Phobias are called pathological irrational fear of the different situations, activities, things or people. Phobia is a kind of mental disorder when a person feels uncontrollable painful fear. The main symptom of this disorder is the desire by all means to avoid the object or situation causing abnormally high expression of fear, which does not have clear logical explanation. When a person is not able to control his fears and they begin to interfere with everyday life, experts often identify it as a variety of anxiety disorders.
Phobias are the most common form of anxiety disorders. Symptoms of such states are dizziness, shortness of breath, nausea, panic, etc. The stronger are the symptoms of the disease, the more person tries to protect himself from the source of the danger, and maybe seeking to isolate from the society. The result of phobias are difficulties of everyday life, at work and personal life. And not all people try to find a medical solution to this problem.
The relevance of this topic lies in the prevalence of the problem of phobias, as well as great attention of scientists and physicians to study of the fears and phobias in modern society.
In this paper will be considered the concept and explanation of phobias, their causes and symptoms. Next will be considered types of phobias, and specially attention will be paid to social phobia, as it is one of the most common type of fears. At the end of the paper it is nessary to consider methods and approaches to the treatment of phobias and fears, which offers modern medicine.
Definition and understanding of phobias
According to the basic definition, a phobia (from “Fobos” – «fear”) – is an irrational fear of uncontrolled, persistent manifestations of different fears. (American Psychiatric Association, 1994)
Phobia is also called the irrational attitude of hostility, rejection and hatred of anything, but fear as an emotion in this case there is a veiled form. The main difference of phobias from the objective emotional processes is the irrationality of the causes of fears, since phobias are forcing people to avoid relatively or absolutely safe situations or objects. People suffering from this disorder can not assess the real threat of a factor, which gives them a fear (for example, a fear of the darkness). A person suffering from a phobia can not logically explain his strongly expressed fear that occurs as a result of an appropriate stimulus. Therefore, the distinction between phobia and objective fear is quite clear, and to recognize the presence of human mental disorder is not so difficult. (Brown et al., 2001)
Phobias (in the clinical sense of that term) are the most common form of anxiety disorders. The American study by the National Institute of Mental Health showed that approximately 18% of Americans suffer from various phobias. With regard to age and gender, the results showed that phobias are the most common mental illness among women in all age groups, and the second most common illness among men older than 25 years. (National Institute of Mental Health)
The main symptom of this disorder is an abnormally high expression of fear, that is, phobia as a disease is based on the concept of fear. Fear is an emotion that arises in situations of threats to biological or social survival of the individual, and directed at the source of the real or imagined danger. Unlike other types of pain and suffering caused by the real actions, the fear arises in their anticipation. Depending on the nature of the threat, the intensity of feelings of fear varies in a wide range of feelings: apprehension, fear, fright, horror. If the source of danger is uncertain or unconscious, there is a condition called anxiety. Functionally, the fear is a warning of impending danger, but when it reaches the condition of affect (panic), it is able to impose patterns of behavior to person (escape, numbness, defensive aggression). Variety of compulsive movement patterns that occur with nervousness, may be present for a long time (a year or more) after the traumatic situation, and before normalization of the conditional reflexive activity. (American Psychiatric Association, 1994)
Phobias have traditionally been considered as obsessive-compulsive disorders, as anxiety disorders, which are related to mental disorders. Obsessive-compulsive disorder is this kind of experience, when a person against his will has different fears, doubts, thoughts, desires, actions. Despite the critical attitude to such phenomena, people can not get rid of them. Obsessive-compulsive disorder is not necessarily says about mental disorder, it can also be found in healthy people, for example, many people can have obsessive repetition of words (so-called “words – parasites”), obsessive singing of favorite song, etc.
Phobia as a conditional reflexive inadequate reaction of fear, associated with a particular situation or a particular stimulus, that occurs due to the ability of human consciousness to store and compare the phenomena occurring at the moment with past experiences. In frightening situations, there must be present at least two of the following symptoms of anxiety:
1. increased or rapid heartbeat;
3. tremors or trembling;
4. dry mouth;
5. difficulty in breathing;
6. feeling of suffocation;
7. pain or discomfort in the chest;
8. nausea or abdominal discomfort;
9. feeling of dizziness, instability, or fainting;
10. derealization (feeling that things are unreal) or depersonalization (feeling of unreality about personal “I”);
11. fear of losing control, madness;
12. fear of death;
13. hot flushes or chills;
14. numbness or tingling. (Davey 1999)
Causes of Phobias
There are different views and opinions on the nature and causes of phobias, that is why it is difficult to point few of them. The most common are called such causes as:
1. Violations of the vestibular apparatus. Vestibular apparatus is a body organ that is responsible for orientation in space. A person who begins to suffer violations of the vestibular apparatus has feeling of uncertainty, which further develops into a fear.
2. Also the cause of phobias can be called experiences that a person had in childhood. It is known that many childhood experiences are stored in our memory very vividly, therefore, in certain vital points childish fears appear in the memory and further develop. Almost all people have something to remember from their childhood, so many people are afraid of water, heights, darkness, loneliness, because in childhood had some terrible event associated with it.
3. Fears that arise in the course of some unpleasant situations in adult life.
From fears in most cases suffer emotional and very sensitive people. It is worth emphasizing what weak minded people are most prone to the formation and development of phobias , as it is much harder for them to resist negative feelings than those with more stable and strong mentality. Phobias can occur in people with rich imagination, as it is quite difficult to distinguish a real danger from imagined. People who are prone to such fear, is actually afraid of what is not real, after a phobia is a fear of fear itself.
Types of phobias
From a scientific point of view there are three types of phobias:
1. Simple (or specific) – when person is afraid of very specific things
– Environment: fear of lightning, water, storm, etc.
– Fear of animals: fear of snakes, rodents, spiders, etc.
– Medical fears, associated with fear of blood, injections, doctor visits, etc.
– Situational: fear of bridges, driving, etc.
– Special (for example, a fear of number 13 )
2. Social phobia, which is a fear to do anything publicly. Social phobia occurs when people avoid places where there are a lot of people, for example, to avoid confusing
3. Agoraphobia. People who suffer from agoraphobia are victims of a complex phenomenon, based on fear of unfamiliar places. Some scholars attribute it to situational phobias, but many distinguish it as a particular type. (Davey 1999)
Also, for example, all phobias can be classified into types depending on age:
1. Children’s phobias. For example, a lot of children are afraid of negative characters of a fairy tales, have a common fear of darkness, and in most cases all these nightmares and fears pass with time.
2. Teenage phobias. As is well known, personality at puberty is just being formed, so virtually all teenagers have unstable nervous system. This turns into teenage fears, the most common of which are tanaphobia (a fear of death), and intimo-phobia (a fear of relationships with the opposite sex). And all these phobias pass rapidly, though if some fears do not pass with the time, it is very important to get rid of them.
It is possible to name the most common types:
Acrophobia – fear of heights
Aichmophobia – fear of needles/sharp objects
Ailurophobia – fear of cats
Androphobia – fear of men
Anthropophobia – fear of people
Apiphobia – fear of bees
Aquaphobia – fear of water
Astraphobia – fear of lightning
Aviatophobia – fear of flying
Brontophobia – fear of thunder
Bufonophobia – fear of toads
Cancerophobia – fear of cancer
Cardiophobia – fear of heart disease
Cynophobia – fear of dogs
Dentophobia – fear of dentists
Genophobia – fear of sex
Gynophobia – fear of women
Herpetophobia – fear of creepy, crawling things
Homophobia – fear of homosexuals
Hypnophobia – fear of going to sleep
Iatrophobia – fear of doctors
Musophobia – fear of mice
Mysophobia – fear of dirt, germs
Necrophobia – fear of death
Neophobia – fear of anything new
Noctiphobia – fear of night
Nyctophobia – fear of darkness
Ophidiphobia – fear of snakes
Pyrophobia – fear of fire
Taphophobia – fear of being buried alive
Sociophobia – fear of social situations
Theophobia – fear of God
Xenophobia – fear of strangers
Zoophobia – fear of animals
It is necessary to take a closer look at a special type of phobias as sociophobia, which was approved in early 1980 in the DSM-III.
Social phobia is called the fear of certain situations with possibility to feel embarrassment or humiliation. Examples of social phobia may be the fear of public speaking and actions, the fear of using public toilets or transport, fear of eating or writing anything in public, to speak with other people. People with social phobia try to avoid frightening social situations that has negative effect on their personal life and professional activities. This is a very common disease, that is why it requires comprehensive investigation and treatment, and according to the National Institute of Mental Health this issue deserves special attention of clinicians.
Sometimes the fear of society is manifested in hand tremors, flushing, sweating, nausea, or stiffness. In some cases, people feel strong fear in usual normal situations such as communicating with strangers, public speaking, phone calls, visiting a public toilet. The most common fear is of being rejected by other people in different social situations, fear of all kinds of criticism about appearance, behavior or character. If the fear of certain situations is rather strong, the person will try to avoid such situations, will be forced to stay home. At work people with social phobia are usually stay away from the team, do not go to meetings, and avoid public gatherings. At the same time, people seek to minimize the risk of attention from others, that is also a form of social phobia. (Hofmann et al., 2001)
Reasons underlying the development of social phobia, still have no definite explanation, and there are various theories about them. One of them is the theory of imitation of social phobia in parents’ behavior by children; another theory says about underdevelopment of social skills, when a person does not know how to behave in a particular situation, then it can cause anxiety and agitation . Also, some scientists point overprotective of a child or a lack of love for him as important reasons of social phobia. It was found that a genetic predisposition to the increasing stress may also be important cause of this disorder. (The National Institute of Mental Health)
Speaking about this disease, it must be said that social phobia can be an important obstacle to normal life for many people. For example,
according to studies, people with social phobia are more lonely, they rarely celebrate holidays, and they are less likely to marry. There are often problems in obtaining an education, since the fear of public speaking and fear of large groups can greatly interfere with the learning process. Also, these people have practically no opportunities of career growth. In an attempt to fight with the anxiety, many are beginning to abuse alcohol, which leads ultimately to self-deprecation. Episodes of depression are also characteristic of people suffering from social phobia. (Hofmann et al., 2001)
Methods of treatment of phobias
In modern medical and psychological literature it is distinguish two main ways of treatment of phobias:
1. Therapeutic (medical care).
Therapeutic tools include traditional means of treatment such as beta-blockers, antidepressants, and other sedatives and behavior therapy.
2. Psychological (psychological impact)
Approaches to the treatment of phobias in psychoanalysis are the same as in treatment of other neuroses: it is a psychotherapy aimed at understanding the unconscious meaning of phobia. The advantages of the psychoanalytic treatment of phobias are that in the process of psychoanalysis specialists work on the underlying causes of phobias, that helps to achieve a sustained therapeutic effect. For example, a symbolization of an irrational fear, based on the recollection, allows the patient to feel more confident in the face of his phobias. Strengthening during the treatment of phobias the patient’s self-esteem helps to overcome his pathological regression, gives strategically significant therapeutic result, which applies not only to the affected by the fear part of his life. Psychotherapy allows also the development of detention functions (for example, sexuality) and the overcoming of fixation in the patient’s mind. (Donald F. et al., 1983)
Great theoretical and practical interest has therapeutic effect of meditation – a therapy to restore the mental and psychological balance in organism, which assumes changing of responses to objects or situations that cause fear. In the Eastern countries meditation has long been used as a means of self-regulation, psychological correction, therapy and psychotherapy. The therapeutic use of meditation is based on the fact that this technique has a positive effect on psychosomatic disorders associated with stress and anxiety. It is proved in a large number of studies (Heimberg et al., 1993; Hofmann, 2004) that have investigated the possibility of using meditation to reduce fears, phobias, stress and hypertension. All the studies point out the successful effects of meditation in various syndromes (the fear of closed spaces, exams, loneliness, heart attack, chronic pain of different nature), in rehabilitation after serious illnesses such as heart attack, and psychosomatic disorders, such as bronchial asthma . It is also interesting to point out experiments that assess the ability of meditation to relieve anxiety.
In the treatment of phobias and treatment of mental disorders ( such as neurotic fear), it should be understood that there is no medicine from fears in the form of simple drugs, but there is a need in qualified and timely mental health care. Treatment of fears that offers today’s psychotherapy clinic is conducted by qualified specialists. Typically, the treatment of phobias requires a detailed study of psychosomatic manifestations of the disease, since mental disorders are often linked to abnormalities in the functioning of internal organs. It is known that very often fears and phobias can cause common diseases of the circulatory system and diseases of the gastrointestinal tract. Treatment of obsessive fear usually leads to the cure of associated diseases. (Davey, 1999)
The efficiency of treatment of phobias is directly dependent on external circumstances, such as drug therapy and psychotherapy, but also on features of personality and history of life of person. The basic principle, which offers modern psychiatry clinic in treatment of the patient are individual approach to patients and sustained confidence contact with the patient’s doctor – a psychiatrist or psychotherapist. Such contact can help to overcome conflict or crisis situation, to find a basis for effective treatment of phobias and fears, to find the true reference point for the patient, as well as the optimal way out of this situation, that the treatment of mental disorders to be effective and final. (Davey, 1999)
In psychiatry, a phobia is known as pathologically increased expression of fear as a response to a particular stimulus. Phobia is a strongly expressed obsessive fear, which appears in certain situations and can not have logical explanation. In case of phobia, a person begins to fear and thus avoid certain objects, activities or situations. Thus, a phobia is a very serious problem, as it may interfere the ability to socialize, work and interact with people and objects in everyday life. Phobias may arise as a consequence of disease, in childhood, or in adulthood.
It is possible to treat phobias in several ways, but rather in a complex of measures: with medical intervention, the use of antidepressants and with help of psychological intervention. All psychologists agree that the main method of treatment is a direct interaction with the source of phobias. It is also very important to fight against childhood fears, to detect and prevent the further development of fears.