Face your Fears

It may be a natural response to avoid what we find scary - but that doesn't mean it's the best response. When people with phobias dodge whatever it is that fills them with terror and anxiety they usually compound the problem - sometimes to such an extent that it eventually cripples their lives. And that is worth avoiding.

Specific phobias (excessive fear related to exposure to specific objects or situations) can affect up to one-third of the population at some point in their lives. Data released last year from a Stress and Health Study conducted nationally from January 2002 to August 2004 shows that 9,8% of Americans will suffer from agoraphobia (excessive anxiety about being in places or situations that may cause panic attacks) at some time in their lives and 2,8% will suffer from social phobia (the excessive fear of experiencing humiliation or embarrassment in a social context).

Despite this frequency, few people seek treatment. Most people only seek treatment when the phobia becomes severe and interferes significantly with their personal lives, career or interpersonal relationships.

Panic Mode

The definition of 'phobia' is 'a persistent, irrational fear of a specific object, activity or situation that leads to a compelling desire to avoid it'. This 'solution', however, soon becomes part of the problem. Avoidance and control behaviors become a handicap, forcing people to use up time, energy and attention that could be better spent on other things. People with a phobia become adept at avoiding that phobic object or situation so they never face the fear, which then becomes more intense and causes the avoidance to be more extreme.

Gradually the sufferer's life may become increasingly restricted and governed by the phobia. For example, socially phobic people learn to avoid social situations that lead to anxiety. They may eventually avoid public-speaking engagements, eating in public or using public toilets. Over time the person avoids almost all social encounters and may even become housebound.

A phobia may also become inclusive of other things related to the phobic object or situation. A person who has a phobia of furry dogs may start to fear anything furry, and then can't even look at a picture of furry dogs or other furry objects. As more and more situations and objects are avoided, the sufferer's world starts to close in.

When phobic disorders go untreated they can lead to secondary conditions such as depression, other anxiety disorders, substance abuse and even suicide. Many people with social phobia become dependent on alcohol or sedatives and use them to reduce their anxiety.

Face the Fear

Two popular treatments for phobias are Cognitive Behavioral Therapy (CBT) and hypnotherapy. There is no good evidence that hypnotherapy is an effective treatment for specific phobias. CBT, however, is useful in the treatment of both specific and social phobias. With CBT, people are gradually exposed to their feared situations, beginning with the situation they fear the least. In people with social phobia, CBT can be used to correct dysfunctional thoughts about fear of failure, humiliation or embarrassment.

With CBT it's important that exposure is graded and repeated, as forced and quick exposure is likely to reinforce the phobia. Treatment is also not dependent on knowing the cause or root of the phobia. By just recognizing and diagnosing the symptoms, treatment through CBT can be very effective.