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Demystifying the DSM: Phobias

A Caught big dark common house spider under a drinking glass on a smooth wooden floor seen from ground level in a living room in a residential home with two male hands

Cristi Bundukamara, Ed. D, PMHNP (aka, Dr. B.), founder and creator of the Mentally STRONG Method, discusses how phobias are defined in the DSM-V, different types of treatment, and how to overcome these irrational fears with the Mentally STRONG Method.

What is a Phobia?

Are you scared of something? Do you know someone so scared of something, such as spiders, that they panic when they see one? A phobia is an excessive and irrational fear of a specific object, situation, or activity that results in the avoidance of the feared stimulus. Common phobias include fear of spiders, heights, and enclosed spaces. Phobias can cause significant distress and impairment in daily functioning if left untreated. They should not be confused with other disorders, such as post-traumatic stress disorder related to a traumatic event. Not all phobias require treatment. When a phobia begins to interfere with our life significantly, it may be necessary to work on it. For instance, if your family lives far and you have an emergency, overcoming your fear of flying may be required.

Systematic Desensitization

Claustrophobia, the fear of small spaces, and the fear of flying are typical phobias – just like the fear of spiders. Many people think they need to face their fear and get over it, and there is a therapy based on this idea called systematic desensitization. Even in this type of treatment, a person is not simply forced into an airplane to overcome their fear of flying, but rather are gradually exposed to their fear and work on controlling their anxiety during the process. They may look at the outside of a plane, then sit in an aircraft in a museum for short periods, learning to manage their panic. In some instances, medication may help the person remain calm, but it is best to work on overcoming your phobias without medicines so that you may genuinely move past them.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT), the basis for the Mentally STRONG Method, is often used to treat phobias. CBT is a type of therapy that focuses on changing negative and irrational thought patterns and behaviors. The goal of CBT for phobias is to help individuals learn to manage their anxiety and overcome their fear by gradually exposing them to the feared stimulus in a safe and controlled environment.

The first step in CBT for phobias is typically education about the nature of anxiety and how it affects the body and mind. The therapist may also help the individual identify negative and irrational thoughts related to their phobia and teach them techniques to challenge and reframe them.

Once the individual is comfortable with these concepts, the therapist will begin exposure therapy, gradually exposing them to the feared stimulus in a safe and controlled environment while teaching them relaxation techniques to manage their anxiety. Over time, the individual will learn to tolerate and overcome fear.

Becoming Mentally STRONG

CBT for phobias is typically a short-term treatment, with most individuals seeing significant improvement within 12-16 sessions. While medication can also be used to manage anxiety symptoms, CBT is often the preferred treatment option as it is effective in the long-term management of phobias. If a phobia interferes with relationships, activities you enjoy, or day-to-day life, it is time to work on strengthening yourself mentally and overcoming your fear.

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