Specific Phobias

New places, high bridges, or old elevators may make all of us a bit uneasy or even frightened. We might try to avoid things that make us uncomfortable, but most people generally manage to control their fears and carry out daily activities without incident.

But people with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there’s no threat or danger. The fear may not make any sense, but they feel powerless to stop it.

People who experience these seemingly excessive and unreasonable fears in the presence of or in anticipation of a specific object, place, or situation have a specific phobia.

Having phobias can disrupt daily routines, limit work efficiency, reduce self-esteem, and place a strain on relationships because people will do whatever they can to avoid the uncomfortable and often-terrifying feelings of phobic anxiety.

While some phobias develop in childhood, most seem to arise unexpectedly, usually during adolescence or early adulthood. Their onset is usually sudden, and they may occur in situations that previously did not cause any discomfort or anxiety. No one can say exactly why a certain person has a specific phobia.

Types of phobias

Specific phobias commonly focus on elevators, animals, insects, germs, heights, thunder, driving, public transportation, flying, dental or medical procedures.

If you believe that a situation is dangerous, that something bad will happen because of it, then you may have a specific phobia. Fearing getting stuck in an elevator, being bitter by a spider, or fear of flying are examples of these. It’s a specific phobia because you fear that specific situation.

Why do phobias persist?

Phobias persist because they are maintained by avoidance. If you keep avoiding the source of the fear, it is unlikely to ever go away. But, that doesn’t answer why we have them in the first place.

There are two main theories as to why. One is that our fears end up learned either directly (we go in an elevator at some point in life, and it got stuck), or indirectly (we witness the same thing happen, and negative responses from others). The other theory is that these fears are innate; there when we are born. It is currently unknown exactly which theory is correct, but the main thing is that specific phobias can be reduced significantly.

Important to realise as well, is that giving in to the fears means they may spread to other situations. Giving in to one makes developing other fears more likely.


The vast majority of people with an anxiety disorder can be helped with professional care.

Success of treatment varies among people. Some may respond to treatment after a few months, while others may need more than a year. Treatment may be complicated if people have more than one anxiety disorder or suffer from depression or substance abuse. This is why treatment must be tailored to the individual.

Almost all fears can be reduced, or even wiped out completely, with proper treatment.

Cognitive-Behavioral Therapy

In general, cognitive-behavioral therapy (CBT) can work for those with specific phobia. Weekly treatment with homework assignments usually succeeds in 12 to16 sessions. First, the therapist helps the patient understand incorrect assumptions and then gradually exposes him or her to the phobia source.

What a therapist usually does in the first couple of sessions is help people identify mistaken beliefs. People with phobias catastrophise; they immediately jump to the worst-case scenario, and they overestimate the probability that it will happen. Catastrophising is a common occurrence in most anxiety disorders. Therapists help them realize they are making those mistakes, and they talk about realistic risks. People are unlikely to be hit by lightening, for example, and their house will probably not catch fire.

Secondly comes exposure, or confronting the feared situation, such as going with a therapist and getting closer to dogs. Another example is a thunderstorm, which would not mean holding up a metal bat in a storm. The therapist and patient would go into a house and stand near a window, learning to take acceptable risks that are relatively safe.

A quick exercise to get you started

If you have a specific phobia, imagine having to put a bet on the chance of a negative outcome happening as a result of that exposure. With the low odds of getting stuck in an elevator, I’m not sure you would not place money on it.

If that is the case, why are you worrying now? Alongside this, think of a time you may have made these previous predictions before, but nothing negative happened. How many dogs have passed you in the street that have had absolutely no interest in mauling your leg? True, anytime could be the first time, but anything you do could prove dangerous.

You do not fear most activities you do, so why is an overemphasis placed on this one?


Dr. Robert Leahy – Anxiety Free: Unravel Your Fears Before They Unravel You,  Second Edition

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