Phobias

• Classification:

  • All Phobias are characterised by excessive fear and anxiety, triggered by an object, place, or situation.
  • The latest version of the Diagnostic and Statistical Manual of Mental Disorders recognises 3 categories of phobias and related anxiety disorders.
  • Specific: Phobia of an object, such as a body part, or a situation such as flying or having an injection.
  • Social Anxiety: Phobia or a social situation such as public speaking or using a public toilet.
  • Agoraphobia: Phobia of being outside or in a public place.
• Behavioural Characteristics:

  • How the person acts when faced with the phobia
  • Panic: Crying, screaming, running away
  • Children often freeze, cling, or have a tantrum.
  • Avoidance: Can interfere with work, education, and social life.
  • Endurance: Remaining in the presence of the phobic stimulus but continues to experience high levels of anxiety.
  • Can be unavoidable.
• Emotional Characteristics:

  • Anxiety: Phobias are classified as anxiety disorders. - They involve an emotional response or anxiety and fear.
  • Anxiety can be long term.
  • Fear is the immediate and extremely unpleasant response we experience when we encounter or think about the phobic stimulus.
  • Excessive and unreasonable responses:
  • Triggered by the presence of or anticipation of the phobic stimulus.
  • Often wildly disproportionate to the danger posed.
  • Example: Arachnophobia: - Going into somewhere you expect spiders = anxiety response. - Seeing a spider = Fear Response.
• Cognitive Characteristics:

  • Thought processes when faced with a phobia.
  • Selective Attention: Hard to look away.
  • Can be Maladaptive but useful when in actual danger.
  • Not so useful if the fear is irrational.
  • Irrational Beliefs: ‘I must always sound intelligent’
  • Social Phobia when in a social situation. -
  • Can increase pressure in phobic situations.
  • Cognitive Distortions: The phobic perception of the stimulus may be distorted and unrealistic.
  • ‘Belly Buttons are ugly and disgusting’ – Omphalophobics
• Mowrer’s 2 Process Model:

  • According to the behavioural approach, abnormal behaviour can be caused by:
  • Classical Conditioning
  • Operant Conditioning
  • Social Learning Theory
  • Mowrer (1947) proposed a two-process model, to explain how phobias are learned through classical conditioning and maintained through operant conditioning.
• Acquisition by Classical Conditioning:

  • Learning to associate something of which we have no fear (Neutral Response) with something that already triggers a fear response (unconditioned response)
  • The resulting fear is a conditioned response.
• Watson and Rayner (1920):

  • Aim: To investigate whether a fear response could be learned through classical conditioning in humans.
  • Method: Their participant was an 11-month-old (Little Albert).
  • Before the experiment, Watson and Rayner noted that Albert showed no response to various objects, in particular, a white rat.
  • To examine whether they could induce a fear response, Watson and Rayner struck a metal bar with a hammer every time Albert reached for the rat.
  • They did these three times.
  • Results: Thereafter, whenever they showed Albert the rat without the sound, he began to cry.
  • Conclusion: This experiment showed that a fear response can be induced through the process of classical conditioning in humans.
  • Little Albert also developed a fear of similar objects, including a White Santa Claus Beard.
  • The experiment revealed Albert had generalised his fear to other white furry objects.
• Maintenance by operant conditioning:

  • Responses acquired by classical conditioning usually decline over time, but Phobias are long-lasting.
  • Classical conditioning can explain how a phobia might develop, but cannot explain why it does not decay over time.
  • Mowrer suggests the maintenance Is a result of operant conditioning.
  • Reinforcement:
  • Negative – avoiding the phobic stimulus, reduces the feelings of anxiety and therefore, that person is more likely to repeat the avoidance.
• Systematic Desensitisation: AO1

  • Joseph Wolpe developed the systematic desensitisation technique for the treatment of anxiety-related disorders and phobias.
  • This technique is based on the basis that what has been learned (conditioned) can be unlearnt.
  • The patient will only move on to the ‘next level’ when they can remain calm and relaxed at the previous stage,
  • The patient and therapist will use counter-conditioning to unlearn maladaptive responses to a phobic situation or object, by eliciting another response.
  • There are three critical components to systematic desensitisation:
  • Fear hierarchy
  • Relaxation training
  • Reciprocal inhibition
• Systematic Desensitisation: AO3: Strength:

  • Research shows that systematic desensitisation is effective in the treatment of specific phobias.
  • ET AL (2003)/Spider Phobia: Using this method would not work for all phobias.
  • For example, a fear of falling, it would be difficult to have a patient physically falling in the exposure phase of treatment.
• Flooding: AO1:

  • Exposing the patient to the phobic stimulus immediately rather than gradually.
  • Intense exposure, done over an extended period of time in a safe and controlled manner.
  • Person is unable to avoid (negatively reinforce) their phobia and through continuous exposure, anxiety levels will gradually decrease.
  • Since the option of employing avoidant behaviour is removed, extinction will soon occur since fear is a time limited response to a situation which eventually subsides.
  • In some cases, the patient may achieve relaxation simply because they are exhausted by their own fear response.
• Flooding: AO3: Strength:

  • Cost effective
  • Ourgrin (2011)
  • However, it is less effective for some types of phobias
  • This matters because if flooding has a quick effect, then patients are free of their symptoms as soon as possible, allowing the patient to carry on with a normal life, and that also makes the treatment cheaper.
• Flooding: AO3: Weakness:

  • A weakness of flooding is that the treatment can be traumatic for patients.
  • This is due to exposing the patients to the phobic stimulus immediately rather than gradually.
  • Research has shown that many patients are often unwilling to see it through to the end.
  • Even though they have given consent, they can find the process difficult.
• What is the 1st stage of systematic desensitisation?

  1. Fear Hierarchy