Specific Phobia

Dr. David L. Kupfer, Ph.D.

A specific phobia is an intense fear of a specific object or situation. Common fears include fears of animals such as dogs or spiders, fears of heights, and fears of medical procedures, and fears of enclosed spaces like elevators. Even more common are phobias related to transportation. In today’s world, people can often feel restricted by fears of driving on highways or over bridges, and of airplane flight. People with these types of phobias often worry in advance of encountering the situations they fear, and find their lives dominated by their need to avoid what they fear. Children might not visit friends with dogs, and adults might miss important family events or business opportunities because of their fears of driving or flying.

Linda felt deeply embarrassed by her fear of flying. She spent her days making excuses for why she couldn’t make a trip to visit a customer or see a family member. Like many people who fear flying, she had never had a horrible real experience with flying. Her primary fear was not that the plane would crash or be hijacked. Like many phobics, her primary fear was of a loss of control, Her worst fear was that she would get on a plane, become more and more nervous, and cause a scene. She pictured herself running up and down the aisles screaming.

Since Linda’s primary fear was that her anxiety would lead to her losing control, the primary treatment goal was to have her see anxiety as tolerable and acceptable. In the therapist’s office, she practiced techniques for making friends with her anxiety. She imagined being on a plane, feeling the anticipated anxiety, and noticing that it would not necessarily lead her to lose control. She practiced just noticing her rapid heart rate, as opposed to fearing it. She learned that she could shift from thinking “I’m going to scream if I stay this nervous one moment longer” to “I’m just having the thought that I’m going to scream…I can actually be quite anxious without losing control.” She learned the value of focusing on the present. Whenever she found herself “predicting” that she was soon going to be screaming in panic, she would shift to studying the colors of the fabric of the carpet on the airplane’s seats. Just as it was helpful for Linda to learn that she had a mind and body that could tolerate a lot of internal anxiety and turbulence, it helped her to learn that the plane could also tolerate a lot of altitude changes, shifts in air pressure, and turbulence. She read about how an airplane is designed to fly safely, and learned to interpret turbulence, which had previously scared her, as the way an airplane safely adjusts to changes around it. Her victory was not just in regaining her ability to fly on planes; she learned that she and the plane were both rather resilient.