Phobias

Children who have phobias are extremely afraid of certain objects, people or situations (please see below). There is no reason for the child to be afraid but he or she is anyway. Phobias are a form of anxiety. Seeing or thinking of the cause of the fear can cause severe anxiety in a child. It can also cause  a panic attack (see full Glossary). The phobia is out of the child’s control and could interfere in the child’s ability to lead a typical life.

Most adults who have phobias know that their fears are not rational, but many children do not. Children, especially younger children (7 years or younger), may truly believe there e is something to fear. Understanding that a fear is irrational does very little to remove the fear. The person continues to experience the phobia, despite knowing that he or she is not being irrational.

There are many types of phobias. The most common types are described below:

• Agoraphobia: fear of being in an open place like the beach, a park or a street (Fig. 1). In severe cases, individuals with agoraphobia do not leave their home, at all (this usually happens to adults and some teenagers, but not children);

Figure 1. Beach

• Social phobia: also known as social anxiety disorder. It will be discussed below;
• Specific phobias, which are sub-divided into:
  • Animal type: fear of dogs, snakes, spiders (Fig. 2);

Figure 2. Spider web

• Natural environment type: fear of thunder, lightning, heights, water;
• Blood injection type: fear of blood and syringes;
• Situational: fear of a certain places, such as bathrooms and elevators;
• Other types: fear of certain types of individuals, such as clowns, or certain types of objects such as rings or dolls (Fig. 3);

Figure 3. Clown

Symptoms of having a phobia include:

• Avoiding the feared object;
• Seeing a picture of the feared object could  start an extremely fearful reaction;
• Hearing someone talk about the feared object could  start an extremely fearful reaction;
• Seeing something that resembles the feared object could start an extremely fearful reaction. For example, a person with a phobia of snakes could have a panic attack just by seeing a snake-shaped necklace;
• Being unable to have a typical life because of the intense fear that he or she is experiencing;
• Having some or all of the physical symptoms of an anxiety-based disorder. Please see the introduction part to this section;
• Having some or all of the mental symptoms of an anxiety-based disorder. Please see the introduction part of this section;
• In children, other symptoms could include crying excessively, screaming, clinging to adults and having temper tantrums.

Social phobia is also known as social anxiety disorder, and its main symptoms are:

• Being very scared of speaking in front of others;
• Being very scared of being embarrassed when speaking with others;
• Just thinking about speaking in front of others could start a panic attack (for example, right before a class presentation);
• Being excessively self-conscious (that is, worrying about how one looks or dresses);

For some children with phobias, the classroom can be a very scary place (Fig. 4). A child with claustrophobia (fear of small spaces) may not like being in a classroom with the door closed. A child with agoraphobia (please see above) may be scared of not being able to get out of the classroom in case of an emergency. A child with social phobia may be scared that the teacher will ask him or her to answer a question in class. Whatever the phobia, children need to be reassured that they are safe and welcome in the classroom. Teachers can:

Figure 4. In the classroom

• Be aware of the phobia and make sure the child does not experience the feared object in the classroom;
• Be aware of the symptoms of an anxiety or panic attack and be ready to handle it if it happens;
• Reassure the child that he or she is safe;
• Be patient and accepting of the child to make the child feel welcome, and act as a role model for everyone else in the classroom;
• Give the child more time for assignments and homework if needed.

A phobia is a type of anxiety disorder. It is a mental illness. It should be treated by a clinical psychologist or a psychiatrist. There are many treatment options for children who have phobias. The most common are listed below:

• Behavioral therapy: in classic behavioral therapy, the child is slowly and gradually exposed to the feared object until the child realizes that there is no reason to be afraid and the fear goes away. For example, if a child is afraid of spiders the typical therapy process could include:
  • Mention the word “spider” in front of the child;
  • Talk about “spiders” with the child;
  • Show the child a picture of a spider;
  • Have the child watch a program that has spiders in it;
  • Have the child be in the same room with a spider that is in a cage;
  • Have the child be in the same room with a spider that is not in a cage;
  • Have the child “virtually” touch a spider (that is, through a computer screen or an electronic game);
  • Have the child get physically close to a spider;
  • Have the child touch a spider;
  • Have the child hold a spider (Fig. 5).
  • Cognitive/behavioral therapy: this type of therapy focuses on the cognitive and behavioral aspects of a phobia. It has two parts:
    • Cognitive: the child is taught how to turn his or her negative thoughts into positive ones. The child is also taught how to think rationally about the fear and how irrational it is;
    • Behavioral: the child is taught how to calm down and self-soothe (see full Glossary) , and eventually be around the feared object without panicking.
  • Medication: some medications, such as beta-blockers, anti-depressants and sedatives are sometimes prescribed to individuals with phobias. It is not clear whether or not these types of medications should be prescribed to children who are under ten years of age.

Figure 5. Holding a spider

Children with phobias may have a very tough time when they experience the object they fear. Some panic attacks are very acute. But when the child is not exposed to whatever he or she is afraid of, the child is typical in every way. Most children who have phobias who undergo therapy do overcome their phobias. Most grow up to lead happy and healthy lives.

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