Feeling anxious or fearful can be distressing. Your heart starts racing and you may also feel light-headed, shaky, short of breath, and slightly nauseous. ‘We all have things that make us feel uneasy or fearful but for anyone who suffers from a phobia, these fears are much more extreme,’ says Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi.
What exactly is a phobia?
‘A phobia is an intense fear of something, for example, an object, situation, place, feeling or animal. It’s a type of anxiety disorder that can be extremely debilitating.’
There are many different types of phobias and these can range from mild to severe. ‘A phobia can occur for all sorts of reasons,’ Gauffin continues. ‘It may be triggered by an incident or trauma in your past or you may be genetically predisposed to feeling more anxious.’ The good news is, it’s usually possible to overcome phobias of all kinds without drugs. A recent meta-analysis (based on 33 studies) shows that cognitive behavioural therapy (CBT) used independently, or as an adjunct to other therapies, is a highly effective treatment.
Phobias fall into two categories:
1. Specific, or simple phobias, include certain animals, situations, or activities (for example, fear of heights, germs or flying). Specific phobias affect around 7.4% of people worldwide – 4.9% of the male population and 9.8% of the female.
2. Complex phobias on the other hand, are associated with more deep-rooted but general fears about a behaviour or circumstance, for example agoraphobia or social phobia. Agoraphobia affects around 1.3% of people, and social phobia, one of the most common anxiety disorders, is estimated to affect around 12%.
What is cognitive behavioural therapy?
‘CBT is a talking therapy that looks at how your thoughts, beliefs, and attitudes affect your feelings and behaviour,’ says Gauffin. ‘It’s based on the idea that how you think influences the way you feel and behave. A therapist helps you to identify negative thinking patterns and shows you what you can do to change them.’
There are a variety of techniques used in CBT, for example, keeping a record of your thoughts and also relaxation and breathing exercises. CBT helps you become more aware of the triggers that exacerbate your anxieties and fears. It is a short-term therapy that can be done face-to-face or online, usually once a week, for anything from five to twenty sessions.’
5 phobias that CBT helps
1. Dental phobia
For people with dental phobia, even the smells, sights, and sounds of a dental surgery can trigger an anxiety attack. Many will avoid seeing a dentist and this can have serious implications on dental health. For most, therapy may be needed to help a patient overcome their fears – this is where CBT can be extremely useful.
In a small 2018 study on children and adolescents, internet-based cognitive behavioural therapy (ICBT) was shown to significantly decrease dental anxiety. In a one-year follow-up, over half the participants were still phobia-free. According to an older systematic review of the evidence, it was concluded that behavioural interventions like CBT could significantly improve dental anxiety in adults.
2. Social phobia
Social anxiety, also called social phobia, is a long-term and overwhelming fear of social situations. It can have a huge impact on friendships, work and social life. For some, everyday activities like meeting people, starting conversations, talking on the phone, working, or being in groups can trigger anxiety symptoms. Social anxiety can lead to increased isolation and depression. In a recent study, CBT was shown to significantly reduce social anxiety.
Most people think agoraphobia is a fear of open spaces. But it’s much more complex than that, encompassing a fear of being in places or situations where escape may be difficult or impossible. Agoraphobia initially starts off as a panic disorder, where you regularly experience panic attacks in certain situations and then avoid them more and more, until a phobia develops.
The standard treatment for agoraphobia, recommended by NICE, is CBT. Now, a recent study has shown that using a CBT- based mobile phone app can help to significantly reduce symptoms, which may be useful for people who are hard to reach, or for whom travel is a problem.
4. Acrophobia (fear of heights)
A fear of heights is one of the most common phobias in the world. As well as bringing on a panic attack, it may also be accompanied by symptoms of vertigo. Sufferers usually try to manage their phobia by avoiding high places which can make life difficult when simply going into a lift can cause anxiety.
Traditional CBT can be helpful for the treatment of the fear of heights. Plus, a recent Dutch study has found that using a self-guided virtual reality CBT based app (VR CBT) could also help reduce symptoms in sufferers after 3 weeks of treatment.
5. Emetophobia (fear of vomiting)
An estimated 6-7 % of women and 1.7-3.1% of men are affected by an intense fear of vomiting. People who have this phobia have a fear of losing control and vomiting in public. So they try to avoid situations where they might be sick. This may include avoiding eating out in a restaurant, having dinner at a friend’s house, trying new food, or leaving the house if there’s a tummy bug going around. A study (the first to evaluate CBT for a specific phobia of vomiting) showed that 58% of sufferers experienced an improvement in symptoms after a course of therapy.
This article has been approved by Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi.