Specific Phobia

What is a Specific Phobia?

Fears are common and expected in childhood; however, for some children and teens, their fears can become very severe over time, and even develop into a phobia. A phobia is an intense and unreasonable fear of a specific object or situation. This means having an extreme anxiety response towards something that is not causing immediate danger. Someone may have a phobia of dogs, spiders, or elevators, for example. Research suggests that phobias can run in families, and that both genetic and environmental factors (nature and nurture) can contribute to developing a phobia. Some children and teens develop a phobia after being exposed to a traumatic or frightening event such as a fear of water after a near drowning or fear of dogs are being bitten. However, other children may develop a phobia by observing others' anxious response to objects or situations. It is not uncommon for a child to develop a spider phobia after watching an older sibling scream and run when in contact with a spider. Although a combination of nature and nurture likely play a role in the emergence of a phobia, many youth cannot explain how or why their phobia begun.

Facts

  • On average, specific phobias begin in childhood, between seven to eleven years with most cases starting before age ten
  • Approximately 5% of children and 16% of adolescents will have a specific phobia in their lifetime
  • Girls are more likely to experience a phobia than boys at a rate of 2:1
  • Phobias are different than common childhood fears. While young children generally become less afraid of things such as strangers, the bath, or the boogie monster, as they mature, children with phobias typically become more afraid as they mature. Furthermore, phobias rarely go away on their own
  • Phobias do not decrease with appropriate reassurance and provision of information. For example, a dog phobia persists despite telling your child that grandmas dog is kind, has no teeth to bite because it is old, and will not scratch

Signs & Symptoms

Thoughts:

  • It’s going to bite/sting me
  • I can’t handle it
  • It’ll be awful
  • What if I vomit

Physical sensations:

  • Increased heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Feeling of choking
  • Chest pain or discomfort
  • Upset stomach
  • Numbness
  • Chills or hot flashes
  • Looking flushed

Emotions:

  • Anxiety/fear
  • Embarrassment
  • Shame
  • Helplessness
  • Sadness
  • Anger

Behaviors:

  • Avoiding the feared stimuli or locations where the stimuli might exist
  • Making parents check things first (e.g. make sure a room is free of bugs before bedtime)
  • Asking a parent to be present or available
  • Running away
  • Crying
  • Clinging
  • Tantrums

Common Situations or Affected Areas

  • School refusal if known feared stimuli might exist
  • Avoiding parks, recreational areas, and outdoor space
  • Refusal to attend appointments at doctors, dentists, hospitals, etc.
  • Avoiding playing in gardens, beaches, and other locations where insects might exist
  • Missing field trips if known feared stimuli will be present (e.g. trip to the park because of fear of dogs)

Be sure to watch our video below for more information... press the play button to start.

How a specific phobia impacts the child at different ages:

Young children often rely on adults to protect them from immediate threat or danger more so than older children and teens. As a result, when young children are faced with a specific phobia they may cry, tantrum, cling, freeze, or want to be picked up. Young children are more likely to be afraid of concrete and immediate situations such as storms, insects, animals, and clowns among others. In contrast, when faced with a feared item or situation, older youth are more likely to express feared thoughts or predictions such as “It will bite me,” or “I’m going to die.” In addition, unlike young children who have less control over their daily lives, older teens can choose to avoid certain situations or escape when confronted with their fear. For example, a teen that is afraid of enclosed spaces can avoid taking an elevator whereas a young child may have to go on an elevator if the whole family wants to travel that way. Finally, teens are more likely than younger children realize that their fear is unreasonable or excessive.

Is there such a thing as a School Phobia?

School phobia is not a diagnosis, although over the lifespan as many as a third of youth will exhibit fears of attending school that present in a similar way to a phobia. For example, school fears can be expressed as minor complaints about having to attend, to full blown tantrums and refusal to attend in younger children, and skipping or cutting school in adolescents. Youth can be afraid of school for many reasons such as being apart from parents as seen in separation anxiety disorder, being in contact with germs as in OCD, and having to interact with peers and teachers like with social anxiety. In all of these cases, your child or teen is not actually afraid of the school itself, but of what could happen while at school. Because of this, the term school phobia is not accurate. Here you can find additional information on managing school refusal (link) when it exists as part of an anxiety disorder.

Click here for Home Management Strategies for Specific Phobia

Stories

 

 

 

Jacob’s Story
Emma’s Story
Mr. and Mrs. Singh story

Jacob is 12 and is really afraid of getting injections. When he was eight years old, he passed out at the doctor's office during a blood test. Since then, Jacob avoids watching or thinking about anything that has to do with blood, needles, or medical procedures. He says they make him feel like “my body is out of control” and that “my mind goes blank”, and he worries he will either "freak out" or "faint again". On the days leading up to a doctor's visit, Jacob repeatedly asks for reassurance and promises from his parents that he will not need to get a shot or have blood drawn, and becomes explosive if they cannot provide that certainty. Although the family has been mildly successful at avoiding shots and blood/medical procedures for Jacob over the past few years, Jacob now has an abscessed tooth that needs extracting and will require several injections. When the dentist told Jacob about this, Jacob got very upset and started to breathe heavily and shake. He also began sobbing loudly and insisted they leave. Jacob's mom was surprised by her son's physical reaction, and thinks he may have had a panic attack. She is worried that Jacob will be unable to have this dental procedure, which is critical to prevent further infection. 

 

Emma is six and terrified of water. She refuses to even go near pools, lakes, the beach, and will not even take a bath. When Emma was 4 years old, the family attended a pool party where another child accidentally pushed her in. Although her father promptly rescued her, she spent the next 30 minutes crying and shaking. Shortly after this incident, Emma started fearing water. When her parents try to reassure her and promise her rewards for going near a swimming pool, she screams, cries, and clings to whoever is nearby. Emma's parents have just about given up trying to get her to go near water. Going out fishing on the lake in the family speedboat, something the whole family used to enjoy is now impossible with Emma. They can’t even join their family for summer weekends at the beach as Emma refuses to exit the car. Even bathing has become so hard, that the family simply washes Emma with a bowl and sponge just to avoid the tantrums that would otherwise occur. Emma’s parents recognize that things are not improving with age, and that Emma is now at risk of missing out on fun opportunities such as pool parties, beach camp, and more.

 

Mr. and Mrs. Singh are second generation Canadians and co-own a prosperous farming business with their extended family. As their business is family run, all of the adolescents are expected to help on weekends and holidays, but recently the Singh’s youngest son has been refusing to work. They are very embarrassed by his behaviour and angry that he is being so difficult. Mr. and Mrs. Singh think they have given their son the easiest job, which is to feed and care for the work dogs, a job with reasonable hours and fair pay. But when they push their son to help, he screams and hits at them, often running away for hours at a time. They have never seen such behaviour before, and when they ask R.J. why he acts this way he just shrugs and mumbles. Mrs. Singh’s sister-in-law thinks he may be afraid of dogs and reminds her that R.J’s grandmother is also afraid of dogs.