By PHOBIAS AND IRRATIONAL FEARS
By Melinda Smith, M.A., Lawrence Robinson, Robert Segal, M.A., and Jeanne Segal, Ph.D.
Is a phobia keeping you from doing things you’d like to do? Learn how to recognize, treat, and overcome the problem.
What is a phobia?
Almost everyone has an irrational fear or two—of spiders, for example, or your annual dental checkup. For most people, these fears are minor. But when fears become so severe that they cause tremendous anxiety and interfere with your normal life, they’re called phobias.
What is a phobia?
Almost everyone has an irrational fear or two—of spiders, for example, or your annual dental checkup. For most people, these fears are minor. But when fears become so severe that they cause tremendous anxiety and interfere with your normal life, they’re called phobias.
It’s only natural to want to avoid the thing or situation you fear. But when it comes to conquering phobias, facing your fears is the key. While avoidance may make you feel better in the short term, it prevents you from learning that your phobia may not be as frightening or overwhelming as you think. You never get the chance to learn how to cope with your fears and experience control over the situation. As a result, the phobia becomes increasingly scarier and more daunting in your mind.
The most effective way to overcome a phobia is by gradually and repeatedly exposing yourself to what you fear in a safe and controlled way. During this exposure process, you’ll learn to ride out the anxiety and fear until it inevitably passes. Through repeated experiences facing your fear, you’ll begin to realize that the worst isn’t going to happen; you’re not going to die or “lose it.” With each exposure, you’ll feel more confident and in control. The phobia begins to lose its power.
It’s important to begin with a situation that you can handle, and work your way up from there, building your confidence and coping skills as you move up the “fear ladder.”
Make a list. Make a list of the frightening situations related to your phobia. If you’re afraid of flying, your list (in addition to the obvious, such as taking a flight or getting through takeoff) might include booking your ticket, packing your suitcase, driving to the airport, watching planes take off and land, going through security, boarding the plane, and listening to the flight attendant present the safety instructions.
Build your fear ladder. Arrange the items on your list from the least scary to the most scary. The first step should make you slightly anxious, but not so frightened that you’re too intimidated to try it. When creating the ladder, it can be helpful to think about your end goal (for example, to be able to be near dogs without panicking) and then break down the steps needed to reach that goal.
Work your way up the ladder. Start with the first step and don’t move on until you start to feel more comfortable doing it. If possible, stay in the situation long enough for your anxiety to decrease. The longer you expose yourself to the thing you’re afraid of, the more you’ll get used to it and the less anxious you’ll feel when you face it the next time. Once you’ve done a step on several separate occasions without feeling too much anxiety, you can move on to the next step. If a step is too hard, break it down into smaller steps or go slower.
Practice. The more often you practice, the quicker your progress will be. However, don’t rush. Go at a pace that you can manage without feeling overwhelmed. And remember: you will feel uncomfortable and anxious as you face your fears, but the feelings are only temporary. If you stick with it, the anxiety will fade.
Facing a fear of dogs: A sample fear ladder
Step 1: Look at pictures of dogs.
Step 2: Watch a video with dogs in it.
Step 3: Look at a dog through a window.
Step 4: Stand across the street from a dog on a leash.
Step 5: Stand 10 feet away from a dog on a leash.
Step 6: Stand five feet away from a dog on a leash.
Step 7: Stand beside a dog on a leash.
Step 8: Pet a small dog that someone is holding.
Step 9: Pet a larger dog on a leash.
Step 10: Pet a larger dog off-leash.
If you start to feel overwhelmed…
While it’s natural to feel scared or anxious as you face your phobia, if you start to feel overwhelmed, immediately back off and use the techniques outlined below to quickly calm your nervous system.
Tip 2: Learn to calm down quickly
When you’re afraid or anxious, you experience a variety of uncomfortable physical symptoms, such as a racing heart and a suffocating feeling. These physical sensations can be frightening themselves—and a large part of what makes your phobia so distressing. However, by learning how to calm yourself down quickly, you can become more confident in your ability to tolerate uncomfortable sensations and face your fears.
Perform a simple deep breathing exercise. When you’re anxious, you tend to take quick, shallow breaths (known as hyperventilating), which actually adds to the physical feelings of anxiety. By breathing deeply from the abdomen, you can reverse these physical sensations and feel less tense, less short of breath, and less anxious. Practice when you’re feeling calm until you’re familiar and comfortable with the exercise.
Use your senses
One of the quickest and most reliable ways to relieve anxiety is by engaging one or more of your senses—sight, sound, taste, smell, touch—or through movement. But since everyone is different, you’ll need to do some experimenting to discover what works best for you.
Movement – Go for a walk, jump up and down, or gently stretch. Dancing, drumming, and running can be especially effective at relieving anxiety.
- Sit or stand comfortably with your back straight. Put one hand on your chest and the other on your stomach.
- Take a slow breath in through your nose, counting to four. The hand on your stomach should rise. The hand on your chest should move very little.
- Hold your breath for a count of seven.
- Exhale through your mouth to a count of eight, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.
- Inhale again, repeating the cycle until you feel relaxed and centered.
- Practice this deep breathing technique for five minutes twice day. When you’re comfortable with the technique, you can use it when you’re facing your phobia or in another stressful situation.
Sight – Look at anything that relaxes you or makes you smile: a beautiful view, family photos, cat pictures on the Internet.
Sound – Listen to soothing music, sing a favorite tune, or play a musical instrument. Or enjoy the relaxing sounds of nature (either live or recorded): ocean waves, wind through the trees, birds singing.
Smell – Light scented candles. Smell the flowers in a garden. Breathe in the clean, fresh air. Spritz on your favorite perfume.
Taste – Slowly eat a favorite treat, savoring each bite. Sip a cup of coffee or herbal tea. Chew on a stick of gum. Enjoy a mint or your favorite hard candy.
Touch – Give yourself a hand or neck massage. Cuddle a pet. Wrap yourself in a soft blanket. Sit outside in the cool breeze.
Meditation for stress and anxiety relief
When fear or anxiety starts to carry you away, meditating can help stop it in its tracks. And with regular practice, meditation boosts activity in the area of the brain responsible for feelings of serenity, helping to quell fear and panic before they strike.
Tip 3: Challenge negative thoughts about your phobia
When you have a phobia, you tend to overestimate how bad it will be if you’re exposed to the situation you fear and underestimate your ability to cope. The anxious thoughts that trigger and fuel phobias are usually negative and unrealistic. By writing down the negative thoughts you have when confronted by your phobia, you can begin to challenge these unhelpful ways of thinking. Many times, these thoughts fall into the following categories:
Fortune telling. For example, “This bridge is going to collapse;” “I’ll make a fool of myself for sure;” “I will definitely lose it when the elevator doors close.”
Overgeneralization. “I fainted once while getting a shot. I’ll never be able to get a shot again without passing out;” “That pit bull lunged at me. All dogs are dangerous.”
Catastrophizing. “The captain said we’re going through turbulence. The plane is going to crash!” “The person next to me coughed. Maybe it’s swine flu. I’m going to get very sick!”
Once you’ve identified your negative thoughts, evaluate them. Use the following example to get started.
Negative thought: “The elevator will break down and I’ll get trapped and suffocate.”
Ask yourself the following 4 questions:
1. Is there any evidence that contradicts my negative thought?
Yes, for example: “People are currently using the elevator and it hasn’t broken down.”
“Even if it did break down, I’ve never heard of anyone dying from suffocation in an elevator. There are air vents which would stop the air from running out.”
“I’ve never been in an elevator that has broken down.”
2. Could you do anything to resolve this situation if it does occur?
“Yes, I could press the alarm or use the telephone to call for assistance.”
3. Are you thinking in an unhelpful way?
“I’m fortune telling, as there is no evidence to suggest that the elevator will break down or that I’d suffocate.”
4. What would you say to a friend who has this fear?
“I would tell a friend that the chances of the elevator breaking down are very slim, it’s not something you hear about happening very often.”
It’s also helpful to come up with some positive coping statements that you can tell yourself when facing your phobia. For example:
- “I’ve felt this way before and nothing terrible happened. It may be unpleasant, but it won’t harm me.”
- “If the worst happens and I have a panic attack while I’m driving, I’ll simply pull over and wait for it to pass.”
- “I’ve flown many times and the plane has never crashed. Statistically, flying is very safe.”
References
Craske, M. G., & Stein, M. B. (2016). Anxiety. Lancet (London, England), 388(10063), 3048–3059. https://doi.org/10.1016/S0140-6736(16)30381-6
Specific Phobias (Symptoms) | Center for the Treatment and Study of Anxiety | Perelman School of Medicine at the University of Pennsylvania. (n.d.). Retrieved July 28, 2021, from https://www.med.upenn.edu/ctsa/phobias_symptoms.html
Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107–1124. https://doi.org/10.1016/j.jaac.2020.05.005
Anxiety Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.dsm05
