What to do when a Phobia Becomes Obsessive

A phobia usually involves having a fear of spiders, dogs, fire, open or closed spaces, heights, animals, blood, or something else. Often, people are affected when faced with their phobia; yet, they can generally switch off when their fear is out of sight. In obsessive-compulsive disorder (OCD), however, people suffer from obsessions that include, among others, a fear of germs, non-contact contamination, and a fear of harm to oneself or someone else. Unlike people who usually only react when their phobia is visible, those who have obsessions are pestered with intrusive thoughts and, therefore, tend to be affected most of the time.

Specific Phobia

A specific phobia is persistent and intense. There is a compelling need to flee or avoid the feared object, substance or situation. These are factors that are determined before the symptoms are classified as a phobia. Another factor is confirming that the person’s fear is seen as irrational and not reasonable in the given situation.

Obsession

In comparison, people who have obsessions are usually never free from their fears, even though these don’t legitimately exist. For example, having a fear of harm coming to a loved one if certain items are not symmetrical, is an obsession. Subsequently, the corresponding ritual to “prevent” harm is to align the objects repeatedly. It’s these rituals that strengthen the obsession.

Obsessive Phobia

There is another factor to consider, which comes from Isaac Mark’s expression “obsessive phobia” which is not, as he puts it, ‘a direct fear of a given object or situation, but rather of the results which are imagined to arise from it’. While there is a distinction between a standard phobia and an obsession, an overlap can be noticed when a person shows signs of one and the other.

So let’s say a person fears spiders but doesn’t think about them when they are out of sight – this would indicate the norm for a standard phobia. In this situation, the obsessive-compulsive symptoms seen in a person who has OCD is non-existent in the person who has the phobia. However, when someone who fears spiders repeatedly locks all windows and covers door gaps to avoid spiders getting into their home, the diagnosis might be better suited as “obsessive phobia”. This is because obsessional behaviour is being used to counter the feared thing (Issac Mark).

Treatment

In the same way that cognitive behavioural therapy (CBT) and exposure response prevention (ERP) are used to help a person actively reduce symptoms seen in OCD, the same methods can be applied to help people overcome phobias and also obsessive-phobias. The cognitive side of therapy helps change the perception about feared things, and ERP means a person systematically resists giving into compulsions, which weakens the obsession. Mindfulness is also often integrated into a person’s treatment plan. A person might be prescribed an antidepressant medication, too, since this helps reduce obsessive-compulsive symptoms on a passive level.

Overcoming my obsessive-phobia of spiders

TRIGGER WARNING: I dealt with my obsessive-phobia of spiders by initially agreeing not to cover door gaps and to bear with my anxiety, until it came down naturally. When my anxiety reduced to a comfortable level on 0-100% distress scale, I was ready to tackle the next fear on my list, which was agreeing to look at small spiders. Next, I held small house spiders, then looked at bigger house spiders, and later let them crawl on my hand. Finally, I was able to handle a tarantula!

Carol Edwards – Overcoming my fear of spiders

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