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Published October 30, 2013, 04:45 PM

Phobias: More than fear

FARGO – When Katie Gordon was a graduate student, she fainted as she was leaving a hospital after a blood draw. “I fainted and fell out of the elevator,” she says.

By: Anna G. Larson, INFORUM

FARGO – When Katie Gordon was a graduate student, she fainted as she was leaving a hospital after a blood draw.

“I fainted and fell out of the elevator,” she says.

Now an assistant professor of psychology at North Dakota State University, Gordon understands why she stayed away from shots and blood draws after the incident. She had developed a mild phobia, or an excessive or irrational fear to an object or situation.

Phobias differ from fear because the person has a physical reaction like increased heart rate, and they overestimate danger, Gordon says.

Her specific phobia was blood-injection-injury, one of the four categories of phobias. The other classifications are situational, such as being fearful of riding in an elevator or airplane; animal, like a fear of snakes; and natural environment, such as being afraid of tornados or heights.

Grand Forks resident Orianah Fast discovered her animal phobia after finding a ball python in her apartment. The snake had escaped from a neighboring unit, and when Fast found it, she “jumped up, screaming at the top of my lungs and crying,” unable to control her emotions.

She ran for help – “all the while hyperventilating and freaking out” – pounding on neighbors’ doors. Eventually, a man answered and scooped the snake into a plastic bag.

“That obviously didn’t make me feel any better, but he tried,” Fast says.

Mysterious but real

Like many Americans, Fast has a phobia that she can’t necessarily understand, but nonetheless, it’s real.

In any given year, 7.8 percent of American adults have phobias, according to the American Psychiatric Institute for Research and Education. They are the most common psychiatric illness among women of all ages and the second most common illness among men older than 25.

Anyone with a high level of baseline anxiety has a greater risk of developing a phobia, Gordon says, and phobias can range from mild to severe.

For example, some people might be squeamish about getting a shot or blood drawn, “but they’ll soldier through,” she says. Other people with a severe phobia won’t get blood drawn even though it’s medically necessary.

Sometimes, it’s not known how phobias develop, but a traumatic event is typically the root of it, Gordon says.

If a person is bitten by a dog as a child, they might pair every dog with the incident. When they avoid dogs, they find their anxiety decreases, which Gordon says only makes the phobia stronger.

Phobias can also develop through vicarious learning, or a person seeing a bad thing happen to someone else, she says.

Phobias may additionally stem from something a person has no memory of, says Ric Ferraro, a professor of psychology at the University of North Dakota in Grand Forks.

“We have what’s called ‘infantile amnesia.’ When you ask someone what’s the earliest memory they can think of and ask their age (then), most people will say 3 or 4 years old,” he says. “If someone tries to recall an earlier memory, even back to their birth, that’s a hazy area.”

Fear – like happiness – is an emotion we are born with, Ferraro says.

A fear rises to the level of phobia “when it starts to restrict behavior,” he says.

People with a fear of driving on freeways might limit their transportation; people who fear shots might avoid medical treatment; others avoid social events.

With most phobias, a person’s physical reaction includes increased blood pressure, anxiety and an increased heart rate, Gordon says.

Blood-injection-injury phobia strays from the norm in that manner – blood pressure typically drops, making people faint as Gordon did post-blood draw.

Learning muscle tensing exercise can help people keep their blood pressure up during an incident so they don’t faint, she says.


People should seek treatment when a phobia affects their life, or if it simply bothers them, Gordon says.

Phobias are one of the most treatable disorders, and among the several treatment approaches, both Ferraro and Gordon say exposure therapy is common.

With exposure therapy, clients are exposed to their fear – an elevator, for example. The person would be instructed to ride the elevator until their anxiety dissipates.

“And it will; the body can’t stay anxious for that long. When you do that repeatedly, it breaks the connection,” Gordon says, adding that exposure therapy is one of the most effective therapy methods for phobias.

After her fainting incident in college, Gordon’s friends took her along when they’d get blood drawn or shots, and eventually, her phobia lessened.

People can also learn relaxation techniques to tame their phobias, and sometimes medications are prescribed to lessen anxiety, Gordon says.

Vicarious learning and virtual reality therapy are other treatment options. The latter exposes people to virtual stimuli until they’re no longer as fearful, Gordon says.

With vicarious learning, a phobic person watches another person ride an elevator, for example, so they can see that they’ll be OK, Gordon says.

Treatment length can vary, but it’s typically short-term. Some studies have shown that even one session of therapy can dramatically decrease a person’s phobia. The difficult part, Gordon says, it getting a person to treat their phobia.

“The tricky part is motivating the client to do it because you’re asking them to do something they’re afraid of. If they do it, they tend to get better, on average, pretty fast,” she says.

Fast says she has no plans to seek treatment for her phobia.

“I don’t think I’m going to get over it,” she says. “It doesn’t limit me. It’s not something I’m interested in. I have no desire to touch a snake.”

It’s something she can live with.

“I don’t think it affects my life too much – other than the fear that it might happen again,” she says.

Pamela Knudson of the Forum News Service contributed to this article

Readers can reach Forum reporter Anna G. Larson at (701) 241-5525