What Kylie Jenner and Sylvester Stallone have in common with 10 per cent of us: phobias and why we get them

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Mine is about snakes. My daughter, grasshoppers, her godmother, sticky labels. I'm talking phobias. My daughter will flee a room if a grasshopper makes an entrance, her godmother can't peel the price tag off a gift, an avocado or even a box of tissues. And I'm not just afraid of snakes in slithering, slippery real life: since childhood I've been unable to comfortably turn the pages of a book if it meant touching colour pictures of snakes.

Phobia derives from the Greek phobos, which means fear or horror.

The National Institute of Mental Health in Bethesda, Maryland, says phobias are the most common mental disorders in the US. Up to 10 per cent of people have specific phobias, for example 7.1 per cent experience phobias with regard to social situations, and 0.9 per cent have agoraphobia - the fear of being out in open or crowded spaces.

Clinical psychologist Dr Quratulain Zaidi from MindnLife in Hong Kong says research shows anxiety disorders are the most prevalent mental health disorders. Phobias are a type of anxiety disorder that causes someone to experience extreme, irrational fear about a situation, living creature, place or object.

Phobias are divided into four main categories: the natural environment (eg fear of water, hydrophobia or thunderstorms, astraphobia); fear of animals (cynophobia, the fear of dogs), fear of medical intervention or injury (particularly limiting is pseudodysphagia or the fear of choking, sometimes confused with phagophobia, the fear of swallowing, both hugely compromising) and situational fears - such as planes or enclosed spaces or a social phobia.

Zaidi says social phobias are much more than just shyness.

"Social phobia involves a combination of excessive self-consciousness and a fear of public scrutiny or humiliation in common social situations. In social situations, the person fears being rejected or negatively evaluated or fears offending others."

She describes the challenges for a person living with agoraphobia, which she describes as a fear of an actual or anticipated situation, such as using public transport, being in open or enclosed spaces, standing in a queue or being in a crowd, or being outside their home alone.

"The anxiety is caused by fearing no easy means of escape or help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoiding the place where it occurred. For some people, agoraphobia may be so severe that they're unable to leave home," Zaidi says.

But why do phobias manifest? When a person has a phobia, Zaidi says, they will often shape their lives to avoid what they consider to be dangerous.

"The imagined threat is greater than any actual threat posed by the cause of terror. Phobias involve both fear and avoidance. The avoidance can reduce the constant feelings of severe distress and sometime this can lead to impairment of daily functioning," she says. It is essentially fear of a non-fear that drives it all.

Phobias can be hugely impairing, presenting early in life and persisting over time. Research shows that the lifetime prevalence of specific phobias around the world range from 3 per cent to 15 per cent. Phobias concerning heights and animals are the most common.

More research is necessary before a specific cause for phobia development can be identified, but factors that may play a role include genetics, and cultural and life experiences. Many phobias are based on real-life events that may or may not be consciously remembered. A phobia of dogs, for example, may stem from being attacked as a small child or seeing someone being attacked as a child. A social phobia may develop from a situation that caused unease - being pointed out in a crowd, say, or being bullied.

The most commonly reported phobias are arachnophobia - the fear of spiders which, perhaps not surprisingly, affects four times as many women as men; ophidiophobia - the fear of snakes - that affects me; and acrophobia, a fear of heights. An estimated 5 per cent of the general population suffer from agoraphobia, cynophobia, the fear of dogs, irrespective of size and breed, and claustrophobia - the fear of small spaces.

Aerophobia - a fear of flying, which is reported to affect 25 million Americans, is another common phobia. But it is less common than it was once: a University of Oslo study concluded that the prevalence of flight phobia fell from 8 per cent in 1986 to 3 per cent in 2015, while the percentage of those reported to never fly fell from 5 per cent in 1986 to 0.5 per cent in 2015. In 1986, 11 per cent of respondents said they always used alcohol while flying; that had fallen to 7.5 per cent in 2015; the use of tranquillisers dropped also, from 3 per cent of respondents in 1986 to 2 per cent in 2015. More women reported being afraid of flying than men. Turbulence, unknown sounds, and fear of terror attacks caused the most anxiety.

Whoopi Goldberg developed a fear of flying after witnessing a mid-air collision from her hotel balcony. 
Photo: South China Morning Post

Actress Whoopi Goldberg reportedly developed an acute fear of flying after she witnessed a mid-air collision from her hotel balcony in 1978. Her fear held out for three decades, until Virgin's Richard Branson, sensing a good PR stunt, coaxed her back on board with one of Virgin's Fear of Flying courses. She will fly now. But she'd rather not - she'd rather take the bus.

Goldberg isn't the only phobic celebrity - singer Sheryl Crow and actor Sylvester Stallone both reportedly suffer from a fear of heights, while media personality Kylie Jenner and actress Nicole Kidman both have a fear of butterflies - lepidopterophobia. "I have tried to get over it," Kidman is quoted as saying on IMDb. "I walked into the big butterfly cage at the American Museum of Natural History and had the butterflies on me, but that didn't work."

But how do you treat a phobia - one that impacts life to such an extent the sufferer can't travel, go out, engage, enjoy life? Exposure therapy - literally forcing you to face your fear, as Kidman tried to do in the butterfly cage - and cognitive behavioural therapy, or CBT, says Zaidi, remain the most effective treatments. CBT, a form of 'talk' therapy, focuses on how a person's thoughts, beliefs, and attitudes affect their feelings and behaviours, to help them find new ways to act by changing their thought patterns.

"Sometimes medication is prescribed and helps with managing the extreme anxiety," Zaidi says. "In my experience a combination of both is most effective."

This article was first published in South China Morning Post.

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