Fear or Phobia?

I remember when I was 16 years old, I was taking an early morning shower before school. It was about 6 am and I was enjoying the quiet while the rest of the household was still asleep. I hadn't put my contacts in yet and have very poor vision, so when I saw something moving out of the corner of my eye I didn't immediately panic. I leaned in closer and that's when it happened. A freaking centipede jumped on me!!! (I know it didn't jump but it really seemed like it did at the time!) I started screaming and crying, running through the house naked and soaking wet without concern about who would see me or how they would react to my hysteria. Even retelling this story causes a certain level of anxiety for me. My heart is beating a little faster, I have butterflies in my stomach and I feel more on edge. The intense fear I felt at the time has stayed with me all these years. Phobias are intense and irrational fears of things or situations that in fact pose no actual danger. There are four identified categories of phobias; animal phobias, situational phobias, blood-injection phobias and natural environment phobias. Examples include fear of spiders, heights, shots, tornados, flying, etc. Most of us have a least one or two fears that we know are irrational but continue to bother us. So when is a phobia diagnosable? How can you know if you should seek treatment?

Even though my reaction to the centipede was on the extreme side (keep in mind, I was a teenager), my fear would not result in a diagnosis by a therapist. Why? A phobia must affect your life significantly in order for you to be diagnosed by a therapist. Luckily, I didn't come into contact with centipedes regularly  in my youth so my fear was not really disruptive to my life. But, if I turned down a high paying job as a plumber because of my fear, it would be considered a true phobia. It is common to have fears that affect us, but when they prevent us from keeping a job, relationship or home, fears are considered phobias.

If you are seeking treatment for a phobia, here are four facts for you to consider:

  1. Avoidance is not the answer

The more you avoid your fear, the bigger and scarier it becomes. Fears are a creation of your mind and not based in reality. Logically you know that you will not die if you sit in a small, dark closet but that doesn't mean that your mind believes it. Fears can develop from childhood when we have little understanding or control over our surroundings and experiences. They can also develop throughout our lifetime as a result of negative or traumatic experiences.

2. Relaxation and self regulation skills are key

Before you begin to tackle your phobia, you need to make sure that you have reliable relaxation skills. Oftentimes people with phobias experience general anxiety in addition to the phobia. It important that when your anxiety rises, you can learn to reduce it. Breathing techniques, visualization, and meditation are some common skills taught in therapy to cope with anxiety. Once you feel that you can contain your anxiety, you can move on to treating your phobia.

3. Treatment is uncomfortable

Although it may seem like your therapist is trying to torture you, she is actually trying to help! As mentioned above, the only way to conquer a phobia is by facing it head on. Treatment for phobias is called exposure therapy and involves exposing yourself to your phobia and allowing your anxiety to rise. Some people prefer to face their fear in the same way as taking off a bandaid and expose themselves all at once. Others prefer systematic desensitization where they take smaller, but increasingly intense steps towards facing their fear. Either way, when you are exposed to your fear, you use relaxation skills to reduce the anxiety during the time of exposure. For me that would mean while I was thinking about, looking at picture of or coming face to face with a centipede, I would use my breathing and visualization skills to calm down. Over time, you stop associating the object of your fear with panic, instead you associate it with the coping skills you used.

4. Self motivation is a must

Because this treatment can feel very uncomfortable at times, it is common for people to want to stop. If you feel like you want to give up, make sure you discuss this with your therapist before you do. She can help remind you of the bigger picture, the long term gains that will result. Ultimately, it is up to you to decide if the treatment process is worth the benefits in the end.

By the way, although I don't particularly enjoy it, I am able to kill centipedes in my basement now. Having an older, sometimes damp house creates an enjoyable space for those little jerks, so I have been unintentionally exposed to them regularly. So next time you feel that your therapist is sadistically tormenting you in your quest to overcome your phobia, remember there is a chance she knows exactly how you feel.