Phobias
What therapy can help with

It’s estimated that as many as 10 million people in the UK have some form of phobia. 

A phobia is a common form of anxiety disorder. We all have fears but for most people they don’t stop us doing things. A phobia is an overwhelming fear – of an object, animal, place or situation – that can make us anxious and cause us to panic.

Our member Lorraine Collins says phobias can stop us doing things easily and, in extreme cases, can interfere with daily life. People may organise their life around avoiding the thing that causes them distress or put in place safety behaviours to help them cope.

“The perceived threat is avoided or endured with distress,” says Lorraine, a counsellor based in London.

“Even though you may be able to rationalise the fear as excessive or unreasonable, exposure to the threat, or even the thought of facing  it, can lead to high levels of anxiety. Trying to keep the threat at bay just continues the distress."

Types of phobias

With the Government’s mass vaccination programme against COVID-19 ongoing, it’s estimated one in 10 people have a fear of needles or injections. The fear is higher in children and decreases with age, but it may mean people don't take up their vaccine. 

Other common phobias include flying, heights, snakes and spiders, blood and visiting the dentist. Complex phobias such as agoraphobia and social phobia can be debilitating.

Agoraphobia is where someone fears and avoids places or situations that might cause them to panic or feel trapped. It could be leaving home, travelling on public transport or being in enclosed spaces.

Social phobia is a fear of social situations such as public speaking, starting conversations or eating and drinking in public.

Often there's no one clear reason why you develop a phobia. It may be associated with an experience or a trauma, or you may have picked it up at a young age from a family member or friend.

Symptoms of phobias

Phobias can cause many different physical symptoms. Lorraine says: “People might experience increased heartbeat, dry mouth, feeling faint, excessive sweating, panic attacks, churning stomach, fainting, feelings of overwhelm, dizziness, nausea, catastrophising about an event in the future, inability to sit still or concentrate, being snappy or irritable and an upset stomach.

"They may also suffer from depression and low self-esteem, with  thoughts such as ‘I’m a hopeless case and will never recover’.”

How counselling can help

“Talking to someone who is outside of your usual circle of family or friends can create a sense of containment,” says Lorraine. “With a therapist you’re in a safe setting that’s set up for you to give voice to any thoughts, feelings and concerns that you might be embarrassed to share with those close to you.

"Speaking to a trained therapist can help you start a treatment plan to enable you to manage and better understand your concerns. They'll also help you to identify and change the unhelpful coping skills you’re using to manage your phobia.

"The aim is to help you feel more grounded, understood and better able to manage your distress."

What is the best therapy for phobias?

The best therapy depends on you and how you respond.

Lorraine says: “It might be graded exposure exercises, role playing, guided imagery or just providing a space in which you can be heard without fear of judgment or ridicule. It really is about working in a way that best suits you.

“In some cases, just being heard, talking through your concerns and fears, can have as much impact as a specific cognitive behavioural therapy (CBT). There’s a witnessing of your distress and a dismantling of any shame that may be attached to it."

Most CBT and exposure therapy aims to develop understanding by testing alternative perspectives, setting up experiments and reflecting on the findings.

“It’s important the experiments are set up collaboratively with a client so they develop a sense of control and empowerment from the start," says Lorraine.

“One of the questions I ask is 'what’s the worst thing that can happen'? I ask this question several times to help the client discover their own distorted thinking. Helping the client to evaluate their fear is key to developing healthy interventions and alternative ways of thinking."

For children with phobias, specialist therapists can teach relaxation exercises using toys or guided imagery to help children manage unhelpful thoughts and bodily sensations that might feel overwhelming.

“Counselling helps to normalise what you’re feeling," concludes Lorraine. "Phobias are common and can be treated successfully with the right help."

If you have any comments or would like to share your story, please email us at communications@bacp.co.uk