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Updated: May 13, 2020

1. PERFORMANCE ANXIETY The fear of performing or speaking in front of an audience is the most common phobia, affecting up to 70 per cent of the population worldwide. In the context of fear of public speaking, it’s sometimes referred to as ‘glossophobia’. It’s a complex fear and can involve any one or all of the flowing components: - Fear of being judged as awkward or inadequate by other’s - Fear of underperforming or making a mistake, as in a musical recital or sports performance - Fear of having your anxiety made visible to others, as in sweating, stammering, shaking or blushing Performance anxiety often has a strong anticipatory aspect, with considerable worry in advance of the performance or speaking presentation. The anxiety usually increases as the time of the performance approaches. For many, the anxiety goes away as soon as they actually start speaking, singing or performing. Others, however, continue to have distracting symptoms during the performance such as pounding heard, hand tremors, sweating , nausea or dry mouth. In the worse case, the anxiety becomes severe enough to interfere with the performance and/or disrupt speech. CAUSES The long term cause of performance anxiety may be a single traumatic experience with speaking before a group or doing a musical performance as a child, or you may simple be prone to social anxiety and shyness from early childhood. The immediate cause of performance anxiety often lies in deep-seated core beliefs. These self-defeating thoughts can be very stubborn and persistent, leading to long-term avoidance of any situation where you might have the opportunity to perform or speak before others. TREATMENT C.B.T ( Cognitive behavioural therapy) consists of identifying self-defeating core beliefs ( and images) and gradually challenging them and internalizing more constructive beliefs. The replacement of dysfunctional beliefs is then followed by a gradual hierarchy of exposures to progressively more challenging performance opportunities. Counselling for anxiety, it’s origins and exploring coping strategies E.F.T ( Emotional Freedom technique). 2. FEAR OF FLYING Fear of flying is the second most common phobia and affects about 20 per cent of the population. Frequently the fear of flying overlaps with other phobias, particularly ‘ claustrophobia’ and the fear of being enclosed on a plane with no ability to exit for a set period of time. Fear of heights ( acrophobia) may also play a role. For some, the main fear is of a plane crash, despite the realistic odds of a crash being less than one in ten million. CAUSES The most frequent cause of flying phobia is a traumatic experience with flying, either related to another phobia or as a result of encountering air turbulence, getting sick whilst in flight and/or having a bad panic attack. Occasionally, witnessing scenes of an air crash on T.V will be enough to initiate a phobia in certain individuals. Also, having a negative experience ‘after’ the flight, such as flying to a meeting only to be told you are fired, could be traumatic enough to instigate a strong negative association with flying. TREATMENT Counselling, Education and CBT are the main effective treatments for flying phobia. Education includes information on how planes fly and all of the multiple precautions .Panic control techniques and EFT can also be used to alleviate feelings, anxieties and catastrophising. 3. CLAUSTROPHOBIA Fear of being closed in and having no escape. It can take a variety of forms including fear of small rooms, fear of being stuck in traffic, fear of tunnels, buses, trains, fear of being stuck waiting in line or fear of sitting in a chair while receiving a procedure. It can overlap with other phobias. Claustrophobia can generalise to a whole range of situations. You may come to avoid crowds in general, or you may always want to sit near the door of any room containing other people ( including cinemas, theatres, music events) in order to have easy access out. Travelling may be very difficult for some claustrophobics since any form of traveling, whether by plane, train or car requires a sustained period of confinement. CAUSES The most common explanation is a traumatic experience in childhood where you were frightened while being confined in some way. Our brains are matching patterns millions of times per day. Difficulties can arise when something in the here and now is pattern matched to something from the past which has caused us problems. TREATMENT As with other phobias, after an exploration, CBT is used effectively to treat claustrophobia. 4. FEAR OF DISEASE (HYPOCHONDRIA) Hypochondria is defined as excessive worry about having a serious disease, even after medical reassurance. Often a particular symptom, such as gastric discomfort, chronic headaches or heart palpitations is taken to be evidence of a life-threatening disease. Hypochondria is often thought of as an OCD-spectrum disorder because it frequently involves intrusive fears followed by compulsive checking ( such as feeling for lumps or continually retaking one’s blood pressure). One difference between OCD and hypochondria is that OCD sufferers tend to fear getting a disease, while hypochondriacs tear they already have a disease. CAUSES Hypochondria may develop through unconscious identification after the death or serious illness of a close family member or friend. Suddenly you become afraid that you could develop the same or a similar disease. Predicted pandemics lead some people to become obsessed with becoming ill. Even seeing a programme on TV about a particular illness may be enough to trigger serious worry about that disease. Family studies of hypochondria find little evidence of a genetic predisposition. TREATMENT CBT is again very effective treatment for hypochondria. The Cognitive component focuses on identifying and countering false beliefs that lead you to overestimate the threat posed by your symptoms. The risk of actually having a life-threatening disease is usually very low, much lower than your estimated risk. The behavioural part focuses on stopping the need for continual reassurance from doctors and others. Work would also be done on stopping continuous monitoring of your body for evidence of the problem, which only reinforces your fear. Another approach used could be imaginal exposure. Here you would write out your worse-case scenario of having the disease in vivid detail. Your script would be audio-recorded and you would listen to the recording repeatedly until you desensitized to the fears and worries it evokes. Mindfulness-based therapy may also be used. The goal would be to develop the ability to more willingly experience uncomfortable thoughts, feelings and sensations without struggling with or trying to control them. 5. DENTAL PHOBIA Dental phobia can involve fear and avoidance of dentistry in general or a more specific fear about having a particular dental procedure. Many people experience some anxiety about going to the dentist, though a much smaller number are phobic to the point of avoiding dentists altogether unless they have a dental emergency. CAUSES The most common cause is actually having had a painful or traumatic dental experience. A second factor is the personality of the dentist. You may also be fearful of receiving any procedure in an antiseptic clinic administered by a health professional. Often a dental phobia can overlap with the fear of confinement or a fear of loss of control especially in cases where you are sedated. TREATMENT CBT, panic control strategies and EFT are all effective treatments. 6. BLOOD/INJECTION PHOBIA About 70% of people who are phobic of blood also have a phobia of injections. On the other hand only about 30 % of injection/needle phobics have fears of blood. Of all anxiety disorders, blood/injection phobia has the strongest degree of family association. Another unusual characteristic of blood/injection phobias is that they often involve a fainting response. When confronted with the sight of blood or the prospect of receiving an injection, there is a twofold response. The first phase is a normal anxiety response with increased heart rate, increased blood pressure and other panic-like symptoms. This is followed by a sudden drop in blood pressure, slowing down of heart rate and reduced blood flow to the brain which often results in fainting. CAUSES Since these phobias tend to run in families, the most likely cause is children learning and internalizing the fear from their parents and siblings. TREATMENT CBT emphasising gradual exposure. EFT. 7. FEAR OF VOMITING ( EMETOPHOBIA) Fear of vomiting is surprisingly prevalent. It can take various forms, including the fear of vomiting itself, a fear of doing so in public, a fear of seeing vomit or a fear of seeing someone else throw up. Emetophobia can develop in childhood or adulthood and last for many years without treatment. Sometimes if accompanies other fears, such as the fear of eating, or other disorders, such as eating disorders or obsessive-compulsive disorder. CAUSES A general fear of losing control can often be found in the background of people who are fearful of vomiting. For some, the phobia begins with a particularly bad instance of vomiting in childhood or seeing vomiting in a loved one who is very ill. TREATMENT The first thing to explore is what it is you are truly afraid of. Is it vomiting itself or is it a fear of rejection if others were to see you vomit? Or does it have to do more generally with losing control of your body ? It is important to identify in therapy and work through the core fear or fears. CBT and EFT are also effective treatments. 8. FEAR OF HEIGHTS The fear of heights of ‘acrophobia’ is another very common phobia. It frequently combines with other phobias, such as the fear of flying, fear of riding elevators or fear of driving over or walking up high buildings/bridges. Sometimes the fear of heights is confused with vertigo. Vertigo is a sensation of spinning usually caused by a medical condition and it rarely occurs with acrophobia. A more common reaction to heights is dizziness and difficult trusting your own sense of balance. A certain amount of acrophobia is instinctive in all animals. It has an evolutionary advantage in preventing falls. However, a true phobia of heights is typically learned and is an exaggeration of the normal, adaptive fear response to heights. It may develop as the result of an actual fall or the memory of an incident where you were very afraid of falling as a child. TREATMENT CBT is effective in overcoming the fear of heights. The acrophobic is first taught panic-control strategies and then undergoes a gradual, progressive exposure ot a hierarchy of situations that involve increasing heights. 9. ANIMAL AND INSECT PHOBIAS This fear can be of snakes, bats, mice, dogs, cats, certain birds, frogs, spiders, bees, cockroaches to name some of the most common examples. People with this type of phobia avoid not only a particular animal/insect but areas where they believe they might be exposed to the feared creature. Evidence of the presence of the feared animal/insect, such as seeing a spider web, hearing a dog bark or being near a zoo is enough to evoke strong fear. Sometimes, even seeing a picture of the animal will lead to a panic attack. In childhood, many of these fears are so common that they are considered normal fears. Only when they significantly disrupt your life and/or cause you significant distress do they qualify as a full-blown phobia. CAUSES It has been argued that certain animal phobias, such as fear of snakes or large animals are a traumatic experience, such as being bitten by a dog, scratched by a cat or stung by a wasp. It’s also possible fear at the sight of a mouse or a spider may instill the same fear in the child. TREATMENT Overcoming animal and insect phobias again involves some exploration in counselling and gradual exposure to the feared creature. Again coping strategies to face the provoked anxiety are useful. EFT techniques. 10. FEAR OF DEATH The fear of death (sometimes referred to as thanatophobia) can involve any one or several of a variety of fears. E.g. Fear of nonexistence – fear of the unknown – fear of negative afterlife – fear of sickness, pain and suffering associated with death – fear of the death of a loved one – fear of what will happen to loved ones after your death – fear of dead things, such as a corpse or things associated with death, e.g. coffins, funeral homes and cemeteries. CAUSES Causes of the fear of death vary depending on which of the above fears is dominant. Existentialist philosophy maintains that the fear of nonexistence is innate to the human condition and shared by all human beings at a deep level. The fear of pain and suffering associated with death may arise from a traumatic experience of witnessing a loved one go through a protracted process of dying. Often the death of a loved one may lead to an increased fear of one’s own death as well as fear of sights and objects associated with death. TREATMENT Treatment of thanaphobia depends on the nature of your particular fear. Working with the fear of nonexistence may require some deep philosophical reflection on the meaning of life in therapy. Some people respond favourably to reading recommended literature. If your fear of death started with a traumatic experience of witnessing a family member or friend’s death, it may be helpful to try EMDR (Eye movement desentising reprocessing) or EFT (Emotional freedom technique) to work through and reconfigure traumatic memories and experiences.

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