Phobia and its treatment ByDr./ Hala Salah Lecturer of psychiatry
PHOBIA Defined as irrational fearthat produce consciousavoidance of the feared subject,.activity, or situation Either the presence or the anticipationofthe phobic entity elicits severe distress inthe affected person who usually recognize . that the reaction isexcessive
:Phobias are divided into two main categoriesSpecific phobias:. Strong persistentfear of an object or situation These includesituational type: )e.g. enclosed spaces- ),elevators, airplanesAnimal type:. particularly spiders, snakes-Natural environment type )e.g. heights,- .) storms, water Blood-injection-injury type- Other type:.flying, germs, illness, death-
Social phobia Strong persistent fear of situation in which embarrassment can occur . Social phobia involves a combination of:- Excessive self-consciousness,- Fear of public humiliation in common social situations,- Fear of negative evaluation by others.
-Feeling of overwhelming anxiety. -Feeling an intense need to escape -Difficulty breathingRacing or pounding heart-Chest pain or tightness- -Feeling dizzy or lightheaded -Hot or cold flashes; tingling sensations -Sweating
The avoidance , anxious anticipation,or the distress may interfere significantlywith the person’s normal routines,occupational, academic functioning orsocial activities.
ETIOLOGY--- Specificphobia BehavioralPairing-1 of a specific object or situation.with emotions of fearModeling :--2 observing the reaction in.another e.g. parentsInformation transfer-3 which the person is.taught to be danger
GENETICAt least one of the firstdegree relative hasspecific phobia of thesame type
AETIOLOGY--- Social phobiainhibition during childhoodBehavioral :Parents are less caring , more rejecting , moreprotecting:GeneticsFirst degree relatives have three times moreincidence than control‘ relatives
Neurochemical factorsIncrease release of epinephrine and-.norepinephrineIncrease sensitivity to normal level of-.adrenergic stimulation.Dopaminergic dysfunction-
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.
Make a list Build your fear ladder Work your fear up the ladder Practice
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 5 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.
A simple deep breathing relaxation exercise!!!!! Once the patient is comfortable with this deep breathing technique, he can start to use it when he is facing his phobia or in other stressful situations
The patient tends to:1- overestimate how bad it will be if he is exposed to the situation he fears.2- At the same time, he underestimates his ability to cope.
A-Telling the future I will definitely suffocate when the elevator doors close.”
“That pit bull lunged at me. All dogs are dangerous.”
“The person next to me coughed. May be it’s the swine flu. I’m going to get very sick!”
Is there any evidence that contradicts this thought? “I see many people using the elevator and it has never broken down.” “I have never actually been in an elevator that has broken down.”
Could you do anything to resolve this situation if it does occur?“I guess I could press the alarm button or use the telephone to call for assistance.” Are you making a thinking error?“Yes. I’m fortune telling, as I have no evidence to suggest that the elevator will break down.”
What would you say to a friend who has this fear? “I would probably say that the chances of it happening are very slim.