From Tears to Triumph: Unraveling the Complexity of Children's Phobia
Written by Keerthi Aithal, Psychologist, Ph.no: +919980476255
Read time 5 minutes
Children can develop fears that are so irrational, persistent, or intense that they are focused on a wide range of objects or situations. Exposure to these stimuli almost invariably provokes an immediate anxiety response. The phobic stimulus or situation is either avoided or endured wit dread, interfering with normal routines and activities for at least 6 months.
The intense fear or discomfort around the feared object or situation can culminate in panic attacks. Symptoms include shortness of breath, dizziness, lightheadedness, fear of losing control, and a racing heartbeat. Symptoms can last several hours or might persist for less than 10 minutes.
Children often express their discomfort by crying, throwing tantrums, freezing, clinging, trembling, or sweating.
Common phobias can be categorized into:
- Animal/Insect Phobias (dogs, spiders, snakes, bugs, etc.)
- Phobias of Imaginary Creatures (ghosts, monsters, etc.)
- Phobias of Natural Environment (storms, water, fire, heights, floods)
- Injury phobia (blood, injections, falling, drowning, death, accidents, etc.)
- Situational Phobia (flying, driving, swimming, tunnels, elevators, etc.)
- People phobia (robber, kidnapper, police, doctor, parents, grandparents, teacher, etc.)
- Transportation phobia (airplanes, buses, trains, etc.)
- Other phobias (darkness, being alone, ridicule, embarrassment, stage fright, exams, dreams, clown, shadows, jail, etc.)
Children are not able to recognize that their fear is excessive or irrational. While some children can face the feared object or situation, many avoid any contact as a way of reducing their fear and worry. This avoidance may alter the child's life, for instance:
- Taking a different route to school to avoid a certain dog.
- Having trouble sleeping at night due to the fear of ghosts.
- Avoiding going to the doctor for a long time due to the fear of doctors and injections, and to prevent the shot.
- Avoiding going on stage due to the fear of ridicule and embarrassment.
In the long run, this altered way of living life leads to interference in normal functioning, carrying out daily activities, missing out on otherwise enjoyable events, and unknowingly shrinking the quality of life.
Factors Influencing Specific Phobias:
Genetic, familial, environmental, or developmental factors play an important role in the development of specific phobias.
Neurobiology of Fear & Specific Phobias:
Fear is an emotion of anticipation expressed innately (innate fear/non-experiential fear/learning-independent fear) or after conditioning (conditioned fear/learned fear/learning-dependent fear, experiential fear), triggered when a danger or a stimulus predicting immediate danger is perceived. The role of fear is to prepare the body to face this danger. These stimuli can evoke "Fight, Flight, Fright, Freeze" reactions or "tend-and-befriend" responses (such as turning to others for help or social support, making a situation less tense, dangerous, or uncomfortable in some way).
At the neurobiological level, significant advances have been made in identifying fear circuits and mechanisms. While fear is an adaptive component of the response to potentially threatening stimuli, too much or inappropriate fear accounts for dysfunction in the circuits/mechanisms and can lead to chronic psychiatric disorders, including post-traumatic stress disorder (PTSD) and various types of phobias, including specific phobias.
While PTSD is always caused by a traumatic event, specific phobia can result from either a traumatic event (experiential-specific phobia) or not (non-experiential-specific phobia).
There is good evidence that the amygdala and its connections with other structures of the basal forebrain and the cerebral cortex are critical for the experience of fear, suggesting that the amygdala is an essential pathophysiological node underlying at least a few types of phobia.
Management & Treatment:
Approaching mental health professionals can make a huge difference in your child's phobia management. Different modalities of pharmacological and psychological treatment are implemented depending on the type of phobia.
Some of the psychological treatment approaches used include exposure treatments, counter-conditioning, and cognitive-behavioral therapy.
References:
1) The ICD-10 Classification of Mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines, A.I.T.B.S., Indian Edition 2007.
2) Phobia of the Supernatural: A Distinct but Poorly Recognized Specific Phobia With an Adverse Impact on Daily Living. Ricardo de Oliveira -Souza. November 2018. Frontiers in Psychiatry. 9:50. DOI:10.3389/fpsyt.2018.00590
3)Phobia Symptoms, Types, and Treatment.By Kendra Cherry, MSEd. February 03, 2020. Medically reviewed by Daniel B. Block, MD.
4)Neurobiology of fearand specific phobias.René Garcia. 2017 Sep; 24(9): 462–471. doi: 10.1101/lm.044115.116. PMCID: PMC5580526 PMID: 28814472.
5)What to know about arachnophobia. Louise Morales-Brown. July 30, 2020. Medically reviewed by Timothy J. Legg, PhD, PsyD.
6)Phobias in Children.
7)Phobias in Children. University of Rochester Medical Center. L Renee Watson MSN RN, Marianne Fraser MSN RN, Sabrina Felson MD.
8)Phobias in Children and Adolescents. Children's Hospital of Philadelphia.
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