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Destler Dodge

It's an ordinary, blissful day. Until you see it: a spider, glaring at you menacingly. Your heart starts racing and hands start sweating. Your breath gets shorter. Every instinct is telling you to run far, far away. You can't think rationally, can't calm down to see that it is not really a threat. This is not an ordinary fear; you have a phobia. 

Fear, to a certain extent, is necessary for survival. It stops us from jumping off cliffs and approaching wild animals, and tells us when we should be wary of a threat. At a certain point, however, fear becomes crippling and inconvenient. Jessamy Comer, a lecturer at RIT who holds a doctorate in psychology, defined what differentiates a phobia from a fear.

"A phobia is an irrational fear. When you have a phobia, it's out of proportion to the threat of the object or situation," said Comer.

Flying in an airplane can be a rational fear, as you are putting your life into the hands of an unseen person; however, commercial airlines fly thousands of people every day who aren't hindered by this rational fear. Someone who has a phobia of flying, on the other hand, will refuse to get on a plane. If they were forced to be on a plane, they would likely have an anxiety attack. 

Where do phobias come from?

Scientists know surprisingly little about this very common psychological disorder, especially when it comes to how they develop.

Phobias are categorized under anxiety disorders, similar to Post-Traumatic Stress Disorder (PTSD) and Obsessive Compulsive Disorder (OCD). Anxiety disorders tend to be caused by a part of the brain called the amygdala, according to the American Psychological Association (APA). The amygdala deals primarily with emotions; when something goes wrong, it can affect emotional behavior, like fear. Most of the available information on phobias comes from what scientists know about other anxiety disorders. There is very little research that focuses on phobias in particular, which means that researchers have yet to discover the exact biological mechanisms that cause phobias.

Different Phobias

Phobias usually appear in late adolescence or early adulthood. Phobias that develop in children tend to go away on their own, while those in adults usually need treatment. Comer speculates that phobias could stem from incidents during childhood. For example, someone with a fear of spiders may have been bitten by one as a child, which eventually led to a phobia. This is only speculation, as psychologists are not sure what causes specific phobias. All phobias appear the same in brain scans, which makes research about them difficult.

According to Comer, there are five different categories of phobias: animal, blood injection injury, situational, natural environment and other. Animal phobias include insects, snakes, spiders and other creatures. Blood-injection injury includes everything from physical blood to needles. Fear of confined spaces, flying and any other fear that has to do with setting or location fall under situational phobias. Natural environment phobias cover earthquakes, thunderstorms and other natural phenomena. The other category covers phobias that don't fall into the other categories, like a fear of choking or vomiting. 

Diagnosis

Psychiatrists don't usually use words like "claustrophobia" or "arachnophobia" when describing phobias, Comer says. Instead, they will use terms more friendly to their patients, of which there are many.

"Phobias are the number one psychological disorder in terms of frequency," Comer explained.

Although it is difficult to get a good estimate, Comer says that approximately 10 percent of the population is afflicted with a phobia. Other estimates, such as the National Alliance on Mental Illness, go up to 20 percent. The statistics are difficult to calculate because of the reluctance of those who suffer from phobias to seek treatment.

Those who do seek treatment work with psychiatrists to see if their fear qualifies as an irrational phobia. Comer stated that there are certain criteria that must be met before a fear is declared a phobia. Some signs the psychiatrist will look for is if the fear causes extreme distress or anxiety and if the fear interferes with everyday functioning.

Treatment

After a phobia is categorized, most patients can be fully cured using Cognitive Behavior Therapy (CBT). CBT focuses on teaching the brain how to think rationally and change behaviors. The cognitive aspect will focus on relaxation techniques, while the behavioral part of the treatment involves slowly building exposure to the stimulus. When the stimulus is absent, patients will be taught how to force their bodies to relax through breathing techniques, meditation and going to their "happy place."

"Before they even start to treat the phobia, they teach you how it feels to make yourself relax," Comer said.

After learning this, patients practice these techniques while presented with a picture of their stimulus, eventually building up to exposure to the stimulus itself. Typically, treatment takes about six weeks, according to Comer.

Occasionally, the anxiety is so intense that it is necessary to use medication to aid the treatment. In these cases, anti-anxiety medication is used to help patients learn how to relax in the presence of the stimulus. The medication is not intended to be permanent; instead, it is only used long enough until the patient can learn to relax for themselves.

Comer says that phobias tend to be the most easily treated among the psychological disorders, but that there are still instances where the phobia is so severe that patients cannot be cured, although this is not common.

As with most mental illnesses, the hardest part about getting cured is seeking help. A large portion of people with specific phobia will go untreated, and of those only 20 percent will be fully cured. In contrast, a large majority of those that seek help will be cured. If you are concerned that you or someone you love has or is developing a phobia or anxiety, please contact the RIT Counseling Center.