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Fear’s Purpose: From Threat to Safety

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Fear is an emotional reaction to a stimulus that implies a real or perceived threat. Even though we highly despise feelings of fear and aim to avoid it as much as possible, fear has a robust adaptive value that contributes to our survival rate. Due to its adaptive nature, it is not surprising that fear is one of the basic emotions alongside sadness, anger, happiness, and disgust. In Ancient Greece, fear was divided into “ normal” and “pathological”. Normal fear was called Deos (eng. fear), which was considered a conscious and functional emotion to protect us. Pathological fear was called Phobos (Eng. phobia). In this therapy sketch, we will discuss fear and what happens if it becomes nonfunctional. 

What do we fear?

Fear is one of the most extensively researched emotions in literature. To answer what we fear, several studies have been conducted. In one of the earliest studies by G. Stanley Hall (1897), 1701 participants described 6456 fears. As you may conclude from the diversity of the answers, this question varies from person to person according to various factors. For example, our fears change with our age. You can fear thunderstorms, lightning, or darkness as a kid. However, Hall’s study revealed some fears, like darkness, blood, the end of the world, kidnapping, loss of orientation, and shyness toward strangers, decreased with age. Specific fears, such as drowning, domestic animals, insects, ghosts, death, and disease, peaked during early adolescence (ages 11-15) and decreased in late adolescence (ages 15-18). Adults are more context-dependent than adolescents regarding fear and generalizations associated with it. Global fears, including economic and political concerns and fears about the future, were found to be the most common fears among older adolescents and adults (Angelino & Shedd, 1953). Despite these changes, Hall noted that a few of our early childhood fears persisted into adulthood (Hall, 1897; Gullone, 2000). For instance, you may still have a persistent fear of the darkness from childhood, and you may have developed economic fears due to contextual variables. In short, what you fear will vary considerably, mainly depending on your age and the situation. Such fears are considered normal if they are not uncontrolled and dysfunctional.

The term “phobia” is used if the feared object has gone beyond the person’s control and impairs their daily functioning. 

Phobias

A specific phobia is a disproportionate level of constant fear of an object (e.g., animal) or situation (e.g., high places), even though it does not pose a real danger (APA, 2013). People with specific phobias immediately overreact when they encounter objects or situations they fear. They are afraid of experiencing feared objects/situations and avoiding various situations. This fear and avoidance causes disruptions in their lives. However, we can not say everything we fear; every avoidance behavior is considered a specific phobia. For fear of an object or situation to be regarded as a specific phobia, it must have particular characteristics and consequences.

  1. First of all, if the object or situation that a person fears involves a realistic threat, it is not called a phobia (APA, 2013). For example, fear of poisonous insects or snakes in the tropics is not considered a phobia. On the other hand, fear of a snake seen in a documentary on television is regarded as a sign of phobia.
  2. The fear must interfere somehow with the person’s work, school, family, or social life (APA, 2013). If a person can get on an elevator or an airplane despite fear, it may not be considered a phobia. Because although they are afraid, they have the ability to manage the fear and function well. However, for instance, if the person does not take the elevator even if they have to go up ten floors, or if they want to visit their child living in another city but cannot do so because they avoid taking the plane, this is a sign of a specific phobia. Because the fear they feel affects their functioning.

Types of Specific Phobias 

We can say that specific phobias can develop towards anything, and about 500 recognized phobias exist eventhough most are not counted as a diagnosis. Many of them describe interesting and extraordinary fears, such as Heptadekaphobia (fear of the number 17), Rytophobia (fear of the color red), and (Oneirophobia = fear of dreams). A more limited number of specific phobias are usually typical. These are grouped into five categories:

  • Animal phobias: Animals such as cats, dogs, mice, birds, insects, pests, spiders, and snakes.
  • Phobias of the natural environment: Natural situations such as high places, darkness, water, storms, and thunder.
  • Situational phobias: Driving a car; traveling by bus, train, or plane; being in enclosed spaces such as elevators, windowless rooms, tunnels, and crowded places.
  • Blood-Injection-Wound phobias: Seeing blood, watching surgery, seeing wounds, giving blood, or getting injections.
  • Other phobias: All phobias that do not fall into the above categories are vomiting, choking, clowns, balloons, and snow.

Another Phobia Type: Social Phobia

Social Phobia, commonly known as Social Anxiety Disorder, is a disorder in which the individual is afraid of being judged by others and has a significant and persistent fear of being embarrassed or disgraced in social settings. People are afraid of situations that require them to interact with others or to perform an action in the presence of others and try to avoid them as much as possible. They may be afraid to speak in public for fear that their hands or voice will be noticed to tremble, or they may experience extreme anxiety when speaking to others for fear of appearing to be unable to speak properly. They may avoid eating, drinking, or writing in the presence of other people (APA, 2013). 

The social situations identified in the Liebowitz Social Phobia Scale are as follows (1987)

  • Talking on the phone in public
  • Taking part in a small group activity
  • Eating or drinking  in public
  • Drinking in public
  • Talk to someone in charge
  • Speaking in front of an audience, role-playing
  • Going to a party/entertainment
  • Working or writing while being watched by others
  • Face-to-face conversation with someone you don’t know very well
  • Encountering strangers, etc. 

Why are social phobia & other phobias happening?

There are two critical factors predisposing to social phobia. Due to the importance of acceptance in social systems for survival, humans are thought to have a genetically encoded readiness to fear angry, critical, or disapproving people (Mineka & Zinbarg,  2006). Research has shown that the fear response in humans develops more quickly when faced with angry expressions (compared to other expressions) and that the fear that develops decreases over a more extended period of time (Dimberg & Öhman, 2004). Studies of people with social anxiety disorder have shown that they recognize faces with angry expressions faster and remember them more than normal people      (Mogg et al., 2004).

In addition, it is thought that the interaction of one’s past learning experiences with general biological and psychological predispositions may trigger social phobia and additionally other specific phobias. Learning experiences include direct experiences in which a person feels humiliated in front of others and observes or hears that such an event has happened to someone else (Mineka & Zinbarg, 2006). For example, a child who raises his/her finger in class and says something that causes everyone to laugh at him/her, if he/she has the relevant predisposition, may experience conditioning to feel fear in similar environments, and this fear may generalize to various social situations. 

And for specific phobias, for example, someone scratched by a cat may start to fear cats. However, phobias can also arise indirectly, without being directly related to a negative life experience. A person may learn that people around him/her may be ‘dangerous’ by observing their behavior when confronted with a phobic object or situation. In addition, the positive and negative information that a person hears plays a role in the development of a phobia. For example, a child who hears his/her parents being afraid of dogs, constantly saying ‘dogs bite’ and ‘stay away from dogs,’ and seeing the behavior of his/her parents when they encounter dogs may develop a phobia towards dogs (Askew & Field, 2007).

Features of Phobias 

Specific phobias cause physical, cognitive, and behavioral changes right after the fear-induced object/situation is perceived. These changes are as follows:

  • Physical features: The person with a specific phobia has physiological reactions such as rapid heartbeat, increased blood pressure, rapid breathing, and sweating when confronted with what they fear. They may even experience panic attacks when faced with what they fear. The sympathetic nervous system causes these physiological symptoms, activated when a person encounters danger.(Garcia, 2017).
  • Cognitive features: Individuals with specific phobias perceive and evaluate their environment as more dangerous than it actually is. In their environments, objects/situations associated with their fears attract their attention more often and faster. They think the things they fear will directly harm them (e.g., dog biting, being trapped in an elevator, airplane crashing, or being teased in a social environment etc.). Some people also fear the consequences of their emotions and physical symptoms when confronted with what they fear (e.g., choking on their breath in an elevator, losing control in an airplane due to fear, etc.) (Hout et al., 1997)
  • Behavioral features: A person with a specific phobia avoids situations in which they are likely to encounter the thing they fear or behaves in a way that makes them feel safe (e.g., a person with height fear never goes out on a balcony or stands away from the balcony bars when they do, a person with an elevator fear choose to take stairs, a person with blood phobia avoid to have blood tests, etc.). The more situations the person avoids, the more their fear starts interfering with their life.

Treatment of the Phobias

  • Exposure-Based Treatments: The primary empirically supported treatment for phobias is exposure therapy (Antony & Barlow, 2002). Marshall (1985) defines exposure as “any procedure that confronts an individual with a stimulus that produces an unwanted behavior or emotional response. Experimental studies show that a three to five-hour treatment is sufficient to treat phobias, even in severe patients.
  • Virtual Reality and Technology-Assisted Therapies: Exposure in virtual reality is based on the same principles as imaginative exposure to real-life situations, i.e., it helps patients gradually confront their fears. However, the stimuli used in the therapy are computer-generated.
  • Cognitive Behavioral Therapy (CBT): CBT is also used to treat specific phobias. CBT incorporates techniques to help people overcome their fear (Choy, 2007).  
    • Balancing Your Thoughts: A lot of people with phobias think in extremes. For example, someone might believe that “If I see a dog, it will definitely bite me.” CBT helps you balance your extreme thoughts and see things more realistically.
    • Facing the Fear: As mentioned above, exposure therapy is essential for specific phobias, and it is used during CBT practice as well. This involves grading what you fear (for instance, seeing a dog on the street might get 6 points over 10 in terms of fear, and seeing a dog vidual might get 3 out of 10). After creating a fear hierarchy, this technique involves exposing yourself to what you fear, starting with less intimidating situations and slowly moving to the more challenging ones. Over time, this helps reduce the fear.
    • Understanding Your Phobia: Learning how thoughts and feelings contribute to phobia can be helpful. It allows people to recognize your fear is not related to a real-life danger. 
    • Relaxation Techniques: When incorporating mindfulness techniques, people also learn relaxation methods, like deep breathing, to help calm themselves when encountering fear-induced objects/situations. 
    • Testing Your Fears: CBT encourages people to test their fears in real life. For example, if you’re afraid of elevators, you might work up to using one to see what really happens. Often, it turns out to be much less scary than you thought.

Takeaways

Fear is the emotion individuals feel when there is any threat or danger. Fear is considered a normal emotion that protects our body from dangers and allows us to take precautions. If the fear felt against threatening and dangerous objects and situations is at an extreme level, this is characterized as a phobia. Specific phobias are characterized by an abnormal state of fear and anxiety when confronted with a specific situation or object. It involves feelings of fear that are out of proportion to the actual danger posed by the phobic object or situation. Encountering the situation or object in question can trigger panic attacks, and the person shows overt avoidance behaviors of phobic stimuli. It is very common to treat specific phobias with psychotherapeutic techniques. It might be beneficial to consult a mental health professional to overcome phobias and develop effective coping strategies that reduce fear and avoidance behaviors.

References

  • Hall, G. S. (1897). A Study of Fears. The American Journal of Psychology, 8(2), 147. doi:10.2307/1410940 
  • Gullone, E. (2000). The development of normal fear. Clinical Psychology Review, 20(4), 429–451. doi:10.1016/s0272-7358(99)00034-3
  • Angelino, H., Dollins, J., & Mech, E. V. (1956). Trends in the “fears and worries” of school children related to socio-economic status and age. The Journal of Genetic Psychology, 89, 263–276.
  • American Psychiatric Association, (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
  • Garcia, R. (2017). Neurobiology of fear and specific phobias. Learning & Memory, 24(9), 462–471. doi:10.1101/lm.044115.116 
  •  Van den Hout, M., Tenney, N., Huygens, K., & de Jong, P. (1997). Preconscious processing bias in specific phobia. Behavior Research and Therapy, 35, 29-34. http://www.sciencedirect.com/science/article/pii/S0005796796000800
  • Liebowitz, M. R. (1987). Liebowitz Social Anxiety Scale (LSAS) [Database record]. APA PsycTests.
  • Mineka, S., & Zinbarg, R. (2006). A contemporary learning theory perspective on the etiology of anxiety disorders – It’s not what you thought it was. American Psychologist, 61(1), 10-26
  •  Dimberg, U., & Öhman, A. (1983). The effects of directional facial cues on electrodermal conditioning to facial stimuli.Psychophysiology, 20, 160–167.
  •  Mogg, K., Philippot, P., & Bradley, B. P. (2004). Selective attention to angry faces in clinical social phobia. Journal of Abnormal Psychology, 113, 160–165.
  • Askew, C., & Field, A. P. (2007). Vicarious learning and the development of fears in childhood. Behavior Research and Therapy, 45(11), 2616-2627.
  • Antony, M. M., & Barlow, D. H. (1998). Specific phobia. International handbook of cognitive and behavioral treatments for psychological disorders, 1-22.
  • Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007). Treatment of specific phobia in adults. Clinical Psychology Review, 27(3), 266–286. doi:10.1016/j.cpr.2006.10.002 

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