Phobias

edvard munch the scream painting

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) classifies the phobias in three main categories:

Social Phobia

Social phobia is an intense and persistent fear of being under the scrutiny and the judgement of others. You are afraid that due to your appearance or behaviour could feel uncomfortable, embarrassed or humiliated. Therefore, you avoid those social situations that might trigger those negative states of mind.

You might have anxious doubts that you said something wrong. Then, since you are not sure about it, you worry that others criticize you. A “wrong” look from someone would make you feel stupid. You are afraid of being rejected or not fitting in. You afraid you’ll have nothing to talk about and feel very anxious to enter a conversation; you do your best to hide your social fear from others. You are afraid that if family and friends find out about your fear, then they would criticize or reject you.

I recall three cases. The first was a young man that was afraid of any situation where he was introduced to a woman she didn’t know. His mind would go blank, his mouth dry and was unable to maintain eye contact.

Another case was a school teacher that would get anxious in meetings. Whenever she in school get together with other teachers and the principals, she didn’t know what to say. She would remain silent.

The third case that I recall was a young man that feared the unexpected events. He couldn’t handle it. If he knew in advance that a given situation was coming; he could sometimes handle it with relative ease. For example, normally if the phone rang or someone knocked at the door, he couldn’t answer it. He would get someone else to do or it just went unanswered. The key was the unexpected situation. If he met someone unexpectedly in the street, even if he knew him very well and was very comfortable talking to him, he was unable to start a conversation. He would go blank, struggle to say some incoherent words.

Specific Phobia

A specific phobia, formerly called a simple phobia, is an extreme fear of a specific object or situation that is considered dangerous or threatening. Exposure to the object or situation brings about an immediate anxiety reaction. The anxiety and fear are so high and intense that the person tends to avoid what might cause this highly distressing emotional state. Needless to say this constant avoidance strategy interferes with the person’s ability to enjoy life.

We can divide specific phobias based on the situations or objects appearing dangerous and menacing such as:

  • Situational phobias: driving, riding in a car or on public transportation, flying, going over bridges or in tunnels, elevators, dark places, etc.
  • Animal phobias: spiders, dogs, cats, birds, snakes, insects, or mice.
  • Natural environment phobias: storms, heights, water.
  • Blood injection/injury phobias: thought of getting injured, seeing blood or some medical procedures, blood tests or injections.
  • Other phobias: fear of falling down, a fear of loud sounds, and a fear of costumed characters, such as clowns.

Agoraphobia

Agoraphobia is an intense and paralyzing fear of being in wide-open spaces and new places. The fear becomes extreme if the place is crowded or if the person fears that cannot get away or have someone rescue them in case they have a panic attack. People who suffer from agoraphobia avoid going out of their homes on their own, getting caught in a line up or in a crowded bus or subway.

Agoraphobia is not simply a fear of open spaces. The fear results from a dread of becoming trapped and helpless somewhere while having a panic attack. Since this never happens in their own home, some prefers staying most of the time in their homes.