Fears and Phobias

Many psychologists believe that our emotions are reactions in the brain that often warn us of distressing situations that can cause hurt or danger. Fear specifically alerts us to danger, letting us know to be prepared to fight, flee or seek safety in a group. When a fear response becomes excessive and prolonged, an individual may develop anxiety that becomes associated with specific objects or situations and can eventually develop into a phobia.

In the Diagnostic and Statistical Manual, phobias are characterized by excessive, persistent or unreasonable fear that is triggered by the actual presence or anticipated presence of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). Exposure to such situations or objects frequently causes immediate anxiety and may take the form of a Panic Attack which then becomes connected with that specific object or situation. In children, excessive anxiety may be expressed through crying, tantrums, “freezing”, or clinging. The individual with a phobia often avoids or endures the situation that provokes intense anxiety or distress. When a person has a phobia, avoidance, anxious anticipation, or distress in the feared situation it interferes significantly with their normal routine, occupational or academic functioning and social activities or relationships. There is often significant distress about having a phobia.

In children or teenagers, the fearful, avoidant, and anxious behaviors must be present for at least 6 months before being diagnosed as a phobia. Other psychiatric disorders such as Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Separation Anxiety Disorder, Social Phobia, Panic Disorder with Agoraphobia, or Agoraphobia without history of Panic Disorder must be ruled out as a cause of these behaviors. The key features of a phobia are the intensity, persistence and unreasonable level of response when compared to a typical or normal fear response.

Phobias have been studied for many years finding an incidence rate of approximately 10% in the general population with females outnumbering males by about 2 to 1. Although the rate of phobias in children may be slightly less than in the adult population, particularly when the criterion of at least 6 months duration is tightly monitored, it still occurs in at least 5% of children.

Even though phobias can be very powerful, people with phobias often respond very well to treatment. Typical treatment interventions generally include some type of actual or simulated exposure to the feared object or situation. Systematic Desensitization is a treatment strategy that gradually increases the amount of exposure to the feared object or situation. Another treatment intervention is called Flooding in which exposure to the feared object is very rapid and prolonged until the anxiety or fear decreases to a manageable level. Additional strategies can also include the use of “virtual” exposure using computer assisted imagery. If a phobia has been present for many years, medication may be needed to bring about the best treatment results in helping an individual with regulating these powerful emotional responses.

The professionals at Silber Psychological Services specialize in treating children and teenagers and have training in the treatment of fears and phobias. We will work with you and your child to determine what type of intervention will be most useful. Although these treatment interventions can initially increase the anxiety or fear that your child is experiencing, the final outcome of being able to deal with the feared object or situation in a healthy and normal manner is worth the initial discomfort.