Causes Of Phobias - What Are The Different Causes Of Phobias
A phobia is one of the major anxiety disorders and has been defined by DSM IV, as an intense, unrealistic and disruptive fear of a particular object or situation that is out of proportion to any danger posed. (Kring, 2010). Phobias can be long-lasting and efforts to avoid the object of fear or situation can interfere with a person’s personal, social and occupational functioning. The difference between a normal fear and a phobia is an arbitrary one of degree, not kind (Gray, 1991) i.e. a fear is not diagnosed as a phobic disorder unless it interferes considerably with a person’s daily life (Smith et al, 2003).
People who suffer from phobias have an exaggerated view of the harmfulness of a situation others do not consider threatening. They often realize their fear is irrational, but are unable to control or explain it. Attempts to hide phobias from others result in more anxiety, shame and guilt. Consequently, they suffer doubly - both from the fear itself and knowing how irrational it is. (Gross, 2005).
Symptoms Of Phobias:
Symptoms of phobias can be very frightening and distressing and usually occur without warning. They are mostly reactions associated with extreme fear and anxiety such as: rapid heartbeat, palpitations, trembling, excessive sweating, chest pain, hyperactive bowels, muscle tension, nausea, dizziness, numbness or pins and needles, ringing in the ears as well as incoherent speech.
Psychological symptoms include: confusion or disorientation, feelings of dread and terror, fear of losing control, fainting or dying as well as an intense desire to avoid or escape the situation (American Psychiatric Association).
Types Of Phobias:
There are three categories of phobias: Agoraphobia, Specific phobia and Social phobia and each one is defined by a different type of key symptom.
Agoraphobia amounts to 60 percent of all phobic patients and is defined by anxiety about situations in which it would be embarrassing or difficult to escape in case of a panic attack. (Gross, 2005). Feared situations include driving, bridges, crowds, malls and churches (Kring, 2010). Although, agoraphobia is commonly known as fear of open spaces, the primary fear is of leaving the safety of home or companions. In fact, almost all cases of agoraphobia stem from fear of panic attacks. (Lilienfeld, 1998, cited in Gross, 2005).
Specific phobia is the fear caused by the presence of a specific object or situation and can seriously interfere with a person’s life goals. (Kring, 2010) E.g. fear of closed spaces (claustrophobia), fear of heights (acrophobia) or fear of snakes (ophidiophobia) (Gross, 2005).
Social phobia is a persistent, excessive fear of social situations that involve being exposed to unfamiliar people such as speaking, performing or eating in public. (Kring, 2010). It is marked by lack of confidence in front of strangers, fear of behaving in embarrassing ways, signs of extreme anxiety, blushing and sweating. People with agoraphobia often avoid eye contact, stand apart from others, and in severe cases, completely refuse to leave their homes. (Gross, 2005). Social Phobias may simply be extreme forms of shyness (Marks, 1987, cited in Gray). However, the symptoms of discomfort and anxiety are much more long lasting than those felt by shy people.
Different Causes Of Phobias:
Different theories involving psychoanalytic, behavioral and cognitive factors explain why phobias develop, but genetics, personality, gender, culture and life events also play an important role.
Treatments for phobias are based on different exposure and cognitive techniques and are mostly effective. However, further research into the exact causes of phobias can give us better insight into their cure and treatment.
Freudian Causes Of Phobias:
There are different theories as to what causes phobias. Freud (1909) believed that phobias are expressions of unconscious fears and wishes, displaced from their original source onto some external situation or object that can be avoided (Gross, 2005).
Freud interpreted Little Han’s phobia of horses in terms of the oedipal fear i.e. Hans loved his mother, feared his father and the anxiety produced by the conflict was displaced onto the horse. Since the boy appeared to lose his phobia after conversations with Freud, he concluded that Hans had gained ‘insight’ into the actual source of his phobia and this had cured it. Critics however pointed out that Hans never provided direct evidence that his real fear was his father instead of the horse and that his phobia diminished over time rather than the abrupt result of an insight (Smith et al, 2003).
Behaviourist Causes Of Phobias:
Behaviorists on the other hand, emphasize phobic conditioning based on Mowrer’s (1947) two-process theory. According to this, phobias are acquired through classical conditioning in which a previously neutral stimulus is paired with some traumatic event and produces anxiety. The fear is maintained through operant conditioning, as avoidance of the phobic stimulus is negatively reinforcing. (Gross, 2005). Other behavioral theories suggest learning phobias through observation (Bandura, 1969). This kind of learning is also called modeling, where phobias are learnt by watching another person get harmed or a child observing his parents react fearfully to a situation may develop a similar reaction. (Smith et al, 2003). Lastly, verbal instruction i.e. an adult warning a child about the danger of something can also cause phobias (Kring, 2010).
However, studies show that most people with phobias do not recall any specific experience with the feared object or situation. (McNally & Steketee, 1985, cited in Gray, 1991). Similarly, a survey in Vermont showed the most common phobia was of snakes, even though there were no dangerous snakes there. (Agras et al, 1969). Supporters of behavioral model argue by saying that most people simply forget conditioning experiences because of memory gaps. (Kring, 2010)
Evolutionary Causes of Phobias:
Seligman (1971) suggests the concept of prepared learning, according to which people are genetically prepared by evolution to fear certain objects (Gross, 2005). This explains why phobias of snakes, spiders, height and darkness are more common than those of automobiles, lambs or flowers.
Studies confirm that initially people can be conditioned to fear different types of stimuli, but though most fears fade with exposure, fears of naturally dangerous objects continue. (Dawson, Schell & Banis, 1986, cited in Kring). However, this does not explain why some phobias are acquired by some people and not by others.
Cognitive Causes of Phobias:
Cognitive theories claim thatpeople with social phobias and agoraphobias have very negative self evaluations and harsh beliefs about the consequences of their social behavior. One study shows that such people focus on internal cues or their own anxiety rather than social cues or external stimuli. (Pineles & Mineka, 2005, cited in Kring, 2010). Moreover, experiences of control during early life and stressful situations may also influence whether a person develops a phobia or not. (Mineka & Zinbarg, 2006, cited in Kring, 2010)
Genetic Causes of Phobias:
Genetics is another important factor and research shows how relatives of people with phobias are 3-4 times more likely than others to develop them, while twin studies suggest that 20-40 percent of phobias are inherited. (Kring, 2010). However, it is unclear whether this is due to observation or genetic transmission and many people with phobias have no relatives with the condition either. According to Hudson and Rapee (2000), it is more likely that children inherit a fearful temperament than the phobia itself. Moreover, certain personality traits like neuroticism, a tendency to react to situations with more than average negativity and behavioral inhibition, a tendency in infants to become agitated or cry has also been linked to phobias (Kring, 2010)
Other Causes Of Phobias:
Gender and gender roles also play a role and studies show that women are twice as likely as men to show symptoms of phobias. This may be because men are under more pressure to face their fears than women (Gray, 1991). Also, certain phobias are specific to cultures. E.g. Taijin Kyofusho, a social phobia in japan, marked by a distinct fear of offending other’s feelings (Kring, 2010).
Lastly, negative life events, trauma and long term stress can make people more vulnerable to phobias. However, it is more likely that a combination of all these factors cause phobias and further research is necessary before a definitive conclusion can be reached.