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Facing up to phobias

Do you scream and freeze when you spot a spider and have to get someone to remove it> If you sense a cat is lurking outside your home or office, do you have to ask a family member or colleague to escort you indoors?

Are you reluctant to leave the security of your own home, and does your intense dislike of being in a crowd mean you frequently refuse invitations to social gatherings?

If you answered yes to any of these, you are not alone.

In fact, it is possible o develop a phobia in response to any kind of stimulus or object. According to the charity No Panic, ten million people in the UK have a phobia but this could well be an underestimate because some are too embarrassed to admit to having one. 

"Phobias are very common," says Adrian Weels, professor of clinical and experimental psychopathology at Manchester University, "and approximately 60 percent of the population experience an unreasonable fear at some point in their lives." While one in ten of us admits to being afraid of flying (aerophobia), according to a YouGov survey the most common phobia in the UK is a fear of heights (acrophobia). This is closely followed by arachnophobia, fear of spiders, coulrophobia, fear of clowns, and claustrophobia, being in an enclosed space.

Fear of situations in which you might have a panic attach (agoraphobia), public speaking (glasophobia) and snakes (ophidophobia) also come high up on the list, and some people are too afraid to sit down with 13 people at the dinner table- triskaidekaphobia.

A phobia becomes a problem when it makes us feel so anxious our health starts to suffer, it affects our working life and it stops us doing hings we want to do.

No one enjoys being in a state of panic, where you come out in a sweat, your heartbeat races, your legs turn to jelly and you feel nauseous. It is not surprising, therefore, that people with a phobia go to all kinds of lengths to avoid situations or objects that trigger such feelings.

However, says Prof Wells, this will only reinforce the phobia. Someone with arachnophobia, for example, will go from simply not wanting to touch a spider to not even being able to look at a picture of one.

"There are thousands of phobias," he adds. "Anything that exists or is n your imagination can become one. Being fearful of the devil, for example, is common. 

"It is time to seek help when the phobia becomes persistent, results in excessive panic attacks and starts interfering with your work and social life."

A phobia is defined as a nervous illness that makes people act in a manner others regard as irrational. It is triggered by a reaction to a particular object or situation that others don't find worrying. Sometimes it can be associated with a past incident,such as being attacked by a dog or being trapped in the toilet as a child.

Complex phobias such as agoraphobia, where people get anxious leaving home and dislike being in crowded places, and social phobia, where they hate being the centre of attention and are afraid of embarrassment, can lead the sufferer to withdraw from society altogether and even quit work. Left untreated, complex phobias like these can lead to depression, substance misuse and even suicide.

The good news is that counselling and cognitive behaviour therapies can help people face their fears and rebuild their confidence.

Prof Wells says: "Even if you've had a phobia for many years, in most cases it can be treated. Normally it takes 12 to 14 sessions.

"A phobia is classed as clinical when it is persistent and results in excessive panic attacks. During the panic attack the sufferer becomes intensely anxious and misinterprets the symptoms as a sign of imminent catastrophe, such as having a heart attack or fainting. It is this misinterpretation that gives rise to the sense of imminent danger that triggers their fight-or-flight response."

cognitive behavioural therapies, where there is a gradual systematic exposure to the feared situation or object, help the anxiety it provokes subside.

"the 'flooding' exposure used years ago," Prof Wells says, "has ;ong gone. It isn't well tolerated and consequently not that effective, so it has fallen out of favour. Today, different methods of exposure are used.

"For someone with a fear of cats, we'd begin with something related to cats such as the word 'cat'. it would be written on a piece of paper they would be asked to look at for a time. 

"As we expose ourselves to what is fearful, we develop an extinction response. The longer we're exposed to the fear, we can adapt to it and get rid of it. But if we avoid the fearful thing, we prevent this extinction response form kicking in.

"I tell patients it's like being at the seaside and dipping you toe in the sea and then rushing out again. If you gradually go further in, your body will adapt to the sea and your anxiety will subside."

The professor has himself developed a new form of treatment called Metacognitive Therapy (MCT) for people with complex phobias.

He says: "Over the past few years, we have discovered that most phobias and anxieties are the result of over-thinking, over-reflecting and over-analysing. People with phobias are thinking 'what if?' the whole time. This brings down their mood and increases anxiety.

"By getting them to break this habit, we can increase their resilience and help them keep their fears under control.

"We encourage them to use detached mindfulness. This allows you to regulate a negative thought when it comes back into your mind, to leave it alone and step back from it. This helps you to separate yourself from that thought and to build a new relationship with it. We can them look at these thoughts as objects in the mind rather than realities.

"This allows you to focus on a different task and switch your attention to something more important, instead of focusing all of it on that negative thought."

Find out more

To learn more about MCT, log on to:

The charity No Panic has a helpline, tel: 08449 674848, as does Anxiety UK, tel: 08444 775774

To find a registered therapist near you, contact the Britsh Associaton for Behavioural and cognitive Psychotherapists

What do you think to this? Do you have any phobias? 

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