It’s normal to be afraid of something. Not only that, it is also right: this emotion is in fact an effective and refined tool of evolution that can protect us and keep us away from dangerous situations. But what happens when fear turns into phobia? We talked about this issue with Dr. Katia Rastelli, psychotherapist at Humanitas.
Fear, how does it become phobia? Here are the symptoms
According to a study conducted by the American Psychiatric Association, phobias manifest themselves through the emotion of fear but have nothing to do with the healthy and natural aversion to what can harm or even kill us. If we have a phobia, in fact, we are aware that what scares us cannot really put us in danger, or harm our safety in any way. A phobia is an irrational fear, usually directed at certain objects or specific situations, which manifests with a rather clear symptomatology. This means that phobia, unlike what many believe, is a real psychiatric condition that affects approximately 19.2 million people in the United States alone. Whatever the cause, phobia usually presents itself with well-defined symptoms: anxiety, an accelerated heartbeat, sweat, palpitations, tremors, nausea, dizziness and a general inability to deal with the situation rationally. Unlike fear, when it is intense, phobia almost always ends up compromising the normal course of daily life.
The highest incidence in women and adolescents
How is a phobia born? Generally, the onset of this psychiatric disease is associated with the period of adolescence and often, especially if not treated or underestimated, risks accompanying the subject throughout his or her life. Women suffer most, while the incidence of this disease in men is drastically reduced by 50%. Usually, the symptomatology occurs alone, in the absence of a truly traumatic event, although it may happen that the personal history of those who suffer from it presents some element that leads to develop it more easily. The fact remains that phobia is almost never born as a controlled and rational reaction to what is really dangerous, but as an uncontrolled and oversized response that prevents those who suffer from it to live through common daily situations peacefully. Especially if they are not treated, phobias can also manifest with a progressively more serious symptomatology that can result in a panic disorder.
The ten most common phobias
The American Psychiatric Association has identified the ten most common phobias. They range from ancestral aversions to animals, to the desire to avoid places or particular weather phenomena, to the uncontrolled fear of contracting diseases or, on the other hand, to undergo treatments that involve the sight of blood, which for our ancestors who lacked medical knowledge, represented a danger to life.
Among the ten most common phobias mentioned by the researchers are arachnophobia, i.e. fear of spiders and arachnids, ophidiophobia, i.e. fear of reptiles and snakes, and cynophobia or fear of dogs. People who are afraid of heights, too much space or crowded places, do not stand the idea of flying and are afraid of thunder and lightning, develop acrophobia and agoraphobia, aerophobia and astrophobia respectively. Those who live with terror of the idea of coming into contact with germs and bacteria and those who, on the contrary, avoid doctors and hospitals because they cannot bear the idea of being “punctured” with a needle suffer from mysophobia or trypanophobia. The tenth phobia, however, remains the most insidious and indefinite of all. It is social phobia: extremely widespread as it is underestimated or, worse, mistaken for a poor social propensity of those affected by it. Those suffering from social phobia avoid contact with others because it generates anxiety; they suffer terribly from the idea of having to expose themselves and talk in public or interact in general in a wider context.
Word from the psychotherapist
“It is important to distinguish between functional anxiety, which alarms us in the face of a real danger, and phobia, which is excessive fear for certain objects or situations that, in everyday life, should not be experienced – said Rastelli. By its definition, phobia is in fact irrational, because the danger is not real, but the malaise that it carries with it is real. Those who find themselves limited in their everyday lives know this well because they cannot take the crowded subway to go to work or have contact with other people because the sense of discomfort they feel is too strong. The problem of phobias, which can present with varying degrees of anguish, is not only that of limiting people in their daily lives (I no longer drive, no longer frequent open spaces, I no longer leave my house) but also of unfortunately developing anticipatory anxiety, that is, the fear of still being in a situation that one feels unable to manage”.
“The first thing to do, however, is to evaluate the origin of the anxiety, i.e. to understand whether it is a real danger or not and assess its intensity – advised the expert. In the event that the perceived danger is really excessive or such as to create discomfort, there are different ways to intervene, and the choice depends strictly on the person. There is a pharmacological route, with the prescription of anxiolytics or antidepressants based on the overall clinical picture that can only emerge during a visit by a specialist. The drug reduces the biological responses of anxiety and acts directly on the symptom. The other way is the path of psychotherapy that on one hand makes the symptom ‘speak’ (since when does it happen and why? What is your phobia telling you? Is there something you need to change? What does it mean in your life story?), but on the other hand it works on the person’s ability to face and manage the fears and situations they put in difficulty. This can be done, for example, either through relaxation exercises or through work on the deeper causes that may have led to the development of precisely that specific type of phobia.
“In psychodynamic psychotherapy, for example, each phobia can be traced back to a symbol and a specific area of the person’s psychic development, and tells a lot about the difficulties that the person is encountering on his way and for which he is, at the moment, “poorly equipped” – said Rastelli. Sometimes both roads are recommended in parallel, depends on the severity of the condition but also and above all on the person’s desire to get involved in self-knowledge.