Specific phobia; It is when a person develops excessive and unreasonable fear of certain objects or situations that are not a real danger. In specific phobia, fear is caused by a limited and specific stimulus (spider, height, etc.). Encountering these stimuli elicits intense fear and avoidance behavior. To be diagnosed with a specific phobia, symptoms must be present for at least 6 months. In other words, we can say that specific phobia is a fear reaction felt from some situations and objects, which appears disproportionate to the situation from the outside.
Although the scope of specific phobia is very wide, the most common phobias are as follows:
*Animal Type (Insect, cat, snake, etc.)
*Natural environment type (Altitude, storm, lightning, etc.)
*Blood-injection-injury type (needle, medical interventions, seeing blood and wounds)
*Situational type (Public transportation, tunnels, bridges, elevators, airplanes, closed areas, etc.)
*Other (Asphyxiation, swallowing, costumed characters, etc.) )
While phobias such as animal, nature and blood phobia begin in childhood; Conditions such as situational phobia begin in young adulthood. Acquiring phobias at older ages increases the likelihood of phobias becoming chronic.
It is seen that specific phobia is often confused with situations such as social phobia. The difference of specific phobia from other types of phobia is that it appears only in response to specific situations or the possibility of encountering those situations/objects, and at other times the person does not show any signs of discomfort.
It is also seen that specific phobias are called simple phobias. Panic attacks may occur when encountering an object that causes fear and anxiety. The person may resort to avoiding stimulating objects. The possibility of encountering the phobic object may cause anticipatory anxiety. Palpitations, sweating, tremors, and hot flushes are physical symptoms that can frequently be observed as a result of encountering a phobic situation or object (Sungur 1997).
The structure of specific phobia can be mentioned in three main components:
1. Basic fear
2.Precognitive anxiety experienced in case of encountering a phobic stimulus
3.Avoidance behaviors attempted to reduce this anxiety
The most frequently observed feeling in people with specific phobia rum is avoidance behavior. A person organizes his life to avoid encountering whatever situation or object he fears. Someone with cat phobia cannot sit in a place with a garden when socializing, someone with a fear of elevators cannot stay in a high-rise house even if they like it very much, etc. Depending on the nature of the situation and the level of reactivity in the person, this avoidance follows a scale from minor adjustments to major transformations that will make the person's life difficult and reduce the quality of life.
Specific phobias are very open to treatment and if applied, therapy support results in a high rate of success. These are situations that can be eliminated. Medicines have little role in treating these fears; It is not preferred most of the time. Although medical treatments are not frequently used in specific phobias, there are studies showing that selective serotonin reuptake inhibitors (SSGI) are effective (Benjamin et al. 2000, Murphy et al. 2000). It would not be wrong to say that this is a situation that can generally be resolved with therapy support. However, we encounter a problem here: People with specific phobias do not seek support much. According to statistics, only one in every six people with a specific phobia seeks treatment. Clinical observation is that in clients who come with other problem areas (depression, anxiety, etc.), this information is sometimes obtained by chance, mostly during anamnesis, and is included in the treatment plan.
One of the main reasons why people with specific phobia do not apply is because it affects their daily lives negatively. It is seen that they do not feel it intensely. But studies on this subject show the exact opposite. A study on specific phobia showed that 15% of people with specific phobia were unable to go to work for a week or more in a month. When we look at the relationship between specific phobia and depression, 28.6% of those with specific phobia also experience depression. Considering that the general prevalence of depression in society is 4%, it can be understood more clearly that this rate is quite high.
There are many explanations as to why specific phobia develops; I will share a few of them here. It is thought that negative-traumatic events experienced by people are effective in the formation of specific phobias. This is a premise that is often valid Even if it is an absolute judgment, it would not be correct to accept it as an absolute judgment. In addition to traumatic events, there are also studies showing that fears are genetically determined: In one of the experiments, it was observed that a monkey, which had never encountered a snake before, showed a great fear reaction when shown a picture of a snake. It is not uncommon for phobias to run in families. When the mother or father is afraid of the dog and avoids it, we cannot expect the child, who sees the world through his parents' eyes and takes a position according to their reactions, to sympathize with the dog.
When we look at the evolutionary explanation, the Darwinian explanation shows that fear has an evolutionary basis. According to this theory, which states that phobias can be transmitted through generations through genetics, and that some fears (especially fears of heights, animals or situations that may threaten life such as snakes) are universal, these fears have helped survival and provided an advantage in terms of natural selection. According to this theory, these fears may not be innate, but they are acquired much more easily than others and are resistant to extinction.
In Freud's Little Hans phenomenon, Hans developed a "meaningless" fear of horses. Freud's interpretation of this is that it is fear of castration. Freud states that emotions arising from the anxiety of separation from or losing a loved one play a role in the development of phobias.
There are many studies on this subject, each theoretical orientation interprets and evaluates phobias according to its own perspective. What this information tells us is; It shows that the formation of phobias cannot be explained by a single factor, that genetic factors and environmental factors are also important and that each case is unique.
We have stated that drug treatment is not preferred in the treatment process of specific phobia, and recovery is generally achieved with psychotherapy methods. While psychoanalysis and dynamic psychotherapies were used in the treatment of phobic disorders before cognitive therapies, today one of the most widely used psychotherapy methods is cognitive behavioral therapies (Sungur 1997).
Eye Movement Desensitization and Reprocessing (EMDR) is an increasingly common practice in the field of psychotherapy in recent years. It stands out as a therapy method. g Currently, its only proven use is in the treatment of post-traumatic stress disorder (PTSD) (Shapiro and Maxfield 2002). There are many studies showing its effectiveness in PTSD and it is recommended by the American Psychiatric Association (American Psychiatric Association 2004, Bradley et al. 2005, CREST 2003, Foa et al. 2000, Kolk et al. 2007, Servan-Schreiber 2006). p>
According to Shapiro's "adaptive information processing (AIP)" model, past traumatic memories can sometimes be stored incorrectly and cause inappropriate responses when faced with triggering situations in the current moment (Shapiro 1995, Shapiro 2001). According to this model, a therapeutic effect can be achieved in specific phobias when the first traumatizing memory related to the phobic object or situation in the past is processed correctly.
F. According to Shapiro, stressful situations cause an imbalance in the person's information processing system and are stored as unprocessed memories in some people. Although there is no requirement for trauma as the basis for the formation of specific phobias, if a traumatic experience is detected, eye movement desensitization and reprocessing seem to be a good option as an alternative to other treatment methods. Even if there is no traumatic experience on the ground, encountering the phobic object or situation can also be treated as a trauma. Evidence shows that emotions (helplessness, etc.) resulting from encountering a threatening situation are the highest risk situations in establishing a specific phobia (Oostering, De Jongh, Aartman 2009). In other words, we can say that EMDR treatment can be used in conditioned specific phobias with or without traumatic origin, which are at high anxiety levels.
Shapiro has determined a special protocol in EMDR treatment for specific phobias. Again, as in all EMDR systems, this protocol is based on taking and processing memories that may cause the person to develop a specific phobia, that is, memories that are likely to interrupt the adaptive information processing system. During this processing, the aim is to achieve adaptive resolution of the person's traumatic memories. After these memories are neutralized, the aim is to establish positive cognition against possible future situations and to strengthen the person against possible avoidable situations.
The effects of EMDR treatment on phobias. When we look at it, we see that there are studies on this subject. In Doering's study in 2013, EMDR treatment was applied to 30 cases who had not gone to treatment due to fear of dental treatment for 4 years or more. As a result of the treatment, there was no return in symptoms for 12 months, and after 1 year, 83% of the cases continued their regular dental treatment.
In short, we can say that EMDR is effective on phobias. If you are having a problem with this issue, do not hesitate to get support without waiting for it to paralyze your life. As seen in the research, very few people receive support on this issue and watch the process make their lives difficult. I can say that taking a step on this issue, as in many challenging issues in your life, and getting support to change the situations that challenge you gives you an experience that greatly improves your quality of life.
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