Treatments for Phobias

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, enclosed 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 response, ultimately resulting in avoidant behaviors towards that animal, thus worrying and feeling anxious when exposed to even the 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.

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 occurrence of drug or alcohol abuse, or self-medication.

Phobias have an excellent prognosis when treated with psychotherapy and, when necessary, medication. In addition to psychotherapy, desensitization or exposure 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.

When a person with a phobia has severe 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 like PCH Treatment Center.

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 Treatment Center offers intensive individual psychotherapy sessions up to five days a week. PCH has highly trained therapists with psychodynamic and cognitive behavioral backgrounds. Additionally, we offer Somatic Experiencing and sensorimotor therapy, Dialectical Behavioral Therapy (DBT), mentalization, mindfulness based stress reduction, anger management, sleep management, psycho-education, and neurofeedback. A thorough assessment of each Client is also performed by our psychiatry staff, who evaluate each Client’s medication regimen, and endeavor to simplify or minimize it. The philosophy at PCH Treatment Center is to focus on mind body healing with holistic therapies and minimal medication usage. Our expertise in psychopharmacology aligns closely with our 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.