Even the 15 million Americans who suffer from them admit that phobias
don't make sense. Nevertheless, a phobia is no laughing matter. Phobic persons
speak not of ordinary fear but of intense horror and a sense of helplessness.
Even while realizing that their fear is irrational, phobic individuals feel
they are on the verge of death or insanity.
Most individuals harbor one or more mild phobias, at least during childhood,
but these usually fade on their own or never affect daily life. A problem
exists only when a phobia causes an individual to limit essential activities
or exces-sively restrict his or her life. In such instances, they can and
should be treated.
Agoraphobia: The Fear of Panic
One of the best known and usually the most debilitating of all phobias,
agoraphobia, is common-ly classified as a separate anxiety disorder. Literally,
the term means fear of the market place or of public places, but in reality
this disorder usually involves an unexplained panic attack and an ensuing
dread of having another attack in public. The first attack may come in a
supermarket, a shopping mall or any other location. Symptoms may include
a racing heart, trembling, profuse sweating, loss of balance and an inability
to think clearly. The agoraphobic often fears a heart attack; at best, he
or she feels incapacitated and compelled to escape to the safety of home.
If the first attack comes in an airport subsequent attacks are likely to
occur in the same or a similar place. As the agoraphobe begins to avoid
certain locations or situations, the phobic response generalizes to other
places and activities making the person more fearful and more constricted.
Some individuals with this disorder go for months without venturing away
Agoraphobia typically develops in individuals during their mid- to late-20s
and results in severe family and social problems. The agoraphobe usually
becomes increasingly demoralized and depressed, sometimes becoming dependent
on drugs or alcohol. A few also suffer from obsessive doubts or fears--a
fear of suicide, for example, or of committing an act of violence. Even
though the victim knows such thoughts are senseless, he or she is unable
to stop them.
Only about one of every 160 American adults has agoraphobia, but those who
have it suffer a great deal. Early detection and treatment is essential.
Treatment usually involves medications plus behavioral and group therapy.
What psychologists call a simple or specific phobia is an irrational
fear associated with one specific kind of object, place or situation. Most
of us can relate to a fear of snakes, spiders, high places or even storms,
but some phobias involve harmless objects such as buttons or balloons.
Social phobias are sometimes difficult to separate from persona-lity traits
such as shyness. Some individuals, however, are terrified about the prospect
of speaking in public, asking someone for a date, or dining out.
Even understandable fears are usually irrational. The acrophobe, or person
who is afraid of high places, might have no problem looking out the window
of a plane but will freeze when trying to cross the George Washington Bridge.
The hydrophobe might fear water that is coming out of a tap but not an ocean
beach, or vice versa.
What Causes Phobias?
Freud proposed that phobias were displaced anxiety, usually involving
ambivalent mother/father/child relationships. In 1920, John B. and Rosalie
Rayner Watson pro-posed that phobias are conditioned responses. The late
scientist Carl Sagan suggested that some phobias, such as fear of reptiles,
may be instinctual memories from the time when dinosaurs ruled the world.
A fear of poisonous snakes, of course, makes a great deal of sense.
Recent research has focused on the biological roots of the phobic response.
Several studies indicate that indi-viduals with social phobias have neurological
systems that overreact to criticism or rejection. Some medica-tions for
depression seem to be effec-tive in overcoming this tendency. As scientists
isolate the neurochemicals involved, even more effective medica-tions might
Don't Fear Treatment
At least 75 percent of persons with disabling phobias can be treated
successfully wih desensitization. A person who is afraid of driving a car
30 miles to work, for example, might first start by sitting in the driver's
seat beside a friend. At the end of a series of gradual steps, the goal
presumably will be reached.
Those resistant to any confron-tation with the object of fear might start
with an imagined experience in the presence of a therapist or with the help
of relaxation therapy. In a group of people with similar problems, members
can help each other conquer fears by offering friendship, support, understanding
and positive examples of success. This has been found particularly helpful
for persons with agoraphobia.
Nearly everyone harbors one or two irrational fears that have little or
no effect on daily life. The person who feels trapped by phobias, on the
other hand, has no reason to fear seeking help. . .and getting it.