Therapy

People are often embarrassed by phobias in a way they are not by other conditions, because the fear is out of proportion and they know it. Knowing it is out of proportion has never once made a phobia go away. That is not a failure of willpower or intelligence — it is how the fear system works, and it is why the treatment is behavioural rather than rational.

—  Flying, and travel anxiety more broadly

—  Driving — highways, bridges, winter conditions, or driving after an accident

—  Needles, blood, dental work and medical procedures

—  Heights

—  Dogs, spiders, snakes and other animals

—  Enclosed spaces, lifts, tunnels

—  Vomiting (emetophobia), which is more common and more disruptive than most people realise

—  Social situations — though this often overlaps with social anxiety and may be treated differently

Specific phobias have among the best treatment outcomes in all of mental health. Graded exposure therapy — approaching the feared thing in carefully planned, manageable steps while your nervous system learns it is survivable — works for the large majority of people, often in a relatively small number of sessions. This is one of the areas where therapy produces clear, measurable, fairly rapid change.

Nobody is going to spring anything on you. The process is:

Assessment. What the fear is, when it started, what you are avoiding, and what you want to be able to do again.

Preparation. Building the tools to manage anxiety before you need them — breathing, grounding, and understanding what your body is doing and why.

Building a ladder. Together you construct a graded list from mildly uncomfortable to genuinely hard.

Working up it. One rung at a time, at your pace, staying with each until it loses its charge. You are never pushed to the next step before you are ready.

Consolidation. Making the gains stick, and planning for the fear resurfacing under stress — which it sometimes does, and which is manageable.

Where a phobia began with a specific incident — a bad flight, a car accident, a traumatic medical procedure — EMDR or ART can shorten this considerably by treating the original event directly.

Phobias often start in childhood. Charles Fai, LPCC works with children, teenagers and families and has particular experience with specific phobias, working with parents as well as the young person — because how a family responds to a child's fear has a lot to do with whether it grows or shrinks.

FAQ