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The fear of spiders can be treated by any of the general techniques suggested for specific phobias. The first line of treatment is systematic desensitization – also known as exposure therapy – which was first described by South African psychiatrist Joseph Wolpe. Before engaging in systematic desensitization it is common to train the individual with arachnophobia in relaxation techniques, which will help keep the patient calm. Systematic desensitization can be done in vivo (with live spiders) or by getting the individual to imagine situations involving spiders, then modelling interaction with spiders for the person affected and eventually interacting with real spiders. This technique can be effective in just one session.
Recent advances in technology have enabled the use of virtual or augmented reality spiders for use in therapy. These techniques have proven to be effective.
Main features of diagnostic criteria for specific phobia in the DSM-IV-TR:
- Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
- Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack. In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.
- The person recognizes that the fear is excessive or unreasonable. In children, this feature may be absent.
- The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
Specific Phobia – DSM 5 Criteria
- Fear or anxiety about a specific object or situation (In children fear/anxiety can be expressed by crying, tantrums, freezing, or clinging)
- The phobic object or situation almost always provokes immediate fear or anxiety
- The phobic object or situation is avoided or endured with intense fear or anxiety
- The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context
- The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The disturbance is not better explained by symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms; objects or situations related to obsessions; reminders of traumatic events; separation from home or attachment figures; or social situations
According to the fourth revision of the "Diagnostic and Statistical Manual of Mental Disorders", phobias can be classified under the following general categories:
- Animal type – Fear of dogs, cats, rats and/or mice, pigs, cows, birds, spiders, or snakes.
- Natural environment type – Fear of water (aquaphobia), heights (acrophobia), lightning and thunderstorms (astraphobia), or aging (gerascophobia).
- Situational type – Fear of small confined spaces (claustrophobia), or the dark (nyctophobia).
- Blood/injection/injury type – this includes fear of medical procedures, including needles and injections (trypanophobia), fear of blood (hemophobia) and fear of getting injured.
- Other – children's fears of loud sounds or costumed characters.
The terms "distress" and "impairment" as defined by the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition" (DSM-IV-TR) should also take into account the context of the person's environment if attempting a diagnosis. The DSM-IV-TR states that if a feared stimulus, whether it be an object or a social situation, is absent entirely in an environment, a diagnosis cannot be made. An example of this situation would be an individual who has a fear of mice but lives in an area devoid of mice. Even though the concept of mice causes marked distress and impairment within the individual, because the individual does not usually encounter mice, no actual distress or impairment is ever experienced. Proximity to, and ability to escape from, the stimulus should also be considered. As the phobic person approaches a feared stimulus, anxiety levels increase, and the degree to which the person perceives they might escape from the stimulus affects the intensity of fear in instances such as riding an elevator (e.g. anxiety increases at the midway point between floors and decreases when the floor is reached and the doors open).
The most common methods for the treatment of specific phobias are systematic desensitization and in vivo or exposure therapy.
Fear of mice may be treated by any standard treatment for specific phobias. The standard treatment of animal phobia is systematic desensitization, and this can be done in the consulting room (in vivo), or in hypnosis (in vitro). Some clinicians use a combination of both in vivo and in vitro desensitization during treatment. It is also helpful to encourage patients to experience some positive associations with mice: thus, the feared stimulus is paired with the positive rather than being continuously reinforced by the negative.
As with most phobias this fear could be cured with therapy. Relaxation techniques or support groups could also be effective.
Phobias are a common form of anxiety disorders and distributions are heterogeneous by age and gender. An American study by the National Institute of Mental Health (NIMH) found that between 8.7 percent and 18.1 percent of Americans suffer from phobias, making it the most common mental illness among women in all age groups and the second most common illness among men older than 25. Between 4 percent and 10 percent of all children experience specific phobias during their lives, and social phobias occur in one percent to three percent of children and adolescents.
A Swedish study found that females have a higher incidence than males (26.5 percent for females and 12.4 percent for males). Among adults, 21.2 percent of women and 10.9 percent of men have a single specific phobia, while multiple phobias occur in 5.4 percent of females and 1.5 percent of males. Women are nearly four times as likely as men to have a fear of animals (12.1 percent in women and 3.3 percent in men) — a higher dimorphic than with all specific or generalized phobias or social phobias. Social phobias are more common in girls than in boys, while situational phobia occurs in 17.4 percent of women and 8.5 percent of men.
The most widely used and possibly the most effective treatment for astraphobia is exposure to thunderstorms and eventually building an immunity. Cognitive behavioral therapy is also often used to treat astraphobia. The patient will in many cases be instructed to repeat phrases to himself or herself in order to become calm during a storm. Heavy breathing exercises can reinforce this effort.
In 2007 scientists found astraphobia is the third most prevalent phobia in the US. It can occur in people of any age. It occurs in many children, and should not be immediately identified as a phobia because children naturally go through many fears as they mature. Their fear of thunder and lightning cannot be considered a fully developed phobia unless it persists for more than six months. In this case, the child's phobia should be addressed, for it may become a serious problem in adulthood.
To lessen a child's fear during thunderstorms, the child can be distracted by games and activities. A bolder approach is to treat the storm as an entertainment; a fearless adult is an excellent role model for children.
Many treatment options are available for those suffering from it. Cognitive behavioral therapy is one form of therapy for people who suffer from certain phobias. It focuses on one's fears and the reason they exist. It tries to change and challenge the thought processes behind one's fear. Studies have shown that it has been effective in treating people with equinophobia. Another treatment option is systematic desensitization, which focuses on gradually acclimating patients to their phobias. The first step in this process may involve thinking about horses, followed by looking at pictures of horses. Once the patient is comfortable with the images, they may proceed to meeting a horse, touching a horse, and finally riding a horse. For extreme cases, it may also be necessary to use medication, even though its effects are only short term.
Although most commonly done with the help of a therapist in a professional setting, exposure to dogs is also possible as a self-help treatment. First, the patient is advised to enlist the help of an assistant who can help set-up the exposure environment, assist in handling the dog during sessions, and demonstrate modeling behaviors. This should also be someone whom the patient trusts and who has no fear of dogs. Then, the patient compiles a hierarchy of fear provoking situations based on their rating of each situation. For example, on a scale from 0 to 100, a patient may feel that looking at photos of dogs may cause a fear response of only 50, however, petting a dog's head may cause of fear response of 100. This list of situations looking at dog photos) to most fearful (petting a dog's head) and the assistant helps the patient to identify common elements that contribute to the fear (i.e., size of the dog, color, how it moves, noise, whether or not it is restrained, etc.). Next, the assistant helps the patient recreate the least fearful situation in a safe, controlled environment, continuing until the patient has had an opportunity to allow the fear to subside thus reinforcing the realization that the fear is unfounded. Once a situation has been mastered, the next fearful situation is recreated and the process is repeated until all the situations in the hierarchy have been experienced.
Sample videos showing humans and dogs interacting without either exhibiting significant fear are available.
The most common treatment for serious cases is behavior therapy—specifically, systematic desensitization.
Several other self-help treatments exist, mainly involving exposure therapy and relaxation techniques while driving. Additional driving training and practice with a certified teacher also help many to become more confident and less likely to suffer from anxiety.
One of the emerging methods of treating this fear is through the use of virtual therapy.
With repeated exposure, all of the subjects displayed significantly less variance from normal in heart rate acceleration, depression readings, subjective distress, and post-traumatic stress disorder ratings.
Zoophobia or animal phobia is a class of specific phobias to particular animals, or an irrational fear or even simply dislike of any non-human animals.
Examples of specific zoophobias would be entomophobias, such as that of bees (apiphobia). Fears of spiders (arachnophobia), birds (ornithophobia) and snakes (ophidiophobia) are also common. See the article at -phobia for the list of various phobias. Sigmund Freud mentioned that an animal phobia is one of the most frequent psychoneurotic diseases among children.
Zoophobia is not the sensible fear of dangerous or threatening animals, such as wild dogs (example: wolves, dingoes, and coyotes), big cats, bears or venomous snakes. It is a phobia of animals that causes distress or dysfunction in the individual's everyday life.
There are several options for treatment of scopophobia. With one option, desensitization, the patient is stared at for a prolonged period and then describes their feelings. The hope is that the individual will either be desensitized to being stared at or will discover the root of their scopophobia.
Exposure therapy, another treatment commonly prescribed, has five steps:
- Evaluation
- Feedback
- Developing a fear hierarchy
- Exposure
- Building
In the evaluation stage, the scopophobic individual would describe their fear to the therapist and try to find out when and why this fear developed. The feedback stage is when the therapist offers a way of treating the phobia. A fear hierarchy is then developed, where the individual creates a list of scenarios involving their fear, with each one becoming worse and worse. Exposure involves the individual being exposed to the scenarios and situations in their fear hierarchy. Finally, building is when the patient, comfortable with one step, moves on to the next.
As with many human health problems support groups exist for scopophobic individuals. Being around other people who face the same issues can often create a more comfortable environment.
Other suggested treatments for scopophobia include hypnotherapy, neuro-linguistic programming (NLP), and energy psychology. In extreme cases of scopophobia, it is possible for the subject to be prescribed anti–anxiety medications. Medications may include benzodiazepines, antidepressants, or beta-blockers.
There are also many options for treatment of Ablutophobia. Generally seeking professional help from a person with a background in psychology is the best option. A sufferer of Ablutophobia can also undergo Exposure-Based Cognitive Behavioral Therapy in which the person is allowed to confront the feared object (in this case, water) in controlled situations.
There are anxiety medications that medical professionals can prescribe as well, however these medications have yet to show much promise in the treatments of specific phobias such as Ablutophobia. The use of d-cycloserine (DCS) in conjunction with Exposure therapy is the only drug to show developments in alleviating the phobia-related symptoms even after a 3-month period.
Anxiety around mirrors and at all costs staying away from mirrors
Fear of needles, especially in its more severe forms, is often comorbid with other phobias and psychological ailments; for example, iatrophobia, or an irrational fear of doctors, is often seen in needle phobic patients.
A needle phobic patient does not need to physically be in a doctor's office to experience panic attacks or anxiety brought on by needle phobia. There are many triggers in the outside world that can bring on an attack through association. Some of these are blood, injuries, the sight of the needle physically or on a screen, paper pins, examination rooms, hospitals, white lab coats, hospital gowns, doctors, dentists, nurses, the antiseptic smell associated with offices and hospitals, the sight of a person who physically resembles the patient's regular health care provider, or even reading about the fear.
In 2009, a study investigated the impact of anthropophobia in specific cultures. 50 patients diagnosed with anthropophobia, 50 patients diagnosed with neurasthenia, and 50 control subjects were recruited from hospitals in Beijing, China. Measures of anthropophobic and anxiety symptoms were administered to the subjects. The patients with anthropophobia could not even make eye contact with others and were afraid of being watched. The conclusion drawn was that anthropophobics, like neurasthenics, experience anxiety and depression, but "more cognitively and less somatically".
The medical literature suggests a number of treatments that have been proven effective for specific cases of needle phobia, but provides very little guidance to predict which treatment may be effective for any specific case. The following are some of the treatments that have been shown to be effective in some specific cases.
- Ethyl Chloride Spray (and other freezing agents). Easily administered, but provides only superficial pain control.
- Jet Injectors. Jet Injectors work by introducing substances into the body through a jet of high pressure gas as opposed to by a needle. Though these eliminate the needle, some people report that they cause more pain. Also, they are only helpful in a very limited number of situations involving needles i.e. insulin and some inoculations.
- Iontophoresis. Iontophoresis drives anesthetic through the skin by using an electric current. It provides effective anesthesia, but is generally unavailable to consumers on the commercial market and some regard it as inconvenient to use.
- EMLA. EMLA is a topical anesthetic cream that is a eutectic mixture of lidocaine and prilocaine. It is a prescription cream in the United States, and is available without prescription in some other countries. Although not as effective as iontophoresis, since EMLA does not penetrate as deeply as iontophoresis-driven anesthetics, EMLA provides a simpler application than iontophoresis. EMLA penetrates much more deeply than ordinary topical anesthetics, and it works adequately for many individuals.
- Ametop. Ametop gel appears to be more effective than EMLA for eliminating pain during venepuncture.
- Lidocaine/tetracaine patch. A self-heating patch containing a eutectic mixture of lidocaine and tetracaine is available in several countries, and has been specifically approved by government agencies for use in needle procedures. The patch is sold under the trade name "Synera" in the United States and "Rapydan" in European Union. Each patch is packaged in an air-tight pouch. It begins to heat up slightly when the patch is removed from the packaging and exposed to the air. The patch requires 20 to 30 minutes to achieve full anesthetic effect. The Synera patch was approved by the United States Food and Drug Administration on 23 June 2005.
- Behavioral therapy. Effectiveness of this varies greatly depending on the person and the severity of the condition. There is some debate as to the effectiveness of behavioral treatments for specific phobias (like blood, injection, injury type phobias), though some data are available to support the efficacy of approaches like exposure therapy. Any therapy that endorses relaxation methods may be contraindicated for the treatment of fear of needles as this approach encourages a drop in blood pressure that only enhances the vasovagal reflex. In response to this, graded exposure approaches can include a coping component relying on applied tension as a way to prevent complications associated with the vasovagal response to specific blood, injury, injection type stimulus.
- Nitrous Oxide (Laughing Gas). This will provide sedation and reduce anxiety for the patient, along with some mild analgesic effects.
- Inhalation General Anesthesia. This will eliminate all pain and also all memory of any needle procedure. On the other hand, it is often regarded as a very extreme solution. It is not covered by insurance in most cases, and most physicians will not order it. It can be risky and expensive and may require a hospital stay.
- Benzodiazepines, such as diazepam (Valium) or lorazepam, may help alleviate the anxiety of needle phobics, according to Dr. James Hamilton. These medications have an onset of action within 5 to 15 minutes from ingestion. A relatively large oral dose may be necessary.
The phobia manifests itself in different ways. For most people it is less about fear than about loathing, similar to the reaction many people have to snakes or rats. Some people experience it almost all the time, others just in response to direct stimuli. Some possible situations that can trigger the loathing of cats are: hearing purring, seeing a cat in real life, imagining the possibility of a cat touching or rubbing against one, the thought of meeting a cat in the dark, seeing the staring eyes of a cat (cats have the tendency to stare at passers-by) cats in pictures and on television, and cat-like toys and cat-like fur. Big cats such as lions or tigers can also trigger the stimuli associated with a phobia.
The standard approach to treatment is the same as with other phobias - cognitive-behavioral therapy, desensitization, and possibly medications to help with the anxiety and discomfort. In recent years, the technique known as "applied tension", applying tension to the muscles in an effort to increase blood pressure, has increasingly gained favor as an often effective treatment for blood phobia associated with drops in blood pressure and fainting.
Because the fear of blood is extremely common, it is frequently exploited in popular culture. Horror movies and Halloween events prey on our natural aversion to blood, often featuring large quantities of fake blood.
Ailurophobia is a type of specific phobia: the persistent, irrational fear of cats. The name comes from the Greek ("ailouros"), "cat" and ("phóbos"), "fear". Other names include felinophobia, elurophobia, and cat phobia.
The fear of flying may be created by various other phobias and fears:
- Fear of crashing, which in rare cases will cause death, is the most common reason for the fear of flying.
- Fear of closed in spaces (claustrophobia), such as that of an aircraft cabin
- Fear of heights (hypsophobia)
- Feeling of not being in control
- Fear of vomiting, where a person will be afraid that they'll have motion sickness on board, or encounter someone having motion sickness and have no control over it (such as escaping it)
- Fear of having panic attacks in certain places, where escape would be difficult and/or embarrassing (agoraphobia)
- Fear of hijacking or terrorism
Phobias of this sort can usually be treated by different types of therapies, including: cognitive behavioral therapy (CBT), psychotherapy, behavior therapy and exposure therapy.
Practice may play an important part in overcoming fear. It may be helpful to sufferers to increase phone usage at a slow pace, starting with simple calls and gradually working their way up. For example, they may find it easier to start with automated calls, move on to conversations with family and friends, and then further extend both the length of conversations and the range of people with whom conversations are held.