Happy woman answers questions during speech in front of crowd.A phobia is a fear related to certain objects or situations. When a phobia is so severe that it interferes with a person’s ability to function, a therapist or other mental health professional may be able to help them address and explore ways to overcome fear, anxiety, and other effects of the phobia so they can be less affected by fear as they move through life.

Addressing Phobias in Therapy

For the most part, phobias are a treatable mental health condition. Once treatment has begun, a phobia is likely to improve and generally does not have long-lasting effects. Those experiencing a phobia may obtain significant benefits from therapy, especially when a specific phobia occurs along with another form of anxiety or a diagnosable personality disorder, as this comorbidity is believed to lead to an increased risk of suicidal ideation and attempts.

Those with phobias are generally aware of them, and many are readily able to discuss the condition with a mental health professional. Some may find their symptoms embarrassing or distressing, and they may be reluctant to discuss their phobia, which can be a barrier to effective treatment.

Types of Therapy for Phobias

Many therapeutic approaches to phobia treatment involve slowly exposing a person to the thing they fear and addressing underlying beliefs that may be contributing to the phobia.

  • Exposure therapy, also known as systematic desensitization, has been shown to be an effective phobia treatment method. This form of treatment involves exposing a person to the source of the phobia in small, gradual steps, which can help a person become able to encounter the object of the phobia in daily life without experiencing significant negative effects. For example, a person who is afraid of birds may first be encouraged to talk about birds with a mental health professional in the safety of an exposure therapy session. The individual then might look at pictures of birds, then visit a pet shop to view birds in cages from a safe distance. Later, they might spend time outside in a park or other area frequented by birds. Finally, when the person feels ready for it, a next step may be exposure to a tame bird. Eventually, the person may find it possible to calmly enter places where birds may be encountered. 
  • Cognitive behavioral therapy is considered to be an effective method of treating phobias, as CBT helps people in therapy identify and address thought patterns that can have a negative impact on well-being. This may allow them to discover which of their thoughts or beliefs is contributing to a phobia.
  • Hypnotherapy may help some manage and overcome a phobia. Most often led by a therapist, hypnotherapy involves taking the person with a phobia through the process of guided visualization. They may imagine they are encountering the object of their phobia and then practice self-soothing techniques.
  • Eye movement and desensitization and reprocessing, or EMDR, could be helpful for people who experience phobias as a result of a past traumatic experience. EMDR therapy for a phobia might involve desensitizing memories that involve the phobia, visualizing a scenario in which the phobia is overcome while using eye movements to calm fear responses, and finally, real-life exposure to the object of the phobia.
  • Relaxation techniques, including breathing and physical exercises and visualization may also be practiced as a part of therapy to treat phobias. Visualization in particular may help an individual become better able to carry out tasks, as it may be easier to face a phobia when one first mentally plans each step. 
  • Support groups may be helpful for some people who experience phobias, as many individuals may find sharing common experiences and coping methods with their support group to be a beneficial step in the process of addressing a phobia.

Self-Care for Phobias

Dealing with a phobia every day can be challenging, especially if that phobia involves a necessary or essential part of life such as going to work, connecting with others, making a phone call, or shopping. 

It it often the case that the object of a phobia might present itself without warning. In these instances, there may not be time for a person to seek professional help, and it may be necessary for them to use relaxation techniques in order to cope and avoid escalating their fear response. Coping strategies people may use when forced to expose themselves to a phobia include:

  • Focusing on or slowing down breathing.
  • Learn about your phobia. Sometimes, education about the object of a phobia may help slow down the fear response associated with it.
  • Progressive muscle relaxation. Practice tensing up and relaxing different muscle groups, focusing all attention on that activity.

Relaxation exercises may help people calm a panic or fear response to a phobia, but if the fear associated with the phobia continues to occur or gets worse, it’s important to seek help from a mental health professional.

Phobia Treatment in Therapy: Case Example

Addressing phobia of hot water in therapy: Claudia, 23, enters therapy, reporting an extreme fear of being burned by hot water. Her phobia is such that she experiences extreme anxiety when showering, doing dishes, or washing her hands because she worries the water will suddenly become hotter and burn her. Although she recognizes that such an occurrence is unlikely, she still finds it nearly impossible to perform any related tasks without significant anxiety, and so she avoids using tap water as much as possible. She tells the therapist the phobia has been present for many years but it has recently worsened to the point where she finds it difficult to even use cold tap water. The therapist asks Claudia if she remembers when the phobia began, but she cannot tell him. It takes some time in therapy, but eventually Claudia is able to recall several instances from early childhood—the memories of which she had buried—of her mother punishing her by holding her hands under running water. Though her mother did not physically abuse her in other ways, further revelations reveal a history of emotional abuse that continued until Claudia went to live with her father at age 10. After her memories are uncovered, Claudia is able to begin working toward recovery with the help of the therapist. She learns relaxation techniques to help manage the anxiety she feels when using running water, and the therapist also suggests eye movement desensitization and reprocessing therapy (EMDR) to address the emotions related to her experience of abuse. Simply talking about her phobia and understanding its cause is helpful for Claudia, and as she continues in therapy, she sees significant improvement.

References:

  1. Moore, A. (2012). The many treatment methodologies for phobias: Finding the best fit. Applied Psychology OPUS. Retrieved from https://steinhardt.nyu.edu/appsych/opus/issues/2012/fall/many 
  2. My anxiety plan for specific phobia. (n.d.). Retrieved from https://www.anxietycanada.com/adults/my-anxiety-plan-specific-phobia 
  3. Pachana, N. A., Woodward, R. M., & Byrne, G. A. (2007). Treatment of specific phobia in older adults. Clinical Interventions in Aging, 3(2), 469-476. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685257