Portfolio of Hope

1. What is a ‘phobia?’

A phobia is a type of anxiety disorder which, according to the NHS, can be defined as being ‘an overwhelming and debilitating fear of an object, place, situation, feeling or animal’ (https://www.nhs.uk/mental-health/conditions/phobias/overview/.)

2. What are the main groups of phobias?

Although phobias are very wide ranging, they can be broadly categorised into two groups, with those groups being specific phobias, and complex phobias.

• Specific phobias refer to those which involve a specific object or situation. One common example that can be used here is spiders. If someone has a phobia of spiders, it is categorised as a specific phobia, having most likely developed in their childhood or adolescence.
• Complex phobias are generally more debilitating of the two groups, as they are based on a deep-rooted fear that tends to cause greater disruption to one’s life. Unlike specific phobias, those complex in nature are more likely to have developed in adulthood, as opposed to being present from a young age. The two most common types of complex phobias are social phobia (aka social anxiety- an intense fear of social situations), and agoraphobia (anxiety about being in places or situations that one may find difficult to ‘get out of.’)

Social phobias cause extreme anxiety to develop around social situations. They can lead to sufferers forgoing any events that involve interacting with people, such as school and work, which can in turn result in them struggling to make friends and facing unemployment. This can cause feelings of being inferior to others to develop and may contribute to their depleting self-esteem. Having such negative thoughts about oneself leads to many with this condition to go on to develop depression and/or substance misuse.

Agoraphobia is a fear of finding oneself in a public place whereby there is deemed to be no ‘easy escape.’ Because agoraphobia often results in one experiencing a panic attack, people with this phobia tend to associate the ‘outside world’ with fear and panic, and so they therefore might get as though they are afraid to leave their house.

3. What are some examples of specific and social phobias?

Specific phobias:

• One of the common things we tend to associate with phobias is spiders, which are a type of animal phobia. Aside from this example, there are other phobias that make up the specific category. One such phobia is that of the natural environment. Examples of ways in which someone might have a phobia of the natural environment is if they have a fear of heights, water, darkness, or storms.

• Another type of specific phobia is of the situational kind. These phobias might include a fear of flying, being closed in a small space like an escalator, or driving through tunnels or up hills.

• Body-based phobias incorporate a fear of seeing blood, invasive medical procedures like injections or blood tests, or being sick.

• The final type of specific phobia, sexual phobia, might result in the sufferer having a fear of being seen naked.

There are also other phobias that are not categorised here but are still just as valid, including the fear of consuming a particular food, the fear of loud sounds, and the fear of costumed characters (e.g., clowns.)

Social phobias:

One large element of social phobia is talking to people, however for people with this condition, the seemingly simple act of talking is in fact incredibly difficult.

Not only do people with the condition often find starting a conversation near impossible, especially if it is with a group of people or someone new, but they also find maintaining that conversation with eye contact excruciatingly hard.

The effects of this condition can wreak havoc on the lives of those who suffer from it, potentially causing them to stop attending important social events such as school or work. And even if they do attend, their experience will be very challenging as they will have to navigate their way through the very situation that causes them intense fear. They might struggle to speak to their teacher or employee about their struggles if they also fear speaking to authority figures, as many people with social phobia do.

4. What are some of the possible causes of phobia?

It is impossible to identify one cause of phobia that is applicable for everyone who struggles with them, for just like there are many different types of phobia, so too are there many different factors that cause them to develop in people.

• One possible cause that could explain the development of phobias, however, is traumatic past experiences. If, for example, en route to a family holiday abroad as a young child you experienced a lot of turbulence on the plane you were travelling on, you might, as a direct result of that negative experience, have a phobia of flying. Similarly, if you were attacked by a dog at a young age, you might associate violence with all dogs, therefore causing you to develop a phobia of them.

• Another reason that might explain why phobias develop is due to learned responses from early life. If, for example, you have parents who are often very worried and anxious, reminding you of the dangers of the ‘outside world’ and the safety of home, you might go on to develop social phobia or agoraphobia, making you fearful of leaving the house based on the narrative you were told when you were growing up, at such an impressionable age.

• Genetic factors are another potential cause of phobias, with people who believe in this cause posing the argument that phobias are not ‘developed’ and nor are they ‘learned.’ They are, in fact, ‘just a part of us.’

5. What feelings might arise when experiencing a phobia?

The symptoms of phobias differ dramatically depending on individual circumstances. There are, however, common feelings that many people report having when they have been ‘face to face’ with their phobia. Not at all dissimilar to the symptoms associated with anxiety disorder, phobias can result in one feeling lightheaded or faint, with an accelerated heart rate and tightness in their chest being present. They might also experience sweating which can result in hot flushes arising. Further physical symptoms of phobias include shortness of breath, nausea, vomiting or diarrhoea, and trembling or shaking.

As phobias are a mental illness, there are, of course, several psychological symptoms that one should look out for if they struggle with this condition. Some people report developing a sudden and intense fear of fainting, losing control, or of dying. They might also experience a sense of dissociation, meaning they have a feeling of being very much ‘out of touch’ with reality. Long-term feelings associated with phobias include stress, anxiety, and depression.

6. How can a specific phobia prevent someone from leading a normal life?

Bodily based phobias which come under the ‘specific phobia’ category, are arguably the most dangerous of them all. Whilst all phobias undeniably have a dreadful impact on the mental health of sufferers, someone who suffers from a phobia of, for example, blood tests, is at an increased risk of their physical health suffering as a direct result.

If they refuse to allow their blood to be tested, the medical treatment they receive will be severely limited. Potential problems may go undiagnosed for they cannot be confirmed. This ultimately means that having a phobia of blood tests could cost people their lives.

It could also have an impact on their day-to-day living, because if they do have problems that go undiagnosed, they might be in pain or feeling ill, something which can only be ‘put right’ by having a blood test to confirm what the problem is.

7. How can agoraphobia prevent someone from leading a normal life?

Agoraphobia is a severe phobia characterised by an intense fear of being unable to escape certain situations. It can therefore have a very big impact on someone’s day to day life, as sufferers of agoraphobia will be likely to avoid the situations which they fear at all costs. This can include public transport as ‘getting off’ is ultimately out of the passenger’s control. Avoiding public transport can and will affect people, especially if they do not have access to a car. It might prevent them from finding employment and generally living their life in the way they want to; with the freedom they deserve. Agoraphobia takes away that freedom, making it impossible to live a ‘normal’ life.

As it can result in people refraining from leaving their house, it can also prevent them from engaging in many activities such as going to work/school, socialising with friends, taking part in hobbies, and exercising. This can lead to one experiencing intense feelings of isolation which can quickly spiral into depression, lowering one’s overall quality of life. They might in turn use unhealthy methods such as alcohol, drugs, or food to try to cope, however what they do not realise at the time is that such methods can contribute to the development of further mental and physical health problems.

8. How can a person’s phobia affect others?

Like many mental illness’, phobias do not just affect the sufferer themselves, but those close to them as well. They can cause disagreements and conflict to arise, putting a strain on relationships. This is because the phobia can limit the activities that people can do together. For example, someone with a specific phobia of dogs will avoid any situations where they may encounter dogs. This would severely restrict what they do, for these days, everyone seems to have dogs. As such, this would give a family one of two options; either leave the person with the phobia of dogs at home and go by themselves, or all stay at home. Either option is not ideal as it prevents the whole family from spending enjoyable quality time together.

Phobias can also affect friendships, because if, for example, a friend has a dog, the person with the phobia would have to try to explain why they cannot visit their house. This would, again, put serious strain on the friendship to the extent that it may not be sustainable, therefore resulting in friendships ending.

9. What are two examples of self-help for phobias?

• Making some simple changes to one’s lifestyle might aid them in reducing their phobia symptoms. The most effective way to do so is by ensuring that you are engaging in regular exercise. Exercise is known to improve both your mental and your physical health, therefore making dealing with your phobia a little bit easier. Further lifestyle changes that should be considered include eating 3 healthy meals a day, getting sufficient sleep (at least 7 hours a night), and reducing caffeine and other stimulant use, such as alcohol and drugs.  

• Another way in which one can practice self-help is by engaging in exposure therapy, sometimes referred to as ‘desensitisation.’ This therapy involves gradually increasing the length of time one is exposed to their phobia. If someone has agoraphobia for example, and they fear being outside of their home environment, exposure therapy might resemble going outside of their home for a very short period initially, e.g., 5 minutes, before gradually increasing the length of time they spend outside. The desired outcome from this would be for the person to eventually be able to leave their house anxiety free, meaning they have recovered from their phobia.

10. What are two examples of treatment for phobias?

• One way in which someone can be treated for their phobia is via talking therapy. This will often comprise of CBT (cognitive behavioural therapy), as well as exposure therapy. CBT is a type of counselling that tries to alter your thinking so that your behaviour can be changed. The aim of this change? So that you can find practical ways to deal with your phobias. Combined with exposure therapy, they work together to help you gain control over what might feel very much uncontrollable initially- your phobia(s.)

• Another treatment option to help with phobias is medication. There are 3 types recommended for this particular mental illness, those options being antidepressants, tranquilisers, and beta-blockers. The desired effect of taking medication is for symptoms of anxiety to be reduced. Whilst medication is effective for many people struggling with phobias, to give them the greatest chance of success, it should be combined with talking therapy, as mentioned above.