PHOBIAS (SPECIFIC PHOBIAS)
Phobia is an intense and unreasonable fear of a specific object or situation. The individual knows that the fear experienced regarding the phobic object or situation is absurd, but continues to feel fear and has difficulty in inhibiting irrational thoughts about it. When fear reaches an extreme level, the individual begins to avoid the object or situation in which they are anxious. After a while, even the thought of the feared object or situation becomes a trigger. Avoiding the feared object or situation significantly affects the individual’s functionality and impairs their quality of life. The frequency of specific phobias in the population is approximately 6%. It is observed more frequently in women than in men. In cases where fears increase too much and render the person dysfunctional in continuing their daily life, it is very important to seek support from professionals working in the field of mental health (psychiatrist, psychologist).
Phobias Observed in Childhood
The onset of phobias observed in childhood is usually between the ages of 7-11. It is observed in approximately 5-6% of children and 15-16% of adolescents. Phobias mentioned under the classification of anxiety disorders are different from fears observed in childhood. For example; a child who is afraid of sleeping alone at night, of strangers or of bathing/water, these fears decrease as they get older. However, in a phobic situation, these fears do not decrease with age. The child cannot relax despite being reassured or assured. For example, a child who is afraid of dogs/cats does not want to touch a dog/cat even if he sees a cute dog/cat or his mother tells him that he will not hurt him.
What are the Causes of Phobias?
The beginning of a phobic situation may occur when the child is directly exposed to a fearful object/situation or observes such an experience. The phobic object/situation creates restlessness, anxiety, fear, and helplessness in the child. The child feels uncomfortable when he/she thinks that he/she will not be able to cope with this situation, that he/she will be harmed, or that he/she will show physical symptoms ( such as vomiting, fainting, dizziness ). In order to reduce this discomfort, he/she avoids the phobic object/situation. This reaction is reinforced by the slight relief he/she feels with avoidance. In the following stages, he/she tends to avoid every time he/she encounters a phobic object/situation. For this reason, he/she can never confront the phobic object/situation.
What are the symptoms seen in phobic situations?
When faced with a phobic object/situation, the child may experience sweating, abdominal pain, trembling, rapid breathing, a feeling of suffocation, chest pain, and the need to urinate. At such times, the child tends to avoid the phobic object/situation. Young children may respond by sleeping with their parents, asking their parents to check when going to places they are afraid of/changing rooms, crying, clinging to their parents, or having a tantrum . When the parents meet the child’s request every time in such avoidance situations, the severity of the phobic situation increases; it reinforces the child’s “avoidance” response.
Types of Phobias
The child may refuse to go to school, go outside to avoid encountering the phobic object, go to the doctor/hospital, or get in the elevator.
The most common phobias:
Fear of being in closed spaces (claustrophobia), fear of heights, fear of elevators, fear of animals, fear of spiders, fear of flying objects, fear of clowns, fear of vomiting, fear of water, blood injection phobia (fear of blood draws/needles). In some cases, more than one phobic condition can be observed together.
Treatment Methods Used in Phobias
When intense anxiety, fear and avoidance behavior related to the phobic object/situation persist for more than six months, it is important to seek professional help. Techniques such as Cognitive Behavioral Therapy or virtual reality are highly effective methods used in the treatment of specific phobias , in addition to drug treatment. The main principle in the intervention of specific phobias is to prevent avoidance by exposing the child to the phobic object/situation that he/she avoids. Intense avoidance behavior is observed in the child who thinks that he/she will be harmed, faint, vomit or die when he/she encounters the phobic object/situation. After a while, he/she starts to avoid everything that may be related to the phobic object or situation and his/her functionality is greatly affected. Gradually exposing the child to the avoided object or situation forms the basis of the treatment protocol. Among the methods used in working with anxiety, it is very important to provide psychoeducation to the child/adolescent and parent/caregiver , to work on attitudes and to establish the connection between the anxiety-provoking event-thought-emotion-behavior.
In addition to psychotherapy, beta-blocker -type medications that reduce anxiety symptoms are also used in the treatment of phobias. The use of these medications, which are prescribed by a psychiatrist when necessary , under the supervision of a physician and their monitoring are very important for the child’s functionality.
