Some phobias can make everyday life very difficult for people. (Image credit: Peter Dazeley/Getty Images)
Many people feel anxious when standing on the edge of a high cliff, and many would prefer to avoid contact with a tarantula or handle a boa constrictor. However, for some people, their fears in certain situations become disproportionate to the actual threat they pose.
In such cases, these people may be diagnosed with a specific phobia. A specific phobia refers to an intense fear or anxiety about a specific object or situation. In colloquial practice, people sometimes claim that they have a phobia about what they fear or are afraid of – but what is actually considered a specific phobia in a psychological context?
To qualify as a specific phobia, the fear must be persistent—occurring every time a person encounters a particular object or situation—and have a negative impact on the person's daily life, such as affecting their hobbies, relationships, or career.
“You have to get beyond what’s called ‘distress’ or ‘functional impairment,’” said Ellen Hendriksen, a clinical psychologist at Boston University’s Anxiety Disorders Center. “Distress means it’s scary, and impairment means it’s interfering with the life you want to live,” Hendriksen told Live Science.
According to Martin Anthony, a clinical psychologist at Toronto Metropolitan University who directs the Anxiety Disorders Research and Treatment Lab, psychologists classify specific phobias into five categories:
However, sometimes phobias develop without a clear trigger. In many cases, these are phobias that involve something truly dangerous – such as falling from a height – but the person’s fear is out of proportion to the actual risk.
“This fear-related anxiety distorts both the likelihood of encountering a particular object or situation and [overestimates] the strength and severity of the consequences,” Capaldi said.
People with one anxiety disorder are more likely to have another anxiety disorder, Anthony said, which is why specific phobias sometimes co-occur with generalized anxiety or panic disorders. Sometimes the disorders overlap in ways that make them difficult to diagnose.
Anthony once worked with a woman with social anxiety who was also afraid of driving. He eventually realized that her fear of driving was not a specific phobia. She was not afraid of getting into an accident, he noted, but rather was afraid of being judged by other drivers on the road. In her case, her fear of driving was an offshoot of her social anxiety, not a specific phobia.
“The diagnosis is not always clear-cut, and it shouldn’t always be based on the situation that people are afraid of,” Anthony said. “It’s also important to consider why they are afraid of the situation.”
Fortunately, phobias have well-studied and highly effective treatments. The gold standard is exposure therapy, in which the patient gradually confronts their fear in a controlled setting. A person with a phobia of snakes might first look at a squiggly line on a piece of paper, then at a picture of a snake, then at a photograph of a snake, and finally at a real snake.
“We want to take the client out of their comfort zone, but not into the panic zone,” Hendriksen added. “The zone in between is called the ‘learning zone.’ We create a slightly more challenging task that activates our anxiety. But if the feared outcome doesn’t happen, our fear doesn’t increase.”
The patient is in control of the entire process, Hendriksen added. They are never presented with unexpected stimuli, and they can decide how to proceed. Patients can begin treatment in a therapist’s office and gradually transition into the real world. A person with elevator phobia might start by looking at pictures or videos of elevators, then eventually step into an actual elevator on their own.
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