PATIENT INFORMATION

AUTHOR: PROFESSOR JOHN MURTAGH

Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.

Phobias

What is a phobia?A phobia is an abnormal fear of a specific

object or a certain situation. It is a type of anx-iety disorder which can precipitate a panicattack. People with phobias tend to avoid thesesituations or objects and become anxious whenthey anticipate having to meet them.

For example, people may dread the sight ortouch of a spider (arachnophobia) or have amorbid fear of heights (acrophobia). Thesetypes of fears do not usually prevent peopleleading a normal life; the feared objects or situ-ations are largely avoidable. On the other hand,fear of confined spaces (claustrophobia) or openspaces are more serious problems to cope with.

What are the three classifications ofphobic states?1. Specific phobias, for example, spiders,

snakes, dogs, toads, thunder.2. Agoraphobia — fear of open spaces or

public places.3. Social phobias — fear of anxiety-provoking

social gatherings.

What are the most common phobias?The 10 most common phobias (in order) are

spiders, people and social situations, flying,open spaces, confined spaces, heights, cancer,thunderstorms, death and heart disease.

What is agoraphobia?Fear of open spaces or public places is one of

the most serious phobic disorders. Avoidanceincludes situations involving the issues of dis-tance from home, crowding or confinement.Typical examples are public transport and shops.

For some people, anywhere outside thehouse is a threat. They feel they may lose con-trol, faint or suffer embarrassment. Agorapho-bia is commonly associated with depressionand marital or family disharmony.

What are the terms for other specific pho-bias?Name of phobia Fear of:Acrophobia heightsAichmophobia needles/sharp objectsAilurophobia catsAndrophobia menAnthropophobia peopleApiphobia beesAquaphobia waterAstraphobia lightningAviatophobia flyingBrontophobia thunderBufonophobia toadsCancerophobia cancerCardiophobia heart diseaseCynophobia dogsDentophobia dentistsGenophobia sexGynophobia womenHerpetophobia creepy, crawling thingsHomophobia homosexualsHypnophobia going to sleepIatrophobia doctorsMusophobia miceMysophobia dirt, germsNecrophobia deathNeophobia anything newNoctiphobia nightNyctophobia darknessOphidiphobia snakesPyrophobia fireTaphophobia being buried aliveSociophobia social situationsTheophobia GodXenophobia strangersZoophobia animals

What is the outcome?The problem is not as serious as you may

believe. It can be treated readily. Most people,especially those with a specific phobia, lead a

normal life. One of the most distressing prob-lems, panic attacks, can also be treated.

What is the treatment?Self-help

To counter a phobia it is good to disciplineyourself to adjust to it gradually. This is calleddesensitisation or graded exposure.

For example, if agoraphobia makes youdread shopping, begin by visiting small localshops and then gradually move to larger shopsuntil big shopping centres no longer seriouslyupset you.

Cognitive behaviour therapyThis counselling technique for more difficult

problems is the method favoured by profes-sionals. Cognitions are thoughts and cognitivetherapy involves the process of knowing oridentifying, understanding or having insightinto your thought process.

The first step is to be educated about thephobia — its cause, its outcome and how it canbe handled. For example, the cause may bean unpleasant childhood experience based onmisinformation, a scary movie or book, apainful accident or bullying at school.

The behaviour component involves desen-sitisation in which an experienced therapistguides the person through the mechanism ofcoping with their fear. It usually involves slowexposure to frightening places or circum-stances and then positively reframing distress-ing thought processes. It can be compared withentering a cold sea gingerly, which is preferredto the shock tactic of plunging quickly into it.

Therapy includes relaxation techniques andgroup therapy where people share their expe-riences. Positives are reinforced and negativesdiscounted. Sometimes specific medicationmay be prescribed. Discuss these issues withyour doctor.