How Do I Find Treatment for Phobias?

Phobia is a neurosis whose main clinical manifestation is horror symptoms. Patients have strong and unnecessary fears about certain specific objects or situations, and they are accompanied by obvious anxiety and autonomic symptoms, and take the initiative to avoid such anxieties. The patient knows that fear is unreasonable and unnecessary, but he cannot control it, which affects his normal activities. The object of fear can be single or multiple, such as animals, squares, closed rooms, ascents, or social activities. The disease is mostly adolescent and elderly, and more common in women. The prevalence rate of the general population reported in foreign countries is 6 (1983), and the average prevalence of surveys in various parts of China is 0.59 (1982). But the 1969 Agras study reported a prevalence of 77 .

Basic Information

English name: phobia
Visiting department: Department of Psychology
Multiple groups: Adolescent and elderly women

Common causes: Related to genetic and psychological factors
Common symptoms: Fear, tension, severe anxiety
Contagious: no

Causes of phobia

Genetic factor

Twins studies have found that homozygous twins have more phobias than homozygous twins, suggesting that genetic factors may be related to the pathogenesis. But there are also pedigree studies of phobias that have not found an increase in twins' same-sickness rates. Therefore, there is no clear evidence that genetics plays an important role in the occurrence of the disease.

2. Quality factors

Before the illness, the patient's personality tended to be naive, timid, shy, dependent and highly introverted.

3. Psychosocial factors

It often plays a more important role in the onset of disease. For example, when someone encounters a car accident, he becomes afraid of riding. It may happen that a certain situation happens on the background of anxiety, or acute anxiety occurs in a certain situation, fear of it, and become a target of terror. The horror of special objects may be related to parents' education, environmental impact, and personal experience (such as being afraid of dogs by being bitten by dogs). Psychokinetics believe that terror is the result of the symbolic and displacing effects of suppressed subconscious conflicts. The role of conditioned reflexes and learning theory in the occurrence of this disease is a more convincing explanation.

Clinical manifestations of phobia

The core symptoms of phobia are fear and nervousness, and severe anxiety or even panic caused by terror. Depending on the target of the terrorist, it can be divided into the following types:

Social phobia

It is mainly the immediate and uncontrollable inducing of immediate onset of anxiety in social situations, and the persistent and obvious fear and avoidance of social scenes. The specific manifestation is that the patient is afraid of embarrassing and shivering expressions on the occasion of someone or being noticed, blushing, sweating, or awkward behavior, helplessness, and fear of getting the attention of others. Therefore, avoid social situations that induce anxiety, dare not sit and eat with other people in restaurants, and be afraid to get close to people, especially avoid talking with others. Crimson horror is more common. Patients feel shy, blushed, embarrassed, awkward, and slow as long as they are in public, fearing to become the object of people's smirk. Some patients are afraid to look into other people's eyes and meet other people's eyes. This is called horror.

2. Specific phobias

A specific phobia is a strong, unreasonable fear or aversion to a specific object or highly specific situation. Frequent in childhood. Typical specific horrors are fear of animals (such as spiders, snakes), natural environments (such as storms), blood, injections, or highly specific situations (such as high altitudes, confined spaces, flying). Patients may have evasive behavior as a result.

3. Place phobia

Not only afraid of open spaces, but also anxiety about being unable to leave quickly in crowded places, or being unable to ask for help. The key feature of the horror situation in the place is that there are no exits available immediately, so patients often avoid these situations or need family members, relatives and friends to accompany them.

Phobia diagnosis

1. Meet the diagnostic criteria for neurosis;

2. Fear is the main concern, which must meet the following 4 items: Have a strong fear of certain objects or situations, the degree of fear is not commensurate with the actual danger; Anxiety and autonomic symptoms during the attack; Repeated or continuous avoidance Behaviour; know that fear is excessive, unreasonable, or unnecessary, but cannot be controlled;

3. Avoidance of fear situations and things must or has been a prominent symptom;

4. Exclude anxiety, schizophrenia, and suspected conditions.

Differential diagnosis of phobia

Anxiety disorder

Anxiety and phobia both have anxiety as the core symptom, but the anxiety of patients with anxiety disorder persists, not for a specific situation or object. The anxiety associated with phobia is mostly situational, targeted, and episodic. It can be reduced or disappeared with avoidance of the object of fear or situational anxiety.

Obsessive-compulsive disorder

Obsessive-compulsive symptoms originate from some thoughts or ideas in the patient's heart. They are afraid of losing self-control. They are not fears of external things. They often have compulsive actions.

3. Suspected condition

Patients with fear of disease may be similar to suspected conditions, and the fear is generally not prominent, and the suspected condition is worried about themselves, and their own doubts and concerns are reasonable; while phobia is afraid of external objects or situations, and think This fear is unreasonable, it is just impossible to get rid of.

Phobia treatment

Drug treatment

To reduce stress, anxiety or panic attacks, benzodiazepines and / or antidepressants can be selected, such as selective serotonin reuptake inhibitors, tricyclic antidepressants, and the like.

2. Psychotherapy

Psychotherapy is an important method to treat the disease. Commonly used are:

(1) Behavior therapy Including systematic desensitization therapy and exposure therapy, etc., are the most important methods for treating specific phobias. Its principles include: one is to eliminate the conditional connection between the object of fear and the reaction to anxiety and fear; the other is to resist the avoidance response.

(2) Cognitive-behavioral therapy Cognitive-behavioral therapy is the first choice for treating phobia. Previous behavioral therapies have emphasized observable behaviors, and their long-term effects are not very satisfactory. Cognitive-behavioral therapy, while adjusting the patient's behavior, emphasizes the adjustment of the patient's unreasonable cognition, which has a better effect. Especially for patients with social phobia, their distorted beliefs and information processing process make the symptoms persist. Correcting these distorted cognitive models is a very important content in the treatment.

(3) Social skills training Patients with social phobia often have defects in social skills or underestimate their social skills, so they can improve their symptoms through training for a certain period of time. Including: the role of therapist's demonstration, social reinforcement, exposed work exercises, self-affirmation training, etc.