“Snakes. Why did it have to be snakes?” I’m sure many people remember this famous quote from the Raiders of the Lost Ark scene where Indiana Jones is faced with a pit full of snakes. Yes, even our brave hero Indy has a phobia. He’s not alone: according to the National Institute for Mental Health approximately 19.2 million Americans age 18 or over have one. Additionally, 15 million people suffer from social phobia, which is essentially a fear of social situations. It’s important to not overlook children as they too can develop a wide variety of phobias.

A fear of snakes is just one of many phobias which exist. Some of the best known are claustrophobia (enclosed places), arachnophobia (spiders) and acrophobia (heights). There are also many which most people haven’t heard of, such as coulrophobia (clowns) and emetophobia (vomiting). There is even a phobia called ephebiphobia, meaning a fear of teenagers! So what is a phobia and how do they develop? A phobia is generally defined as an excessive and irrational fear of a situation, object or activity. While the cause is unknown, it is believed that life experiences and genetics both probably play a major role in their development. For example, someone with a spider phobia may have been frightened by one crawling on him or her as a child. A family history of anxiety may also help explain why not everyone in those types of situations becomes phobic.

Fortunately, we usually don’t need to know much about the cause for phobias to be successfully treated. While cognitive therapy is very helpful in changing irrational beliefs, it isn’t likely to be enough if used alone. Since the single-most common coping strategy in dealing with phobias is avoidance, exposure therapy is a necessary part of the treatment. The essence of exposure therapy is for someone to gradually put themselves in increasingly more difficult circumstances, and stay in the situation long enough until the anxiety begins to dissipate. If someone with a fear of elevators uses the stairs all the time they’ll never get to the point of recognizing that there truly is little to fear. While using the elevator initially will often cause considerable anxiety, that anxiety is very likely to lesson thru repeated exposure exercises. Yes it can be frightening, though often not as hard as someone may anticipate.

It is important to add that not all phobias are worth working on. If you have a fear of snakes but never come in contact with them there isn’t much of a reason to seek therapy for it. Treatment, however, may be very important if you have a fear of flying and need to travel for business. Or, if you are Indiana Jones and need to confront your fear of snakes as you avert various crises around the globe.

— Scott M. Granet

Scott  Granet, LCSW is a long-time resident of Redwood Shores, and is director of the OCD-BDD Clinic of Northern California in Redwood City. He would like to hear your suggestions for future columns, and can be reached at 650-599-3325 or .