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A phobia is a strong but irrational fear of something specific — usually an object, a situation, a person, or an experience.
Having a phobia is not uncommon: According to the National Institute of Mental Health, an estimated 12.5 percent of U.S. adults will experience a phobia at some point in their lifetimes.
The most effective treatment for phobias is psychotherapy. This involves working with a specially trained therapist to change your beliefs about the feared object or situation in an effort to manage your emotional response.
This article will take a closer look at the types of therapy that can help treat a phobia and how to find the right therapist.
Lots of people have an unconventional fear or two. Spiders may give you the heebie-jeebies. Your chest may tighten as the airplane you’re on taxis along the runway.
Sometimes, being confronted with these fears brings on a barrage of anxiety symptoms like:
- sweaty palms
- an increased heart rate
- quick breathing
Phobias magnify those symptoms even further.
About half the people who have specific phobias describe them as mild. The other half say their symptoms are moderate to severe. Sometimes, simply thinking about the source of a phobia can prompt a flood of anxiety.
For some people, the anxiety provoked by their phobia is so intense that they spend considerable time and energy avoiding the triggers. Sometimes, the avoidance interferes with their personal relationships or work life.
If you’re avoiding certain activities or finding that the physical symptoms of fear are interfering with your daily life, you may want to consider therapy.
Some of the more common phobias include fear of:
The good news here is that psychotherapy is usually effective at treating phobias. Here are a few approaches worth exploring.
Exposure therapy is a type of behavior therapy. With this type of treatment, a therapist usually begins by training you in relaxation techniques that can calm you when you’re under a lot of stress.
Another approach to exposure therapy is systematic desensitization. This is a process of gradually exposing you to fear-provoking situations from least scary to most scary.
Once you’re equipped to calm yourself when under stress, you and your therapist can build a hierarchy of experiences related to your phobias. Include the least scary ones at the bottom and the biggest fears at the top.
Exposure therapy is a way of gradually bringing you closer to something you fear. It usually begins first in your imagination, then in various representations, perhaps cartoons, drawings, or photographs.
As you approach each one, your therapist guides you in using your relaxation skills to calm your anxiety.
Once you can defuse anxiety related to one kind of representation, you and your therapist can proceed to the next level on your hierarchy.
The goal is to systematically desensitize you to the specific phobia, so it no longer triggers the same symptoms and gets in the way of you living your life to the fullest.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) often incorporates the same systematic desensitization methods used in exposure therapy. CBT also focuses on the specific thoughts and beliefs you have associated with the phobias.
Often, people with phobias have developed thought patterns around the phobia that aren’t based in reality.
For example, when you encounter a specific fear, you might have a tendency to catastrophize (imagine the absolute worst that might happen). This can amplify your anxiety.
CBT helps you identify cognitive distortions. These are unhelpful thought patterns that aren’t accurate. Once you’ve identified these thoughts, you can replace them with more accurate ones instead.
When you’re immersed in the intense fear of a phobic episode, CBT can help you:
- remind yourself that you’re experiencing a phobia
- recall that the episode will be over soon
- notice the thoughts that are ramping up your fear
- replace the inaccurate thoughts with statements that are more realistic
Mindfulness techniques can help reduce the level of stress you feel. This technique may not stop the initial rush of anxiety a phobia can release, but mindfulness training may help you lessen the severity of the fear.
It may be a good idea to work with a therapist to learn mindfulness techniques. Practicing them often on your own as well can help you use them when you’re face-to-face with a phobia.
Here are some mindfulness techniques that may be helpful:
In a small 2010 study, mindfulness techniques combined with cognitive behavioral therapy improved participants’ social phobia symptoms in the long term.
And recent research has shown that mindfulness techniques can be used along with exposure therapy to curb the effects of anxiety.
A reading list for little ones with big fears
Phobias can be experienced by people of all ages, including young children. If you know a child who has a phobia, the following books may be especially helpful.
The first two books on this list treat the subject of childhood fear with a respectful blend of gravity and whimsy.
The second two offer practical guidance on mindfulness strategies to help children deal with anxiety in real life.
These books may open up opportunities for you to share conversations about phobias with youngsters in your life:
Choosing a therapist is a personal matter.
You may have practical questions (Is the therapist in my insurance provider network? How close is the therapist’s office?) or personal preferences about gender, communication style, and cultural awareness to consider.
When you search for a therapist to help you with a phobia, you may want to find one who is trained and experienced in cognitive behavioral therapy, and exposure therapy more specifically.
It’s always important to make sure your therapist is licensed to practice in the state where you live.
Treating a phobia takes time, so be prepared to invest several weeks or months into the process.
Many health insurance plans cover psychotherapy. To find out about your insurance plan’s benefits and limitations, contact your plan administrator or review your policy documents.
If your employer provides an Employee Assistance program, you may find that the program offers mental health counseling as a benefit.
Medicare Part B and private Medicare Advantage (Medicare Part C) plans offer mental health benefits.
Medicare requires you to only work with certain health professionals who accept Medicare when you’re receiving therapy, such as:
- clinical psychologists
- social workers
- nurse specialists
- nurse practitioners
- physician assistants
Since Medicare Part C plans are run by private insurance companies, specific benefits and costs differ from plan to plan.
Medicaid is a health insurance program funded by the federal government but operated by each state individually.
Medicaid also offers mental health services. You may be able to access care in a community health center near your home or workplace.
If you don’t have access to health insurance through your employer or through Medicare or Medicaid, there are other options. You may be able to find a therapist whose rates are based on your income level.
And a number of organizations offer sliding scale fees and therapy “scholarships” for people in communities that are often marginalized.
Here’s a brief listing of organizations that may be able to match you with a licensed counselor near you:
- The Loveland Foundation
- DRK Beauty
- The Boris Lawrence Henson Foundation
- Inclusive Therapists
- Project Healthy Minds
Phobias and cultural sensitivity
Phobias may be one more example of differences in health outcomes because of racial discrimination in our culture.
According to a 2014 research review, phobias are more common among African American women than in the general population.
Researchers think that chronic exposure to systemic racism may be playing a role in the prevalence of this anxiety disorder.
A culturally sensitive therapist may be able to adapt your treatment to make it more effective for you.
If talk therapy doesn’t help ease your phobia symptoms, you might have success combining psychotherapy with other treatments. Talk with a healthcare provider about some of these alternatives:
For some people, sedatives (benzodiazepines) can help lessen the severity of anxiety symptoms during a phobia encounter.
Both types of medication have risks and side effects, so they aren’t a good option for everyone. Talk with your doctor to find out whether they’re the right choice for you.
A licensed therapist with special training in advanced relaxation techniques can guide you into a state of deep relaxation aimed at reducing your anxiety.
Hypnotherapy may help replace some of the unhealthy thought patterns that make phobias worse.
Some therapists use virtual reality devices in exposure therapy. Virtual reality allows a therapist to simulate contact with a phobia without exposing you to the actual threat.
But more research needs to be done before researchers know whether virtual reality is more effective than exposure to real-life threats.
If you have a phobia, working with a trained therapist can be an effective way to learn how to manage your symptoms and to correct the inaccurate thinking that provokes your anxiety.
Exposure therapy is the gold standard for treating phobias. Many people have also had success with cognitive behavioral therapy, which aims to replace cognitive distortions with realistic ideas about what scares you.
If you’ve ever experienced a phobia, you probably already know that the terror you feel isn’t rational.
But there are effective, well-researched treatments that can bring you relief and help you unlearn the fear response that may be interfering with your daily life.