Categories of Phobia
- Animal Type.
- Environmental Type – i.e. storms, thunder, earthquake.
- Situational Type (i.e. public speaking, trains, lifts).
- Other Specific.
When The Problem Has Been Present For So Long, Why Today?
Phobias are usually only presented to clinical practice when (i) avoidance of the phobic situation is no longer possible and/or (ii) when the phobia is secondary to a larger pattern set of problem behaviours.
Most Common Phobias Reported To Clinical Practice
Public Speaking – the situation most commonly avoided amongst the normal population.
Speaking to Desirable Members of Opposite Sex.
Blood/Injections – most commonly seen in medical/clinical/dental settings.
Agoraphobia – most common of the “psychiatric” or “complex” phobias. Often occurring with other psychiatric disorders such as depression and body dysmorphic disorders, physical disorders (deformity, chronic illness) and traumatic events (PTSD).
Social Anxiety/Blushing. Often a social developmental problem, issue of identity and of belief.
Vomiting in Public – surprisingly common and often unspoken of by sufferers.
Phobias of snakes and spiders although common are rarely presented to clinical practice for correction.
The Counter-Phobic Attitude
The psychoanalyst, Otto Fenichel, called attention to the fact that phobic anxiety can be hidden behind attitudes and behaviour patterns that represent a denial, either of the dreaded object or situation that is dangerous or that the person is afraid of it. Instead of being a passive victim of external circumstances, a person reverses the situation and actively attempts to confront and master whatever is feared. People with counter-phobic attitudes seek out situations of danger and rush enthusiastically toward them. Devotees of potentially dangerous sports, such as parachute jumping and rock climbing, may be exhibiting counter-phobic behaviour. Such patterns may be secondary to phobic anxiety or may be a normal means of dealing with a realistically dangerous situation. Children’s play may exhibit counter-phobic elements, as when children play doctor and give a doll the shot he received earlier that day in the paediatrician’s office. This pattern of behaviour may involve the related defence mechanism of identifying with the aggressor.
c/f ‘Abnormal Psychology’, Barlow/Durand