Specific Phobias

Noah was unexpectedly and severely bitten in the face by a dog when he was five years old. He had mistakenly judged the dog to be friendly and innocently attempted to pet him. Although Noah is now 13 and knows rationally that some dogs are friendly and some are not, he does not trust his judgment and panics when he gets too near a dog of any size or temperament. His heart races, he begins to tremble, he feels he can't breathe, he is afraid of dying, and his only thought is that he must escape immediately. Because Noah has such severe reactions to dogs, he tries to avoid them at all costs. Before accepting an invitation to go to a friend's house, he surreptitiously finds out if the friend has a dog. If a dog is present, he makes up an excuse as to why he can't accept the invitation. Specific phobias, which are irrational or grossly exaggerated fears of certain objects or events, occur only in the presence of those objects or events and are therefore predictable. The object or event will either be endured with great discomfort or avoided altogether. In order to be diagnosed as phobic, the individual must suffer extreme distress or impairment of normal functioning.

Phobic individuals may be irrationally afraid of certain beings that occur in nature (dogs, spiders, snakes). They may also be afraid of things in the environment (storms, heights), blood or injections, situations (bridges, elevators), and other objects or events (clowns, vomiting, loud sounds). Having one phobia increases the likelihood of developing another. The first symptoms of specific phobias usually, but not always, occur in childhood or adolescence, and usually at a younger age for women than men.

Noah represents the case of a specific phobia whose origin was very clear, and the resolution of which was easily accomplished. While the origin of a specific phobia is not always so clear, Noah's experience serves as a clear example of a specific phobia with panic attacks.

Specific phobia affects approximately 8.7% of individuals in the US, of whom twice as many are female than male.

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