Phobias vs. Fears: An Important Distinction

The only thing worse than my flying phobia was listening to everyone explain how flying is statistically safer than driving.  During my most phobic years, I always wanted to turn to these good Samaritans and say, “Listen, you idiot, I am a semi-intelligent adult; I know planes are the safest mode of transportation and I also know that what I am feeling isn’t rational, and listening to you yammer on about survivor statistics is making my anxiety worse.”

Now, however, I understand why so many people insisted on that line of reasoning: they didn’t understand that I wasn’t just afraid of flying—it was a genuine phobia, which is a very different animal:

• Fear is an emotional response to a real or perceived threat whereas phobia is usually an irrational response to a non-threat or, less typically, a greatly exaggerated response to a real threat.

• Fear is protective—it is a basic survival mechanism. Phobia is restrictive—it encourages avoiding behaviors which can compromise survival.

• Everyone experiences fear at one time or another—it is a normal human emotion. Phobia is experienced by only 8.7% of the population—it is considered an anxiety disorder.

So back to my story. Had I been afraid to fly, commentary about the safety of airline travel could have been helpful because fear is a rational response. However, since I was suffering from aerophobia, which by definition is irrational, all attempts to use logic were useless (and even more anxiety-provoking).

We know that phobias are caused by both environmental and genetic sources. A person that was attacked by a dog as a child may develop a severe phobia to dogs. Likewise, someone that witnessed 9/11 (either in person or over and over on TV) may find herself with a flying phobia. These phobias are not the same as a natural fear of dogs or flying (which causes some mild discomfort) but a crippling physical reaction (anxiety attack) that makes it impossible to function. For example, a person afraid of dogs might back away and laugh nervously when a small, docile toy poodle approaches, tail wagging. That person may or may not choose to pet the dog, but will be able to remain in the vicinity of the animal. A person with a dog phobia, however, may begin to tremble uncontrollably, feel sick to her stomach and have to leave the room.

Another way phobias can develop is through parental “modeling.” If a child witnesses a parent’s phobic reactions, he/she may adopt the same behaviors. But there is also a strong genetic component. Identical twins, separated at birth, have been found to have the same exact phobias even though they were raised separately.

Whatever the reason for our phobias, the following 4 tips are really useful:

1) Don’t try to rationalize yourself or your child out of a phobia—it does not work. Try to understand that the phobic person is having a brain misfire and needs more help than you can give.

2) There are very specific treatments that are particularly effective for phobias: Cognitive Behavioral Therapy (CBT), Exposure Therapy, eye-movement desensitization, and medication. To get help for phobias, go to someone that specializes in the treatment of them. The typical “talk” therapist is often not trained in these techniques.

3) If you go to someone with help for phobias and she/he is absolutely against the use of medication, you may want to look elsewhere. As Anxiety Sisters, we believe people can manage their disorders in many different ways—some involving medication and some not. However, when phobias are long-standing and severe, medication is an extremely effective tool and may be the only way to allow the sufferer to do the therapy portion of getting over a phobia.

4)  If you have a phobia that stops you from engaging in life, it’s time to get treatment. In some cases, phobias grow and bring on new phobias. This is especially true of complex disorders like social anxiety disorder which, left untreated, can lead to agoraphobia (fear of leaving the house). And this, in turn, can lead to SWS (Shrinking World Syndrome) which can reduce one’s world to a sofa, bed and bathroom.

Phobias CAN be treated. We know lots of anxiety sisters who have successfully overcome their phobias (in fact, 2 of them write these blogs!!). So, please consider reaching out for help.