A phobia (from the Greek word for “fear”) is a persistent and unreasonable fear of a particular object, activity, or situation. People with a phobia feel scared even when they just think about what they fear. DSM-5 indicates that phobia is more intense and persistent than common fear.

There are two main categories of phobia. They are specific phobia and agoraphobia.

Specific Phobia

A specific phobia is a persistent fear of a specific object or situation.

There are some features of specific phobia. First, there is marked, persistent, and disproportionate fear of a particular object or situation, usually lasting at least six months. Second, exposure to the object produces immediate fear. Third, there is avoidance of the feared situation. Fourth, the fear causes significant distress or impairment.

Common specific phobias are intense fears of animals or insects, enclosed spaces, blood, etc. Women are affected twice (2×) more than men. The prevalence also varies among racial and ethnic groups.

Agoraphobia

People with agoraphobia are afraid of being in public places or situations where escape might be difficult or help unavailable, should they experience panic or become incapacitated (APA, 2013). This is a complex phobia. Women are affected twice (2×) than men, and poor people are affected twice than wealthy people.

There are several features of agoraphobia. First, there is pronounced, disproportionate, and repeated fear of being in at least two of the following situations: public transport, open spaces, closed places, lines or crowds, and being alone away from home. Second, the fear comes from worrying that escaping or getting help would be hard if something bad happens. Third, people avoid agoraphobic situations. Fourth, symptoms usually continue for at least six months. Fifth, there is significant distress and impairment.

Many people with agoraphobia have panic attacks.

Cause

Behaviorists believe that people with phobias learn to fear through conditioning. They propose that phobias often develop through classical conditioning. Here, two events occur close together in time and become strongly associated in the mind. So, if one event triggers a fear reaction, then the other may also.

A clinical case described a young woman who acquired a specific phobia through classical conditioning. In this case, a young girl went on a picnic. She ran into the woods and got trapped between rocks. While struggling, she heard the sound of running water. Her brain linked the fear of being trapped with the sound of water. Later, she developed a strong phobia of running water.

In conditioning terms, the unconditioned stimulus (US) was entrapment, and the unconditioned response (UR) was fear. The conditioned stimulus (CS) was running water, and the conditioned response (CR) was fear.

Modeling: Another way of acquiring phobia is by modeling, which is through observation and imitation. If a person sees another person being afraid, they might develop the fear of the same thing. For example, a young boy sees that his mother is scared of illness and hospitals. She often talks about her fear. After some time, the boy also developed the same fear.

 

Behavioral–Evolutionary Explanation

Some phobias are more common than others. For example, fear of animals, heights, and darkness are very common, but fear of meat and houses are rare. Theorists explain this by saying humans are naturally prepared to develop certain fears. This is called preparedness.

According to some theorists, these fears have been transmitted genetically. Long ago, our ancestors who were afraid of dangerous things like animals and heights were more likely to stay safe and survive. They then passed these fears through genes.

 

Treatment of Specific Phobias

Specific phobias were among the first anxiety disorders to be treated successfully. The main treatment methods are systematic desensitization, flooding, and modeling. Together, these are called exposure treatment because the person is exposed to the objects they fear.

Systematic Desensitization: This method was developed by Joseph Wolpe. It teaches people to relax while facing feared objects. The idea is that relaxation and fear cannot happen at the same time, so relaxation replaces fear.

First, relaxation training is given. Then the client makes a fear hierarchy, which is a list of fears arranged from least scary to most scary. The client learns to pair relaxation with the feared object. The client starts with the least scary item and faces it while staying relaxed. This may be an actual confrontation, a process called in vivo desensitization, or the confrontation may be imagined, a process called covert desensitization. Over time, the client works through the whole list until the most feared situation no longer causes fear.

Flooding: Another way to treat phobias is flooding. In flooding, the person faces their fear all at once without relaxation training. The idea is that when people see that nothing bad happens, their fear will go away. Flooding can be real (in vivo) or imagined (covert).

Modeling: Modeling is another method. Here, the therapist faces the feared object or situation while the client watches. This shows that the fear is unnecessary. In participant modeling, the client is encouraged to join in with the therapist.

Treatment for Agoraphobia

In the past, agoraphobia was hard to treat, but now there are better methods and treatments. These treatments are not as successful as those for specific phobias, but they still provide good results.

Exposure Therapy: The main treatment method is exposure therapy. In this method, therapists help people slowly go further from home and enter public places step by step. Therapists may use support, encouragement, and reasoning to help clients.

Exposure therapy for people with agoraphobia often includes additional features such as support groups and home-based self-help programs to motivate them.