phobias

• define a phobia


  excessive fear and anxiety triggered by an object, place or situation . The extent of the fear is out of proportion to any real danger presented by the phobic stimulus
• what is a phobic stimulus

  The specific object or situation producing the fear associated with a phobia
• 3 characteristics of phobias


  behavioural

  cognitive

  emotional
• examples of behavioural responces


  panic

  -may include crying, screaming or running away

  
  

  avoidance

  -people try to avoid the stimulus which can make daily life hard

  
  

  endurance

  -when someone chooses to remain in the presence of a stimulus
• examples of cognitive responces


  selective attention to the phobic stimulus

  -can be hard to look away from the stimulus as it allows us to react quickly to a threat but can cause us to loose concentration on other more important subject areas

  
  

  irrational beliefs

  -a person might have thoughts which are not true which puts pressure on the person

  
  

  cognitive distortions

  -perceptions may be inaccurate and unrealistic someone may see mushrooms as disgusting
• examples of emotional responces


  anxiety

  -phobias are anxiety disorders

  
  

  fear

  -more intense and shorter than anxiety

  
  

  unreasonable emotional responce

  -the anxiety or fear is disproportionate to any danger the stimulus can cause a person
• 2 behavioural approaches to treating phobias


  Systematic desensitisation and flooding
• aims of systematic desensitisation


  -reduce an unwanted responce eg anxiety to a stimulus

  -gradually reduces phobic anxiety through classical conditioning

  -new responce to the phobic stimulus is learned (relaxation instead of anxeity)
• 3 steps of systematic desensitisation


  anxiety hierarchy

  relaxation

  graduated exposure
• Process of the anxiety hierarchy


  a list of anxiety provoking situations related to the phobic stimulus, it is arranged from least frightening to most frightening

  eg, most frightening is spider on your hand and least frightening is picture of a spider
• process of the relaxation step


  the patient is taught to relax as deeply as possible

  -may involve being taught breathing exercises or mental imagery techniques
• process of graduated exposure step


  -the patient is exposed to the stimulus in a relaxed state

  -happens over several sessions at the lower end of the hierarchy

  -when the patient can stay relaxed in the lower levels they move up

  -treatment ends when the patient can stay relaxed in the higher levels
• how does flooding work


  flooding is an intense exposure to the phobic stimulus with no graduated exposure or escape opportunities

  -the idea is that anxiety cannot be sustained for a long period of time so the anxiety will subside and the person will relax and learn a new association with the stimulus

  
  

  the patient may achieve relaxation because they have exhausted their fear response

  
  

  this is called extinction in classical conditioning
• ethical safeguards with flooding


  -important to obtain informed consent + make sure people are fully prepared for the procedure

  -therapists should be fully trained and create a safe context

  -flooding therapies aren't cruel despite looking like it, they may be the kindest thing to do for a patient
• Strengths of systematic desensitisation


  -gilroy et al showed that the effects are long lasting, he followed 42 patients who were treated for a spider phobia vs a control group not taught relaxation techniques, at 3 months and 33 months the systematic desensitisation group were less fearful

  
  

  -it is suitable for most people, flooding + cognitive therapies may not be good for people eg with learning difficulties who cant engage with the tough mental tasks or understand why its good to experience the anxiety
• Weaknesses of systematic desensitisation


  it is not appropriate for all phobias

  -its been suggested that SD may not be appropriate to treat phobias that have an underlying evolutionary survival component eg heights/snakes and it is better for treating phobias that were caused by personal experience

  
  

  (weakness for both)

  -frued argued that symptom substitution would play a role, a displacement of anxiety from a real source eg death to one easier to deal with eg zombies. This limits behavioural therapies as the treatment does not address the underlying cause
• strengths of flooding


  -choy et al suggested it is more effective than other methods whilst other research suggests it is equally effective

  
  

  it is cost effective and quicker than alternatives

  -as it can be completed days quicker than SD, often taking only 2 sessions rather than SD takes 10+ this means more people can be treated in the same time
• weaknesses of flooding


  -treatment can be fightening and unpleasant, for young children + people with learning difficulties may not understand why they are being exposed

  -some patients will refuse to flood so time and money is wasted

  
  

  its less effective for social phobias

  -as they often involve cognitive aspects such as irrational thinking and they would benefit from more cognitive therapy

  
  

  (weakness for both)

  -frued argued that symptom substitution would play a role, a displacement of anxiety from a real source eg death to one easier to deal with eg zombies. This limits behavioural therapies as the treatment does not address the underlying cause
• what is the main explanation of phobias


  behavioural explanation: two process model
• who proposed the two process model to explain phoibas


  hober mowrer
• what is the two process model


  phobias are acquired and then maintained
• how are phobias acquired


  through classical conditioning

  - an unconditioned stimulus that causes fear (eg the dark) is associated with a neutral stimulus

  - this causes the neutral stimulus alone to also cause a fear response
• how are phobias maintained


  avoiding the stimulus

  - avoiding it is rewarding which maintains the phobia

  -this is negative reinforcement as avoiding a phobia means that we do not experience the unpleasant feelings with it

  -a phobia will then become stronger because the sufferer continues to make reinforcing avoidance responces
• positive evaluation of two process model


  It can be applied to behavioral therapy in order to treat phobias

  -behavioural therapies eg systematic desensitisation aim to decondition phobias by gradually reducing phobic anxiety through classical conditioning where a new positive responce to the stimulus is learned
• negative evaluation of the two process model


  it ignores cognitive factors, as there are cognitive aspects to phobias that cannot be traditionally explained

  - cognitive factors such as irrational thoughts cannot be explained by the 2 process model, irrational thoughts can trigger anxiety

  
  

  it does not factor in biological factors for phobias

  - bounton points out that evolutionary factors may have a role in phobias as we easily aquire phobias that pose a danger to us like heights so we will have evolved to be afraid of these things

  -this has been described as biological prepardness- the inate predisposition to aquire certain fears

  
  

  some phobias appear to be aquired by social learning

  -a child might see a parent react with fear to a stimulus which might trigger the child to imitate this behaviour as the parents are a model for them