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Fear Factors? Experts Tell You Why

Spiders, blood or tight spaces make your skin crawl? Experts explain why some fear is good and what you can do to keep it from taking over.

Oct. 25, 2012   |  
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Even actor John Goodman has a fear of spiders.
Even actor John Goodman has a fear of spiders. / Robert Sebree / USA Weekend

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Halloween — the one day of the year when we supposedly embrace scary things — is fast approaching. But there are plenty among us for whom fright lasts all year. 'Everybody experiences fear,' says clinical psychologist David Tolin of Hartford.

“Everybody experiences fear,” says clinical psychologist David Tolin of Hartford. “Without fear, we would never survive. It’s fear that stops us from doing dumb things. Most of the time, those fears help us function better.”

When humans experience fear, they adapt, experts say. But when it impedes life, that’s when it may be an official phobia.

“People often interchange the terms ‘fear’ and ‘phobia,’ but clinically, it’s different,” says psychiatrist Yujuan Choy of the University of California-Irvine. “When fearful, we’re wired to react automatically and have a lot of physical symptoms — the flight-or-fight response. Fear can become a problem when you’re afraid of things that would not really pose a danger. Usually, the person overestimates the perceived threats.”

Specific phobias fall into four major categories: animal (such as fear of spiders, insects or dogs); natural environment (including heights, storms or water); blood-injection-injury (such as needles or invasive medical procedures); and situational (elevators, airplanes or enclosed spaces).

About one in five adolescents have what would clinically be termed a specific phobia, according to a 2010 study published in the Journal of the American Academy of Child & Adolescent Psychiatry. Lead author Kathleen Merikangas, a senior investigator at the National Institute of Mental Health in Bethesda, Md., says such prevalence holds true for adults. The study is based on data from 10,123 people ages 13-18.

Psychologist Peter Norton, director of the Anxiety Disorder Clinic at the University of Houston, says what’s key is how out of line the fear is with the threat.

“If you live in a dangerous neighborhood and are afraid to go out at night, that’s not considered a phobia. That would be considered appropriately fearful. If you live in a region of India where there are poisonous cobras, a healthy fear of snakes makes sense,” he says.

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Norton says more people seek treatment for the social fears, which, according to the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, is defined by a “marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others.”

Alisa Simmons, a design consultant from Alexandria, Va., has avoided the rodents (possums and rats) that have scared her since childhood, saying “the long tail creeps me out.”

Although she grew up in the New Jersey suburbs, Simmons says her two sisters — both at least 10 years older — went to college in rodent-riddled New York City, and “they would both share rat stories.”

Merikangas has found a “familial tendency to phobias” but says family members don’t necessarily pass on the same fears.

Age, though, does play a factor in the onset of phobias. Merikangas says specific phobias start in childhood, on average, at age 5. Animal phobias emerge soonest, she says, between ages 3 and 6.

“A lot of researchers think that from infancy on, we become confronted with these things in the environment,” says Merikangas. “Most of us learn when to turn on the fear system for survival. People with phobias is they never learn that these things don’t warrant such fear.

Merikangas says specific phobias are the earliest form of expression of most of the forms of anxiety.

Some celebrities have made no secret of the fact that they have fears. Actor John Goodman says he used to be afraid of heights.

“They didn’t have a lot of big buildings like that in St. Louis (where he grew up). I never went up the arch (in St. Louis),” he says. “The first time I went up to the top of the Empire State Building, I had a hard time.”

Other famous folks have said they are skittish:

Scarlett Johansson has a fear of cockroaches: “I can’t stand them! I’m crippled by them. It’s my kryptonite,” she’s said in previous interviews.

Nicole Kidman fears butterflies: “I’m not afraid of snakes or spiders. But I’m scared of butterflies,” she’s been quoted saying.

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So what’s a person with a somewhat irrational fear to do?

Face it head-on, experts say. “Overcoming a fear means learning to say ‘no’ to what your instincts are telling you — to get away from there. You need to step back and say ‘I choose not to avoid this. I can’t make myself not feel afraid, but what I can do is not fall into a pattern of avoidance,’” Tolin says. “The best thing people can do to avoid developing a phobia is to make sure you’re not avoiding it,” Tolin says. Face your fears and confront the thing you’re afraid of. “You can control what you avoid and what you don’t.”

Tolin, author of the book Face Your Fears, out earlier this year, says that means people need to learn to accept “a certain degree of anxiety.”

Exposure therapy, in which people are gradually exposed to their fears and increase their tolerance, has been found as an effective treatment for specific phobias, experts note. There is even some virtual-reality exposure that simulates the environment.

A new study Merikangas co-authored, yet to appear in the journal Depression and Anxiety, also finds that “people who tend to have [phobias] will have a bunch of them,” she says.

That makes perfect sense to Amanda Woodhead, 36, a corporate communications manager from Arlington, Va., who remembers always having a litany of fears, including elevators, bridges and the 13th of any month. Woodhead won’t travel or schedule anything important on that date.

“I travel for work once a month and have intentionally adjusted my travel dates because of this,” she says.

Nor will she do anything important on the 13th.

“My boss scheduled my annual review on Friday, Jan. 13, so I rescheduled it. I won’t have big meetings on the 13th. It’s completely irrational. I know that,” Woodhead says.

As for elevators, she says she grew up in rural Mississippi, where there were few high-rise buildings. Much like Goodman, she wasn’t in them much.

“I could avoid them. I had a panicky fear and I could just take the stairs,” she says.

The turning point was her doctor’s office — on the fifth floor.

“I remember going to an appointment late in my pregnancy and climbing the stairs. On the third floor, I was winded, thinking, ‘This is ridiculous,’” she says.

Woodhead spent eight weeks of weekly light therapy and eye-movement desensitization, which, she says, helped her overcome that fear.

“If it’s a choice, I will take the stairs,” she says. “But when I’m pushing the stroller and there is no option, now I can get in the elevator comfortably.”

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