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Water Cooler: Clearing up misconceptions of phobias

Spokesman-Review
Aug 22, 2021

Aug. 22—Phobias live in an interesting place between the pop culture understanding of them and their actual medical definition.

It's common to joke that someone who is tidy is "OCD," but in reality, people with obsessive-compulsive disorder often suffer crippling worries that interfere with their daily functioning. Someone might claim they have a phobia of spiders or small spaces when those things only cause them general discomfort, not a deep anxiety that can lead to a panic attack.

Part of what contributes to this casual usage of phobia and related terms is a misconception of them and their severity. Understanding what causes phobias and how they are expressed may help clear up their image.

In general, phobias have roots in a common, relatable and unpleasant mental state — anxiety. What differentiates between an occasional bout of anxiety and an anxiety disorder is a distinct dysfunctional pattern of behaviors, feelings or thoughts that interfere with healthy, daily functioning.

Anxiety disorders are characterized by the behaviors that help one cope with or reduce anxiety.

For instance, someone who has a phobia of flying (aviophobia), will likely avoid traveling by plane at all costs. Someone who just doesn't like flying will usually fly anyway and deal with feeling tense.

OCD is an anxiety disorder that is well known by its behavioral characteristics such as repetitive behaviors like hand washing or checking that the stove is off in order to relieve intense feelings and obsessions that developed from repetitive, unwanted thoughts.

Although OCD is categorized as its own disorder, it shares with anxiety disorders a persistent sense of worry, fear and lack of control.

There are many different anxiety disorders.

Generalized anxiety disorder is marked by the experience of constant worry about daily life and all sorts of other things. Those who suffer from it often cannot pinpoint why they feel anxious. Social anxiety disorder, also called social phobia, is an anxiety of being seen by others or interacting with people. Panic disorder instead comes on in quick episodes, called panic attacks. These are bursts of intense dread or worry that may arise without warning and cause physical symptoms such as chest pain, sweating, nausea, a racing heart and more.

An anxiety disorder generally becomes a phobia after the initial anxiety has evolved into a fear of that anxiety itself. For example, panic attacks can be especially terrible to experience in public settings, so it is common for someone who has had a panic attack at a concert or on a bus to subsequently fear all similar and crowded settings.

Researchers who see anxiety as something that is learned believe anxiety can be formed and shaped through conditioning and observational learning. Phobias can develop stimulus generalization, when an object of fear becomes a general category of fear such as fearing all dogs because of a bad encounter with one dog. This anxiety or phobia is reinforced by avoiding all dogs. For someone who fears dogs, the relief felt by avoiding a dog on the street or at a park reinforces that avoidance behavior and further solidifies the phobia.

Some researchers also see genetics and biology as a predisposition for certain anxieties. They theorize that things learned during human evolution such as snakes being dangerous could be passed on as a widespread fear of snakes among humans. Identical twins have been shown to often develop similar phobias even if they are raised in separate environments. Researchers have also found 17 genes that are often expressed alongside anxiety disorders. People with anxiety disorders also often show extra arousal in areas of the brain involved with habitual behavior and impulse control.

Phobias are relatively rare, but they are easier to understand once you learn that they stem from universal emotions and experiences.

Rachel Baker can be reached at (509) 459-5583 or rachelb@spokesman.com.

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