An Excess of Phobias and Manias

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The Future of Our Mental Health Depends on What We Do Today

Awareness of phobias, fears, and anxieties must be understood

Public awareness of phobias, fears, and anxieties has grown considerably in our time. It is only in these last decades that we have become aware of how surprisingly prevalent these problems have become in the general population. More people are suffering from anxiety disorders since the September 11, 2001 attack on the "Twin Towers" in New York.

Phobias can be just as debilitating as so-called "major" mental problems.

Many people are extremely disabled by so-called "minor" mental disorders. "Minor" is a misnomer, given that the disability from such problems can be as great as that from "major" mental illnesses. The problems may cause sufferers to become housebound, lose their jobs, and even cease carrying out normal family routines so that daily activities have to be carried on by relatives. Such difficulties can hamper child-rearing badly and create a marked family burden.

More knowledge about phobias and fears has increased in the recent years

Concerning the causation of certain fears, it has become evident that the range of phobias that appears in the population is limited and nonrandom given how frequently we all see a huge variety of different situations in everyday life. Although we all encounter beds, glass, and plants every day, phobias of such objects are very rare. Much more common are phobias of heights, snakes, spiders, strangers, public places, dirt, and terrorist attacks. Despite the fact that statistical chances of death from sharks or rabies are minute, those fears are quite frequent. On the other hand, automobile accidents are the chief cause of death in young people, yet phobias regarding cars are rare.

Like all species, humans are believed to have been programmed to fear some things for survival

The fact that certain kinds of anxiety behavior is an integral part of our psyche does not mean that they can not be overcome. Although many of our phobias reflect constraints in our learning capacity that have been shaped by natural selection, we should not despair of overcoming those fears. Research has shown that even obviously programmed fears can be overcome by systematic treatment. Within a few days or weeks of appropriate exposure therapy, many "natural" fears of heights, snakes, spiders, and strangers do improve, just as much as do fears of more unnatural dangers.

Exposure treatment is one way to help most sufferers of phobias

Exposure treatment has been found in many experiments in many different countries to help most sufferers from phobias and from phobia-like obsessive-compulsive rituals. In addition, such improvement after the completion of exposure treatment has lasted for a four- to eight-year follow-up that has been carried out in many centers in different countries.

The central principle of exposure treatment is persuasion of the sufferer to stop avoiding what he or she fears and instead to start approaching it and staying in its presence until the ensuing panic starts to subside. It can take 20 to 30 minutes of exposure treatment for the panic to come down a bit and an hour or two for it to greatly reduce. This exposure exercise is repeated daily with avoidance situations until most of the discomforts and tendencies to avoid them have disappeared, and the phobic individual has obtained freedom from associated work, social, and family disabilities.

Even better news is that some phobic sufferers have been capable of successfully treating themselves without ever needing a clinician to be with them during their tasks. When phobics applied the self-exposure approach using a self-treatment manual, they improved substantially, as much as when they received such instructions from a psychiatrist. This was true for agoraphobics with panic, for specific (simple) phobics, and for social phobics. Such work illustrates the rapid advances being made in the field of phobias and fears, both in theoretical understanding and in the ability to help sufferers overcome their problems.