“A. Marked fear or anxiety about a specific object or situation (eg: getting on a plane, heights, animals, injections, seeing blood...)
Note: In children, fear or anxiety is manifested by crying, yelling, kicking, freezing, or hugging.
B. The phobic object or situation almost always directly provokes fear or anxiety.
C. The phobic object or situation is actively avoided or intensely avoided. it is endured with fear or anxiety.
D. The fear or anxiety felt is disproportionate to the actual danger posed by the specific object or situation and in the socio-cultural context.
E. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
(American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), from the Diagnostic Criteria Book, trans, Köroğlu E, Hekimler Publishing Association, Ankara, 2014)
This situation; It cannot be better explained by panic-like symptoms, obsessions (OCD), post-traumatic reminders, separation anxiety, social anxiety.
Specific Phobia; It can be worked with Cognitive Behavioral Therapy and Schema Therapy.
In cognitive behavioral therapies: emotion, thought (automatic thought, intermediate belief, core belief), behavior (gradual exposure method) and relaxation while working with exercises; in schema therapy, which is an extended form of cognitive behavioral therapy; phobias go through a 4-stage assessment. Intellectual, emotional, physiological (feelings in the body) and motivational (behavioral).
In schema therapy for example in needle phobia; At the intellectual level, “I don't want to have an injection. The needle will hurt me a lot. As the thought of "I can't stand this pain" passes, emotionally, the person may feel fear. Various reactions may occur as symptoms of fear experienced in the body. In behavior, the avoidance response can be given. In schema therapy, first of all, we break the effect of the schema (resilience schema) on the intellectual front and the healthy adult side. trying to strengthen it. After completing this stage, the emotional front, which is the 2nd stage, is passed; On the emotional front, the experiential (imagination/visualization) technique is used. At this stage, the oldest memory of the subject that the person can remember is studied to reach the hurt (sad, angry, frightened...) child inside the person. The emotional needs of the hurt child are met by the therapist through reparenting, helping to strengthen the healthy adult side of the person. Breathing exercises can be applied for physiological symptoms, which is the third stage, as well as mental control and awareness will help to reduce symptoms. However, if it is still very intense, psychiatric treatment may be necessary. If the 4th stage is on the behavioral front; It is important how the person reacts to the feared situation. Does the person surrender to his fear? Does he avoid facing the feared situation? Or is he trying to be too confrontational with his fear? For example, in needle phobia, the benefits and harms of the avoidance response are studied, and efforts are made to strengthen the healthy adult side in the face of the anxiety-provoking situation. When the person is spiritually ready, avoidance is overcome and then the gradual exposure method (first at the imaginary level and then gradually in real life) is applied.
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