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Phobic Disorders: What Do You Fear?

For law enforcement officers, fear can save your life. Sure, there are plenty of things to fear if you are a cop.  Most of them center on bad guys, equipment failure, unforeseen disasters, human error, etc.  These are things you should be afraid of.  In fact, fear is a normal and healthy part of everyone’s life and survival. Recognizing real danger allows you to respond accordingly and appropriately. Fears keeps you alert, they force you to prepare, to practice worst case scenarios and to respond responsibly.  Under normal circumstances, fear can be managed through reason, logic and training.  Normal fears do not take over our lives. To be defined as a phobia, the fear must cause some level of physical or psychological impairment. 

But what about any irrational fears?   Irrational fears are commonly referred to as phobias.  Phobia is a fear gone awry.  A phobia twists the normal fear response into something that is difficult, if not, impossible to control.  The American Psychiatric Association reports that each year 7.8% of American adults suffer from a phobia.  More than 12 percent of the population will experience a phobia at some point in their life; making this disorder the most common mental illness in the United States.

Phobic Disorders:  A phobic disorder is a type of anxiety disorder in which the main symptom is excessive and unrealistic anxiety and fearfulness.   A phobic disorder is a persistent, irrational fear.

Here is an example:  Let’s face it; approaching a house with a dog barking wildly in baritone can be a scary thing for anyone, especially if there is a sign saying “Beware of Dog” on the door (with a picture of a large dog brandishing wolf sized gnarled teeth and a razor spike collar).  You arrive on a priority call, 911 hang-up, unknown problem, shots fired, screams heard by neighbors.   Your partner is going around back; you knock and call out, the only response is a deafeningly series of dog barks that is getting closer and closer.  Back-up is in route.  Your heart races, you remove your OC, and have your hand on your firearm. You tell yourself; stay calm; there is nothing to be afraid of – desperately trying to convince yourself that you are in control. Suddenly there is loud thud as the dog thrusts himself at the door, panic seizes you in a death grip; it squeezes the breath out of you; your heart races; you sweat profusely; you feel faint. What is going on?  You could be one of many people who suffer from Cynophobia, a phobia that usually begins in childhood, resulting from a traumatic encounter involving a dog.  In your career this could be a problem, let’s face it.  You will undoubtedly encounter dogs on other calls.  Additionally, at least one of your friends or partners is going to have a dog; your family might want a pet, etc.  Dogs are simply a reality in our society. There will come a time you will have to face your fear.  There are treatments to get over your fear of dogs but we will get to that later. 

The Three Primary Forms of Phobia

  1.  Social phobia is a complex and frequently disabling disorder. Social phobia is characterized by an overwhelming fear of being criticized, scrutinized, or humiliated in social situations. Social phobia disrupts normal life by interfering with career, familial, and social relationships. Individuals with social phobia are afraid to enter into conversations for fear of saying something wrong that would be overwhelmingly embarrassing. They may avoid eating or drinking in public, using public restrooms, or signing a check in the presence of another. Social phobias generally develop after puberty and without treatment can last the individual’s life. The disorder often runs in families and is frequently associated with depression or alcoholism.  Epidemiology:  15 million Americans (6.8% of the population) suffer from social phobias.  It is equally common among men and women, typically beginning around age 13.  36% of people with social anxiety disorder report experiencing symptoms for 10 or more years before seeking help.
  2.  Agoraphobia is a fear of being someplace, with no easy means of escape or help if a panic attack should occur. Agoraphobia is the most disabling of all the phobias, and treatment is difficult because there are so many associated fears (crowds, elevators, traffic, bridges). This disorder is specifically paired with a panic disorder.  People who suffer agoraphobia avoid places and situations associated with previous panic experiences. As the fear of panic attacks increase, the agoraphobic's world narrows to only a few places where he/she feels safe. In some cases, this is limited to the home. Approximately 3.2 million American adults (4.9% of the population) ages 18 to 54 suffer from agoraphobia; the disorder usually develop between late adolescence and the mid thirties.
  3. Specific (also called simple) phobias are the most common form of phobias. Specific phobias produce an intense and disproportionate fear of a particular object or situation. People who suffer from specific phobias are aware that their fear is irrational, but the thought of facing the object or situation often brings on anxiety symptoms including panic attacks. Specific phobias usually begin in childhood or adolescence and as many as 50% subside on their own within five years. There are five subtypes of specific phobias: animal phobias (snakes, spiders, rodents, dogs, etc); natural environment phobias (heights, storms, water, darkness, etc); situational phobias (enclosed spaces, elevators, flying, dentists, tunnels, etc); blood injection/injury phobias; and everything that doesn't fall in the above four categories (clowns, death, vomit, choking, etc).  Statistics: 19 million Americans (8.7% of the population) suffer from specific phobia.  Women are twice as likely to be affected as men.  The disorder typically begins in childhood; the median age of onset is 7.

Signs and Symptoms of a Phobia Disorder

People with phobias experience immediate anxiety-related symptoms when exposed to their feared object or situation. Often the individual knows that his/her fears are out of proportion with the actual threat. However, their reactions are automatic and uncontrollable. These symptoms of phobias are identical to those that occur in the fight-or-flight response to genuine danger. The associated anxiety can range from mild feelings of apprehension to dread, horror, terror, or a panic attack. The closer you are to the thing you're afraid of, the greater your reaction to the fear will be. Your reaction will be further intensified if escape from the feared object or situation is difficult.

Common phobia symptoms and feelings include: shortness of breath or smothering sensation; palpitations, pounding heart, or accelerated heart rate; chest pain or discomfort; trembling or shaking; feeling of choking; sweating; nausea, diarrhea; feeling unsteady, dizzy, lightheaded, or faint; feelings of unreality or of being detached from yourself; fear of losing control or going crazy; fear of dying; numbness or tingling sensations; hot or cold flashes; jelly legs; dry throat; restricted or blurry vision or hearing.

Causes of Phobias

Much is still unknown about what causes phobias. However, research has shown a strong correlation between an individual's phobias and the phobias of their parents; indicating that children may learn fears by observing a family member's phobic reaction to an object or a situation. Sometimes the start of a phobia may be triggered by a stressful life event, such as bereavement, illness or divorce. Additionally, some people can trace back their phobia to a certain frightening event during their childhood.

Treatment

Any phobia that significantly interferes with daily living should be treated. With appropriate treatment, most phobic individuals can completely overcome their fears and be symptom-free for years, if not for life. Effective relief can usually be gained through cognitive behavior therapy, medication, or a combination of both.

Exposure-based cognitive–behavioral therapy is the treatment of choice for specific phobias. Using cognitive restructuring strategies with graduated exposure to the feared object, the therapist helps the client to correct anxiety-evoking misappraisals and to replace them with more realistic interpretations and predictions. For example, let’s go back to the case of cynophobia. Exposure-based cognitive–behavioral is used to retrain the brain, teaching it that in general, dogs are harmless and do not merit an intense fear reaction. With repeated exposures, the brain becomes more and more accustomed to relaxing in the presence of dogs. If you are performing exposure therapy on yourself, be sure you choose a dog that is extremely friendly and well-trained. Puppies, although adorable, may also be untrained and have a tendency to nip, and the last thing you want to do is have another bad experience with a dog.

Medications are prescribed to control panic and reduce anticipatory anxiety associated with agoraphobia and social phobia. SSRI antidepressants) are usually the drug of choice. Benzodiazepines are prescribed for severe anxiety. There is a strong potential for dependence on these medications, and should not be taken for longer than four months. Additionally, beta-blockers (cardiovascular drugs) may be prescribed to reduce the physical symptoms of anxiety such as palpitations, elevated blood pressure, and increased heart rate.

Other treatments include the use of relaxation techniques including progressive muscle relaxation, breathing techniques, and mental imaging of calming scenarios or successful confrontation of a phobic experience. Hypnosis has also been demonstrated as an effective treatment by providing individuals with posthypnotic suggestions that help them control their breathing, slow their heart rate, and achieve a relaxed state of mind. Additionally, self-help books are available to individuals. Some individuals benefit by sharing experiences and methods of coping with others in support groups.

The 20 Most Common Simple Phobias

  1. Arachnophobia:  fear of spiders
  2. Social Phobias:  fear of social situations
  3. Ophidiophobia: fear of snakes
  4. Acrophobia: fear of heights
  5. Agoraphobia: fear of situations in which escape is difficult
  6. Glossophobia:  fear of public speaking
  7. Cynophobia: fear of dogs
  8. Astraphobia:  fear of thunder and lightning
  9. Trypanophobia:  the fear of injections
  10. Aviophobia:  fear of flying
  11. Mysophobia:  the fear of germs or dirt
  12. Claustrophobia: fear of enclosed spaces
  13. Nyctophobia: fear of the dark
  14. Autophobia:  fearof being alone
  15. Nosophobia:  fear of having a disease
  16. Dentophobia:  fear of dentistry
  17. Coulrophobia: fear of clowns
  18. Atychiphobia:  persistent fear of failure
  19. Necrophobia:  fear of dead things
  20. Pyrophobia:  fear of fire

Tips for LEOs

As LEOs you are bound to encounter someone who is in a full blown case of panic secondary to a phobia or other stressors.  Know that there are ways to help.  If this is the first time the individual has experienced a reaction like this, or if you have any doubts about what is happening, seek emergency medical attention. This is doubly important if the individual has heart disease, diabetes, asthma or other medical problems.  Talk to the individual and try to determine if he/ she is having a panic attack and not another kind of medical emergency (such as a heart or asthma attack) which would require immediate medical attention. If they've experienced it before, they may be able to clue you in to what's going on.  It is important to remove the cause of the panic or take the individual to a quiet area ASAP. Speak to them in a reassuring but firm manner. Be prepared for the possibility of the individual trying to escape. Ask the individual to remain still; try to avoid grabbing, holding, or even gently restrain them if at all possible.  Do not dismiss or minimize their distress.  Next, encourage them to try to control breathing; try counting breaths or get them to breathe into a paper bag to prevent hyperventilation.  Keep them cool and as comfortable as possible.  Encourage them to relax their muscles, one muscle group at a time starting with their shoulders.  Don’t leave them alone; stay with them while they wait it out.  Panic attacks tend to peak at around 10 minutes and get better from there on a slow and steady decline.  Finally refer them to get profession treatment as needed. 

FYI:  If someone freaks out just by the site of you, it probably doesn’t mean you are the ugliest person alive (there are exceptions); the individual many have a simple case of policophobia. 

Just for fun try to guess what Hippopotomonstrosesquipedaliophobia involves.

 

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