A phobia is an overwhelming and debilitating fear of an object, place, situation, feeling or animal.  Phobias tend to be more pronounced than fears.  They develop when a child or adult has an exaggerated or unrealistic sense of danger about a situation or object.  If a phobia becomes very severe, a person may organise their life around avoiding the thing that’s causing them anxiety. As well as restricting their day-to-day life, it can also cause a lot of distress.

 

What are the common symptoms of a Phobia?

A phobia is a type of anxiety. You may not experience any symptoms until you encounter the source of your phobia but in some cases, even thinking about the source of a phobia can make a person feel anxious or panicky. This is known as anticipatory anxiety.  The most common phobias for children are of animals such as dogs, cats or insects.

 

Symptoms of a Phobia may include:

  • unsteadiness, dizziness and light-headedness
  • nausea
  • sweating
  • ‘racing’ heart or palpitations
  • Feeling short of breath
  • trembling or shaking
  • An upset stomach or needing to go to the toilet more frequently
  • If you don’t encounter the source of your phobia very often (for example snakes) it may not affect your everyday life
  • If you have a complex phobia, leading a normal life may be very difficult

 

Types of phobia

There are a wide variety of objects or situations that can lead to a phobia.  On the whole phobias can be divided into two main categories:

  1. specific or simple phobias
  2. complex phobias

 

Specific or simple phobias

Specific or simple phobias centre around an object, animal, situation or activity.

They often develop during childhood or adolescence and may become less severe as you get older.  Common examples of simple phobias include:

  • animal phobias – such as dogs, spiders, snakes, mice or bees
  • environmental phobias – such as heights, deep water, germs or thunder
  • situational phobias – such as visiting the dentist or flying
  • bodily phobias – such as blood, vomit or having injections

 

Complex phobias

Complex phobias tend to be more profound than simple phobias. They usually develop during teenage years and adulthood and are often associated with a deep-rooted fear or anxiety about a situation or circumstance.  The two most common complex phobias are:

  1. agoraphobia
  2. social phobia

Agoraphobia is often thought of literally as a ‘fear of open spaces’ however, that can undermine the complexity of agoraphobia.  Someone with agoraphobia may feel anxious about being in a place or situation where escaping may be difficult if they have a panic attack.

The anxiety usually results in the person avoiding situations such as:

  • being alone
  • being in crowded places, such as busy restaurants or supermarkets
  • travelling on public transport

Social Phobia also sometimes known as Social Anxiety centres around feeling anxious in social situations.  If you have a social phobia, you might be afraid of speaking in front of people for fear of embarrassing yourself or being embarrassed in public.  In severe cases, this can prevent you from carrying out everyday activities, such as eating out or meeting friends.

 

What causes phobias?

Phobias do not have a single cause, but rather several associated factors; a phobia may be associated with a particular incident or trauma, but this is not always the case.  A phobia may be a learned response that a person develops early in life from a parent or sibling (brother or sister) who have ‘modelled’ a phobic response.  We know that genetics can play a role, there is some evidence to suggest that some people are born with a tendency to be more anxious than others.  Three common learning scenarios which may influence whether a child develops a phobia are:

  1. Seeing other people (such as parents or friends) get very scared in a specific situation, or around an object or animal. This is called “modelling”. When you see someone else “model” a fear reaction to certain things, you may learn to be afraid of the same thing.
  2. Hearing or reading scary stories about a situation, object or animal. For example, a parent who always tells you, “dogs are dangerous”, “never approach a dog”, “beware of dogs”, teaches you that ALL dogs are dangerous, ALL of the time, which may contribute to you developing a fear or phobia of dogs.
  3. Having a frightening experience with an object, animal or situation. We call this “direct conditioning”. For example, you may have been growled at or even bitten by a dog; or be swept up in wave in the sea; or have had a tree fall on your house in a bad storm. These experiences are often very scary, and some children may then feel afraid whenever they are in that situation again.

It is important to remember, however, that not all children who see, hear or experience difficult situations develop a specific phobia. There are other things that might contribute. Research suggests phobias often run in families, so there may be a genetic link. Personality, or what we might call “temperament”, may even play a role.

 

Protective Factors

There are many other factors that might help to protect children or adolescents from developing a phobia, even if you have had a very bad experience. Support from family and friends can help a child when they have a scary experience.  Some research suggests that being of an optimistic predisposition can protect you from developing a phobia.

 

Diagnosing phobias

Phobias are not usually formally diagnosed. However, whilst most adults with a phobia are fully aware of the problem, children may be confused as to why they are particularly fearful of a specific object/animal.  Adults will sometimes choose to live with a phobia, taking great care to avoid the feared object or situation.  If you or your child have a phobia, continually trying to avoid what you’re afraid of will make the phobia worse.

 

Treating phobias

Most phobias can be successfully treated and cured.  Simple phobias can be treated through a supportive therapeutic relationship and gradual exposure to the object, animal, place or situation that causes fear and anxiety in a safe environment. This is known as ‘Desensitisation’ or ‘Exposure Therapy’.

Treating complex phobias can take longer but also involves the same approach; building a supportive therapeutic relationship with a therapist and using approaches such as Cognitive Behavioural Therapy.  This is a therapeutic model which supports children and young people in pinpointing when and where the fear is occurring, understanding the anxiety reaction to the feared object and supporting children in a range of strategies to slowly get used to the ‘feared object’ by reducing the anxiety.  This type of approach can also teach children and young people valuable tools to manage future anxiety more generally in their lives.

 

How common are phobias?

Phobias are the most common type of anxiety disorder.  They can affect anyone, regardless of age, gender and social background.  Specific phobias tend to begin in childhood between the ages of seven to eleven years with most cases starting before age ten.  Approximately 5% of children and 16% of adolescents will have a specific phobia in their lifetime and girls are more likely to experience a phobia than boys at a rate of 2:1.

 

Some of the most common phobias include:

arachnophobia – fear of spiders

claustrophobia – fear of confined spaces

agoraphobia – fear of open spaces and public places

social phobia – fear of social situations

One of my favourites is ‘Brontophobia’ – fear of thunder! It conjures up images of dinosaurs noisily walking across the clouds!

 

How you can help your child or teenager if they are struggling with a phobia:

Find a ‘Diaphragmatic Breathing’, ‘Progressive Muscle Relaxation’ and/or ‘Meditation’ exercise that your child feels comfortable practicing on YouTube.  Practise the breathing and relaxation techniques with your child once to twice a day.  Never force your child to think about, look at or have contact with the feared object as this will likely make their fear worse and they will lose trust in your support.  Introduce them to small manageable pieces of information about the feared object such simply talking about the feared object for a set amount of time, look at cartoon pictures, read stories.  Whilst taking these steps ask your child to practice the breathing and relaxation techniques until they feel completely calm either talking about or looking at the pictures of the feared object.   As your child becomes more confident talk together about how you might slowly approach having contact with the feared object in a safe environment.  Remember that avoidance will slowly make the phobia worse.

If you think your child or teenager might have a phobia, you may find the book below helpful as a support to this work.  If it feels too tricky to tackle it alone, don’t be afraid to ask for help.

 

Overcoming Your Child’s Fears and Worries: A Self-Help Guide Using Cognitive Behavioral Techniques (Overcoming Books) Paperback – 2007 by Cathy Creswell.

 

By Dr Elise Kearney, The Fold’s Clinical Psychologist