By Ho Shee Wai

Director & Registered Psychologist

Survival Purpose of Fear

America's 32nd President, Franklin D. Roosevelt famously once said, "The only thing we have to fear is fear itself. " All of us have fears. It's a natural adaptive response built within us to alert and protect us from danger. You might have witnessed a child's interest with fire for the first time by displaying fascination rather than fear. But as they reach out to touch the bright colours — ouch! Fear therefore can be a good thing. It keeps us from being harmed physically, mentally and emotionally.

Fear vs Phobia

In my career as a Counselling Psychologist, I've come across many clients who have developed a level of fear which is no longer healthy and has become a phobia — a persistent irrational, disproportional fear of an object or a situation which instigates them to go to great lengths to avoid being in this self-imposed fearful situation. A phobia can create immense emotional distress and also significantly impact your day-to-day functions.

The Diagnostic & Statistical Manual 5 (DSM5) defines phobia as:

Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack. The phobic object or situation almost always provokes immediate fear or anxiety. The person recognizes that the fear is excessive or unreasonable. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context. The phobic situation(s) is avoided or else is endured with intense anxiety or distress. The phobic object or situation is actively avoided or endured with intense fear or anxiety.

The sad truth is the majority of people don't seek treatment for phobias. Only 10% of phobia suffers seek professional counselling treatment. However, some phobias are considered more common than others such as the fear of spiders, snakes, flying, height, people and public speaking or dirt and enclosed spaces. Sufferer of these particular phobias are usually more willing to disclose their fears and seek help. Those who have fears regarded as less common — such as the fear of wetting your pants, cursing, exuding an unpleasant odour, choking or blushing - may feel they have a problem and believe society will judge or taunt them if they seek help. So, they choose to suffer in silence.

Do I have phobia?

Is you fear normal or is it a phobia? Ask yourself the following questions to find out if your fear is appropriate or has reached a point where it has become a phobia:

• Do you allocate a lot of energy, time, and effort avoiding an object or situation you fear?

• Do you worry about the possibility of being in a particular situation or in contact with a certain object?

• Would you live your life differently if you didn't have this fear?

• Do you worry others will find out about your fear?

• Do people you come in contact with notice or comment on your fear?

If you've answered "yes" to any of these questions, your fear may not be "normal". It's highly unlikely you'll overcome your phobia on your own as your natural instinct in such a situation is to flee and avoid the altercation completely. So, the best thing to do is seek professional counselling help with a psychologist, counsellor, or psychotherapist for more efficient and effective support in overcoming your suffering — in the long run.

Phobia treatment

There are a number of treatment options available with a trained psychologist, counsellor, of psychotherapist.

Exposure therapy

Exposure therapy is a form of Cognitive Behaviours Therapy (CBT) that focuses on changing your response to the object or situation that you fear. Gradual, repeated exposure to the source of your specific phobia, and the related thoughts, feelings and sensations, may help you learn to manage your anxiety.

EMDR

Eye Movement Desensitized Reprocessing (EMDR) has been found to be more effective than a placebo control condition, but less effective than exposure in vivo. It is a time-limited procedure, and that it can be used in cases for which an exposure in vivo approach is difficult to administer.

Other coping method which does not cure phobia but provide temporary relief include:

Medication

The most often prescribed medication for phobia is what is known as a benzodiazepine. These are medications such as Xanax, Ativan, and Klonopin. Benzodiazepines are intended for acute anxiety, meaning a discreet anxiety episode or a panic attack.

Mindfulness

Research has shown that mindfulness can help you unlearn your fear responses. An example of mindfulness exercise can be:

“Breathe deeply in and out while calming your mind. You might repeat a sound, word, or phrase, like "life is good" or “I’m ok” If your mind wanders, as it inevitably will, gently steer it back to the present. Think of your intrusive thoughts as clouds. Acknowledge them, but then let them drift away.”

Grounding Techniques

Grounding techniques are exercises that may help you refocus on the present moment to distract yourself from anxious feelings. For example, 5-4-3-2-1 method (5 things you can hear, 4 things you can see, 3 things you can touch, 2 things you can smell, and 1 thing you can taste) or the alphabet method (name an object that start with each letter of the alphabet).

Don’t let your fear steal your life away, confront your fear by booking in with a counselling professional like a psychologist, counsellor, or psychotherapist to start your journey of a fear free life.