Fears and phobias

One question I hear asked quite often is ‘What's the difference between a fear and a phobia?’

In short, a fear of something is fairly rational, even if we might think that there's no need for us to fear it, the fear still makes some sense. A phobia, on the other hand, is in some way irrational - either because the thing itself cannot hurt you or because the effect the fear has on you is also controlling other aspects of your life. It's one thing to be scared of a dog that's in front of you, but if there isn't a dog anywhere, but you're still scared of the ‘possibility’ of a dog, then that's a phobia. Having a fear of dogs doesn't stop people walking to work, but a phobia of dogs certainly could.

Sometimes, though, it’s neither fear nor phobia. Quite often people will talk about their fear of spiders or frogs and actually it's not a fear as such, it's a heightened sense of disgust. If you've ever been shown a picture of something and said ‘Urgh, no I can't look at that!’ and pulled a grimacing face, then you know the difference between fear and disgust. Sometimes though, fear and disgust get mixed up and people think that they're scared of spiders because they can't go near them but it may be the issue is that they don't like feeling disgusted.

Is it nature or nurture?

As with many issues it does seem to be a bit of both. Learned behaviour can absolutely create fears and phobias. But there is also the possibility of a genetic component to having heightened anxiety levels, which makes us prone to phobic responses.

Even at birth you can test how sensitive someone is to surprises and loud noises. Midwives will test babies’ reflexes immediately after birth by clapping to surprise them. Some will almost roll their eyes and hardly react, and others will practically jump off the table.

So, we know we can be born with a heightened sensitivity to stimuli but it maybe takes experiences to switch the fears and phobias on.

How can psychotherapy help?

Treating fears and phobias with psychotherapy can be quite simple. For some it may involve gently introducing the feelings of anxiety and learning emotional regulation skills, until it takes more of the stimulus to feel anxious. For others an understanding or new perspective on how the phobia came about may be appropriate, with the aim of training the brain to leave the past in the past.

In your initial session your psychotherapist will ask you to talk about your history of anxiety and will make suggestions as to the most appropriate type of therapy to see what you think.

Even a single session has been shown to be beneficial for some phobias although some people may need regular sessions in order to feel significant improvement. Therapy ultimately provides a safe space for exploration and discussion to help you find coping strategies so you can better manage your fears or phobias.

Find a UKCP accredited therapist on our website

You can also find support by contacting:

In an emergency, call: 999

NHS (England), call: 111

NHS Direct (Wales), call: 0845 46 47

The Samaritans 24-hour helpline, call: 116 123