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Anxiety & Panic Disorders Health Center

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The Truth About Phobias

Phobias may be irrational but they are real medical conditions that can be treated.

When Panic Attacks continued...

And if the backyard isn't safe, maybe crossing the street isn't, either. "This is where phobic people's worlds start getting smaller and smaller," Ross says.

Which is what happened to Wolicki, who has agoraphobia, a fear of open spaces. When she was in high school, she could rarely leave her house. In fact, on many days she rarely left her bed. "I thought that if I slept all day, the hours would pass faster and I would not have to experience panic attacks," she says.

Nature or Nurture?

Most people think fear has a primal source. If you're afraid of dogs, the thinking goes, a dog must have bitten you. But very few people with phobias recall these kinds of "conditioning events," says McNally. To explain this, psychologists developed the notion that we are hardwired to fear certain things. Fear of snakes, for example, helped our ancestors avoid poisonous bites. Scared but safe, they passed on their snake-fear genes.

But this theory doesn't come close to explaining most phobias.

"Why," McNally asks, "would we have an evolutionary fear of spiders if the vast majority are not poisonous to humans?" His answer? "Spiders and snakes move quickly and unpredictably. They are highly discrepant from human form. It may not be so much that we are biologically prepared to fear spiders because they threatened our early ancestors but that certain things related to spiders happen to elicit fear."

Certain things trip wires in our brains. As we get older, most of us outgrow these fears. Some of us don't. And some of us apparently have extraordinarily sensitive fear alarms.

Which is why, in the future, McNally says, phobias may be referred to as a kind of "fear circuitry disorder."

Not everyone who is scared by a spider or who feels anxious in a crowded elevator or airplane has a phobia. Phobias are learned behaviors. And while they can't be unlearned, it's possible to override them with new learning.

Treatment for Phobias

"The goal of treatment is not to disconnect the fear but to overcome it with new learning that overrides the underlying fear," McNally says. The technique is called exposure therapy. Here's how it works:

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