Back More
Salem Press

Table of Contents

Magill’s Medical Guide, 8th Edition

Phobias

by John Panos Najarian, Ph.D., Nancy A. Piotrowski, Ph.D.

Disease/Disorder

Anatomy or system affected: Psychic-emotional system

Specialties and related fields: Psychiatry, psychology

Definition: Excessive fears of certain objects, people, places, or situations.

Causes and Symptoms

Phobias can induce a state of anxiety or panic, often debilitating sufferers, restricting them from full freedom of action, career progress, or sociability. For example, a heterosexual person who fears talking with the opposite sex will have problems dating and progressing socially.

Fear serves an important and necessary function in life. It keeps one from putting a hand in a flame or walking into oncoming traffic. The fear of death and the unknown is commonplace; it causes many to dislike, even dread, passing by cemeteries, even though there is no logical reason. While many forms of fear are normal, if they occur out of context, in socially unacceptable manners, too severely, or uncontrollably, then the diagnosis is a phobia.

Many different phobias have been cited in the literature and have specific terms in dictionaries, constructed by prefixing the word “phobia” with Greek or Latin terms (such as acrophobia or claustrophobia). While their enumeration is an interesting pastime, phobias are serious conditions and should be treated by professional psychologists.

Phobias are caused by perceived dangerous experiences, both real and imagined. Sometimes, it is gradual: A worker may develop anxiety reactions to a boss over several weeks. Likewise, a single moment of terror can cause a lifetime of avoidance: A dog attack can generate cynophobia (fear of dogs) in a child. Children are especially susceptible to phobias, most of which are caused by fear of injury. The death of a close relative is difficult for children to understand and requires a delicate, sensitive, and honest explanation. Questions and expressions of feelings (often resentment) by the child should be encouraged and discussed. It is repression, unanswered questions, lack of supportive people, and guilt feelings that can lead to morbid attitudes and fantasies, by which phobias develop. Experiences in the past and associated fears remain dormant, to recur and be relived.

Information on Phobias

Causes: Psychological disorder

Symptoms: Feeling of anxiety or panic, impaired social interaction, impaired freedom of action

Duration: Often chronic

Treatments: Cognitive and behavioral therapy (e.g., controlled exposure to object of fear)

Anticipatory fears can also cause phobias. Driving trainees and beginning drivers often have phobic reactions, dreading possible accidents. Students, often the best or most conscientious ones, may spend sleepless nights worrying about the next day’s examination. They fear experiences that may never occur, irrationally magnifying the consequences of their performance to one of absolute success or utter doom. Concentration produces positive results (that is, good grades), but obsession may cause paralyzing fear and pressure, even suicide. Several other theories exist regarding the cause of phobias.

Phobias can be classified into three primary groupings: simple phobias, social phobias, and agoraphobia. Simple phobias are directed toward specific things, animals, phenomena, or situations. Rodents, cats, dogs, and birds are common objects of fear. A swooping gull or pigeon may cause panic. Insects, spiders, and bugs can provoke revulsion. Many cultures have a fear of snakes. A phobia exists, for example, when a house is inspected several times each day for snakes; a phobic person may vacate a rural home for an urban dwelling in order to avoid them. Blood, diseased people, or hospital patients have caused fainting. Some vegetarians dread meat because of traumatic observations of slaughter. Fear of heights, water, enclosed spaces, and open spaces involves imagined dangers of falling, drowning, feeling trapped, and being lost in oblivion, respectively. These feelings are coupled with a fear of loss of control and harming oneself by entering a dangerous situation. Sometimes, a specific piece of music, building, or person triggers reactions; the initial trauma or conditioning events are not easily remembered or recognized as such.

Social phobias are fears of being watched or judged by others in social settings. For example, in a restaurant, phobics may eat in rigid, restrictive motions to avoid embarrassments. They may avoid soups, making noises with utensils, or food that requires gnawing for fear of being observed or drawing attention. Many students fear giving speeches because of the humiliation and ridicule resulting from mistakes. Stage fright, dating anxiety, and fear of unemployment, divorce, or other forms of failure are also phobic conditions produced by social goals and expectations. The desire to please others can exact a terrible toll in worry, fear, and sleepless nights.

Agoraphobia is a flight reaction caused by the fear of places and predicaments outside a sphere of safety. This sphere may be home, a familiar person (often a parent), a bed, or a bedroom. Patients retreat from life and remain at home, safe from the outside world and its anticipated perils. They may look out the window and fear the demands and expectations placed on them. They are prisoners of insecurity and doubt, avoiding the responsibilities, risks, and requirements of living. Many children are afraid of school, and some feign illness to remain safely in bed. Facing the responsibilities of maturation causes similar reactions.

Treatment and Therapy

Different schools of psychology espouse different approaches to the treatment of phobias, but central themes involve controlled exposure to the object of fear. Common core fears include fear of dying, fear of going crazy, fear of losing control, fear of failure, and fear of rejection.

The most effective approach to treating these disorders is a cognitive-behavioral strategy. With this approach, dysfunctional thinking is identified and changed through collaborative efforts between the patient and therapist. Additional dysfunctional behavior is identified and changed through processes involving conditioning and reinforcement.

Through an initial minimal exposure to the feared object or situation, discussion, and then progressively greater controlled contact, patients experience some stress at each stage but not at a level sufficient to cause a relapse. They will proceed to become desensitized to the object in phases. Therapists may serve as role models at first, demonstrating the steps that patients need to complete, or they may provide positive feedback and guidance. In either case, the role of the patient is active, and gradual exposure occurs. In the process, patients learn to adapt to stress and become more capable of dealing with life.

Other supervised therapies exist, some involving hypnosis, psychoanalysis, drugs, and reasoning out of one’s fears. In dealing with phobics, it must be recognized that anyone can have a phobia. Patience, understanding, supportiveness, and professional help are needed. Telling someone simply to “snap out of it” increases stress and guilt.

See also

Antianxiety; Anxiety; Body dysmorphic disorder; Bonding; Death and dying; Depression; Emotions: Biomedical causes and effects; Neurosis; Nightmares; Post-traumatic stress disorder; Psychiatric disorders; Psychiatry; Psychiatry, child and adolescent; Psychiatry, geriatric; Psychoanalysis; Psychosomatic disorders; Separation anxiety; Stress; Stress reduction; Toilet training.

For Further Information:

1 

Barlow, David H. Anxiety and Its Disorders. 2d ed. New York: Guilford Press, 2004. Examines the subject in the context of recent developments in emotion theory, cognitive science, and neuroscience. Reviews the implications for treatment and integrates them into newly developed treatment protocols for the various anxiety disorders.

2 

Bourne, Edmond J. The Anxiety and Phobia Workbook. 4th ed. Oakland, Calif.: New Harbinger, 2005. This is an excellent self-help book for problems related to anxiety. It may also be helpful for family members seeking to understand anxiety better or to support those affected by anxiety.

3 

Maj, Mario, et al., eds. Phobias. Hoboken, N.J.: John Wiley & Sons, 2004. Reviews the diagnosis, classification, pharmacotherapy, psychotherapy, and social and economic burdens of phobias.

4 

Marks, Isaac M. Fears, Phobias, and Rituals: Panic, Anxiety, and Their Disorders. New York: Oxford University Press, 1987. This book draws on fields as diverse as biochemistry, physiology, pharmacology, psychology, psychiatry, and ethology to form a fascinating synthesis of information on the nature of fear and of panic and anxiety disorders.

5 

Saul, Helen. Phobias: Fighting the Fear. New York: Arcade, 2001. Traces the historical and cultural roots of phobias, examining case studies and literature in the process.

6 

Stewart, Gail B. Phobias. San Diego, Calif.: Thomson/Gale, 2005. Discusses phobias, especially as they relate to children. Includes bibliographical references and an index.

Citation Types

Type
Format
MLA 9th
Najarian, John Panos, and Nancy A. Piotrowski. "Phobias." Magill’s Medical Guide, 8th Edition, edited by Bryan C. Auday, et al., Salem Press, 2018. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2018_1025.
APA 7th
Najarian, J. P., & Piotrowski, N. A. (2018). Phobias. In B. C. Auday, M. A. Buratovich, G. F. Marrocco & P. Moglia (Eds.), Magill’s Medical Guide, 8th Edition. Salem Press. online.salempress.com.
CMOS 17th
Najarian, John Panos and Piotrowski, Nancy A. "Phobias." Edited by Bryan C. Auday, Michael A. Buratovich, Geraldine F. Marrocco & Paul Moglia. Magill’s Medical Guide, 8th Edition. Hackensack: Salem Press, 2018. Accessed December 14, 2025. online.salempress.com.