Phobia

The Fear Factor: Phobias

From aviophobia, the fear of flying, to zelophobia, the fear of jealousy, the list of phobias that harrow the human mind runs long.

By Heather Hatfield
WebMD Feature

Reviewed by Brunilda Nazario, MD

Phobias come in many different forms. Acrophobia is the fear of heights. Aviophobia is the fear of flying. Felinophobia is the fear of cats. Myxophobia is the fear of slime. Xyrophobia is the fear of razors. While some are well-recognized, others are unheard of, but whatever the phobia, the person suffering from it is living with fear and anxiety.

"Phobias are the most common mental disorder," says R. Reid Wilson, PhD, spokesman for the American Psychological Association. "Over their lifetimes, 11% of people will have a phobia."
What are phobias, and how can someone get treatment for a fear that prevents them from shaving? WebMD looks at the different phobias that harrow the human mind, and experts explain what treatment options stand a chance against razors.

Fear vs. Phobia

"Phobias involve the experience of persistent fear that is excessive and unreasonable," says Wilson, who is author of the book Don't Panic. "Phobias are cued when a person approaches a particular situation or object, or even anticipates the approach of it, and they understand the fear they will experience as a result of that situation will be unreasonable and excessive."

The key to distinguishing a fear from a phobia is that that while most people get the jitters if a spider crawls on their arm, people suffering from arachnophobia -- the fear of spiders -- are physically and/or psychologically impaired by it.

"To be defined as a phobia, the fear must cause some level of impairment," says Wilson. "I had a woman come in who was afraid of spiders, and it got to the point where she wouldn't go out at night because she couldn't see where they were."

How does someone get to the point where she is so afraid of spiders she can't go outside?

"There are nature and nurture components to phobias," says Kathy Hoganbruen, PhD, National Mental Health Association spokesperson. "While we don't know exactly why or where phobias originate, they are a type of mental illness, with genetics playing a role, as well as environment, meaning maybe someone had a negative or traumatic experience related to the core of their phobia."

Fear Itself

When Franklin Delano Roosevelt said, "The only thing we have to fear is fear itself," he was describing phobophobia -- the fear of being afraid.

Though FDR had a different message in mind, he unknowingly hit on something else: Phobias run the gamut of life and include everything from spiders to outer space.

"The most common phobias involve natural disasters or elements, like water and lightning; animals or insects, like spiders; and blood, injuries, or injections, such as people who faint at the sight of blood or a needle," says Hoganbruen.

Fear of flying is another a well-recognized phobia, and since 9/11, has only gotten worse.

"Fear of flying, in recent times, has become more common," says Hoganbruen. "Since 9/11, it has come up much more than it did in the past."

Then there are social phobias, which include the fear of public speaking, the fear of test taking, or the fear of people, in general.

According to Phobialist.com, which catalogues hundreds of tormenting phobias, people suffer from the fear of the number 8, or octophobia, and the fear of 13, triskaidekaphobia; the fear of noise, or acousticophobia; the fear of ventriloquists dummies or wax statues, or automatonophobia; the fear of sitting down, or kathisophobia; and the fear of beautiful women, or venustraphobia.

How can a person possibly be treated for the fear of all that is the number 8 -- eight french fries on a plate, eight words in a sentence, eight on the jersey of a football player?

Fear No More

"People are generally not treated for phobias," says Wilson. "A very small percentage -- 6% of people with a phobia -- go in for treatment, in part because they are not totally disabled by it, so they find their way around."

Not before a person's phobia is extremely severe do they seek help, Wilson explains to WebMD.

"The treatment that was most common in the past was called systematic desensitization," says Wilson. "It was a pretty standard treatment -- people were taught to relax and in that relaxed state, in a hierarchical way, they would have increased degrees of exposure to their fear."

As the person became anxious, the stimulus would be removed, and he would be allowed to relax. Then they would start over again -- but up the ante and go one step further.

"Now, we are much more provocative in treating people with phobias," says Wilson. "Using cognitive-behavioral treatment, instead of allowing a person to relax after being exposed to the stimulus, we teach them how to manage their feelings."

The American Psychological Association defines cognitive-behavioral modification as "a therapeutic approach that combines the cognitive emphasis on the role of thoughts and attitudes influencing motivations and response with the behavioral emphasis on changing performance through modification of reinforcement contingencies."

Simply, if you change the way you think, it will change the way you act, and if you change the way you act, it will change the way you think.

"One of the shifts I've been making is to have people with phobias work on the attitudes they carry with them," says Wilson. "It's a game against the phobia: Invite the feelings that make you fearful and anxious and learn to tolerate them, setting aside relaxation as a core piece of treatment and using intensity instead -- that's the fastest way to get better."

It's also using more than one technique to solve the problem.

"Not all therapists stick to one treatment doctrine or another," says Hoganbruen. "Many combine several different techniques -- systemic desensitization, behavioral therapies, cognitive behavioral therapies -- into a treatment regimen."

Treating Phobias With Technology

The treatment of phobias is going high-tech as well, with virtual reality being used as a tool in helping people overcome their anxieties.

"Virtual reality is the other newer treatment being used for phobias," says Wilson. "It's three to four years away from being used on a broad basis because the equipment is so expensive to use, but there are four or five places in the U.S. that are using it today."

The University of Washington is one institution that uses virtual reality (VR), coupled with real life, in treating phobias. According to a news release, "Researchers at the University of Washington's Human Interface Technology Lab measured aversion and anxiety responses of students, some of whom had a clinical phobia of spiders, before and after undergoing VR therapy. During the therapy, some of the subjects touched a realistic model of a large spider while grasping a virtual one."

The combination of fact with fiction worked: Those students were able to come twice as close to a real spider after completing three therapy sessions, and reported a greater decrease in anxiety during treatment, than those who underwent VR therapy alone.

Phobias

Whether its ablutophobia, the fear of washing or bathing, or zoophobia, the fear of animals, phobias can truly be harrowing. From phobialist.com, here are some of the more peculiar:

Alektorophobia: Fear of chickens
Bogyphobia: Fear of bogeys or the bogeyman
Coulrophobia: Fear of clowns
Dendrophobia: Fear of trees
Euphobia: Fear of hearing good news
Frigophobia: Fear of cold or cold things
Geniophobia: Fear of chins
Homichlophobia: Fear of fog
Isopterophobia: Fear of termites, insects that eat wood
Japanophobia: Fear of Japanese
Kosmikophobia: Fear of cosmic phenomenon
Lutraphobia: Fear of otters
Mnemophobia: Fear of memories
Novercaphobia: Fear of your stepmother
Ophthalmophobia: Fear of being stared at
Paraskavedekatriaphobia: Fear of Friday the 13th
Ranidaphobia: Fear of frogs
Sciophobia: Fear of shadows
Textophobia: Fear of certain fabrics
Urophobia: Fear of urine or urinating
Verbophobia: Fear of words
Wiccaphobia: Fear of witches and witchcraft
Xanthophobia: Fear of the color yellow or the word yellow
Zemmiphobia: Fear of the great mole rat

There is panophobia, or the fear of everything.