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Phobias (Introduction)

Last updated 22 Mar 2021

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Phobias are categorised as an anxiety disorder which cause an irrational fear of a particular object or situation .

There are three categories of phobia, including:

• Simple (specific) phobia
• Social phobia

Agoraphobia

Simple phobias

Simple, or specific phobias, are the most common type of phobia. This is where a person fears a specific object in the environment, for example arachnophobia, the fear of spiders.

Simple phobias are further divided into four categories:

• Animal phobias
• Injury phobias
• Situational phobias, and
• Natural phobias

Extension: Common animal phobias include arachnophobia (see above) and ophidiophobia, the fear of snakes. Injury phobias include haematophobia, the fear of blood. Situational phobias include aerophiba, the fear of the flying and natural phobias include hydrophobia, the fear of water.

Social phobias

Social phobias involve feelings of anxiety in particular social situation, for example, when giving a speech in public.

Sufferers feel like they are being judged which leads to feelings of inadequacy and apprehension.

Social phobias are further divided into three categories:

• Performance phobias
• Interaction phobias, and
• Generalised phobias

Extension: Performance phobias result in feelings of anxiety when performing in public, for example, eating in a restaurant with friends; interaction phobias result in feelings of anxiety when mixing with others, for example, when answering questions during an interview and generalised phobias result in feelings of anxiety when other people are present, for example, when in a large crowd at a music concert.

Agoraphobia is a fear of open or public spaces and sufferers may experience panic attacks and anxiety, which make them feel vulnerable in open spaces.

Agoraphobia can be caused by simple phobias and/or social phobias.

For example, the simple phobia mysophobia, which is the fear of contamination, could lead to a fear of public spaces, as well as social phobias, in particular generalised phobias.

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Phobia Symptoms, Types, and Treatment

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

According to the American Psychiatric Association, a phobia is an irrational and excessive fear of an object or situation. In most cases, the phobia involves a sense of endangerment or a fear of harm. For example, those with agoraphobia fear being trapped in an inescapable place or situation.

Phobia Symptoms

Phobic symptoms can occur through exposure to the feared object or situation, or sometimes merely through thinking about the feared object. Typical symptoms associated with phobias include:

• Breathlessness
• Dizziness, trembling, and increased heart rate
• Fear of dying
• Preoccupation with the feared object
• A sense of unreality

In some cases, these symptoms may escalate into a full-scale anxiety attack .  

In response to these symptoms, some individuals may develop social anxiety disorder (SAD)—previously known as social phobia—and begin to isolate themselves, leading to severe difficulties with functioning in daily life and with maintaining relationships.

In other cases, such as with hypochondriasis , a person may seek out medical care due to a constant concern with imagined illnesses or imminent death.

Types of Phobias

The American Psychiatric Association defines phobias as anxiety disorders and categorizes them into three different types:

• Agoraphobia : This describes a fear of being trapped in an inescapable place or situation. As a result, the phobic individual may begin to avoid such situations. In some cases, this fear can become so pervasive and overwhelming that the individual even fears to leave their home.
• ​ Specific phobias : These involve the fear of a particular object (such as snakes or butterflies and moths ). Such phobias typically fall into one of four different categories: situational, animals, medical, or environmental. A few examples of common fear objects include spiders, dogs, needles, natural disasters, heights, and flying.
• Social phobias : A fear of social situations includes an extreme and pervasive fear of social situations. In some cases, this fear may center on a very particular type of social situation such as public speaking. In other instances, people may fear to perform any task in front of other people for fear that they will be somehow publicly embarrassed.

More examples of the four major types of specific phobias   include:

• Animal : Fear of snakes, rodents, cats, or birds.
• Medical : Fear of seeing blood or visiting a doctor.
• Natural environment : Fear of lightning, water, storms, hurricanes, tornadoes, or mudslides.
• Situational : Fear of bridges, leaving home, or driving.

Prevalence of Social Anxiety Disorder

According to the National Institute of Mental Health, social anxiety disorder affects about 7% of adult Americans in a given year and specific phobias affect approximately 9% . In general, women are affected more than men.  

According to the  Diagnostic and Statistical Manual of Mental Disorders , only about 10% of reported phobia cases become life-long phobias.

Phobia Treatments

There are a number of treatment approaches for phobias , and the effectiveness of each approach depends on the person and their type of phobia. 

In exposure treatments,   the person is strategically exposed to their feared object in order to help them overcome their fear. One type of exposure treatment is flooding, in which the patient is confronted by the feared object for an extended length of time without the opportunity to escape. The goal of this method is to help the individual face their fear and realize that the feared object will not harm them.

Another method often used in phobia treatment is counter-conditioning. In this method, the person is taught a new response to the feared object. Rather than panic in the face of the feared object or situation, the person learns relaxation techniques to replace anxiety and fear.

This new behavior is incompatible with the previous panic response, so the phobic response gradually diminishes. Counter-conditioning is often used with people who are unable to handle exposure treatments and has been effective for treating children and adolescents.  

Finally, for both adults and children with social phobia, medication like a low dose of a benzodiazepine  or potentially an antidepressant (like a selective serotonin reuptake inhibitor, or SSRI) in combination with cognitive-behavioral therapy can prove helpful.  

Get Advice From The Verywell Mind Podcast

Hosted by Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares how to face your fears in a healthy way.

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A Word From Verywell

If you think you may have a phobia, please seek out treatment from a licensed therapist, psychologist , or psychiatrist . You deserve to develop control of this fear, and you can with proper therapy. 

Garcia R. Neurobiology of fear and specific phobias . Learn Mem. 2017;24(9):462-471. doi: 10.1101/lm.044115.116

Tsitsas GD, Paschali AA. A Cognitive-Behavior Therapy Applied to a Social Anxiety Disorder and a Specific Phobia, Case Study. Health Psychol Res . 2014;2(3):1603. Published 2014 Oct 21. doi:10.4081/hpr.2014.1603

Burstein M, Georgiades K, He JP, et al. Specific phobia among U.S. adolescents: phenomenology and typology . Depress Anxiety . 2012;29(12):1072–1082. doi:10.1002/da.22008

McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res . 2011;45(8):1027–1035. doi:10.1016/j.jpsychires.2011.03.006

McGuire JF, Lewin AB, Storch EA. Enhancing exposure therapy for anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder . Expert Rev Neurother . 2014;14(8):893–910. doi:10.1586/14737175.2014.934677

Davis TE 3rd, Ollendick TH, Ost LG. Intensive Treatment of Specific Phobias in Children and Adolescents . Cogn Behav Pract . 2009;16(3):294–303. doi:10.1016/j.cbpra.2008.12.008

Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci . 2017;19(2):93–107.

American Psychiatric Association. (2013).  Diagnostic and Statistical Manual of Mental Disorders (5th ed.).  Washington, DC: American Psychiatric Publishing. 

National Collaborating Centre for Mental Health (UK). Social Anxiety Disorder: Recognition, Assessment and Treatment . Leicester (UK): British Psychological Society (2013).

National Institute of Mental Health. The Numbers Count: Mental Disorders in America (2013).

Richard T.A. Social Anxiety Association. Social Anxiety Fact Sheet: What Is Social Anxiety Disorder? 

Samra, Chadan K., Abdijadid, Sara. Specific Phobia . Treasure Island (FL): StatPearls Publishing (2020).

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Facing Your Fears And Phobias

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Introduction & Theoretical Background

Everyone feels afraid sometimes. Uncomfortable as it is, fear is an unavoidable part of life. In fact, a little fear can help you stay safe and avoid danger. However, fear can become so intense, or trouble you so often, that it leads to serious problems. When particular objects or situations cause intense fear, psychologists refer to this as a ‘phobia’. 

Facing Your Fears And Phobias is a guide written for clients who struggle with their fears, and can be used to introduce them to exposure therapy. It will help them learn:

• What fear is.
• How fear gets ‘stuck’ and becomes a problem.
• How to use exposure to overcome their fears.

Therapist Guidance

Facing Your Fears And Phobias is designed for use as guided self-help and can be used to support work completed in session. Alternatively, it can provide a scaffold for self-help for sufficiently motivated clients. 

The guide begins with psychoeducation, guiding clients through a discussion of fear, its purpose, and when it becomes a problem. It then elaborates fear from a CBT perspective (exploring fearful thoughts, images, physical responses, and behaviors) before introducing the principles of exposure, habituation, and inhibitory learning. 

The second part of the guide leads clients through practical steps they can take to overcome their fears and phobias. Exercises include developing a fear ladder and then conducting an exposure session which includes multiple repetitions of exposure to a a feared stimulus. Finally, instructions concerning relapse prevention are elaborated.

References And Further Reading

• Ciuca, A. M., Berger, T., Crişan, L. G., & Miclea, M. (2018). Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results. Journal of Anxiety Disorders , 56, 43-55. DOI: 10.1016/j.janxdis.2018.03.009.
• Furmark, T., Carlbring, P., Hedman, E., Sonnenstein, A., Clevberger, P., Bohman, B., ... & Andersson, G. (2009). Guided and unguided self-help for social anxiety disorder: randomised controlled trial. The British Journal of Psychiatry , 195, 440-447. DOI: 10.1192/bjp.bp.108.060996.
• Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry , 69, 621-632.
• Papworth, M. (2020). How to beat fears and phobias one step at a time. Using evidence-based low-intensity CBT . Robinson.
• Springer, K. S., & Tolin, D. F. (2020). The big book of exposures: Innovative, creative, and effective CBT-based exposures for treating anxiety-related disorders . New Harbinger.
• Tolin, D. (2012). Face your fears: A proven plan to beat anxiety, panic, phobias, and obsessions . John Wiley and Sons.
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What Is a Phobia?

A phobia is an excessive, persistent, and irrational fear of something, and is a type of anxiety disorder. It can be directed toward objects, places, activities, situations, animals, or people. We all try to avoid things that make us feel uncomfortable, but people with phobias work hard to avoid what scares them, so much so that it disrupts their daily activities. Symptoms can range from mildly inconvenient (like sweating) to disabling (like avoidance behaviors that make someone miss out on important opportunities).

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A phobia is a type of anxiety disorder that magnifies perceived threats and trigger exaggerated stress responses.

The American Psychiatric Association identifies three major categories of phobias:

• Social phobia, now called social anxiety disorder , is where people unreasonably fear being humiliated, embarrassed, or judged by others in social situations. Unfamiliar people and groups can be particularly distressing
• Agoraphobia refers to an intense and debilitating fear of public places and situations where it is difficult to escape or embarrassing to exit. This may include enclosed and/or open spaces. Many people with agoraphobia also have panic symptoms or panic disorder, which involves intense fear plus uncomfortable physical symptoms, such as trembling, heart palpitations, and sweating
• Specific phobias, known as simple phobias , are the most common type of phobias. These phobias can be of animals (such as dogs and cats ), people ( such as clowns and healthcare providers), environments (such as dark or high places), and situations (such as flying or taking a train)

Specific Phobias

• Acrophobia: Fear of heights
• Amaxophobia : Fear of driving
• Androphobia: Fear of men
• Arachnophobia : Fear of spiders
• Automatonophobia : Fear of animatronics
• Chronophobia : Fear of time
• Cynophobia : Fear of dogs
• Mysophobia : Fear of germs
• Megalophobia : Fear of large objects
• Pedophobia: Fear of children
• Phasmophobia : Fear of ghosts
• Spectrophobia: Fear of mirrors
• Thalassophobia: Fear of deep water
• Tocophobia: Fear of childbirth
• Trypophobia : Fear of repetitive patterns of holes
• Zoophobia: Fear of animals

Symptoms often overlap across different types of phobias. Commonly experienced psychosocial and physical reactions related to phobias include:   

• Uncontrollable and severe feelings of panic and anxiety: Anxiety-associated physical effects, such as nausea, sweating, blushing, heart palpitations, and trembling. Other physical symptoms include increased heart rate, shortness of breath, a choking feeling, chest pain or discomfort, upset stomach, feeling dizzy or faint, a feeling of losing control or “going crazy” numbness, and chills or hot flashes  
• Intentional avoidance: People with phobias may try to avoid the things that cause them intense fear and anxiety. Depending on the exact phobia, this can look like avoiding everything from meeting new people to going into elevators to avoiding flying on a plane or even leaving the house.
• Understanding the fear is irrational but unable to control the exposure response: When someone has a phobia, they are aware that their reaction is exaggerated but unable to remedy it without help. Untreated phobias are life-limiting in that they cause significant interference with daily activities and interpersonal relationships

The Difference Between Fear and Phobia

Everyone experiences fear, but not everyone has a phobia. The difference exists in the degree of anxiety involved and how long a high level of anxiety persists. For example, it's normal to feel anxious around your neighbor’s pit bull, but you may have a phobia if you avoid your neighbor for fear of seeing their dog. What people with phobias are afraid of usually poses little to no danger. Also, regular, everyday fears do not require treatment, while phobias can become chronically impairing in the absence of treatment.

Diagnosis of phobias is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5) and requires the response to be disproportionate to any actual threat.

Necessary elements of a phobia diagnosis include:

• Exposure to the phobia almost always triggers an exaggerated stress response
• The fear, anxiety, or aversion is persistent, typically lasting six or more months
• It results in avoidance or enduring with extreme distress
• Everyday functioning is impaired, impacting relationships and opportunities
• The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder)

A mental health professional may ask about current symptoms and family history, particularly whether other family members have had phobias. You may also be asked about any experience or trauma that may have set off the phobia, such as a dog attack leading to a fear of dogs.

When to Seek Help

Getting help is an effective way to treat phobias. If you are experiencing new or worsening symptoms of phobias, it is essential that you seek help to reduce its impact on your livelihood and quality of life. If your current treatment plan has stopped working, you should also connect with your healthcare provider.

Remember that your practitioner or mental health professional understands the nature of your phobias and can help you recover.

For more information on ways to get help, visit:

• Anxiety Disorders Association of America (ADAA)
• Phobics Anonymous at (760) 322-COPE

Childhood phobias typically present between ages 5 and 9, and go way beyond the typical fears of childhood and can be life-disrupting. They are often short-lived, however, and disappear within a few months.   While children with phobias can fear the same things as children without phobias, the key difference is that for a phobic child, there is no on-off switch for the fear. It’s ever-present and so extreme that it interferes with their ability to relax, concentrate, and enjoy activities.  

In adults, about 80% of new phobias become chronic conditions that do not go away without proper treatment.  

Social Anxiety Disorder

Social anxiety disorder is more than shyness or introversion. It is characterized by extreme fear and distress in social situations.

Men and women are affected equally with this disorder. This condition affects about 7% of Americans. People with social phobia can experience extreme difficulty in social activities, from dating and meeting new people to answering questions in school and interviewing for jobs. People with social phobia can lost out on opportunities as a result of aversion and avoidance. 

People with social phobia are at high risk for alcohol or other drug use because they may come to rely on these substances to relax in social situations.

Agoraphobia

The fear and aversion in agoraphobia comes from feeling unable to easily escape or get help. Diagnosis requires a marked fear or anxiety about two (or more) of the following five situations: Using public transportation, being in open spaces, being in enclosed spaces (e.g., shops, theaters, cinemas), standing in line or being in a crowd, and being outside the home alone.

Agoraphobia sometimes occurs when a person has had a panic attack and begins to fear situations that might lead to another panic attack.

Specific Phobias 

Having a specific phobia means responding unfavorably to a specific trigger that is generally not threatening to or distressing for others. It could be an environmental trigger like a lightning or rain storm, an animal trigger like snakes or spiders, or a situational trigger such as entering an airport or flying in a plane. Other common specific phobias include extreme fears of and aversions to heights, needles, and seeing blood. 

There is no way to prevent a phobia, but early treatment of panic disorders may help prevent agoraphobia.

Phobias in general are highly treatable because people are typically aware of their trigger. Psychotherapy, medication, or a combination of both can be used, but the exact treatment plan depends upon the type of phobia.

Psychotherapy

Healthcare providers will usually recommend talk therapy first, which includes:

• Cognitive behavioral therapy: It is used to change specific thoughts that cause fear
• Exposure-based treatment : It involves tackling parts of the phobia, working from the least fearful to the most fearful. You may also be gradually exposed to your real-life fear to help you overcome it
• Phobia clinics and group therapy: They help people deal with common phobias such as a fear of flying
• Social skills training: This may be recommended for people with social phobia, and involves social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation
• Support groups: Sharing with others who have common experiences and problems can help alleviate the stress and anxiety that come with phobias. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. The Anxiety and Depression of America has a list of support groups for people with phobias on its website

Typically medications work best when combined with psychotherapy. Some drugs used to treat phobias include:

• Beta-blockers like propranolol (Inderal) can be prescribed to dull the physical effects of anxiety before exposure to a trigger like public speaking . This is particularly useful in cases of social phobia
• SSRI antidepressants , and other types of antidepressants, such as mirtazapine (Remeron), venlafaxine (Effexor), clomipramine (Anafranil), and imipramine (Tofranil) can be used in the treatment of agoraphobia
• Benzodiazepine and anti-anxiety medications , such as clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan) may also be administered to treat social anxiety (phobia) or agoraphobia. Do not drink alcohol while on these medications  

A Word From Verywell

Phobias become less powerful and more manageable with adequate treatment. Even if you have a phobia, through the right interventions, you can prevent it from taking over your life. The most distressing step is probably reaching out and seeking help, but remember that proper treatment with a professional can drastically improve outcomes.

Harvard Health Publishing. Phobia .

Boston Children's Hospital. Phobias Symptoms & Causes .

Substance Abuse and Mental Health Services Administration. Table 3.11, DSM-IV to DSM-5 Specific Phobia Comparison - Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health . Rockville (MD): Substance Abuse and Mental Health Services Administration (US).

NCBI Bookshelf. Social Phobia .

MedlinePlus. Social anxiety disorder .

Substance Abuse and Mental Health Services Administration. Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).

MedlinePlus. Phobias - simple/specific .

Anxiety and Depression Association of America. Support Groups .

By Michelle Pugle Pulge is a freelance health writer focused on mental health content. She is certified in mental health first aid.

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Prompt children to begin a discussion about anxiety and fear using the My Fears anxiety worksheet. This worksheet will give your clients an opportunity to discuss the feelings of fear and anxiety, why they are important, and how they can be harmful.

Children are asked to list their fears, describe their thoughts about the anxiety, identify where in their body they sense the feeling, and finally to create a plan for dealing with fear in the future. The goal of this worksheet is to begin introducing children to the concept that thoughts and feelings are linked, and to increase awareness of their emotions by asking them to identify how their body responds to anxiety.

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