Phobia Treatments: Therapy, Medication, & Self-Help

How to Know You Need Phobia Treatment

If your phobia is impacting your quality of life, work, relationships and day to day activities, or keeping you from accessing essential medical care (like if you have a fear of needles), it may be time to consider treatment. It can be scary to face the phobia, however it can be worse long term if the phobia is left untreated.

How Are Phobias Diagnosed?

Specific phobias are diagnosed by mental health professionals including a therapist and a psychiatrist. They will work with you to understand the history of the phobia, related traumas, and family history, and come up with a diagnosis after a handful of sessions. Your team may ask you to consider some specific treatments or tests to help understand the exact condition you may be facing.

Therapy for Phobias

People with specific phobias are aware of their condition. Most recognize their fears as being irrational or disproportionate; however, that recognition doesn’t necessarily translate to less fear or anxiety. Therapy provides action-based solutions for change. Depending on your condition, your health insurance may cover some or all of your treatment.

Here are six effective therapy treatments for phobias:

1. Exposure Therapy

Exposure therapy is a type of behavioral therapy that helps clients confront their feared situations. Your therapist will consistently “expose” you to your phobia via in-vivo or real-life experiences. They may create a fear hierarchy with you, slowly leading you to facing the most significant fear. Over time, this repeated exposure often creates a desensitization effect.³

Virtual reality exposure therapy can be a helpful intervention. It is exposure therapy that is done in a virtual setting and has specific benefits depending on the phobia being treated, as someone can be in a simulation instead of being presented with a real-life version of the phobia.

2. Cognitive Behavioral Therapy (CBT)

CBT is an evidence-based psychotherapy used to treat a variety of mental health conditions, including specific phobias.² This treatment is short-term, structured, and collaborative. You will work with your therapist to identify the negative thoughts surrounding your specific phobia triggers. You’ll also learn how to challenge and restructure these thoughts into more realistic ones.

3. Eye Movement Desensitization & Reprocessing (EMDR)

Although it is generally used for treating trauma, some research highlights the benefits of EMDR for phobia treatment.¹⁴ The onset of phobias can correspond with traumatic experiences, and EMDR can resolve both the trauma and the associated phobic reactions that may have emerged as a result.

4. Narrative Therapy

Narrative therapy focuses on helping people feel empowered and in charge of their unique stories. For example, when treating anxiety, narrative work supports clients in using storytelling to rewrite how they perceive their experiences. Over time, this therapy can help clients see themselves separately from their phobias.

5. Group Therapy

Although it does not appear to be as widely studied as individual treatments, group therapy with a CBT focus can help people with phobias.⁵ Group therapy offers peer support and a sense of community and validation. Clients recognize they are not alone in their struggles and can review progress and setbacks in their recovery together.

6. Mindfulness Training

Mindfulness-based cognitive therapy helps people stay grounded in the present and helps them learn how their thoughts can impact their actions. It highlights the power of thoughts and mindfulness approaches to challenging unreasonable fears like phobias.

How to Choose the Right Therapist for Specific Phobia Treatment

It is important to do some research when getting a therapist for a specific phobia. Looking at clinician bios to see therapists’ background and experience as well as training and certification is important. Calling and talking to them for an initial consultation can also give you a good understanding of who they are and help you determine if they are a right fit. Someone looking for phobia treatment should find a therapist who specifically mentions that they treat phobias, ideally with experience using exposure therapy.

Is Phobia Therapy Covered by Insurance?

Phobia therapy is typically done by a mental health professional and if that specific therapist takes your insurance and you have mental health benefits, it is likely covered by your insurance. Consider calling and making sure that your insurance will cover the specific therapist you choose.

Medication for Phobias

Some health professionals prescribe anxiety medication for treating phobias. Medication is often used in conjunction with therapy, as it helps reduce anxiety symptoms. You must have a prescription to take these medications, so discuss your options with your primary care physician or a psychiatrist. Your health insurance may subsidize some or all of the associated costs.

Here are three forms of medication for specific phobia treatment:

1. Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs (e.g., Paxil, Lexapro, Zoloft, and Prozac) are a type of antidepressant often prescribed for both depression and anxiety symptoms. In addition, they are commonly recommended for treating phobias. These medications work by increasing serotonin levels. Side effects tend to be mild and rare, but you may experience fatigue, nausea, and headaches, as well as weight gain for some.⁶ These symptoms tend to disappear after a few weeks. It is important to note that it is possible to have severe side effects to these medications and you should talk with your doctor about the risks before starting  medication.

2. Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are less frequently prescribed, but physicians may recommend them if someone doesn’t benefit from SSRIs. MAOIs include Parnate, Nardine, and Manerix. These medications act on parts of the brain associated with dopamine, serotonin, and norepinephrine.

MAOIs can have serious side effects, including muscle cramps, low blood pressure, and involuntary muscle jerks. They also interact with numerous food and beverages, including certain cheeses, meats, and soy products.⁷ You should talk with your doctor about the risks before starting medication.

3. Benzodiazepines

Benzodiazepines (e.g., Xanax, Klonopin, Valium, and Ativan) are tranquilizers that slow down the central nervous system. These medications can provide sedative effects and provide fast-acting relief for anxiety or panic attack symptoms. A physician may prescribe a benzodiazepine for managing a high-stress phobia situation (like being on an airplane). However, because benzodiazepines can be addictive, this medication is only advised for short-term, monitored use. You should talk with your doctor about the risks before starting medication, and continually check in with them regarding the impacts of the medication once you begin taking them.

Hypnotherapy for Phobias

Due to the intense nature of the fear caused by phobias, hypnotherapy can offer some specific benefits for phobias, especially as a complementary treatment to psychotherapy. Hypnotherapy can help someone understand the origin of their fear and why it was developed, and once they understand that, it will be easier to understand how to move forward.

Self-Help Tips for How to Get Over Phobias

It’s possible to cope and live a meaningful life despite your phobia and you can learn how to overcome phobias. The first step is to recognize the problem. Ultimately, you may benefit from a combination of professional therapy, medication, and individual lifestyle changes. Keep in mind that being proactive in your treatment can make a significant difference in your recovery.

Here are nine self-help strategies for coping with phobias:

1. Label your feelings: Labeling your feelings allows you to be more objective about your experience. Get in the habit of identifying how you feel in given situations. For example, “I feel worried and insecure right now.” Over time, you’ll start recognizing patterns and triggers, allowing you to make necessary changes in your routine.
2. Practice deep breathing: Breathwork helps promote a state of calmness, and it can also help quiet the cluttered thoughts in your mind. When you start to feel anxious, pause for a moment. Inhale for five counts, hold for a second, and then exhale for five counts. Repeat several times.
3. Examine the evidence: Identify the worst-case scenario (which is the root of the anxiety). Now, identify other possible scenarios, including the best-case scenario and the most likely scenario. Examining the evidence removes some of the emotional intensity from the situation and focuses more on objective data.
4. Imagine yourself facing fear: Positive visualization can be a powerful tool in your recovery. Spend some time imagining yourself successfully conquering your phobia. Note how empowered you feel and what positive changes this success brings.
5. Challenge your thoughts: Phobias often coincide with all-or-nothing negative thoughts like, “I’m going to die” or, “Something horrible will happen.”The next time you encounter one of these thoughts, take a moment to challenge it. How likely is it to come true? Is there another realistic, helpful thought you can use in its place?
6. Affirm small successes: It’s unrealistic to conquer a fear overnight. Instead, it’s important to recognize and celebrate all victories as they happen. Validating yourself is an important part of self-empowerment and maintaining strong momentum.
7. Talk with peers and loved ones: Phobias can trigger shame, which can deeply affect your confidence and self-esteem. However, phobias are common, so you might find that talking to others about your fears invites them to share their own experiences. Moreover, your loved ones can provide support and reassurance for your well-being.
8. Be mindful of avoidance tendencies: Phobias become so intense because you spend a great deal of time avoiding (or attempting to avoid) the feared situation. Try to be mindful of this tendency. While you may not feel comfortable conquering the feared situation right away, start reflecting on the mental energy you devote to this avoidance. You may soon realize how much it affects your life.
9. Reach out for support: You don’t have to conquer your phobia on your own. Working with a therapist can help you understand your fear and develop a realistic plan for managing your symptoms.

Final Thoughts on Specific Phobia Treatment

Phobias may feel like they’re life-threatening, but you can learn how to cope with this anxiety. If you are struggling, consider reaching out for support from a therapist and/or loved one. Phobias are treatable, but you must commit to taking positive action towards change.