Issues Treated in Therapy:
Phobias are irrational fears of particular things: situations (like being in public, or public speaking), animals (snakes, spiders, dogs), people (tall men, clowns, priests) or places (heights, open spaces, farms). While there are certain phobias that are far more common than others, and some that are very rare or unheard of, the range of phobias reported in therapy is almost endless. Sometimes, phobias are so persistent they interfere with the ability to function. Phobias of driving, or of being in open spaces, talking on the phone, or being around other people can severely disrupt a person’s life – and that of their family and close friends.
True phobia is recognized by the phobic person as being irrational, but still cannot overcome the fear. This indicates the person has not split from reality, as in schizophrenia. The key word in the definition is “irrational.” Being afraid of a large snarling canine running towards you in a park or on the street is rational. Exercising caution before going near a dog is wise. If you have been attacked by dogs, a period of recovery where your fear of dogs is increased and intensified is normal; a very long period might indicate Post Traumatic Stress more than a true phobia. However, a fear of dogs is phobic if, for example, a person will never go near any dog, even a household pet on a leash calmly sleeping, or becomes terrified at even the sound of dogs barking in the distance. Phobias also persist – they don’t get better with time, unless treated. Phobias seem to have no apparent cause, but therapy often reveals one, and can then begin offering solutions. Phobias usually have a root in childhood, and may hide deeper fears having nothing directly to do with the consciously feared thing or situations.
Agoraphobia is diagnosed when a person fears that he or she will have a panic attack in public and thus avoids public spaces. Sometimes, this fear arises even though the person has never had a panic attack. Other common phobias include fears of storms, blood, enclosed spaces (claustrophobia), insects, germs, and loud noises. Phobias seem to have a familial inheritance pattern, whether genetic or learned, and often are apparent in childhood, diminishing and sometimes disappearing in adulthood, but often resurfacing later in life again.
Social phobia or social anxiety is diagnosed when there is "A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. (In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.)
Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a panic attack.
Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people. Thus, the feared social or performance situations are avoided or else are endured with intense anxiety or distress, which interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
Zack, 29, seeks help for his fear of going out in public, and of enclosed spaces. He already takes a medication for anxiety but “it’s not helping.” The therapist works with Zack to uncover the beginnings of this fear, and soon Zack is able to discover great anger at his parents and great fear of his own inadequacy. Working on these emotions, while gradually exposing Zack to open and closed spaces (with help from his closest friend, who accompanies him), therapy reduces Zack anxiety and frees him to function.
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Last updated: 05-14-2013