Psychiatry identifies three different categories of phobias (DSM-IV,1994):
(with panic attacks): 300.21
(without panic attacks): 300.01
Irrational anxiety about being in places from which escape might be difficult or
Social phobia: 300.23
Irrational anxiety elicited by exposure to certain types of social or performance situations,
also leading to avoidance behavior.
Specific phobia: 300.29
Persistent and irrational fear in the presence of some specific stimulus which commonly
elicits avoidance of that stimulus, i.e., withdrawal.
animal type - cued by animals or insects
natural environment type - cued by objects in the environment, such as storms, heights,
blood-injection-injury type - cued by witnessing some invasive medical procedure
situational type - cued by a specific situation, such as public transportation, tunnels,
bridges, elevators, flying, driving, or enclosed spaces
other type - cued by other stimuli than the above, such as of choking, vomiting, or
contracting an illness
By definition, phobias are IRRATIONAL, meaning that they interfere with
life or daily routine. For example, if your fear of high places prevents you from crossing
necessary bridges to get to work, that fear is irrational. If your fears keep you from enjoying
life or even preoccupy your thinking so that you are unable to work, or sleep, or do the
things you wish to do, then it becomes irrational.
One key to diagnosing a phobic disorder is that the fear must be excessive
disproportionate to the situation. Most people who fear heights would not avoid visiting a
friend who lived on the top floor of a tall building; a person with a phobia of heights would,
however. Fear alone does not distinguish a phobia; both fear and avoidance must be evident.
(Lefton, L. A., 1997)
The Freudians speculate that as young children agoraphobics may have
by a cold or nonnurturing mother and the fear has generalized to a fear of abandonment or
helplessness. By contrast, modern learning theory suggests that agoraphobia may develop
because people avoid situations they have found painful or embarrassing. Also, failed
coping strategies and low self-esteem have been implicated (Williams, Kinney, & Falbo,
1989). Other research (Ost & Hugdahl, 1981) suggests that almost half of all people with
phobias have never had a painful experience with the object they fear. Perhaps we hear that
someone has been injured by a snake, for example, and we become afraid too. Almost no
one is afraid of cars, even though almost everyone has experienced or witnessed a car
accident in which someone got injured. As Martin Seligman (1971) put it, people may be
inherently "prepared" to learn certain phobias. For millions of years people who quickly
learned to avoid snakes, heights, and lightning probably have had a good chance to survive
and to transmit their genes. We have not had enough time to evolve a tendency to fear cars
Another possible explanation is that people generally develop phobias
for objects they
cannot predict or control. Danger is more stressful when it takes us by surprise (Mineka,
1985; Mineka, Cook, & Miller, 1984). Lightning is unpredictable and uncontrollable. In
contrast, you don't have to worry that electric outlets will take you by surprise, so it's not
likely that you'll have an "electric outlet phobia."
Humans seem biologically prepared to acquire fears of certain animals
and situations that
were important survival threats in evolutionary history (Seligman, 1971, McNally, 1987).
People also seem predisposed to develop phobias toward creatures that arouse disgust, like
slugs, maggots, rats, or cockroaches (Webb & Davey, 1993).
Neuroscientists are finding that biological factors, such as greater
blood flow and
metabolism in the right side of the brain than in the left hemisphere, may also be involved in
phobias. Identical twins reared apart sometimes develop the same phobias; one pair
independently becoming claustrophobic, for example (Eckert, Heston, & Bouchard, 1981).
There may be other reasons why some phobias are more common than others.
One is that we
have many safe experiences with cars and tools to outweigh any bad experiences. We have
few safe experiences with snakes or spiders or with falling from high places (Kleinknecht,
1982). Cross-cultural psychologists point out that phobias are influenced by cultural
factors. Agoraphobia, for example, is much more common in the United States and Europe
than in other areas of the world (Kleinman, 1988). A social phobia common in Japan but
almost nonexistent in the West is taijin kyofusho, an incapacitating fear of offending or
harming others through one's own awkward social behavior or imagined physical defect
(Kirmayer, 1991). The focus of cognition for a sufferer of this phobia is on the harm to
others, not on embarrassment to the self as in social phobias in the West. Taijin kyofusho is
described by Japanese psychiatrists as a pathological exaggeration of the modesty and
sensitive regard for others that, at lower levels, is considered proper in Japan (Gray, 1994).
Most psychologists believe that people with panic disorder develop their
social phobia or
agoraphobia because they are afraid of being incapacitated or embarrassed by a panic attack
in a public place. In a sense, they are afraid of their own fear (McNally, 1990).
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