Spiders, Needles, Airplanes: How to Handle These Common Phobias

Ghosts, ghouls and goblins, oh my! October’s big holiday is right around the corner.

You might love the scary side of Halloween or find yourself indifferent to the hoopla, but the spooky themes leave an opportunity to discuss a timely topic: fear. Specifically, fear and phobias.

There are many who are terrified of needles. Others faint at the sight of a spider. And – as in my case – getting on an airplane is enough to make one’s knees knock.

No matter the trigger, the response is the same: a burst of hormones telling you to leave or fight the battle. When humans were cave-dwellers, this fight or flight reaction was helpful. As people of modern society, however, we’re left dealing with our hardwiring from epochs ago.

There’s not too much separating fear from its cousin phobia.

Fear, experts say, is a normal, healthy and innate reaction. Often, fear helps protect us from harm.

The National Institute of Mental Health defines a phobia as intense, irrational fear of something that poses little or no actual danger. Even if phobia-prone adults realize these fears are irrational, thoughts of the feared object bring on anxiety symptoms.

Dr. Kendea Oliver, PhD, is a clinical psychologist at Lahey Hospital & Medical Center in Burlington, Mass., and much of her work focuses on people with anxiety. I spoke with Dr. Oliver to learn more about phobias and how to manage them.

Are fear and phobias the same thing? If not, what is their relationship to one another?

Kendea Oliver (KO): Fear and phobias are not the same thing. I often describe phobias as a learned false alarm of danger, where your brain becomes overly cautious and is inaccurately signaling a real threat is present. It’s like a smoke detector that has become faulty and is signaling a fire anytime there is steam from a shower. The smoke detector can help detect actual fires, but this one is getting triggered too easily and too often by anything that starts to resemble real smoke.

Do experts know what causes fear? It seems it takes more of a stimulus for some people than for others?

KO: This is a really complicated question. Yes, there is a general understanding around how fear is experienced and how that response is triggered. It is also true that some people seem to have a higher threshold for what type of stimulus will trigger a fear reaction, while others have a very low threshold.

There have been some very interesting studies done recently looking at humans who seem to have a higher threshold for triggering a fear response. One example is the research done with Alex Honnold, a professional climber, who climbed a 3,000-foot vertical rock face in Yosemite without any ropes or protection.

Can you get rid of phobias? Are there ways to minimize them?

KO: Yes! There are phobias that seem to respond well to treatment, specifically cognitive or behavioral (or combined) interventions, though treatment is often underutilized. One of the things that people tend to do in managing their fear is avoiding the source of the phobia. In reality, that can actually work to maintain, or even intensify, the fear. While it is a bit more complicated than just exposing yourself to the thing you fear, it’s important to realize that avoiding the feared objects or experiences teaches your brain two unhelpful lessons. The first: avoidance is your best strategy for coping. So, you cannot manage your fear in any other way. The second: the brain learns that the fear stimulus is actually as scary as you think it is (otherwise, why would you have to avoid it, right?). It becomes circular emotional reasoning – the brain learns to react to the phobic stimulus with fear, fear is a signal of danger, and the brain reasons that the stimulus must actually be threatening, otherwise I would not be reacting with fear.

I’m particularly interested in the fear of flying. What causes it?

KO: Phobias in general can be caused by a number of factors, sometimes more than one for any individual. It may include a genetic predisposition to higher baseline anxiety, having experienced first-hand or second-hand a scary or threatening event with the feared stimulus, or having read/learned/been told about dangers associated with the feared stimulus.

It may also be an accidental association where you experienced anxiety in a setting for one reason but then assigned that anxiety to an unrelated specific object or situation. There are other factors there too, like when someone reads about three extreme airplane events in the span of two weeks and assumes that airplanes must be really dangerous. The issue there is that you don’t hear about the thousands of flights that land each day without any issue or the more general statistic regarding the overall safety of airplane travel.

Is fear a big problem for people? What are the best ways of handling it?

KO: Fear is healthy to an extent. Phobias are when that fear becomes a problem because it’s bigger and more irrational than the situation calls for. Phobias often result in avoidance in order to manage the fear.

If you’re scared of getting blood draws and you constantly avoid doing it, your brain never learns that blood draws are actually harmless the vast majority of the time. After you’ve gone through the experience a few times, and realized that you came out fine, your brain eventually has an easier time remembering these good or harmless experiences and that fear reaction dampens.

To learn more about any phobias or fears you may be experiencing, speak with your Lahey Health provider.

*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

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