Phobias( Causes, Symptoms, Treatment)

Phobia is an anxiety disorder that is accompanied by intense fear and avoidance of frightening objects or situations. Avoidance is manifested when a person tries not to approach objects of fear. For example, a person does not go to the dentist when his teeth hurt, or does not fly on airplanes when he wants to relax. To summarize this definition, we can say that if a person is afraid, then this is fear, if he is afraid and avoids it is a phobia. From the fear of castration to conditioned reflexes: a history of the study of phobias.

Phobias began to be studied in the late XIX - early XX centuries. Freud described a phobic neurosis in his analysis of the phobia of a five-year-old boy in 1909. Little Hans often played horseback with his father. Once, on the street, he saw a live horse fall, and it frightened him so much that he began to fear these animals and clearly avoid meeting them - which was difficult at the beginning of the 20th century. Reflecting on why the horse incident caused frustration, Freud concluded that fear of castration was hidden behind phobic avoidance. Hans was in the oedipal phase of development, when the child’s attraction to the mother and his father’s fear worsened, and the phobia became a protective mechanism protecting the boy from conflict with his father.

At the same time, behaviorists developed psychology as an experimental science, and as part of an experiment in 1919, the father of behaviorism George Watson and his assistant Rosalie Reiner artificially formed a phobia in a nine-month-old boy. The scientist showed the child a white rat, accompanying it with a loud and unpleasant sound. As a result, the boy developed a fear and avoidance of a white rat, which spread to other soft and fluffy objects.

The experiment showed that a phobia is formed by a combination of conditioned and unconditioned stimuli. In the case of the Watson and Reiner experiment, the conditioned stimulus was a rat, which in itself did not cause fear in the child, and the unconditioned one was a loud sound, causing an unconditioned reflex. Why did the fear caused by the loud sound spread to the rat? The mechanism of classical conditioning worked, described by physiologist Ivan Pavlov. When experimenting with dogs, he noticed that the salivation reflex works not only when the animal begins to eat, but also when it only sees a bowl or hears the footsteps of a person bringing food. If you ring the bell during feeding, after a few repetitions, its sound will also begin to cause salivation.

What could be a source of phobia

Phobic disorder is included in the anxiety disorder registry. Among its manifestations, three clusters can be distinguished.

• Specific phobias - fear of specific phenomena or situations. The most common phobias of spiders, snakes and heights. Specific phobias are further divided into groups: animal phobias, natural phenomena, special situations (eg, claustrophobia), blood and medical interventions.

• Social phobias are the most severe in their consequences for the quality of life. People with such phobias experience a threat to their "I" and avoid social interactions, which limits their choice of lifestyle, opportunities to develop and be successful.

• Finally, agoraphobia is often associated with panic disorder. People are afraid of a recurrence of a panic attack, especially there where they will not be able to get help. This is not so much a fear of open spaces as a fear of being far from home or loved ones in a place where something bad happens - for example, it becomes bad with your heart, a panic attack occurs, and pressure rises.

• personality characteristic, like neuroticism, which to some extent reflects the increased reactivity of the limbic structures of the brain in response to stimuli. It was shown that when a person suffering from phobia interacts with frightening stimuli, a certain neuroanatomical structure is activated, which includes the insula, the anterior cingulate cortex, the amygdala, the prefrontal and orbitofrontal cortex. In patients with phobias, these areas of the brain are activated more strongly than in representatives of the control group.

• secondly, psychological vulnerability - all kinds of mistakes in thinking. For example, catastrophy is an exaggeration of the likelihood that something will go wrong. Or black-and-white thinking - when everything that is imperfect is perceived as a failure.

he experiences phobic reactions in significant adults; he often assimilates such behaviors and, as it were, “becomes infected” from them by fear. Macrosocial influences at the level of society, culture, state. For example, the way the media covers certain topics, from cancer treatment to disaster investigation, can provoke phobic behavior (carcinophobia, aerophobia).

What are the similarities and differences between phobias and PTSD?

If a person experiences a traumatic experience - sexual violence or a threat to life - then the consequence may be post-traumatic stress disorder or some of its symptoms. One of them is the avoidance of stimuli associated with trauma, similar in its mechanisms of avoidance to a phobic disorder.

The difference is that the object of the phobia could not be experienced by a person as a real threat to life, that is, not be a traumatic experience, and also that with phobias the experiences come to life when they meet the object of the phobia (in reality or imagination), while with PTSD they can occur spontaneously, like flashes in memory (flashbacks) and without a real reminder of the injury.

People differ in their phobic experiences. In some, they manifest themselves more strongly, while others cope with them more easily. People are different, but we are all a product of evolution, during which phobias were even useful because they protected us from dangers (like poisonous insects and snakes). Therefore, evolutionary psychologists consider phobic behavior as adaptive.

Some studies in clinical psychology are devoted to the study of the characteristics of mental processes in individuals with certain disorders. People with specific.

How phobias are treated

• The longer a person avoids a fearful object or situation, the more difficult it is to fight a phobia. Some people cope with their phobias themselves, especially if they have the resource to periodically refuse to avoid, but sometimes the help of a specialist is required.

• To reduce the excitement associated with the experience of fear, and to help the patient get closer to the object of phobia, tranquilizers and antidepressants are used. And then systematic desensitization or cognitive-behavioral therapy is connected.

• Systematic desensitization is a method based on gradual addiction. Person offer a phobic situation or object "in a small dosage" and gradually increase this "dose". For example, if a patient is afraid to ride the subway, he first goes with a psychotherapist, then he passes one station on his own, then two and so on, being in the discomfort zone for as long as he can bear. Modern reviews of studies on the effectiveness of psychotherapy indicate the greatest productivity of this approach.

• In cognitive-behavioral therapy, the emphasis is on the cognitive component: the therapist helps to correct incorrect thinking, dysfunctional thoughts and beliefs. In my experience, people most often turn to psychotherapy, either in the case of social phobia, when they are afraid to be among people, or in the case of agoraphobia, which is associated with panic disorder, the fear of being far from possible help.

Do xenophobia and homophobia belong to the phobia class?

Phobias are psychological and psychiatric phenomena that are classified as anxiety disorders. The criterion of mental disorder is the presence of subjective suffering combined with a restriction in the quality of life and a request for help Massive social phenomena such as xenophobia and homophobia are not mental disorders. The criterion is simple: who suffers from the manifestation of a phobia, whose standard of living is declining? People suffering from real phobias on the anxiety disorder registry often cannot travel, speak in public, or leave home. But xenophobia and homophobia do not suffer from xenophobia or homophobia, but the people around them - homosexuals or people of other nationalities.