1. Phobia and its
treatment
By
Dr./ Hala Salah
Lecturer of psychiatry

2. PHOBIA
Defined as irrational fearthat produce
consciousavoidance of the feared subject,
.activity, or situation
Either the presence or the anticipationof
the phobic entity elicits severe distress in
the affected person who usually recognize
. that the reaction isexcessive

3. :Phobias are divided into two main categories
Specific phobias:. Strong persistent
fear of an object or situation These include
situational type: )e.g. enclosed spaces-
),elevators, airplanes
Animal type:. particularly spiders, snakes-
Natural environment type )e.g. heights,-
.) storms, water
Blood-injection-injury type-
Other type:.flying, germs, illness, death-

4. 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.

5. -Feeling of overwhelming anxiety.
-Feeling an intense need to escape
-Difficulty breathing
Racing or pounding heart-
Chest pain or tightness-
-Feeling dizzy or lightheaded
-Hot or cold flashes; tingling sensations
-Sweating

6. The avoidance , anxious anticipation,
or the distress may interfere significantly
with the person’s normal routines,
occupational, academic functioning or
social activities.

7. ETIOLOGY--- Specific
phobia
Behavioral
Pairing-1 of a specific object or situation
.with emotions of fear
Modeling :--2 observing the reaction in
.another e.g. parents
Information transfer-3 which the person is
.taught to be danger

8. GENETIC
At least one of the first
degree relative has
specific phobia of the
same type

9. AETIOLOGY--- Social phobia
inhibition during childhoodBehavioral :
Parents are less caring , more rejecting , more
protecting
:Genetics
First degree relatives have three times more
incidence than control‘ relatives

10. Neurochemical factors
Increase release of epinephrine and-
.norepinephrine
Increase sensitivity to normal level of-
.adrenergic stimulation
.Dopaminergic dysfunction-

12.  Selectiveserotonin reuptake
inhibitors (SSRIs)
 Benzodiazepines
 Beta Blockers

14.  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.

15.  Make a list
 Build your fear ladder
 Work your fear up the ladder
 Practice

16.  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.

17.  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.

18. 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

19. 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.

20.  A-Telling the future
 I will definitely suffocate when the elevator
doors close.”

21.  “That pit bull lunged at me. All dogs are
dangerous.”

22.  “The person next to me
coughed. May be it’s the
swine flu. I’m going to get
very sick!”

23.  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.”

24.  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.”

25. What would you say to a friend who has
this fear?
 “I would probably say that the chances of it
happening are very slim.

26. Thank you