Phobias can limit the quality of life

Qn. “I hear people complain of phobia for different things such as flying, heights or even insects, but where do these phobias come from?”

The simple answer to your question is that nobody knows “where phobias come from!”

That, however, does not mean that we know nothing about phobias. Indeed, a great deal is known about the many different types that exist. Without wishing to be too academic in reply to your fascinating question, let me state that there are four broad types of phobias.

The first one is the phobia of natural things around us. There are, for example, people who are extremely afraid of water, and will not come near any body of water. Others are terrified of thunder in a way that most normal people are not.

The second common phobia is that of being mutilated. Persons with this kind of condition will not willingly come close to a dentist and will run a mile in under four minutes at the sight of a needle! An adult with this condition will refuse to have blood taken for a medical examination! There are many people who will not willingly go anywhere near a doctor for fear of being injected. This sometimes leads to fainting at the sight of blood.

The fear of animals is the third category of phobias. Dogs, cats. And insects can become the subject of extreme fear to the extent that even a picture of a cat can create a great deal of fear in the sufferer. To qualify for a medical diagnosis however, the reaction must be severe and out of proportion with the actual danger posed. To be terrified of a bulldog that is known to have mauled a child does not qualify for a phobia. Fear of flies that stops a person from going out of the house would qualify.

The fourth category of phobias is situations where extreme fear is elicited in certain situations. Some people are extremely fearful of open spaces like farms where others are terrified by enclosed spaces such as lifts.

We have used the words fear and phobia as though they are interchangeable. In lay minds, the two are the same. To the specialist, however, the difference is clear and well documented. To reach clinical significance, the fear must, among other things be unreasonable, and excessive to the extent that the ordinary person recognises it to be abnormal. The fear, say of a lift or of an open space happens immediately upon exposure and the person becomes clearly more scared that he should be.

For an individual who is excessively afraid of say a needle, or a dentist, they will endure much pain to avoid any contacts with doctors, just in case they are injected!

Avoidance of situations is a key element in the definition of a phobia, because in truth many people fear dentists and injections but are still able to pay a visit if they are unwell.

When one is afraid of enclosed spaces, for example, a lift, it might limit their ability to work on the 20th floor of a building. If a herder is afraid of open spaces, then one’s life as a herder becomes very limited. So, a phobia becomes limiting in the way life is carried out by the person with the condition.

It is also important to note that extreme fear of a situation is not considered a phobia until it has lasted at least six months.

If, for example one is in a light aircraft that goes through turbulence, one could experience great fear of flying for a while, but most people get over it after some time.

Many people would experience transient fear of a fierce bulldog that appears threatening. Again, this does not translate to a phobia of all dogs in most people.

To put it simply, a phobia is a clinical entity that is beyond fear in that it is excessive and unreasonable, and occurs immediately upon exposure, limits the life of the sufferer and lasts for many months if not years. The exact “cause” of this condition however remains mysterious.