What are phobias?

A phobia is a type of anxiety disorder characterised by an extreme fear of a situation or a specific object even when there is no danger.

Phobias are categorised as follows:

  • specific phobias
  • complex phobias

A specific phobia is characterised by fear of a specific stimulus examples of which are: a spider, an animal, a needle, high places or edges, enclosed spaces or blood. Many people have such fears but they don't significantly affect their lives. For others even thinking about the phobia will provoke intense anxiety. A fear is regarded as a phobia if:

  • the fear is out of proportion to the danger
  • it has lasted for more than six months
  • it significantly impacts upon an individual's daily life

 Complex phobias tend to have a more disabling and disruptive impact upon someone's life. Two of the most common are:

  • agoraphobia - a fear of going somewhere that may be difficult or embarrassing to make an escape. This could be for instance a crowded room, a shopping centre or a motorway.
  • social phobia or social anxiety - a persistent fear of social situations where the individual predicts that they may act in a way that will result in humiliation.  Typically the individual predicts that they will be judged negatively by others and worry about displaying he physical symptoms of anxiety or embarrassment e.g. blushing. This may apply to a specific social situation such as public speaking or more general social situations.

How many people suffer from phobias?

It is difficult to estimate the number of people who actually suffer from a phobia as avoidance is pervasively used to cope with symptoms and it is likely that many individuals do not seek help. It is however believed that at least 10% of individuals suffer from a phobia at some point in their life.

What is the evidence that CBT is an effective treatment of phobias?

The research base for the treatment of phobias is dominated by studies of CBT approaches. It is estimated that CBT is effective for 70-85% of individuals suffering from specific phobia. The weight of evidence supports a behavioural approach known as exposure therapy where an individual is gradually desensitised to their fear of a particular stimulus by repeated exposure.

Research studies have shown that a combination of both cognitive and behavioural approaches are effective for complex phobias such as agoraphobia and social anxiety.

How many sessions are required?

There is no single recommended number of sessions. Studies using a combination of cognitive and behavioural approaches which have indicated an effective outcome have been between 16-20 sessions.

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Contact Rory Downes

Cognitive Behavioural Psychotherapist at Nottingham CBT