Too many of us are not living our dreams because we are living our fears.

— Les Brown

One of the most frustrating aspects of phobias is that we know they’re irrational yet we still can’t seem to shake them. A phobia is a lasting and unreasonable fear caused by the presence or thought of a specific object or situation that usually poses little or no actual danger.

At My LA Therapy, we will help you get to the root of your phobia so you can finally release the grip of fear from your life. We will provide you with practical techniques as well as explore the deeper issues in order to attack your phobia from all sides. We will use evidence-based treatments to help you face and overcome your phobias so that you can feel free again.

The DSM-5 emphasizes these points in diagnosing Phobias:

  • Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
  • The phobic object or situation:
    • almost always provokes immediate fear or anxiety.
    • is actively avoided or endured with intense fear or anxiety.
  • The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
  • The fear, anxiety, or avoidance:
    • is persistent, typically lasting for 6 months or more.
    • causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, or avoidance of situations with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in post-traumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
  • Specified by the phobic stimulus: animal, natural environment (heights, storms, water), blood-injection-injury, situational (airplanes, elevators, enclosed places), and other (e.g., situations that may lead to choking or vomiting; in children, e.g., loud sounds or costumed characters).

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Factors and Causes of Phobias

  • Environmental (Beliefs) – Phobias may be a learned behavior. People may develop their fear from observing the anxious behavior of others or seeing what happened to someone else as the result of their behavior.
  • Psychological (Past Negative Experiences & Brain Structure) – You may have had a general time of major life stress or loss. This is including the amount and severity of trauma you’ve gone through since early childhood. Specifically, many phobias develop as a result of having a negative experience or panic attack related to a specific object or situation. Experiencing a frightening traumatic event, such as being trapped in an elevator or attacked by an animal, may trigger the development of a specific phobia. Even hearing about negative information or experiences, such as plane crashes, can lead to the development of a specific phobia. Also, the way your brain regulates the chemicals and hormones your body releases in response to distress. Changes in brain functioning also may play a role in developing disorders (the way your brain regulates the chemicals and hormones your body releases in response to stress).
  • Biological (Genetics) – Specific phobia may be somewhat more likely to occur when it is also present in a first-degree relative (parent, sibling, or child). In other words, anxiety disorders tend to run in families; you’re more likely to develop social anxiety disorder if your biological (blood) relatives have the mental health condition (inherited traits).

Other Complications of Phobias

  • Social isolation: Avoiding places and things you fear can cause academic, professional and relationship problems. Children with these disorders are at risk of academic problems and loneliness, and they may have trouble with social skills if their behaviors significantly differ from their peers.
  • Mood disorders: Many people with specific phobias have depression as well as other anxiety disorders.
  • Substance abuse: The stress of living with a severe specific phobia may lead to abuse of drugs or alcohol.
  • Suicide: Some individuals with specific phobias may be at risk of suicide.

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Treatment of Phobias

Treatment often includes a combination of the following options:

  • Supportive care – Because symptoms can be related to health problems, it’s important to be in regular/good contact with and be evaluated by a healthcare provider. If symptoms of specific phobia are present, your doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose specific phobia, the doctor may use various tests to rule out physical illness as the cause of the symptoms. If no physical illness is found, you may be referred to a mental health professional, who is specially trained to diagnose and treat mental illnesses.
  • Psychotherapy – Mental health professionals (such as psychotherapists, social workers, or professional counselors) use specially designed interview and assessment tools to evaluate a person for specific phobia. A variety of approaches are used to treat people with a specific phobia, including types of cognitive behavioral therapy, called systematic desensitization or exposure and response prevention (ERP) therapy, in which patients are gradually exposed to what frightens them until their fear begins to fade.
  • Medications – Sometimes medications can help reduce the anxiety and panic symptoms you experience from thinking about or being exposed to the object or situation you fear. For situational phobias that produce intense, temporary anxiety (for example, a fear of flying), benzodiazepines (sedatives) may be prescribed on an occasional, as-needed basis to help reduce anticipatory anxiety. Unless a phobia is accompanied by other conditions such as depression or panic disorder, long-term or daily medicines are generally not used. Occasionally, antidepressants may have potential value for some patients. More recently, beta-blockers (blood pressure drugs) have been used to treat anxiety related to specific phobias.

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Support for Phobias

  • Self-care – Get enough rest/sleep, eat healthy, and try to be physically active/exercise every day. Avoid substances even caffeine, as it can make anxiety worse. Don’t forget to celebrate successes.
  • Break the cycle and learn about your fears – This knowledge can help you understand what you’re feeling, and then you can develop coping strategies to help you respond effectively. Mindfulness strategies may be helpful in learning how to tolerate anxiety and reduce avoidance behaviors; Relaxation techniques, such as deep breathing, progressive muscle relaxation or yoga, may help cope with stress while reducing anxiety symptoms.
  • Reach out – Consider joining a support group to connect with others facing the same problems and who may understand you. Participate in activities by staying involved in work, social and family activities. Socialize (Don’t let worries isolate you from loved ones or enjoyable activities. Social interaction and caring relationships can lessen your worries).
  • Try not to avoid feared situations – Practice staying near feared situations as frequently as you can rather than avoiding them completely. Family, friends and your therapist can help you work on this. Practice the techniques you learn in therapy and work with your therapist to develop a plan if symptoms get worse.
  • Take action – Work with your mental health provider.


  1. WebMD
  2. Mayo Clinic
  3. Very Well Mind

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