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Phobia and its
  treatment
      By
Dr./ Hala Salah
       Lecturer of psychiatry
PHOBIA
 Defined as irrational fearthat produce
 consciousavoidance of the feared subject,
.activity, or situation

 Either the presence or the anticipationof
the phobic entity elicits severe distress in
the affected person who usually recognize
 . that the reaction isexcessive
:Phobias are divided into two main categories

Specific phobias:. Strong persistent
fear of an object or situation These include
situational type: )e.g. enclosed spaces-
 ),elevators, airplanes
Animal type:. particularly spiders, snakes-
Natural environment type )e.g. heights,-
 .) storms, water
     Blood-injection-injury type-
  Other type:.flying, germs, illness, death-
Social phobia
   Strong persistent fear of situation in which
 embarrassment can occur .

     Social phobia involves a combination of:
- Excessive self-consciousness,
- Fear of public humiliation in common social situations,
- Fear of negative evaluation by others.
-Feeling of overwhelming anxiety.
 -Feeling an intense need to escape
 -Difficulty breathing
Racing or pounding heart-
Chest pain or tightness-
 -Feeling dizzy or lightheaded
 -Hot or cold flashes; tingling sensations
 -Sweating
The avoidance , anxious anticipation,
or the distress may interfere significantly
with the person’s normal routines,
occupational, academic functioning or
social activities.
ETIOLOGY--- Specific
phobia
                Behavioral
Pairing-1 of a specific object or situation
.with emotions of fear

Modeling :--2 observing the reaction in
.another e.g. parents

Information transfer-3 which the person is
.taught to be danger
GENETIC
At least one of the first
degree relative has
specific phobia of the
same type
AETIOLOGY--- Social phobia
inhibition during childhoodBehavioral       :
Parents are less caring , more rejecting , more
protecting

:Genetics
First degree relatives have three times more
incidence than control‘ relatives
Neurochemical factors

Increase release of epinephrine and-
.norepinephrine

Increase sensitivity to normal level of-
.adrenergic stimulation

.Dopaminergic dysfunction-
Phobia & its Treatment
 Selectiveserotonin reuptake
 inhibitors (SSRIs)

 Benzodiazepines


 Beta   Blockers
Phobia & its Treatment
   Through repeated experiences facing your
    fear, you’ll begin to realize that the worst isn’t
    going to happen; you’re not going to die or
    “lose it”.

   With each exposure, you’ll feel more
    confident and in control. The phobia begins to
    lose its power.
 Make  a list
 Build your fear ladder
 Work your fear up the ladder
 Practice
 Step  1: Look at pictures of dogs.
 Step 2: Watch a video with dogs in it.
 Step 3: Look at a dog through a window.
 Step 4: Stand across the street from a dog
  on a leash.
 Step 5: Stand 10 feet away from a dog on
  a leash.
 Step  6: Stand 5 feet away from a dog on
  a leash.
 Step 7: Stand beside a dog on a leash.
 Step 8: Pet a small dog that someone is
  holding.
 Step 9: Pet a larger dog on a leash.
 Step 10: Pet a larger dog off leash.
A simple deep breathing relaxation
 exercise!!!!!

   Once the patient is comfortable with this
    deep breathing technique, he can start to use
    it when he is facing his phobia or in other
    stressful situations
The patient tends to:
1- overestimate how bad it will be if
 he is exposed to the situation he
 fears.
2- At the same time, he underestimates
 his ability to cope.
 A-Telling          the future
   I will definitely suffocate when the elevator
    doors close.”
   “That pit bull lunged at me. All dogs are
    dangerous.”
 “The  person next to me
 coughed. May be it’s the
 swine flu. I’m going to get
 very sick!”
   Is there any evidence that contradicts
    this thought?

   “I see many people using the elevator and it
    has never broken down.”

   “I have never actually been in an elevator that
    has broken down.”
   Could you do anything to resolve this
    situation if it does occur?

“I guess I could press the alarm button or use
  the telephone to call for assistance.”

 Are you making a thinking error?
“Yes. I’m fortune telling, as I have no evidence
  to suggest that the elevator will break down.”
What would you say to a friend who has
 this fear?

   “I would probably say that the chances of it
    happening are very slim.
Thank you

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Phobia & its Treatment

  • 1. Phobia and its treatment By Dr./ Hala Salah Lecturer of psychiatry
  • 2. PHOBIA Defined as irrational fearthat produce consciousavoidance of the feared subject, .activity, or situation Either the presence or the anticipationof the phobic entity elicits severe distress in the affected person who usually recognize . that the reaction isexcessive
  • 3. :Phobias are divided into two main categories Specific phobias:. Strong persistent fear of an object or situation These include situational type: )e.g. enclosed spaces- ),elevators, airplanes Animal type:. particularly spiders, snakes- Natural environment type )e.g. heights,- .) storms, water Blood-injection-injury type- Other type:.flying, germs, illness, death-
  • 4. Social phobia Strong persistent fear of situation in which embarrassment can occur . Social phobia involves a combination of: - Excessive self-consciousness, - Fear of public humiliation in common social situations, - Fear of negative evaluation by others.
  • 5. -Feeling of overwhelming anxiety. -Feeling an intense need to escape -Difficulty breathing Racing or pounding heart- Chest pain or tightness- -Feeling dizzy or lightheaded -Hot or cold flashes; tingling sensations -Sweating
  • 6. The avoidance , anxious anticipation, or the distress may interfere significantly with the person’s normal routines, occupational, academic functioning or social activities.
  • 7. ETIOLOGY--- Specific phobia Behavioral Pairing-1 of a specific object or situation .with emotions of fear Modeling :--2 observing the reaction in .another e.g. parents Information transfer-3 which the person is .taught to be danger
  • 8. GENETIC At least one of the first degree relative has specific phobia of the same type
  • 9. AETIOLOGY--- Social phobia inhibition during childhoodBehavioral : Parents are less caring , more rejecting , more protecting :Genetics First degree relatives have three times more incidence than control‘ relatives
  • 10. Neurochemical factors Increase release of epinephrine and- .norepinephrine Increase sensitivity to normal level of- .adrenergic stimulation .Dopaminergic dysfunction-
  • 12.  Selectiveserotonin reuptake inhibitors (SSRIs)  Benzodiazepines  Beta Blockers
  • 14. Through repeated experiences facing your fear, you’ll begin to realize that the worst isn’t going to happen; you’re not going to die or “lose it”.  With each exposure, you’ll feel more confident and in control. The phobia begins to lose its power.
  • 15.  Make a list  Build your fear ladder  Work your fear up the ladder  Practice
  • 16.  Step 1: Look at pictures of dogs.  Step 2: Watch a video with dogs in it.  Step 3: Look at a dog through a window.  Step 4: Stand across the street from a dog on a leash.  Step 5: Stand 10 feet away from a dog on a leash.
  • 17.  Step 6: Stand 5 feet away from a dog on a leash.  Step 7: Stand beside a dog on a leash.  Step 8: Pet a small dog that someone is holding.  Step 9: Pet a larger dog on a leash.  Step 10: Pet a larger dog off leash.
  • 18. A simple deep breathing relaxation exercise!!!!!  Once the patient is comfortable with this deep breathing technique, he can start to use it when he is facing his phobia or in other stressful situations
  • 19. The patient tends to: 1- overestimate how bad it will be if he is exposed to the situation he fears. 2- At the same time, he underestimates his ability to cope.
  • 20.  A-Telling the future  I will definitely suffocate when the elevator doors close.”
  • 21. “That pit bull lunged at me. All dogs are dangerous.”
  • 22.  “The person next to me coughed. May be it’s the swine flu. I’m going to get very sick!”
  • 23. Is there any evidence that contradicts this thought?  “I see many people using the elevator and it has never broken down.”  “I have never actually been in an elevator that has broken down.”
  • 24. Could you do anything to resolve this situation if it does occur? “I guess I could press the alarm button or use the telephone to call for assistance.”  Are you making a thinking error? “Yes. I’m fortune telling, as I have no evidence to suggest that the elevator will break down.”
  • 25. What would you say to a friend who has this fear?  “I would probably say that the chances of it happening are very slim.