Phobias

Specific Phobia

A phobia characterized by excessive fear and anxiety towards a specific object, place, or situation, disproportionate to the actual threat posed.

Social Anxiety (Social Phobia)

A phobia involving intense fear of social situations like public speaking or using public facilities.

Agoraphobia

A phobia marked by fear of being outside or in public spaces.

Behavioural characteristics

1. Panic – crying, screaming, running away, some people may freeze

2. Avoidance – effort is made to avoid coming

Emotional characteristics

Anxiety –unpleasant state of high arousal, which prevents the sufferer from relaxing and experiencing pleasant emotions.

It can arise from the presence or anticipation of the phobic object or situation.

This response is disproportionate to the danger posed.

Cognitive characteristics

1. Irrational beliefs – the sufferer cannot be persuaded by rational argument that their fear is unfounded.

2. Cognitive distortions – the perception of the phobia may be distorted e.g. a wasp may be seen as ‘aggressive’.

3. Selective attention – the sufferer cannot move their attention from the phobic object/situation.

Two-Process Model

Phobias can be explained using the two –process model (Mowrer, 1947)

 Phobias are acquired by classical conditioning

 Phobias are maintained by operant conditioning

What are phobias acquired by

Classical conditioning

Learning occurs through the pairing of a neutral stimulus and another stimulus that produces an automatic response.

Eventually the neutral stimulus can produce the automatic response.

What are phobias maintained by

Operant conditioning

Learning is based on the principle of consequences e.g. reinforcement. If a behaviour is reinforced it is more likely to be repeated

Positive reinforcement - a behaviour will be repeated if it gains a reward

Negative reinforcement – a behaviour will be repeated if it means an unpleasant situation can be avoided

Phobic responses are negatively reinforced.

When the sufferer avoids a feared object or situation, the fear response is reduced.

This reduction in fear reinforces the avoidance behaviour so the phobia is maintained.

how may someone develop a phobia?

A unconditioned stimulus (UCS) such as a big bang leads to an automatic response (UCR) being afraid.

The UCS is then paired with a neutral stimulus (NS), such as a nice, unfrightening white mouse.

Through conditioning this neutral stimulus, the mouse, becomes a conditioned stimulus (CS) leading to a conditioned response (CR) being afraid.

This conditioning then generalises to similar objects

This is how someone may learn a phobic reaction.

strength of the 2 process model

• Supporting Evidence: Little Albert Experiment (Watson and Rayner, 1920)

• Little Albert (9 months old) showed no fear towards a white rat

• Association of the rat with a loud noise led to fear response in Little Albert

• Little Albert was classically conditioned to fear the rat due to the repeated pairing with the loud noise

• Effective treatments e.g. systematic desensitisation. By exposing the patient to the feared stimulus and preventing avoidance behaviour the phobic reaction is reduced.

This shows that it is a useful way of understanding phobic reactions.

weaknesses of the 2 process model

• Incomplete explanation-we acquire phobias of things that have been a source of danger in our evolutionary past; phobias of more recent dangers like guns or cars are rare; there is more to acquiring phobias than conditioning.

• Not everyone with a phobia can recall a traumatic incident.; Different processes may be involved in the acquisition of phobias – e.g. social learning theory and modelling; the two-process model is not a complete explanation.

• Doesn't take into account biological explanations

• Seligman (1971) argued that sometimes humans are genetically predisposed to learn an association with something that could be highly fearful

• Seligman called this biological preparedness, this means that we may have an increased likelihood of developing certain phobias because of a specific variation in our DNA which predisposes us to this fear

Systematic Desensitization

A behavioral treatment for phobias aiming to reduce anxiety by gradual exposure to feared stimuli and teaching relaxation techniques.

Systematic Desensitization Processes

1. Relaxation Techniques

   • Breathing exercises

   • Mental imagery techniques

   • Meditation

   • Medication (e.g., valium)

2. Anxiety Hierarchy

   • Creating a hierarchy of situations related to the phobic stimulus

3. Gradual Exposure

   • Exposing the client to the phobic stimulus in a relaxed state

   • Sessions progress from least to most frightening situations

   • Success: Patient can stay relaxed in high-anxiety situations

   • Virtual Reality Exposure Therapy (VRET): In vitro form of SD

Flooding

A behavioral therapy involving immediate and intense exposure to the phobic stimulus to reduce anxiety.

Extinction in Classical Conditioning

The gradual weakening and eventual disappearance of a conditioned response when the conditioned stimulus is repeatedly presented without the unconditioned stimulus.

Evidence of effectiveness

Lisa Gilroy et al. (2003) followed up 42 people who had SD for spider phobia in three 45-minute sessions. At both three and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure. In a recent review Theresa Wechsler et al. (2019) concluded that SD is effective for specific phobia, social phobia and agoraphobia.

Virtual Reality Exposure Therapy (VRET)

A form of systematic desensitization using virtual reality to expose individuals to phobic stimuli in a controlled environment.

Strengths and limitations of VRET

Exposure through VR can be used to avoid dangerous situations (e.g. heights) and is cost-effective because the psychologist and client need not leave the consulting room.

Rothbaum et al(2000)- VRET&Standard exposure with people who fears flying. Participants had 8 sessions over 6 weeks, then agreed to have a real flight. Findings:lower anxiety levels than a control group. Effect lasted 6 months+ as they conducted the same after this period

On the other hand there is some evidence to suggest that VR exposure may be less effective than real exposure for social phobias because it lacks realism (Wechsler et al. 2019).

-Less traumatic

-Patients are in control of the process

Pros and cons of flooding&SD

Pros of Flooding:

1. Highly cost-effective compared to other therapies like systematic desensitization (SD).

2. Treats more people at the same cost due to its efficiency.Flooding can work in as little as one session as opposed to say, ten sessions for SD to achieve the same result, so time-efficient.

3. Less expensive than SD.

Cons of Flooding:

1. Highly unpleasant and stressful experience for individuals, which raises ethical concerns about causing stress to clients.

   • Risk of reinforcing the phobia if not conducted properly.

   • Possibility of creating a lifetime fear if not ended appropriately.

2. Higher attrition rates compared to SD due to its traumatic nature.

Comparing to Biological treatments

Beta-blockers and benzodiazepines

• Very beneficial as short-term solutions as they reduce the physiological response

• Doesn’t take a long time as SD

• Doesn’t have a problem of being emotionally shocking and traumatic as flooding

• So behaviourist therapy can be questioned

• However, drugs are not the long term solution as their not dealing with the cause of the problem, can also lead to a different side effects