signs of mild depression.

Diagnosis
For characteristic findings in this condition, see Diagnosing phobias, pages 460 and
461.
Treatment
The effectiveness of treatment depends on the severity of the patient’s phobia.
Because phobic behavior may never be completely cured, the goal of treatment is to help the
patient function effectively.
Antianxiety medications, tricycli antidepressants, monoamine oxidase inhibitors,
and selective serotonin reuptake inhibitors may help relieve symptoms in patients with
agoraphobia or social phobias.
Systematic desensitization, a type of behavioral therapy, may be more effective than
drugs, especially if it includes encouragement, instruction, and suggestion.
In some cities, phobia clinics and group therapy are available. People who have
recovered from phobias can usually help other phobic patients.

Special considerations
❑ Provide for the patient’s safety and comfort, and monitor fluid and food intake, as
needed. Certain phobias may inhibit food or fluid intake, disturb hygiene, and disrupt
the patient’s ability to rest.
❑ No matter how illogical the patient’s phobia seems, avoid the urge to trivialize his
fears. Remember that this behavior represents an essential coping mechanism.
❑ Ask the patient how he normally copes with the fear. When he’s able to face the
fear, encourage him to verbalize and explore his personal strengths and resources
with you.
❑ Don’t let the patient withdraw completely. If an agoraphobic patient is being treated
as an outpatient, suggest small steps to overcome his fears such as planning a brief
shopping trip with a supportive family member or friend.
❑ In social phobias, the patient fears criticism. Encourage him to interact with others
and provide continuous support and positive reinforcement.
❑ Support participation in psychotherapy, including desensitization therapy.
However, don’t force insight. Challenging the patient may aggravate his anxiety or
lead to panic attacks.
❑ Teach the patient specific relaxation techniques, such as listening to music and
meditating.
❑ Suggest ways to channel the patient’s energy and relieve stress (such as running
and creative activities).
Your Secret Weapon to Beat Phobias

Phobia is defined as an anxiety disorder characterized by extreme and irrational fear of

simple things or social situations. It also may just refer to the extreme and irrational fear itself.
Many people experience them in everyday life. Just about everyone has some phobia or
another. Spiders, airplanes, heights, or those creepy little nocturnal minions of the devil
known as owls.
Most of the time, this isn’t a big problem, but what if you have to fly for business? What if you
are traveling in Japan where they don’t kill spiders, so they are everywhere? What if you live
alone and one is on your bed!?
Phobias are actually a pretty big deal. Luckily, there are plenty of different ways to treat
Phobia. First, we have to understand how they come about.

Cause of Phobia

There are a number of good and bad theories, but professionals agree that these are
the most likely explanations of their origins.
The Genetic/Evolution Theory – This argument says that due to the circumstances of
evolution, certain phobias are with us because they would have saved the humans who had
them from dying and, as the survivors reproduced, these traits that allowed for the phobias
would have been passed on and reinforced through generations. Basically, phobias are an
advantage.
You can see the logic here. If people knew to be afraid of spiders without being told
they might be poisonous, they are more likely to survive.
The Child/Trauma Theory – This theory suggests that at some point in earlier life,
usually childhood, a traumatic event happens and the experience becomes deeply engrained
in the mind. So, whenever we are reminded of this event, that fear is reproduced. In this way,
it is similar to Post-Traumatic Stress Disorder, though not the same.
As the phobia is with us from childhood, it is really hard to shake.
Conditioning (and Two Process Conditioning) – This is a sort of combined
interpretation. Conditioning says that when there is a certain stimulus or event and we have a
good or bad reaction, from there on in we will have a positive or negative association. This
happens somewhere in the unconscious mind. Two Process Conditioning suggests that this is
true, but it works within some sort of genetic framework that is hard-wired into the brain.
Some Common Phobias
• Arachnophobia – The fear of spiders
• Ophidiophobia – Fear of snakes. Supports Genetic/Evolutionary Theory of Phobias.
• Acrophobia – Fear of heights.
• Agoraphobia – Fear of anywhere from which it would be difficult to escape
• Cynophobia – Fear of dogs. Supports Trauma Theory.
• Trypanophobia – Fear of needles or injections.
• Pteromerhanophobia – Fear of flying.
• Mysophobia – The fear of germs.
There are lots of weird ones too:
• Chronomentrophobia – Fear of clocks
• Dendrophobia – Fear of trees
• Papyrophobia – Fear of paper
• Sitophobia – Fear of food
Treatment
There are many effective ways to treat: Counter Therapy, Hypnosis, Behavioral
Therapy, and Neurolinguistic Therapy, but for all the things that really don’t get in the way of
life, you can just take Xanax when you DO have to deal with it. Plane flights for example. Talk
to a doctor about taking Xanax. Xanax is intended for short-term use.
Overcoming Phobias: You Don't Have to Live With Irrational Fears
or Phobic Behavior

Overcoming phobias or irrational fears can involve exposure, virtual reality, &
counseling. Exposure is an effective phobia treatment.

Overcoming phobias can involve exposure, systematdesensitization, and counseling.

All are effective phobia treatments. Virtual reality is a fairly new method of overcoming
phobias.

Overcoming phobias: Hal, a case study

Hal can’t shop for groceries because he has a phobia or irrational fear that the
customers behind him in line will get angry. Even when Hal buys a single item he feels fearful
and phobic about their response. He totally avoids grocery shopping and gets all his meals
from drive-throughs of various restaurants (he also has an irrational fear or phobia about
eating in public). Hal really needs help overcoming phobias.
Angrophobia, or fear of anger, puts a major damper Hal’s life. Fear of flying or
aviophobia is another phobia that could hamper living life fully – as could glossophobia (fear
of public speaking).
Dentophobia or fear of the dentist could cause serious health problems, and so could
iotrophobia, or fear of doctors. Common phobias are irrational fears as well as a type of
anxiety disorder. Overcoming phobias involve reducing anxiety.

Overcoming phobias or irrational fears: treatments for phobia

Some phobia treatments include exposure, systematic desensitization, virtual reality, fear
hierarchies, positive reinforcement, massing, and extinction. Overcoming phobias effectively
depends on the personality and the phobia itself.

Overcoming Phobias by Exposure

Exposure to the situation is a widely-used phobia treatment. Exposure can be real: For
instance, Hal would go to the grocery store for a visit at first, then to buy a single item, then
two items, and so on. This is systematic desensitization and it works in overcoming phobias.
Exposure can be also be imagined: a psychologist or counselor helps Hal imagine shopping
at the grocery store, standing in line with people behind him, paying for groceries, etc.. This
phobia treatment is imagined but still effective in overcoming phobias. Hal could employ these
techniques by himself or, perhaps preferably, with the help of a counselor. If there are other
issues regarding overcoming phobias or irrational fears, it's important to have a trained
professional.
Overcoming Phobias by Virtual Reality
Overcoming phobias by virtual reality involves 3-D computer graphics that simulate the
situation that causes the phobia or irrational fear. Hal would enter a “grocery store program”
that puts in him in line with people behind him. The beauty of this in overcoming phobias is
they could give him more or less groceries, friendly or neutral people, big or small stores, etc
– thus exposing him to a variety of situations that cause his irrational fear. The more he’s
exposed to grocery stores, the less fear he’ll have in real life.
Gathering information about the irrational fear could help in overcoming phobias, as
could examining underlying beliefs or irrational fears of the situation. Perhaps Hal had a really
negative grocery store experience when he was a child, or even as an adult. It would make
sense for him to avoid the situation – we all shy away from negative experiences.
Understanding why and where irrational fears come from is important in overcoming phobias.

Overcoming Phobias With Counseling

Overcoming phobias can involve a combination of exposure, virtual reality, and
information. If your phobia is seriously impacting your life and you want to get help, call your
doctor and ask for a referral to a counselor. Be honest about wanting to overcome your
phobia. Talk to your friends or family – are any of them in counseling and able to give you the
name of a good therapist? Look up support groups in your city or town. Read about
overcoming phobias. Use the Internet, phone book, bulletin board at your community centre
or church when you're looking for information about overcoming phobias.
The Most Common Phobias in Psychology

Phobia are are irrational fears, but many people suffer from them. If you struggle with
phobic behavior, don't despair: you're not alone! One out of eight Americans has a phobia or
irrational fear of something.

Common Phobias in Psychology

According to The Complete Idiot's Guide to Psychology, "a person with a phobia
suffers from an ongoing, irrational fear of something that is so strong it creates a compelling
desire to avoid it." Some phobias simply go away over time. Other phobias become a big part
of people's lives - and stay that way.
The Far Side cartoonist Gary Larson jokes that luposlipaphobia is the fear of being
pursued by timberwolves around a kitchen table while wearing socks on a newly waxed floor.
This isn't a common phobias and may seem a tad far-fetched, but it's real in the sense that
involves common objects. Most common phobias usually involve an unreasonable, extreme
fear of everyday objects or events – which is why phobias are irrational.
What Are the Most Common Phobias?

Common phobias can center around almost anything. Some irrational fears that don’t
seem to make much sense include arachibutyrophobia, the fear of getting peanut butter
stuck to the roof of your mouth, or geniophobia, the fear of chins. Another irrational fear is
being afraid of Friday the 13th – not the movie, the actual day – which is called
paraskavedekatriaphobia. Most people who have common phobias are intellectually aware
that their fears are irrational, but they just can’t help feeling paralyzed by fear, anxiety, and
helplessness.
Other common phobias seem understandable. For instance, I’m scared of developing
ALS (Lou Gehrig’s Disease) or cancer, which could indicate I’m panthophobic. When I lived
in Africa, my roommate Tracy was myrmecophobic (she feared and hated ants more than
anything, and millions of them fed her angst) – but this seemed understandable since a friend
of ours once woke up covered with creepy-crawly ants. Common phobias often stem from
everyday situations.

Where Do Irrational Fears Come From?

Most common phobias develop in adulthood, but can stem out of a childhood fear. The
most common phobia in North America is arachnophobia, or the fear of spiders. Speaking in
public or glossophobia is another common phobia, as is agoraphobia (the fear of open
spaces). Birds is another fairly common phobia: I knew someone who couldn’t look at, hear,
or even say the word “bird” without hyperventilating and crying (she was ornithophobic).
Common phobias range from animals to food.
Phobias Versus Healthy Fears
Healthy fears and phobias are two different things. You can be worried about, say,
being single for the rest of your life - this can be a healthy fear. Or, you can display phobic
behavior and be anuptaphobic (irrationally afraid of staying single). Healthy fear keeps you
alive and well, alert and energized. Unhealthy fear can cause paralysis and suffering – and
can develop into common phobias.

Do You Have a Phobia?

You may have a phobia if:
1. Your professional or social life is negatively affected by your irrational fears
2. Your feelings won’t go away and seem irrational even to you. Phobias seem unhealthy
to everyone, even you.
3. You arrange your life to avoid the situation or object. Phobias are disruptive.
My fear of getting sick and dying a horrible death is just that: a fear (perhaps a healthy
one if it causes me to pursue a healthy lifestyle). It’s not a phobia because my life isn’t
negatively affected, my feelings stem from personal experiences with chronic illnesses and
death and are thus rational, and I haven’t rearranged my life to avoid illness. My old
roommate Tracy’s hatred of ants is just that – an intense dislike – but not a phobia. My friend
Angela is definitely ornithophobic, as she can’t look at a picture of a bird without becoming
hysterical.

Overcoming Irrational Fears

Overcoming a phobia is possible. Systematic desensitization to overcome phobic
behavior is effective for many people. However, if the phobia isn't negatively affecting your
life, then maybe you'll simply live with it. Many phobic people lead productive, happy lives!
Xenophobia and Islamophobia in the USA
By Paul J. Balles

Paul J. Balles considers the mindset – the ignorance, irrationality and faulty reasoning
– behind xenophobia and it’s latest manifestation in the United States and other Western
countries, Islamophobia.
“To generalize is to be an idiot.” – William Blake
Xenophobia is a fear or contempt of that which is foreign or unknown, especially of
strangers or foreign people. It includes hatred of persons belonging to a different race, or
different ethnic or national origin.
The fear or hatred that makes up xenophobia involves a great deal of generalizing
about “others”.
Unfortunately, if you develop a mindset about large numbers of people based on the
actions of a few, you can treat whole populations badly.
British historian Thomas Macaulay said: “In proportion as men know more and think
more they look less at individuals and more at classes.”

Generalizations involving xenophobia include thoughts like “immigrants are not as

worthy as natives”, and “women are not as capable as men”.
There are those in America who consider Barak Obama unworthy of being its president
because of his colour, because his father was not American by birth or because Obama’s
middle name is Hussain.
The mental degradation as part of this generalizing applies to any and all who don’t
belong to the tribe or group of the xenophobes.
Philosopher and author Eric Hoffer observed that “We are more prone to generalize
the bad than the good. We assume that the bad is more potent and contagious.”
Thus, by faulty reasoning, if there is one bad black, all blacks are bad; and if one
Muslim has committed a crime, therefore all Muslims must be criminals.
A special name – Islamophobia – applies to xenophobia involving Muslims; and
Islamophobia has been growing alarmingly in America recently.
A knife-wielding lunatic attacked a Muslim taxi driver in New York City. Why? The driver
admitted to a drunk lunatic that he (the taxi driver) was a Muslim.
The attacker reasoned from the specific (an attack attributed to Muslims on 9/11) to the
general (all Muslims were responsible).
A mosque under construction in Tennessee suffered an arson attack. Why? Comments
by Islamophobes like Newt Gingrich have incited a general hatred of Muslims.
Newt Gingrich, once the speaker of the US House of Representatives, would naturally
have others attaching greater credence to what he says.
How many people has Gingrich fed anti-Muslim thinking with his inflammatory public
remarks about Islam? The false generalization: if one Muslim is bad, all Muslims must be bad.
 Florida Pastor Terry Jones planned to burn copies of the Quran on the anniversary of
9/11. Why? He generalized from Muslims alleged to have been responsible for 9/11 to all of
Islam.
Documentary film-maker Michael Moore pointed out: “Blaming a whole group for the
actions of just one of that group is anti-American. Timothy McVeigh was Catholic. Should
Oklahoma City prohibit the building of a Catholic Church near the site of the former federal
building that McVeigh blew up?”
Protesters have been assailing the building of an Islamic cultural centre – including a
mosque – near Ground Zero in New York. The protestors disregard the fact that before
Ground Zero became Ground Zero, it had two mosques.
The problem: general and increasing Islamophobia. According to a Washington
Post/ABC News poll, 49 per cent of all Americans say they have generally unfavourable
opinions of Islam. A larger percentage opposes the cultural centre.
Poet Ezra Pound wrote: “Any general statement is like a cheque drawn on a bank. Its
value depends on what is there to meet it.” In other words, if the money isn’t in the bank the
cheque is worthless.
Applied to the generalizations about Islam, if they don’t fit Muslims generally, they are
worthless expressions of xenophobia and the ignorant fear called Islamophobia.