“There are as many different kinds of phobias as there are different kinds of people,” says Jerilyn Ross, MA, LICSW. In the classic sense, a phobia is “an irrational, involuntary, inappropriate fear reaction that generally leads to an avoidance of common everyday places, objects, or situations,” she says. In the real sense, though, a phobia is the fear of fear itself. “A phobia is a fear of one’s own feelings and impulses. It’s a fear of having a panic attack, feeling trapped, of losing control or getting sick.” Phobias are classified into 3 types: simple or specific phobias, social phobias, and agoraphobia. People with specific phobias experience a dread of certain objects, places, or situations. People with social phobias avoid public situations, like parties, because they’re afraid they’ll do something to embarrass themselves. Agoraphobics are victims of a complex phenomenon based on a fear of being in public places without a familiar person or an escape plan. According to Rego, there are 3 common pathways to phobias. The first is direct conditioning, in which an experience earlier in life leads to the phobia—for example, being bitten by a dog causing a fear of dogs. The second is vicarious conditioning, in which an experience of someone close to you leads to a phobia. And the final pathway is receiving information or instruction, such as the fear of flight after September 11, or a fear of pit bulls after negative news reports about them. MORE: Are You Just Stressed Out…Or Is It Anxiety? People with phobias always recognize that their fear is inappropriate to the situation, says Ross. For example, if you’re flying on an airplane during a thunderstorm, feeling fearful is a normal reaction. If, however, your boss tells you you’ll have to take a business trip in a few weeks and you immediately start worrying about having a panic attackon the plane, that’s inappropriate to the situation. Does this sound like something you’ve experienced? If so, here’s some rational advice for irrational behavior from those who deal with the problem every day.
Rely On Relaxation
If you face a situation in which fear or panic are beginning to take hold, simple relaxation techniques can help, says Cathy Frank, MD. “Just relax your muscles and mind,” she says. “Form images of a place you’d rather be, such as lying on a beach or walking through the woods. This can release tension and bring you back down.” MORE: 3 Yoga Poses To Help You Relax
Do Something Distracting
Another approach, says Frank, is to train your attention on something else entirely and focus hard on it. “This usually helps if it’s an absorbing activity, such as a crossword, jigsaw puzzle, or computer game,” she says. “Other mental exercises that can help are counting backward, playing word games, or thinking about vacation plans. These can work, but they’re short-term solutions.”
Face Your Phobia Head-On
While these techniques can work, says Rego, they do nothing to help you face and ultimately overcome your phobia. That’s why he advocates cognitive behavioral therapy (CBT), which has you face your fear head on to triumph over it. This can be done with the help of a therapist for more severe phobias, or on your own if it’s a minor phobia.
Establish A Hierarchy
Of course, there’s more to overcoming a phobia than just facing it, says Frank. One common approach in cognitive behavioral therapy is to create a hierarchy within your phobia of the least anxious aspects of it to the most fearful, and rank them from 1 to 10. “For example, if you’re afraid of flying, going to the airport might be a ‘1,’ and going on a very long flight would be a ‘10,’” she says. “It’s best to start by facing the smaller challenges first, overcoming them, and then working your way up to the larger fears.”
Challenge It Intellectually
If you begin to feel panic and anxiety when facing your fear (and you inevitably will), don’t let it affect you unchecked, says Frank. “You need to challenge the thoughts you have about your anxiety,” she says. “If you’re panicky on elevators, for example, ask yourself, ‘What evidence do I have to be afraid of this elevator?’ or, ‘What’s the worst that could happen?’ By using Socratic questioning to verify or refute your notions about your phobia, you can gradually begin to overcome it.” MORE: 7 Pill-Free Ways To Fight Your Anxiety
Be Aware
Even with a gradual approach to facing your fears—and a logical approach to reasoning through them—those with phobias are likely to have panic attacks. David Carbonell, MD, advocates the “AWARE” technique of facing the attack and allowing it to pass. The steps involved in “AWARE” are “Acknowledge and Accept,” in which you accept the oncoming attack, realize that it’s scary, but also accept that it is not dangerous. Once you have accomplished this, you need to “Wait and Watch.” Here, you’re not trying to run away from the fear, but are instead letting it wash over you. Next are the “Action” steps, in which you bring the panic under control with breathing (see the information that follows), and resume the fearful activity. Finally, you’ll want to “Repeat” the steps if necessary, and then let yourself acknowledge that no matter how it feels now, the attack will come to an “End.”
Rely On Breathing
When panic is beginning to take hold, Carbonell recommends fighting it off with a technique called diaphragmatic breathing, or belly breathing. In the simplest of terms, this is a method for deep breathing, explains Carbonell. A panic attack often begins a feeling that you can’t breathe, but in reality, you’re taking rapid breaths, and not exhaling between them. To combat this, Carbonell says to breathe by placing one hand on your belt line, and another on your breastbone. Then, exhale forcefully by sighing, as if somebody just told you something very annoying. Now you can begin the process of inhaling, which you want to do slowly through your nose. As you inhale, push your stomach out. Then hold the breath for as long as it is comfortable, and exhale by opening your mouth, breathing out, and pulling your stomach in. Repeat the process until the panic begins to subside.
Play Muscle Games
One thing that often occurs during a panic attack is that your muscles tense up. That’s why Frank recommends that people practice muscle control by intentionally tightening their muscles for 10 to 15 seconds, and then relaxing them. “This gives people a sense of empowerment, that they, and not their emotions, are in charge of their muscles,” she says.
Beware Of The Effects Of Caffeine
While it’s not a major factor, Carbonell adds that high caffeine intake or caffeine addiction can only heighten your anxiety and increase your reaction to phobias. So if you drink a lot of coffee or caffeinated soda, now might be the time to cut back on your intake. (Here’s 8 things that happen when you quit caffeine.)
Reward Yourself
Overcoming a phobia is nothing to be taken lightly, which is why Carbonell says it’s important to give yourself a pat on the back and congratulate yourself for any breakthroughs that you make. However, it’s also important to make sure that the breakthroughs are the type you’re after. “This is good, so long as one defines ‘triumph’ accurately,” says Carbonell. “A typical triumph in working with a phobia is not to approach the object and then not feel afraid. This motivates a person to fight the fear, which leads nowhere useful. Rather, a triumph is to feel the fear and stay in the situation, working with the fear in an accepting manner.”
When To Call A Doctor For Help Coping With Phobias
If your phobia interferes with your life, seek professional help. Who you seek out is as crucial as seeking help itself. “It’s important that you get help from someone who understands phobias,” says Ross. “Many people with phobias end up going from doctor to doctor before getting a diagnosis and appropriate help.”
Panel Of Advisors
David Carbonell, MD, is the director of Anxiety Treatment Center, Ltd, in Chicago, author of Panic Attacks Workbook: A Guided Program for Beating the Panic Trick, and web master of anxietycoach.com. Cathy Frank, MD, is a psychiatrist at the Henry Ford Medical Center in Detroit, Michigan. Harold Levinson, MD, is a psychiatrist and neurologist in Great Neck, New York. He discovered that an inner-ear dysfunction was responsible for dyslexia and related learning, concentration, and phobic or anxiety disorders. He is coauthor of Phobia Free. Simon A. Rego, PsyD, is director of quality management and development for University Behavioral Associates in Yonkers, New York. Jerilyn Ross, MA, LICSW, is president and chief executive officer of the Anxiety Disorder Association of America, director of the Ross Center for Anxiety and Related Disorders in Washington, D.C., and author of Triumph Over Fear and One Less Thing to Worry About.
