Introduction

All of us fear certain objects to an extent - like spiders, ants, snakes, height, hospital visit, wild beasts and so on. But when these fears start interfering with the lifestyle and daily activities and just a thought or glimpse of the object causes anxiety, nervousness. There is lasting and unexplained fear when these objects in actual are causing negligible or no danger at all. If you or someone you know have experienced these things it is possible that the person may have Specific phobia. So, specific phobia can be explained as the excessive, recurrent, unexplained and unreasonable fear of a specific feared object when it practically causes little or no threat. Even the thought, anticipated presence or actual presence may cause the fear. It leads to learned avoidance of the feared object. This learned avoidance starts interfering with a person’s normal functioning and routine.

What are the different types of specific phobia?

Specific phobias have been classified into five broad categories. They can be summed up as under:

• Animal phobias (phobia of spiders, phobia of snakes, phobia of dogs, phobia of insects etc.)
• Situational phobia (phobia of specific situations such as closed spaces, open spaces, bridges, tunnels, elevators etc.)
• Environmental phobia (fear of heights, waterfalls, storms, lightening etc.)
• Blood-injury-injection phobia (fear of hospital visits, blood tests, injections, bleeding etc.)
• Others (fear of planes, fear of choking etc.)

Some of the phobias are listed below:

Who can have specific phobia?

Anyone can have phobia but the probability is higher for a person who had any psychiatric disorder. It is more common in people with anxiety disorders like panic disorder, social phobia and other behaviour disorders like mania, depression etc. Women are more likely to have phobias than men. Specific phobias usually occur in childhood or adolescence. Animal phobia is more common in children around 5-7 years of age and it usually regresses by itself as child grows. Claustrophobia (fear of closed spaces) is more common in twenties. Only a small percentage of phobias regress by themselves, a professional medical help is required in most of the cases.

What causes specific phobia?

Studies suggest that there is no single cause for specific phobia. Genetic and environmental factors both play a role in causing phobia. Fear of certain objects has been seen to run in families. For example if you have a relative who is afraid of closed spaces, it is quite possible that you might also have fear of closed spaces. It is interesting as well as controversial to see whether it is a learned behaviour or genetic predisposition is there. Some environmental factors have a deep impact on the psyche. The role of environment is important in animal and situational phobia. Many theories have been put forward to explain the cause of specific phobias.

Psychoanalytical study: It states that the fear is the representation of one’s unresolved unconscious conflict which presents itself as phobia.

• The learning theory: It states that whenever a traumatic event occurs in life, such as near drowning experience, encounter with wild animals or snakes, person learns to avoid such situations or objects where threat might be possible. This learned behaviour or conditioned fear is actually a reminder of a traumatic past event. These events might be self-experienced or observed on near-dear ones.

• The preparedness theory: It states that fear is a non-cognitive process and it is selectively acquired. Fear of certain situation or an object may be attributed to the evolution of certain species or survival of an individual.

What are the symptoms of specific phobia?

Symptoms of specific phobias may present themselves in different ways and may vary from person to person. But generally symptoms of specific phobias can be summed up as follows:

• Excessive or irrational fear of a specific object or situation.
• Avoidance behaviour- Person affected starts avoiding the object or situation which causes fear. And if so ever it has to be faced it causes a lot of anxiety.
• Even the thought or anticipated exposure to the specific fear causing object or situation causes a marked distress, anxiety and panic.
• In children it may be difficult to diagnose as they start crying or throwing a tantrum and are not able to explain.
• The physical symptoms are same as for anxiety or a panic attack. They include:
  • Fast heartbeat or pounding heart
  • Nausea(feeling like vomiting)
  • Diarrhoea
  • Excessive sweating
  • Trembling or shaking
  • Problems with breathing such as shortness of breath or rapid breathing
  • Feeling dizzy or lightheaded
  • Tightness of chest

What are the associated complications?

A specific phobia usually has many other presenting problems along with it. The panic, anxiety and fear has a deep impact on the mind and hence it may give rise to another psychiatric or anxiety disorders such as agoraphobia, social phobia, panic disorder, obsessive compulsive disorder and psychosis.

What are the treatment options?

There is a wide array of treatment options available depending on the stage, complexity and severity of the disease. According to the above mentioned factors your doctor will chose the best possible treatment option for you. Specific phobias are not self- limiting, if not treated the complexity and severity of disease increase and it tends to become more chronic. The major difficulty in treatment and management is that the affected individual learns to avoid these situations and objects and reports only when it becomes chronic i.e. it starts hindering the daily routine and it becomes too necessary to confront the feared object. So, the different treatment options are-

1. Behaviour therapy: It is one of the treatments of choice. It helps in reducing the fear of object or situation by repeated mild exposure to increasing exposure and finally being attuned to the fear causing substance. Other methods like behaviour modelling, reciprocal inhibition and flooding.
2. Cognitive therapy: It aims at reducing fear, stress and anxiety by educating about the irrational fear and how to cope with it; it has shown to be more beneficial in the long run.
3. Pharmacological: It is not the standard treatment option and is used only to suppress anxiety when other behaviour or cognitive therapy is taking place. It has not been shown to be beneficial alone.

References

1. Kendler KS, Neale MC, Kessler RC,et al. (1992) The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry 49, 273-81.
2. Marks IM (1969) Fears and Phobias Academic Press: New York.
3. Oxford handbook of psychiatry, 1st edition.Editors: Semple, David; Smyth, Roger; Burns, Jonathan; Darjee, Rajan; McIntosh, Andrew