Understanding cause and treatment of phobias

A man who fears injection.

Research indicates that phobias may develop for a number of reasons.

A panic attack, for example, can follow a traumatic experience or loss of a loved one.

On the other hand, many scientists believe that phobias are learned from others.

By observing their parents, children can, as they grow up, learn to react to parental phobias in a similar way.

In some instances, however, as the child matures, the fear can be transferred from its original source and manifest itself in a different situation.

Helen, had nearly died in a vacation-trailer fire some months earlier.

Helen admits:


I have had a tendency toward mild phobias for as long as I can remember.”

Was the experience something learned, or perhaps transferred, in her case?

There is really no sure way of telling.

A phobia that originates in a specific experience is more easily identified.

If, for example, a child is badly frightened by a dog or bitten by one, such an event can develop into cynophobia, a fear of dogs, in later life.

Similarly, aquaphobia (or, hydrophobia), a fear of water, may stem from an experience of nearly drowning.

According to modern analysis, all phobias fall into three well-known basic types.

It is helpful to be able to identify them.

So first of all, let us look at

Social and simple phobias

A man suffering from social phobia.

Do you know people who are afraid to sign their name in public because they are terrified their hand will tremble?

Or some who are afraid to speak up in public or to attend a party?

Such problems are examples of social phobias.

They are induced by the presence of other people.

Simple phobias relate to specific objects or situations, such as the fear of dogs or of water.

An excessive fear of cats, mice, or spiders is also commonplace, as is a fear of heights.

In this same category doctors will include claustrophobia, fear of confined spaces, as it fits into the pattern of being triggered by a specific cause.

Irrational as it must appear to most of us for anybody to be completely terrified by such basic fears, it is not difficult to imagine how extremely frustrating life can be for those who cannot escape their grip.

Why ‘the fear of fear’?

A man with a fearful face.

The third type of phobia, agoraphobia, is the most complex of all phobias.

Literally, the word means “fear of the marketplace.”

Some authorities maintain that this fear is really of what the marketplace represents: crowds and a loss of safety or control that one can enjoy in a more confined area.

Sufferers therefore describe agoraphobia in different ways, perhaps as a fear of crowds or even as a fear of leaving home.

As it is so all-embracing, agoraphobia is also described as ‘the fear of fear itself.’

Many victims are immobilized to the extent that they will go to extremes to avoid any situation that they feel could bring on a panic attack.

As a result, their lives become more and more closely fenced in by this gripping phobia until they eventually become too cramped to make any movement at all.

Is it all in the mind?

Some research indicates that agoraphobia may be a physical illness, a disorder of the nervous system.

Psychiatrist Dr. David V. Sheehan, author of The Anxiety Disease, asserts:

What is becoming increasingly clear is that we are dealing with a medical illness.”

Some feel that there is validity to this medical-illness idea, indicated by the fact that injections of sodium lactate can bring on panic attacks in people suffering from this phobia, as Dr. Ferris Pitts, professor of psychiatry at the University of Southern California, discovered.

This, however, is only one theory.

Research into the cause of phobias is systematically being pursued in many directions.

Some seek a genetic connection.

Others believe that hormonal imbalances may be at the root of the trouble.

Has what we eat anything to do with it?

According to Dennis Charney and his team of researchers at Yale University School of Medicine, caffeine can produce “anxiety, nervousness, fear, nausea, palpitations, restlessness and tremors” in some agoraphobics.

Yet the fact remains that nobody can pinpoint a common cause of phobias.

They are still a mystery.

What aid for phobics?

Can phobias be cured by medication and the vast array of modern drugs?

In some cases, it would seem so.

But here again, the response of individuals can vary as much as their phobias.

Psychiatrist David Burns, comments:

In spite of promising successes in treating some anxiety disorders with medications, there is a complete lack of evidence that drugs alone will do the job.”

In fact, for many victims some drugs have no effect at all, or if they do, it lasts only for a short time—a few months or as little as a week or so.

Side effects from drugs also have to be taken into consideration, and they can be quite unpleasant.

For this reason it has been estimated that only 70 percent of phobics can take them.

Aside from insomnia, blurred vision, and other problems, some drugs in certain cases can produce symptoms of a panic attack, much to the distress of the sufferer.

It is therefore not uncommon for phobics to pursue more than one therapy in their quest for relief.

“The method which has worked wonders for one may do little for another,” observes Muriel Frampton in her book Agoraphobia—Coping With the Outside World.

In addition to the orthodox medical treatments, homeopathy, osteopathy, acupuncture, and various nature remedies are all on record as helping some individuals.

Personal preference plays its part in the selection of medications.

Even so, it is good to be alert to some problems in this regard.

ECT and hypnosis

A woman performing self hypnosis.

One therapy for anxiety is ECT (electroconvulsive therapy), or shock treatment as it is commonly called.

A weak electric current is passed through the brain to induce a mild fit.

It can bring relief, but as far as removing phobias is concerned, its effects may not be long lasting.

There are also possible side effects, such as a loss of memory.

This treatment has now been banned or restricted in parts of the United States and in some European countries.

Hypnosis, or hypnotherapy, has also been recommended by some doctors.

But as Frampton states:

Experience has suggested that therapy is more soundly based when it involves the conscious will of the patient.” Agoraphobia—Coping With the Outside World"

The value of self-help

A happy woman enjoying smell a flower.

In view of the limitations of medication, can phobics do anything to help themselves?

Yes, and many doctors and therapists teach that self-help is the best way to treat phobias.

Results can be rewarding and often long lasting.

First of all, the victim has to learn the art of relaxation.

Thorough physical relaxation is essential for the all-important easing of mental tension.

Along these lines, psychologist Alan Goldstein reports:

We teach agoraphobic patients to relax, to use breath control and to stop their panicking thoughts and focus on the ‘here and now’ to help them deal with panic attacks.”

Once this far (and it is not easy, as it can take weeks of patient effort to learn to relax adequately), the next step is to identify the source of the fear and face up to it.

A skilled therapist can help a patient to understand the stages that lead to a panic attack.

Then, step by step, he encourages the patient, in his imagination, to overcome them.

As Alan Goldstein puts it:

“We help them to identify their feelings and get in touch with them.”

Not all sufferers can master this desensitization technique, as it is called.

But it can eventually lead those who do master it to face the actual experience and overcome it.

Even if a complete cure is not effected, the cause, or causes, of the phobia may at least be tolerated thereafter.

Therapists using the technique claim that eight out of every ten phobics who try this approach gain substantial relief.

Fighting the fear

Overcoming fear of height.

An extension of this desensitization idea is to have the patient deliberately face the source of his fear for as long as possible.

This takes a lot of courage and can be exhausting and emotionally upsetting in some cases.

For these reasons it is often best pursued under some type of professional direction rather than on an individual basis.

Either way, it often brings good results.

Tony Elliott, himself a former agoraphobic, formed a phobic association in Nottingham, England.

To help sufferers beat the phobia of traveling by train, he arranges for those involved to visit a train station and sit in a railway carriage in a siding.

Later on, a short ride in the station is the first step, progressing eventually to a journey of a few miles to the next station.

Doctors monitor the trip and stand by with a supply of tranquilizers.

Results have been encouraging. “I can get some of them 90 percent cured,” is Elliott’s claim.

The same therapy is now being applied to bus and airplane travel and is being used by numerous associations.

How easy it is to laugh at other people’s phobias!

Such fears, however, are very real and call for deep understanding and compassion.

Those who suffer are rarely exaggerating or pretending.

The ironlike grip of fear can be intense and the handicaps experienced completely genuine.

Yet it is not unknown for well-intentioned friends to make light of the problem, encouraging the phobic to ‘snap out of it.’

‘You give in too easily!’ ‘Don’t be silly, it can’t hurt you!’ are commonly heard expressions.

But they are, in fact, counterproductive—and unkind.

The phobic person requires patient help and empathy.

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