Phobias: Irrational Fears, Dogs, Snakes, Dentists ...

by Food and Drug Administration (FDA)

From 50 yards away, you see the animal approaching. Silently it watches you as it slinks ever so much closer with each padded step. Stay calm, you tell yourself. There's nothing to fear.

But suddenly, panic seizes you in a death grip, squeezing the breath out of you and turning your knees to Jell-O. Your heart starts slam-dancing inside your chest, your mouth turns to cotton, and your palms are so sweaty you'd swear they'd sprung a leak. You'd escape this terrifying confrontation, if only you could make your legs work!

Just what is this wild and dangerous animal making you hyperventilate and turning your legs to rubber? A man-eating tiger, hungry for a meal? A lioness bent on protecting her cubs? Guess again. That's Tabby, your neighbor's ordinary house cat, sauntering your way. Ridiculous, right? How can anyone experience so much fear at the sight of such an innocuous animal? If you're one of the thousands who suffer from galeophobia — the fear of cats — or any one of hundreds of other phobias, sheer panic at the appearance of everyday objects, situations or feelings is a regular occurrence.

Irrational Fears

A phobia is an intense, unrealistic fear of an object, an event, or a feeling. An estimated 18 percent of the U.S. adult population suffers from some kind of phobia, and a person can develop a phobia of anything — elevators, clocks, mushrooms, closed spaces, open spaces. Exposure to these trigger the rapid breathing, pounding heartbeat, and sweaty palms of panic.

There are three defined types of phobias:

• specific or simple phobias — fear of an object or situation, such as spiders, heights or flying
• social phobias — fear of embarrassment or humiliation in social settings
• agoraphobia — fear of being away from a safe place.

No one knows for sure how phobias develop. Often, there is no explanation for the fear. In many cases, though, a person can readily identify an event or trauma — such as being chased by a dog — that triggered the phobia. What puzzles experts is why some people who experience such an event develop a phobia and others do not. Many psychologists believe the cause lies in a combination of genetic predisposition mixed with environmental and social causes.

Phobic disorders are classified as part of the group of anxiety disorders, which includes panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder. Several drugs regulated by the Food and Drug Administration are now being used to treat phobias and other anxiety disorders.

Dogs, Snakes, Dentists . . .

A person can develop a specific phobia of anything, but in most cases the phobia is shared by many and has a name. Animal phobias — cynophobia (dogs), equinophobia (horses), zoophobia (all animals) — are common. So are arachnophobia (spiders) and ophidiophobia (snakes). And, of course, there's the fear of flying (pterygophobia), heights (acrophobia), and confined spaces (claustrophobia).

"One of the most common phobias is the fear of dentists [odontiatophobia]," says Sheryl Jackson, Ph.D., a clinical psychologist and associate professor at the University of Alabama at Birmingham. "People who suffer with this phobia will literally let their teeth rot out because they are afraid to go to a dentist."

Jackson says that most specific phobias do not cause a serious disruption in a person's life, and, consequently, sufferers do not seek professional help. Instead, they find ways to avoid whatever it is that triggers their panic, or they simply endure the distress felt when they encounter it. Some may also consult their physicians, requesting medication to help them through a situation, such as an unavoidable plane trip for someone who is phobic about flying.

Drugs prescribed for these short-term situations include benzodiazepine anti-anxiety agents. These medications include two approved for treating anxiety disorders: Xanax (alprazolam) and Valium (diazepam). Beta blockers such as Inderal (propranolol) and Tenormin (atenolol), approved for controlling high blood pressure and some heart problems, have been acknowledged, partly on the basis of controlled trials, to be helpful in certain situations in which anxiety interferes with performance, such as public speaking.

Some phobias cause significant problems that require long-term professional help. "People usually seek treatment when their phobia interferes in their lives — the person who turns down promotions because he knows public speaking will be required, someone who must travel frequently but who is afraid of flying, or a woman who wants to have children but who has a fear of pain or blood. These are the people who seek long-term treatment," says Jackson.

While anti-anxiety medication sometimes may be used initially, systematic desensitization may also be an effective initial approach. Jackson explains that this nondrug treatment works on the theory that the more a person is exposed to the object of his phobia, the less fear that object generates.

First, the patient and therapist establish a hierarchy of feared situations, from the least to the most feared. For someone who fears elevators, for example, stepping onto the elevator causes a certain level of anxiety; going up one flight causes another level of anxiety. With each additional flight the anxiety increases until it becomes intolerable.

Therapy begins with the patient and therapist practicing the least fearful event, riding out the anxiety until the physiological symptoms subside. This step is repeated until the anxiety level is acceptable. Then the person progresses to the next step in the hierarchy. Each successive step is repeated until the physical reactions and anxious mood decrease to the point where the person can step onto an elevator and ride to the top floor without panicking.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.