Specific Phobia: Spider, Heights, and Beyond
Phobias, or Specific Phobia, is an intense irrational fear of something and over-reaction beyond the genuine level of danger or risk. Research shows that 1 in 8 adults will experience a phobia at some point in their life. While people don’t often talk about these fears publicly, a surprising amount of people have them! Because phobias are not often openly shared and discussed, anxiety suffers often feel alone in their fear, and feel that there is no hope for their recovery.
Phobias and Fear
Phobias exist on the anxiety spectrum along with Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and Panic Disorder. While they are all separate diagnoses, they all share the same anxiety cycle.
As a general principle, we must remember that everything we can be afraid of, may it be spiders, snakes, or public speaking, are neutral. Meaning, they are truly neither good nor bad, but just objective things, places, or activities.
The brain thinks about the world in relationship to itself and what impact the world could have on it. As a self-protective measure, the brain tries to predict what will happen if we encounter various things then evaluates whether the anticipated outcome is safe or dangerous. The problem comes when our brain skews our perception of reality ever so slightly to consider the worst case scenario. For example, it says “if you see a snake on that hike, it’ll bite you and you’ll die” or “if you raise your hand to speak in a work meeting, you’ll be found out for not knowing anything and you’ll be fired!”
Obviously, these stories end in a less-than-desirable outcome. Translation: they are terrifying!
To make sure these stories never happen, or at least to make us feel better for the moment, we try to do things that we think will help us avoid the feared outcome, or help us mitigate the unwanted results. These can include avoiding work functions, refusing to go hiking, avoiding going to the doctor or dentist, asking for reassurance that “nothing bad will happen, right” and using superstitious rituals like knocking on wood.
These attempts to control the life’s outcomes, while understandable, only provide a temporary sense of relief and a false sense of safety. They ultimately do not give any long term certainty that we are completely safe or free from bad outcomes.
It is important to recognize that anxiety tends to exaggerate the level of risk in a given situation. Our anxious brain will elevate the perceived level of danger from “possible” to “probable” and insist that we will experience a catastrophic outcome. This is not to say that our fears are baseless because we can be bitten by snakes and get into car accidents, but generally speaking the probability of our worst case scenario actually happening is not nearly as likely as our fear would suggest.
Despite all of this, “better safe than sorry” sometimes wins. When it does, anxiety and the exaggerated response and avoidance is reinforced. Subsequently, we learn that avoidance, inappropriate reassurance seeking, and magical thinking kept us from harm, so we continue to do these actions and rituals.
Unfortunately, while we feel free from danger for that moment, over time we may discover that our self-protective measures are actually holding us back from enjoying life and pursuing our goals. Eventually many find that their attempt to avoid feeling afraid is actually making them miss-out on joy and opportunities.
Anxiety and OCD is only limited by the human imagination. Because people are creative, there is no limit to what they can be afraid of. However, the most common phobias, according to the NIMH and the Anxiety Disorders Association of America, are:
- Closed-in places
- Highway driving
- Dental and medical procedures
Symptoms of anxiety impact on the sufferer’s life can range from minor annoyance to engulfing and crippling. People experiencing phobias can experience sudden symptoms such as:
- Increased heart rate
- Feeling “out of body”
- Hot or cold sweating
- “Stomach drops”
- Trembling or shaking
- Difficulty breathing
- Muscle tension
Phobias can be effectively treated using Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and mindfulness-based treatments, such as Acceptance and Commitment Therapy (ACT). These treatment methods help clients reconsider the validity of their fears while developing a more rational and balanced perspective of their anxieties.
Emboldened by this perspective, clients will progressively work to face their fears through structured and guided Exposure and Response Prevention exercises. These exercises start small and progressively increase in intensity and realism. Building on the experience of the previous exercise, clients learn that they were able to face their fear, handle the mental and emotional discomfort, and find that their worst fears did not happen. With consistency and courage, clients find that they are overcoming anxiety while developing the confidence to face greater challenges.
The following is an example of a progressive exposure treatment for dog phobia. This road-map for exposures will vary from person to person, but it will show how starting small and building confidence that one can face their fears as they move up to higher level exposures.
- Write and say “dog”
- Look at a picture of a cartoon dog
- Look at a picture of a real dog
- Watch videos of dogs
- Watch videos of barking and aggressive dogs
- Write stories about encountering dogs
- Go to a dog park, standing outside first, then eventually going in
- Pet a dog
Eventually, over time and continual exposure to their fears, clients develop a new sense of freedom through reduced anxiety and a greater willingness to embrace and engage their biggest fears!
Virtual Reality Exposure Treatment
As virtual reality technology becomes more available and accessible, traditional phobia and anxiety treatment with CalOCD will be augmented with the use of virtual reality exposures therapy.
Virtual Reality Exposure Treatment (VRET) is on the cutting edge of psychotherapeutic technique. VRET uses virtual environments to simulate anxiety inducing situations in the safety and convenience of the therapist’s office. Additionally, Virtual Reality Exposure Treatment helps bridge the gap between in-office exposures and in-vivo (real life) exposures.
New research into VRET shows that the use of virtual reality environments is as effective as traditional therapeutic techniques at eliciting feared responses and eventual habituation and phobia extinction.
If you would like to learn more about treatment for your phobias, or would like to schedule an appointment, please contact me.
FearCast Podcast Episodes about Specific Phobias:
Episode 5- Getting Fired
Episode 8- Rational Vs Irrational Phobias
The California OCD and Anxiety Treatment Center offers specialized therapy for Existential OCD in its Fullerton offices. In addition to serving North Orange County, Los Angeles, and the Inland Empire, CalOCD offers online therapy, group therapy, and Intensive Out-Patient treatment.