Understanding yourself
Specific phobia
“I’ll drive to Chattogram. I always do.”
A fear far bigger than the danger, and a life arranged around it. Phobias respond well to treatment, sometimes in a single long session.
Imran runs the Bangladesh arm of a regional bank, and the board meets in Singapore every quarter. He has not flown for six years. He joins by video and tells colleagues the connection is better. Last year he turned down a promotion that would have meant flying monthly. His wife has stopped asking about holidays.
An illustration drawn from common experience. The person is invented; the pattern is not.
Understanding specific phobia
A specific phobia is an intense fear of a particular thing or situation, such as lifts, heights, flying, injections, blood, dogs or water, that is far out of proportion to the actual danger. Just thinking about it can bring on fear, and people go to great lengths to avoid it. Avoidance brings relief, which teaches the brain the fear was justified, and so the phobia grows.
Signs and symptoms of specific phobia
- Immediate, intense fear when facing the trigger, or even thinking about it
- Going to great lengths to avoid it
- Turning down opportunities, journeys or medical care because of it
- Knowing the fear is excessive, and feeling unable to stop it
Treatment for specific phobia
Phobias respond well to treatment. The main treatment is gradual, planned exposure: facing the feared thing in small steps, with support, until the fear fades. It can work quickly. In a 2023 randomised trial with children and young people, one exposure session of up to three hours, after a one-hour planning visit, was as effective as a full multi-session course of therapy, building on work by Lars-Göran Öst that began in the 1980s.
What getting better can look like
Imran might begin with a short flight to Cox’s Bazar with the therapist’s plan in his pocket, then Kolkata, then a board meeting in Singapore, in the room, with the window seat behind him.
Common questions about specific phobia
Can a fear of flying be treated?
Yes. Phobias, including a fear of flying, respond well to treatment, mainly gradual, planned exposure: facing the feared thing in small steps, with support, until the fear fades. It can work quickly; in a 2023 randomised trial with children and young people, one exposure session of up to three hours was as effective as a full multi-session course of therapy. In adults, one-session exposure was reported in a 1989 series of 20 patients, most of them much improved or recovered about four years later.
Is it a phobia or just an ordinary fear?
Many people dislike heights, injections or dogs. A specific phobia is a fear far out of proportion to the actual danger, strong enough that even thinking about the trigger brings on fear, and people go to great lengths to avoid it, sometimes turning down work, travel or medical care. Avoidance brings relief, which is why the fear tends to grow.
When to see a psychiatrist
If a fear is costing you work, travel, or medical care you need, it is worth treating. For many people it changes faster than they expect.
Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.
If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.
If some of this sounds familiar, a first conversation is a good place to start. You do not need the right words, or to be certain.
Dr. Tajreen is consulting in Uttar Badda now, until 8:00 pm. Call +880 1847-331010Every address and its hours
Sources
- Wright et al., Journal of Child Psychology and Psychiatry, 2023 (ASPECT trial)
- Öst, Behaviour Research and Therapy, 1989
You do not need to have everything figured out before you begin.
