Phobias are constant, excessive fears of an object or situation that interfere with one's life and/or cause personal distress. A phobia is an anxiety disorder. It is an extreme or irrational fear of an animal, object, place, or situation. Phobias aren't just extreme fear; they are irrational fear. You may be able to ski the world's tallest mountains with ease but panic going above the 10th floor of an office building.

Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety. Phobias develop when a person begins to organize their life around avoiding the things they are afraid of. Yet, no one knows why they hang on in some people and disappear in others.

If you have a phobia, you will have an overwhelming need to avoid all contact with the source of your anxiety. Coming into contact, or even the thought of coming into contact, with the cause of your phobia will make you anxious and may cause you to panic.

Coping with a phobia is an ongoing battle, and it is necessary to have support from a variety of sources. Although finding that support may seem daunting at first, the rewards are well worth the difficulties. Cognitive Behavioral Therapy and other psychotherapy treatments can be effective in successfully managing and treating your different phobias.

Most people admit they are afraid of certain things, such as snakes, blood, and/or public speaking. It could be said that some fears are useful, as they alert us so that we can prepare for potential danger. Fears of certain objects or situations are considered a phobia when:

• The fear is excessive or unreasonable.
• The person almost always has an anxiety reaction when he or she encounters the feared object or situation.
• The feared object or situation is either avoided or endured with extreme distress.
• The avoidance, anxious apprehension, or distress in the presence of the feared object or situation disrupts one or more aspects of a person's normal routine.

In other words, when a person notices a specific fear getting in the way of routine activities or life satisfaction, then it is possible that he or she is suffering from a phobia. Phobias are typically grouped into one of five categories:

• Animal Type (fears of spiders, snakes, cats, dogs, mice, birds, or other animals)
• Natural Environment Type (fears of being near water, storms, and high places)
• Blood-Injection-Injury Type (fears of seeing blood, medical procedures, and injuries, receiving injections, and having blood drawn)
• Situational Type (fears of driving, flying, and being in enclosed spaces)
• Other Type (fears of vomiting, choking, loud sounds and other fears not belonging to any of the other categories)

There are many ways a person can develop a phobia. Some individuals remember a particularly traumatic experience with the feared object or situation. More often than not, however, people report that they have had the phobia as long as they can remember, or that they were always fearful of an object or situation and that it gradually developed into a phobia. Most psychologists believe that a combination of factors explains why phobias develop, including biological vulnerability, such as the tendency to be startled or alarmed, traumatic experiences with feared objects or situations, observations of others reacting fearfully to certain objects or situations, and learning information about the danger of certain objects and situations. These circumstances, in turn, make it likely that phobic individuals will develop problematic ideas about the feared object or situation, such as the amount of danger it poses, the frequency with which they will encounter it, and their ability to cope with it. Interestingly, people are more likely to develop phobias of insects and storms rather than guns or knives. Many researchers believe things like insects and storms posed a threat to our ancestors, and it helped them to survive if they had a moderate level of fear toward them.

Phobia may seriousely interfere with one's life and/or cause personal distress. If left untreated, a phobia may worsen to the point in which the person's life is seriously affected, both by the phobia itself and/or by attempts to avoid or conceal it. In fact, some people have had problems with friends and family, failed in school, and/or lost jobs while struggling to cope with a severe phobia. There may be periods of spontaneous improvement, but a phobia does not usually go away unless the person receives treatments designed specifically to help phobia sufferers.

At times, phobias can cause disagreements in close relationships, as they can limit the activities that partners and families can do together. Families of children with phobias often create time-consuming rituals to structure the phobic child's environment so that the child either successfully learns to deal with the phobia, or so that the family can avoid a "scene" caused by the phobia. Partners and family members often find themselves trying to strike an unstable balance between showing love and concern toward the phobic individuals, and encouraging them to overcome their fears.

Simple or specific phobias have been quite effectively treated with behavior therapy. The main idea in behavior therapy is to promote the client to respond to the phobic fear in a reflex and non-dangerous stimuli. If the person were to be exposed to the non-dangerous stimulus time after time without any harm being experienced, the phobic response would gradually extinguish itself.

So, behavior therapy sets up phobic treatment involving exposure to the phobic stimulus in a safe and controlled setting. This technique is called exposure treatment as the patient is exposed to the phobic stimulus as part of the therapeutic process. One simple form of exposure treatment is that of flooding, where the person is immersed in the fear reflex until the fear itself fades away. Some phobic reactions are so strong that flooding must be done through one's imagining the phobic stimulus, rather than engaging the phobic stimulus itself.

Some patients cannot handle flooding in any form, so an alternative classical conditioning technique is used called counter-conditioning. In this form, one is trained to substitute a relaxation response for the fear response in the presence of the phobic stimulus. Relaxation is incompatible with feeling fearful or having anxiety, so it is said that the relaxation response counters the fear response. This counter-conditioning is most often used in a systematic way to very gradually introduce the feared stimulus in a step-by-step fashion known as systematic desensitization. This desensitization involves three steps: (1) training the patient to physically relax, (2) establishing an anxiety hierarchy of the stimuli involved, and (3) counter-conditioning relaxation as a response to each feared stimulus beginning first with the least anxiety-provoking stimulus and moving then to the next least anxiety-provoking stimulus until all of the items listed in the anxiety hierarchy have been dealt with successfully.

Also, systematic desensitization can be paired with modeling. In modeling, the patient observes others (the "models") in the presence of the phobic stimulus who are responding with relaxation rather than fear. In this way, the patient is encouraged to imitate the model(s) and thereby relieve their phobia.

Virtual Reality technique requires the client to wear a virtual-reality helmet being which then displays a phobic situation which is controlled and monitored by the therapist. The scene might be one of driving a car over a high bridge, while pulse rate is being monitored by the therapist. When the pulse rate gets too high, the scene is either shut down or frozen in frame to allow the therapist to counter-condition relaxation to replace the fear and anxiety response.

• National Institute of Mental Health
  Describes symptoms and treatments of all major anxiety disorders including phobias and information on new developments, statistics, and organizations related to phobias) and other anxiety disorders), as well as links to local resources, including clinical trials involving free treatment.
• Nemours Foundation
  Information on phobias tailored to children.
• National Phobics Society
• Anxiety Panic Attack Resource Site
  Help to those who suffer from anxiety attacks and panic attacks by offering information on symptoms, medications, treatments, and support

(Part of this text was written by Amy Wenzel, PhD, Sabine P. Schmid, and Aaron T. Beck.)