Phobias
Phobias are persistent and recurrent fears of a particular situation, object or activity that poses little or no danger. The person experiencing a phobia knows that the fear is irrational, but they cannot help it. Simple Phobias consist of a fear of one particular object or event, such as snakes, insects, heights, flying, etc. Agoraphobia is a fear of open spaces or crowds. Simple phobias manifest as feelings of panic or terror, in a manner that is uncontrollable and debilitating. Physical symptoms, including rapid heart beat, lightheadedness, nausea, shortness of breath, and trembling occur. Ultimately, the person suffering from a phobia will take severe measures to avoid interacting with the object, activity or situation that causes the fear. Phobias often begin in childhood, with an average age of onset between 15 and 20 years of age.
Simple phobias derive from an intense fear related to a specific object, activity, or situation, which then initiates anxiety. A person with a phobia is aware of their fear, but cannot control it; it is possible that the fear may lead to a panic attack. Specific phobias include fear of animals, reptiles, insects, (especially spiders, arachnophobia) heights, closed spaces (claustrophobia), bridges, air travel, or other objects or situations that cause them to feel uncomfortable and afraid.
Agoraphobia is the most severe of the specific phobias; it is a fear of open spaces, public places, and crowds. The person fears and avoids places for which there is no quick escape. It is also common for agoraphobics to fear being alone, so they usually stay at home with a friend or relative present. If they do leave the house, they usually need to be accompanied by a friend or family member. This phobia is most often associated with women, and usually arises during late teens or early twenties. Agoraphobia often begins with a panic attack while the person is away from the house, and the person then stays at home to avoid experiencing that situation again.
Phobias are believed to have a genetic basis, as they run in families. This may be related to temperament, and how a person chemically deals with a stress response. Phobias also have cultural overtones. In Japan, a common phobia which is not prevalent in other societies, is Taijin kyofusho or fear of offending someone in a social situation. Traumatic events can precipitate phobias. For example, a person who has a negative interaction with an animal may develop an overly vigorous stress reponse, ultimately resulting in avoidant behaviors towards that animal, and worrying and anxiety when exposed to even mention of it. Phobias differ from a normal fear response because severe anxiety and stress arise and progress to maladaptive isolating or avoidant behaviors. These phobias also can cause debilitating generalized anxiety and even depression.
How is a Phobia diagnosed?
Diagnosis of a phobia follows selective criteria. There is a presence of anxiety or irrational fear of an object or situation. However, simple phobias may be complicated by other anxiety issues such as panic attacks, agoraphobia, or social anxiety. Specific avoidant or isolating behaviors are also usually present. Diagnosis of a simple phobia requires proper assessment of symptoms to differentiate it from other psychological problems such as Obsessive-Compulsive Disorder, paranoia, or even early psychosis. Consideration of how the anticipatory anxiety and avoidant behaviors are interfering with a Client’s everyday living, including negative effects on family, friends, work or school is important. A family history of anxiety issues or phobias is also explored, as well as occurence of drug or alcohol abuse, or self-medication.
What is the Prognosis for a Phobia?
Phobias have an excellent prognosis when treated with psychotherapy and, when necessary, medication. In addition to psychotherapy, desensitization procedures, relaxation strategies, sleep and stress management and psycho-education can help someone with a severe phobia. Persons with phobias may be predisposed to other anxiety disorders, depression or substance abuse, which complicates treatment of the simple phobia.
How Can Friends and Family Help?
Persons with a phobia may be reluctant or afraid to seek treatment. The existence of other anxiety issues, self-medication or substance abuse (especially alcohol, marijuana or cocaine) is also prevalent among persons with phobias. Thus, family and loved ones are pivotal in helping a person with a phobia seek mental health care. Family members who observe the anxiety and avoidant behaviors will realize assistance is needed. They can be a valuable resource in compelling a person with a phobia to enter a treatment center. Additonally, they can assist with monitoring medications and being vigilant in watching for exacerbations. Family members also provide valuable financial resources and emotional support.
When Should a Client enter a treatment center?
When a person with a phobia develops associated anxiety, or isolating or avoidant behaviors, there may be a negative impact on school or work life and personal and family relationships. If a person with a phobia is not responding to weekly therapy or medication, they should consider entering an intensive treatment program. A treatment facility, like PCH Treatment Center, offers a much more immersive treatment milieu which is appropriate for severe phobia issues.
How does PCH Treatment Center treat Phobias?
When a Client arrives at PCH Treatment Center with a phobia, an initial evaluation is performed by a doctoral level Psychologist who is assigned to their care. In conjunction with Executive and Clinical Director, Dr. Jeff Ball and the PCH clinical team, a treatment plan is designated. PCH Phobia Treatment Center offers intensive individual psychotherapy sessions up to five days a week. Additionally, we offer Somatic Experiencing, Dialectical Behavioral Therapy (DBT), anger management, sleep management, psycho-education, and neurofeedback. A thorough assessment of each Client is also performed by Dr. William Wirshing, our psychiatrist. He evaluates each Client's medication regimen, and endeavors to simplify or minimize it. The philosophy at PCH Phobia Treatment Center is to focus on mind body healing with holistic therapies and minimal medication usage. Dr. Wirshing's expertise in psychopharmacology aligns closely with this philosophy. At PCH Treatment Center we offer yoga, mindfulness meditation, art therapy, acupuncture and massage, to help Clients maximize the healing process. Family therapy groups are also available to address phobias in the context of the family support system. Clients may choose Intensive, Day or Evening Treatment Programs depending on the extent of their symptomatology and complexity of any associated issues.
