Phobias

A phobia is an overwhelming debilitating fear of an object, place, situation, feeling or animal.  The definition of a phobia requires it to generate excessive fear which is considered disproportionate, to have lasted for at least six months and to lead to behaviour that interferes with normal functioning.  Phobias are commonly experienced in the population generally.

There is currently a very strong evidence base that CBT for phobias is the most effective treatment for phobias.  CBT (cognitive behavioural therapy) is based partly upon a school of psychology known as behaviourism, the idea that we often act and think in particular ways because of the ‘conditioning’ we experience, particularly during our early years of life, when we learn to associate certain situations with certain feelings, thoughts and behaviours. 

The treatment of CBT for phobias uses an evidence-based technique called systematic de-sensitization.  The idea is that one learns relaxation techniques that lower the ‘fight and flight’ response.  Then, there is a very gradual repeated exposure to the feared stimulus, until a new conditioned response is created.  This exposure process is discussed collaboratively between client and therapist beforehand, empowering the client and allowing for some creativity in the procedure.  This is done using a very gradual hierarchy of exposure, with lots of repetition.    

There is evidence that cognitive behavioural hypnotherapy (CBH) for phobias can be even more effective than just CBT alone.  This is because the integration of hypnosis exploits our human tendency towards suggestibility, giving us greater leverage in terms of changing unwanted patterns of behaviour.  Hypnosis is sometime described as imagination therapy, as it is almost like using a form of virtual reality to allow clients to imagine experiencing threatening situations, whilst combining these with the relaxation techniques taught by the therapist.  In this way, a degree of the systematic desensitization process of the exposure hierarchy, as mentioned above, can be done in the therapy room.