You have nothing to fear from your phobias

Dr.Surachai Kuasirikul

A phobia is a an unconquerable, unusual and intense fear. This fear usually occurs when facing specific things, people, activities or situations. A person who has a phobia can be severely affected by the feared stimulus and can therefore be diagnosed as having an anxiety disorder when it is beyond control.

It might sound like phobia is just another type of normal fear, but that is not necessarily the case. A person who fears something will not cry excessively or be nauseous or worried all day, for example. In short, individuals with phobias know exactly what they are afraid of, but usually do not understand why these specific things or situations cause so much psychological or even physical change.

Phobias are irrational. The cause of the disorder is not related to a virus or family genes; unlike other disorders, it is involved with fear or aggression learned or associated through life experience. This fear of the stimulus is overwhelming and is recognised in the mind as deadly or excessively dangerous. Sometimes they also know their feared stimulus is not that scary, yet they cannot control their anxiety and aggression. When encountering the stimulus they automatically respond with mental or even physical difficulties such as a fast heartbeat, profuse sweating, an inability to breathe properly, nausea, and/or being in an uncontrolled state of shock.

Some people with phobia will attempt to avoid a situation where they might confront the feared stimulus. This attempt to try to overcome their phobia by staying away from it will usually result in even more stress.

Some phobias are more specific than others. For example, some conditions involve a fear of cats (ailurophobia), a fear of chickens (alektorophobia), or a fear of insects such as spiders (arachnophobia) or bees (melissophobia). Some people are phobic of certain environments such as heights or storms, and some fear having to be in a tunnel, train, plane or lift. Some people are excessively scared of blood, needles or syringes. In most cases the fear stems from a childhood experience of feeling threatened or being attacked. When children grow up this fear develops into a phobia that can interfere with daily life. In some cases, children can observe their parent's phobia and project that reaction towards certain things onto their own memory.

Theoretically, phobia is often link to the amygdala, one of the brain's centres for processing emotional reactions through hormones. The amygdala affects fear and aggression. Some people might have a defensive amygdala that works more immediately than others and thus causes irrational responses spontaneously when alerted to a phobia.

There is also a common phobia called social phobia - a fear of socialising, making new friends, meeting strangers or appearing in public places. Basically this is a fear of being embarrassed by others. People with a phobia of social activities will then avoid meeting others.

To others, these people are very shy, but phobia is more serious than that. Some patients suffering from social phobia cannot leave the house without someone they trust and cannot run any errands by themselves. Social phobia sufferers are also at risk of being depressed. If it gets very serious, the depression can develop into a mental disorder.

In psychological theory, a fear can also be represented by a symbol of subconscious fear. To some people this fear occurs only unconsciously. To understand phobia, some therapists will seek the bottom of their fear to find what exactly they are angry at or worried about. An interesting case was one in which a man had a phobia of horses. A deeper analysis found that a horse to him suggested someone with the highest power over his life. His actual phobia was probably a fear of his own father.

Treatment for phobia varies, but the most common one for a specific phobia is to expose a person directly to what he or she fears. Before the day they have to face their phobic stimulus, they are trained to relax and control their nerves little by little. For instance, they are asked to close their eyes and imagine the thing or activity they fear, then they look at pictures, then try to touch them, etc, before fully being exposing to the object, place or situation.

In other fairly common cases, some medication is required. Both treatment and medication will act to calm a patient's nerves. The patient will also be trained to develop a new attitude and accept things around them more easily, especially what they have to initiate in everyday life. The happier the mind is, the better the general health and the better the brain can function accordingly.

Concentrating on breathing is another common method to overcome nerves - almost like meditation. Patients are told to breathe in and hold their breathing and start counting from one to four, then breathe out while counting from one to seven. After holding their breath for two seconds they repeat the same breathing pattern. This way the nerves and brain get trained to relax more. Last but not least, exercising by walking quickly will also help balance the oxygen level in the body. Once oxygen is balanced, the brain will tend to maintain the hormones properly too.

BangkokPost, Family Matters January 11, 2011 Dr Surachai Kuasirikul is a psychological specialist at Manarom Hospital.

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