Phobias | Types, Symptoms and Treatment
A phobia is an intense fear of a specific object, animal, situation or activity that is out of proportion to the actual danger. Phobias are the most common type of anxiety disorder in the UK, and they respond well to treatment. Most people who seek help find the fear stops shaping their decisions.
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What is a phobia?
Most people have things they dislike or find unnerving. Spiders, heights, needles, flying. That is not a phobia.
A phobia is when the fear becomes severe enough to affect how you live, when it is out of proportion to the danger the thing actually poses, and when it has lasted more than six months.
Many people with a phobia feel no anxiety at all unless they encounter the thing they fear. For others, simply thinking about it is enough to produce anxiety or panic. What most people with phobias have in common is avoidance: arranging life so that contact is unlikely.
An estimated 10 million people in the UK have a phobia, and they affect people of every age and background.
Simple and complex phobias
Phobias divide into two broad groups, and the distinction matters because it affects how much they interfere with life and how long treatment tends to take.
Simple phobias, also called specific phobias, centre on a particular object, animal, situation or activity. They often begin in childhood or adolescence and may become less severe with age. Common examples include:
| Phobia | Fear of |
|---|---|
| Arachnophobia | Spiders |
| Acrophobia | Heights |
| Claustrophobia | Confined spaces |
| Emetophobia | Vomiting or being sick |
| Aerophobia | Flying |
| Trypanophobia | Needles and injections |
| Cynophobia | Dogs |
| Dentophobia | Dental treatment |
| Hemophobia | Blood |
| Astraphobia | Thunder and lightning |
Complex phobias tend to be more disabling and usually develop in adulthood. They are bound up with a deeper anxiety about a situation rather than a single object, and they are harder to avoid without restricting daily life. The two most common are agoraphobia and social phobia, also known as social anxiety disorder.
When you encounter the thing you fear, or sometimes when you only think about it, you may experience:
immediate intense fear, anxiety or panic
a racing heart, sweating, trembling or breathlessness
chest tightness, nausea or dizziness
an overwhelming urge to escape
awareness that the fear is out of proportion, without being able to control it
anxiety that builds as the situation gets closer in time or distance
Between encounters, the main effect is usually the planning: the routes not taken, the invitations declined, the appointments postponed.
Symptoms of a phobia
What causes phobias?
It is not always clear why a phobia develops. Many can be linked to a frightening event or a period of stress, and they usually begin in childhood, adolescence or early adulthood. Some appear to run in families.
For a good number of people there is no identifiable starting point at all, and that does not make the phobia less real or less treatable. Treatment does not require you to find the origin.
How are phobias treated?
NICE has not published guidance on treating specific phobias, so treatment follows the approaches used for other anxiety disorders, where the evidence is strong.
The core of it is graded exposure, sometimes called desensitisation. This means approaching the feared thing gradually and deliberately, starting well below the level of your worst fear and building up in agreed steps. Anxiety falls on its own if you stay with a situation long enough, and each completed step provides evidence that contradicts the fear.
CBT addresses the thinking that holds the fear in place alongside the exposure work: what you predict will happen, and the safety behaviours that stop you finding out otherwise.
Simple phobias often respond quickly, sometimes in a small number of sessions. Complex phobias usually take longer, because more of life has been organised around them.
Treatment is not about being pushed into the thing you fear. Steps are agreed together, and pace is set by you.
Phobias we help with at Regal Private Therapy Practice
Our Clinical Psychologists provide CBT with graded exposure for phobias, for adults and for children and young people, in person in London and online across the UK.
We have detailed pages on the phobias we are most often asked about:
Emetophobia, the fear of vomiting or being sick, which is the most common specific phobia among people who seek treatment
Agoraphobia, a fear of situations where escape might be difficult or help unavailable
Social anxiety, also known as social phobia
Panic attacks, which often occur alongside phobias
If your phobia is not listed, that does not mean we cannot help. The treatment approach is broadly the same regardless of what the fear attaches to.
Read more about therapy for adults, therapy for children and adolescents and cognitive behavioural therapy.
If you need urgent support
If you are struggling to cope or worried about your safety, help is available now. Call 111 and select the mental health option, or contact your GP. Samaritans are available 24 hours a day on 116 123. In an emergency, call 999 or go to your nearest A&E.
If you are eating very little, or a child is, speak to a GP. This can affect physical health and should be looked at properly.
Frequently asked questions about phobias
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A fear becomes a phobia when it is out of proportion to the actual danger, has lasted more than six months, and affects how you live. Most people have fears. A phobia is one that has started making decisions for you, through avoidance, planning around it, or distress at the thought of encountering it.
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Simple phobias often improve in a relatively short course of treatment, sometimes only a handful of sessions. Complex phobias such as agoraphobia usually take longer, because they involve more situations and more avoidance. Your psychologist should discuss an expected range with you at assessment.
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Sometimes. Phobias that begin in childhood can become less severe with age, particularly simple ones. Phobias that persist into adulthood, and complex phobias in particular, tend not to resolve without treatment, largely because avoidance prevents the fear from ever being disproved.
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References
NHS. Phobias. https://www.nhs.uk/mental-health/conditions/phobias/
NHS. Phobias: self-help. https://www.nhs.uk/mental-health/conditions/phobias/self-help/
NHS inform. Phobias.
South London and Maudsley NHS Foundation Trust. Phobias.
Mind. Coping with phobias.