What Are Phobias?

A phobia is an anxiety disorder characterized by intense fear and avoidance of certain objects or situations. Avoidance occurs when a person tries not to approach the source of their fear. For example, someone might avoid going to the dentist even when they have a toothache, or refuse to fly on airplanes when they want to travel. In short, if a person is afraid, that’s fear; if they are afraid and avoid the source, that’s a phobia.

From Castration Anxiety to Conditioned Reflexes: The History of Phobia Research

Phobias began to be studied in the late 19th and early 20th centuries. Freud described phobic neurosis in his 1909 work “Analysis of a Phobia in a Five-Year-Old Boy.” The boy, known as Little Hans, often played horse games with his father. One day, he witnessed a live horse collapse in the street, which frightened him so much that he developed a fear of horses and began to avoid them—a difficult task in the early 20th century. Freud concluded that Hans’s phobia masked a deeper fear of castration, linked to the Oedipal phase of development, where a child’s attachment to their mother and fear of their father intensifies. The phobia acted as a defense mechanism, protecting Hans from conflict with his father.

At the same time, behaviorists were developing psychology as an experimental science. In 1919, John B. Watson, the father of behaviorism, and his assistant Rosalie Rayner, artificially induced a phobia in a nine-month-old boy. They showed the child a white rat while making a loud, unpleasant noise. As a result, the boy developed a fear and avoidance of the white rat, which later generalized to other soft, furry objects.

This experiment demonstrated that phobias can form through the pairing of conditioned and unconditioned stimuli. In Watson and Rayner’s experiment, the rat was the conditioned stimulus (not initially frightening), while the loud noise was the unconditioned stimulus (naturally frightening). The mechanism at work was classical conditioning, first described by physiologist Ivan Pavlov. Pavlov noticed that dogs would salivate not only when they received food, but also when they saw the food bowl or heard the footsteps of the person bringing food. If a bell was rung during feeding, after several repetitions, the bell alone would trigger salivation.

Around the same time, the prominent German psychiatrist Emil Kraepelin included phobias in psychiatric textbooks. Later, in the 1940s, phobias were added to the International Classification of Diseases, and in the 1960s, agoraphobia, social phobia, and specific phobias were distinguished as separate categories.

What Causes Phobias?

Phobic disorder is classified as an anxiety disorder. Its symptoms can be grouped into three clusters:

• Specific phobias—fear of particular objects or situations. The most common are phobias of spiders, snakes, and heights. Specific phobias are further divided into groups: animal phobias, natural environment phobias, situational phobias (like claustrophobia), and phobias of blood or medical procedures.
• Social phobias—these have the most severe impact on quality of life. People with social phobias fear threats to their self-image and avoid social interactions, which limits their lifestyle, opportunities for growth, and success.
• Agoraphobia—often accompanies panic disorder. People fear having a panic attack, especially in places where they can’t get help. It’s not just a fear of open spaces, but a fear of being far from home or loved ones in a place where something bad might happen, such as a heart problem, panic attack, or high blood pressure.

What Makes People Vulnerable to Phobias?

1. Biological or physiological vulnerability. For example, the personality trait of neuroticism, which reflects increased reactivity of the brain’s limbic structures to stimuli. Studies show that when people with phobias encounter frightening stimuli, certain brain areas—such as the insula, anterior cingulate cortex, amygdala, prefrontal, and orbitofrontal cortex—are more active than in people without phobias.
2. Psychological vulnerability—various thinking errors. For example, catastrophizing (exaggerating the likelihood that something will go wrong) or black-and-white thinking (seeing anything less than perfect as a failure).
3. Micro- and macrosocial factors. Microsocial factors include the influence of close surroundings: if a child observes phobic reactions in significant adults, they may adopt similar behaviors and “catch” their fears. Macrosocial factors operate at the level of society, culture, or government. For example, how the media covers topics like cancer treatment or disasters can provoke phobic behaviors (such as cancer phobia or fear of flying).

How Are Phobias and PTSD Similar and Different?

If a person experiences a traumatic event—such as sexual assault or a life-threatening situation—they may develop post-traumatic stress disorder (PTSD) or some of its symptoms. One of these is avoidance of trauma-related stimuli, which is similar to the avoidance seen in phobic disorders.

The difference is that the object of a phobia may not have been a real threat to life or a traumatic experience. Also, in phobias, distress is triggered by encountering the phobic object (in reality or imagination), while in PTSD, distressing memories (flashbacks) can arise spontaneously, without any real reminder of the trauma.

How Do Phobic Experiences Differ Among People?

People vary in their phobic experiences. Some are more severely affected, while others cope more easily. We are all products of evolution, during which phobias were actually useful—they protected us from dangers like poisonous insects and snakes. Evolutionary psychologists see phobic behavior as adaptive.

Some clinical psychology studies focus on how people with different disorders process information. People with specific phobias tend to focus their attention on phobia-related images. For example, those with social phobia focus on aspects of social situations that threaten their self-esteem and interpret ambiguous situations as threatening: “If someone raised their eyebrows, it means I did something wrong and they’re angry at me,” and so on.

How Are Phobias Treated?

The longer a person avoids the object or situation they fear, the harder it is to overcome the phobia. Some people manage their phobias on their own, especially if they can occasionally resist avoidance, but sometimes professional help is needed.

To reduce the anxiety associated with fear and help patients approach the phobic object, tranquilizers and antidepressants may be used. After that, systematic desensitization or cognitive-behavioral therapy (CBT) is introduced.

• Systematic desensitization is a method based on gradual exposure. The person is exposed to the phobic situation or object in “small doses,” which are gradually increased. For example, if a patient fears riding the subway, they might first ride with a therapist, then ride one stop alone, then two, and so on, staying in the discomfort zone as long as they can tolerate. Modern research reviews show this approach is highly effective.
• Cognitive-behavioral therapy (CBT) focuses on the cognitive component: the therapist helps correct faulty thinking, dysfunctional thoughts, and beliefs.

In my experience, people most often seek therapy for social phobia (fear of being around people) or agoraphobia (fear of being far from help, often linked to panic disorder).

Are Xenophobia and Homophobia True Phobias?

Phobias are psychological and psychiatric phenomena classified as anxiety disorders. The criteria for a mental disorder include subjective suffering, reduced quality of life, and a desire for help.

Mass social phenomena like xenophobia and homophobia are not considered mental disorders. The key question is: who suffers from the phobia, whose quality of life is reduced? People with true phobias often can’t travel, speak in public, or leave their homes. But with xenophobia or homophobia, it’s not the xenophobes or homophobes who suffer, but those around them—such as LGBTQ+ individuals or people of other nationalities.

Of course, these two essentially different phenomena have similarities: both involve irrational fear and have evolutionary roots (fear of the unfamiliar, like fear of spiders, once protected us from danger and aided survival). Aggression toward outsiders is common in animals and has a rational explanation. However, the more developed and prosperous a society is, the safer people feel, and the less reason there is to fear those who are different.