Phobias

• What are phobias?


  An extreme, irrational fear of an object or situation

  10% of ppl suffer a phobia at some point
• 3 categories of phobias

  1) specific phobia- fear of specific object or situation

  2) social phobia- being over anxious in social situations

  3) agoraphobia- fear of being in open spaces and leaving home
• Behavioural characteristics of phobias

  - Panic - involves range of behaviours crying, screaming or running away from phobic stimulus

  - Avoidance - conscious effort to keep away from stimulus, this can make it hard to go about daily life

  - Endurance - remaining in presence of stimulus while experiencing extreme anxiety
• Emotional characteristics of phobias

  - Anxiety- unpleasant state preventing an individual relaxing and makes it difficult to experience positive emotion

  - Fear- the immediate response when encountering or thinking about the phobic stimulus

  Unreasonable emotional response - the extent of fear is out of proportion to any real danger presented by the phobic stimulus
• Cognitive characteristics of phobias

  - Selective attention to the phobic stimulus, a person with a phobia finds it hard to look away from the phobic stimulus

  - Irrational beliefs- person may hold irrational beliefs and be resistant to rational arguments

  - Cognitive distortions- perception of the phobic stimulus may be distorted
• Behavioural approach to explaining phobias --
• Two-process model


  Mowrer 1960 argued that phobias are acquired through classical conditioning and maintained through operant conditioning
• Classical conditioning


  - learning through association

  - UCS triggers a fear response which is the UCR , NS is associated with UCS , NS becomes CS producing fear which is now the CR.

  - Watson and Rayner 1920 showed how fear of rats could be conditioned in Little Albert

  - Whenever Little Albert played with a white rat a loud noise was made close to his ear, the noise, UCS caused a fear response UCR

  - Rat, NS did not create fear until the bang and the rat were paired together several times

  - Albert showed a fear response , CR every time he came in contact with a new rat which became a CS.
• What does classical conditioning often lead to?

  - leads to the generalisation of fear to other stimuli

  - e.g. Little Albert also showed a fear response to other white furry objects
• How are phobias maintained?

  - operant conditioning (negative reinforcement)

  -takes place when our behaviours are reinforced or punished

  - negative reinforcement- an individual produces behaviour that avoids something unpleasant

  - when a person with a phobia avoids a phobic stimulus they escape the anxiety they would have experienced, this reduction in fear negatively reinforces the avoidance behaviour and the phobia is maintained
• Example of negative reinforcement


  - if a person has a morbid fear of clown they would avoid places where they would encounter them.

  - The relief felt from avoiding the clown negatively reinforces the phobia ensuring it is maintained rather than confronted
• One strength of the behavioural approach to explain phobias

  - the two process model has real-world application

  - the idea that phobias are maintained by avoidance is important in explaining why people benefit from exposure therapies such as systematic desensitisation.

  - One avoidance behaviour is prevented , it stops being reinforced by the reduction of anxiety, avoidance behaviour therefore declines

  - this shows the value of the two process approach because it identifies a means of treating phobias
• Limitation of the BA to explain phobias

  - inability to explain cognitive aspects of phobias

  - behavioural explanations such as the two process model are geared towards explaining behaviour and the avoidance of a phobic stimulus

  - However, we know that phobias also have a significant cognitive component such as people holding irrational beliefs about their phobias

  - this means that the two process model does not fully explain the symptoms of phobias
• Limitation of the BA to explain phobias

  - Buck suggested that safety is a greater motivator for avoidance behaviour, rather than simply avoiding the anxiety associated with the phobic stimulus.

  -For example, he uses the example of social anxiety phobias - such sufferers can venture out into public but only with a trusted friend, despite still being exposed to hundreds of strangers which would usually trigger their anxiety.

  - This means that Mowrer's explanation of phobias may be incomplete and only suited for some.
• The BA to treating phobias ---
• Systematic desensitisation


  - the therapy aims to gradually reduce phobic anxiety through gradual exposure to the phobic stimulus. - It relies upon the principle of counterconditioning i.e. learning a new response to the phobic stimulus i.e. one of relaxation rather than panic. - This works due to reciprocal inhibition i.e. it's impossible to be both relaxed and anxious at the same time so one emotion prevents the other
• What does SD involve?

  - the client and therapist design an anxiety hierarchy in which fearful stimuli is arranged in order from least to most frightening

  - person with the phobia is taught relaxation techniques such as deep breathing and meditation

  - the person then works through the anxiety hierarchy, the person is exposed to each level in a relaxed state

  - this takes place over several sessions starting at the bottom of the hierarchy

  - treatment is successful when the person can stay relaxed in high anxiety situations
• Strength of SD


  - there is evidence of effectiveness

  - Gilroy et al 2003 followed up 42 people who had SD from spider phobia. At follow-up the SD group were less fearful than a control group as they had reduces symptoms

  - this shows that SD is likely to be helpful to those with phobias
• Strength of SD


  - SD is suitable for many patients including those with learning disabilities

  - many alternatives to SD are unsuitable for people with learning disabilities such as cognitive therapies which require a high level of rational thought

  - SD on the other hand does not require understanding or engagement on a cognitive level and is not a traumatic experience like flooding may be.

  - this means that SD is a more appropriate treatment for some people
• Flooding


  - a behavioural therapy designed to reduce phobic anxiety through immediate exposure to the phobic stimulus without a gradual build up

  - Without the option of avoidance behaviour the person quickly earns that the phobic stimulus is harmless through the exhaustion of their fear response, this is known as extinction

  - Flooding is not unethical but it is an unpleasant experience so it is important that people being treated give informed consent. They must be fully prepared and know what to expect
• Strength of flooding


  - it is cost-effective

  -Flooding is clinically effective as it can work in as little as one session and is not expensive

  - even with a longer session this makes flooding more cost-effective than alternatives

  - this means that more people can be treated at the same cost by flooding than by SD or other therapies
• Limitation of flooding


  - it can be a traumatic experience

  - There are ethical concerns about knowingly causing stress, offset by informed consent and the traumatic nature of flooding also leads to higher attrition rated than SD

  - This suggests that overall therapists may avoid using this treatment