Lesson 3: Neurosis

12 - Phobias

Phobias are excessive, irrational fears that go far beyond natural fear; they occur in the absence of real danger. Phobias are often successfully hidden from the attention of medical personnel and casual acquaintances. Many individuals accept their phobias as inevitable parts of their lives. They quietly plan self-imposed limitations on their daily lives to control their phobias without bringing attention to their problems. Repression causes the victims to be unaware of the sources of underlying hostilities related to their particular phobias.

An entirely normal apprehension or fear could escalate until it becomes a phobia that controls one’s life. For example, a healthy respect for elevator safety keeps you alive; a phobic fear that prevents you from getting into an elevator can be a serious disadvantage if you live in or work in a high-rise building. No phobia should be taken lightly. In extreme cases, acute fear or panic can do severe damage. In many cases, extreme fear in the form of a phobia produces physical symptoms and feelings of uncontrollable terror.

The boundaries of a phobia vary. In some cases, a phobia is confined to a specific object or event. However, sometimes the phobic problem worsens as the number of phobias spread and grow to include other objects and situations. Some people are continually fear-prone, so if one phobia problem is removed, the victim may quickly acquire another. In theory, a person could go through life developing one phobia after another if proper treatment is not undertaken.

What are some of the reasons people develop such strong and such weird phobias? The conditioning theory explains it this way. First, an emotionally traumatic experience occurs and may trigger feelings of guilt that the person attempts to repress. Therefore, unusual fears are commonly traceable to early experiences in which these situations possessed a terrifying hold on the person.

A second theory known as the dynamic theory explains phobias in a slightly different way. Impulses that we are not aware of (unconscious) generate an emotional response. The person will not allow the impulse to be expressed, but the underlying emotion still remains. Emotional anxiety eventually builds up and the person uses a phobia as a defense mechanism for protection. The person unconsciously chooses an object and believes that object is the source of anxiety. The person has attached a definite (although not necessarily accurate) label to his or her fears and maintains control of anxiety by the avoiding the phobic object or situation. The object identified as the phobic one may be purely symbolic, or it may have a genuinely close connection to the underlying conflict or perceived danger experienced by the individual.

But perhaps more important than the theory behind the phobia is the concern about how the phobia can be effectively treated.

One of the most gentle ways of treating a phobia is through desensitization. First, the phobic patient is asked to relax. Then, the patient is led through a hierarchy of fear—he or she is asked to imagine a mild fear in relation to the phobia. The patient gradually imagines successive scenes that are more directly involved with the source of fear and, therefore, are more terrifying. For example, if you have a phobia about birds, the therapists using desensitization would ask you to look at pictures of birds, then be in a room with stuffed birds, then be a block away from a live bird, and eventually get very close to a real bird. Patients lose their fear in small steps.

Flooding means that the patient is confronted with the full phobic reaction right in the beginning by being exposed to the full emotional experience all in one step. The flooding method of phobia therapy exposes a patient to the exact object of fear at the start of the treatment. For example, if you have a bird phobia, a live bird would be placed close by you in the initial treatment session. You would have to adapt to your fears and conquer them immediately.