How To Overcome Your Phobia
What is something that scares you? Really scares you? We all have them, some people might feel a knot in their stomach before stepping on a plane, others may feel their heart start racing before going to the dentist. Fears are relatively normal and quite common, however phobias … can be much more intense.
Before addressing the question of how we overcome phobias, it is important that we understand what phobias are and how they develop in the first place.A specific phobia is an irrational fear of a specific object or situation that very clearly interferes with an individual’s ability to function.
According to the DSM 5 the phobic object or situation almost always provokes immediate fear or anxiety and is actively avoided or endured with an intense fear or anxiety. It is also important to remember that the fear or anxiety experienced is out of proportion to the actual danger; if you were about to be bitten by venomous spider and felt fearful, this would be a perfectly natural response, however if you actively avoided any areas that spiders could potentially be hiding and felt anxious whenever you walked out in nature … this may be more of an indication of a phobia.
The fear or anxiety experienced is also persistent, typically lasting for six months or more and causes clinically significant distress or impairment in social, occupational or other important areas of functioning.So how do people develop phobias?
There are four main ways that phobias can come about.
Direct experience: This is when a real danger or pain has resulted in an alarm response that has thereafter remained when confronted with this object or situation.
False alarm: This is when someone may have experienced a panic attack in a specific situation and thereafter associated the situation or object with fear.
Vicarious experience: This is when someone has observed another person experience severe fear from an object or situation and has internalised this fear to apply to them.
Information transmission: This is when we are told about the danger of an object or situation and thereafter develop a phobia of it.
So how can we overcome our phobias?
Flooding: Flooding is a process used in therapy by which a client is directly exposed to their phobias for a prolonged period of time in a safe and controlled environment. Fear is a time limited response, initially the person might find themselves feeling overwhelmingly anxious, panicked and scared … however these responses can be quite taxing on both our physical and psychological resources and so after a while, these feelings will usually subside and exhaustion tends to take over.In a ‘real life’ situation, a person would do everything in their power to either avoid or get out of a situation such as this should it arise, however in the practice of flooding they don’t have this option. In this way, they are eventually able to come to the realisation that they were in fact able to endure it (even though it may have been uncomfortable initially) and with no harm inflicted upon them, thereafter overcoming their fear.
Systematic Desensitisation: The aim of systematic desensitisation is to replace the fear response of a phobia with a relaxation response instead. This is done in three stages. Firstly, the client is taught a number of relaxation strategies such as muscle relaxation, controlled deep breathing, progressive muscle relaxation, sensory grounding strategies or meditation.
Secondly, the client puts together a ‘fear hierarchy’ beginning with a stimulus associated with the phobia that triggers the least anxiety and slowly building up to the phobia itself. For example, a girl afraid of swimming might begin her fear by visiting a pool, she might then sit by the pool, then dip her toes in the water … all the way up to swimming in an open water ocean.
Thirdly, the client needs to implement the steps outlined in the fear hierarchy starting at the least anxiety provoking stimulus and working their way up. If the client feels anxious throughout this experience they can utilise the relaxation techniques they had learnt in step one and if the client becomes too distressed they can retreat to an earlier stage in the hierarchy. The idea is that a client moves on to the next stage once the fear response is diminished, eventually being faced with the phobia itself and not experiencing a fear response at all.
Challenging thoughts:
This is also a form of CBT and can be effective when used alongside of an exposure therapy (flooding or systematic desensitisation). By challenging our thoughts we can come to understand the discrepancy between our perceived danger of the object/situation and the reality of the danger.
Virtual reality:
Virtual reality is not necessarily a technique itself, rather it is a tool that could be used throughout the process of either flooding or systematic desensitisation. In this way a person can be exposed to their phobia in a vivid way however in a very low risk and safe environment. The idea behind this is that eventually the person will become accustomed to this experience, resulting in less anxiety in ‘real life’ situations.
Overcoming phobias does take some work however it is very possible to achieve and the results are long lasting. Brain imaging studies have found that these sorts of treatments actually change brain functioning in an enduring way by modifying our neural circuitry in regions associated with emotions. After treatment, there is a diminished response in the fear sensitive network but increased activity in prefrontal cortical areas (the ‘logical’ part of our brain), suggesting that our emotional appraisals of danger have been replaced with more rational appraisals.