When goose bumps pucker your skin and a chill rises through your toes to the tips of your hair, that’s fear. When your breath quickens, your throat feels smaller, and the space around you is too tight, that’s fear. When you can no longer remember how to move your legs, your thoughts fade in and out, and are unable to catch up with each other, that’s fear.
Fear can be felt anywhere—from willingly subjecting yourself to the boost of adrenaline during a horror film, to a flashback of a traumatic experience. It can be terrifying. It can affect your life.
Fear Versus Phobia
“Fear is most rational,” says Marlon Familton, M.A. LMHC, a mental health counselor in Bellevue who works with patients suffering from anxiety, phobias and anger issues. “But sometimes [elicits] an irrational reaction to a real or perceived threat.” He says that phobias act the same way with the added caveat that an acute response often cripples one’s ability to function. “Think about a phobia as a fear or anxiety on speed.”
The difference is in thought versus action. For people with a fear of heights, their reaction comes once they’re experiencing it, or when they have to make a decision about it (say, going up to the 15th story of a building). People with a height phobia will have a reaction just from talking about heights, even if they’re standing on low, solid ground, says Marlon.
Shana Olmstead, LMHC, a licensed mental health counselor in Kirkland who specializes in behavioral changes, anxiety and changing negative thinking, agrees that intensity is often the distinguishing factor between fear and phobia, as is the daily impact. “Someone with a phobia experiences a severe anxiety response when they come in contact with the stimulus, and will spend considerable time worrying about and avoiding any interaction with the object of their phobia,” she says.
Mental triggers, say seeing a spider for someone with a fear of spiders, flood the body with stress hormones, which cause the feelings of anxiety, stress and fear, Shana says. But triggers can also be physical, say for someone with a social anxiety disorder. The physical act of being in a social situation will set off these same chemical reactions.
“In either case, the physical and mental responses are intertwined, and the fear causes the body to physically respond with symptoms such as increased heart rate, perspiration, fast breathing and trembling,” Shana says.
Uncovering the Source
While fears can be about anything, Marlon notes that many phobias are specific and significantly irrational. “Phobias usually start as a fear or anxiety that grows with someone’s thoughts. Thoughts create feelings, so the more someone thinks about the fear, the more the thoughts can morph into a phobia.”
Often, these phobias are linked with past traumatic experiences, so a person suffering from the phobia will go out of his or her way to avoid experiencing it again. This, Marlon says, can often lead to obsessive-compulsive disorder, created by a fear or anxiety combining with a behavior to lessen that feeling.
“There is not one way that most phobias begin,” Shana says. “They are an anxiety disorder caused by a combination of genetics, life experience and brain chemistry.” People can be born predisposed to anxiety, or have a parent who suffers, and when this is combined with a stressful, frightening experience, a phobia can develop. Shana adds that many develop in early childhood, adolescence or early adulthood.
In Shana’s experience, social phobia (now known as social anxiety disorder) is very common among adults. She defines it as a debilitating fear of criticism or judgment in a social setting. Agoraphobia, the fear of being in a public place, is also widespread, as sufferers worry about embarrassing themselves in a public place by having a panic attack, which means they are often too afraid to leave their homes.
In his work, Marlon says that he treats patients who have anxiety, and people with phobias often seek help only when the behavior becomes debilitating. “Coming in to a counselor for help is quite hard because it means talking about and facing that greatest fear,” he says.
Treatment is often best accomplished through talking, because Marlon says, medications can mask the issue. “Since most phobias develop from irrational thinking, and thoughts create feelings, real treatment will help phobia sufferers with understanding their thoughts and resulting feelings.”
This means questioning the fear and the beliefs about what may happen if the object of their fears arises. From there, it’s about changing their response. Under these circumstances, Marlon says that counseling is the best place to start, and that sometimes exposure therapy can be beneficial for alleviating the underlying fear.
He also recommends cognitive tools—talking, processing related fears/traumas and changing thinking—and even energy psychology in the form of acupuncture and hypnotherapy. “Phobias, like anxiety, can be beat with some work.”
Shana also suggests cognitive behavioral therapy, as it helps patients identify triggers and unsound thoughts and replace them with more productive ones. Breathing exercises are also useful to help people stay calm when presented with their triggers. “Phobias are not a terminal condition,” she says. “As long as you are motivated to make a positive change, you can absolutely be free of a phobia.”
The first step is awareness, recognizing that a phobia has taken control of your life. After that, it’s about finding the courage to ask for help. As Shana says, “Why spend another day in fear when you can be free?”