Phobia

Phobia, intense and persistent fear of a specific object, situation, or activity. Because of this intense and persistent fear, severely phobic people lead a constricted life. The anxiety they suffer is typically out of proportion to their real situation, and the victims are fully aware that the fear is irrational.

Phobic anxiety is distinguishable from other forms of anxiety only in that it occurs specifically in relation to a certain object or situation. This anxiety is characterized by physiological symptoms such as a rapid, pounding heartbeat; stomach disorders; nausea, diarrhoea, and frequent urination; choking feelings; flushing of the face; perspiration; tremulousness; and faintness. Some people with phobias are able to confront their fears. More commonly, however, they avoid the situation or object that causes the fear—an avoidance that may often impair the sufferer's freedom.

Psychiatrists recognize three major types of phobias. Simple phobias are fears of specific objects or situations such as animals—for example spiders or snakes, closed spaces, and heights. The second type, agoraphobia, is fear of open, public places and situations (such as buses or trains, and crowded shopping centres) from which escape is difficult; agoraphobics tend increasingly to avoid more situations until eventually they become housebound. Social phobias, the third type, are fears of appearing stupid or ashamed in social situations.

The simple phobias, especially the fear of certain animals, may begin in childhood and persist into adulthood. Agoraphobia characteristically begins in late adolescence or early adulthood, and social phobia also tends to be associated with adolescence.

Although agoraphobia is more often seen in treatment than the other types of phobia, it is not believed to be as common as simple phobia. Taken together, the phobias are believed to afflict 5 to 10 people in 100. Agoraphobia and simple phobia are more commonly diagnosed in women than in men; the distribution for social phobia is not known. Agoraphobias, social phobias, and animal phobias tend to run in families.

Behavioural techniques have proved successful in treating phobias, especially simple and social phobias. One technique, systematic desensitization, involves gradually confronting the phobic person with situations or objects that are increasingly close to the feared ones. Exposure therapy, another behavioural method, has recently been shown to be more effective. In this technique, phobics are repeatedly exposed to the feared situation or object so that they can see that no harm befalls them; the fear gradually fades. Antianxiety drugs have also been used as palliatives. Drugs to treat depression have also proved successful in treating some phobias.