All of us have known feelings of fear. Often such feelings teach us of situations to avoid. We sometimes experience fears about specific objects or situations where we feel uncomfortable, but such fears do not significantly interfere with our lives. But phobias, which are excessive and persistent fears, can seriously interfere with our lives.

        From infancy until school age, three categories of fear are present in children, each becoming less important as the child grows. First is the fear of noises and sudden movements associated with noise. The sudden, loud noise of thunder is frightening to most young children. Usually by eight or nine years of age, children have redefined it as exciting. They've decided it's fun to be scared . . . a little bit. The second category is fear of strange situations. Children become frightened when placed in unfamiliar circumstances where they don't know what to expect and do not have their parents nearby for support. Examples might be being left alone in a strange room with new people or getting lost at an amusement park. Thus most moms and dads spend a few weeks in the Primary nursery while Junior gets acquainted." Fear of the dark also fits here because, in the absence of visual cues, even one's bedroom can become a strange place. This fear is often associated with the child's increasing ability to imagine frightening situations. One man described how important it was as a young boy for him to get to sleep before his father. His dad snored loudly, and, even though the boy knew it was his father, he also thought he could see lions and tigers coming into his room, growling around the posts of his bunkbed. Imaginary fears can develop from a fear into nightmares, which also occur in the dark. Thus, a six-year-old girl may not feel comfortable about going to sleep until she tells her parents, "Goodnight, sweet dreams," which reassures her that nightmares won't come. Small children often develop innocent bedtime rituals that help them feel more comfortable with their fears.

        Some nightmares become what are called night terrors. Children with night terrors wake up screaming and crying and can't be comforted. That is because they are technically still asleep even though their eyes are open and they may be talking. Once they are gently and truly awakened, the dream is gone. Unlike most dreams, night terrors occur in the deepest stages of sleep. As a rule, children don't remember such dreams, and research suggests that they are harmless to the child (even if harrowing to the parent who thinks his child is delirious).

        The third category of childhood fear is fear of animals. The sudden approach of a frisky dog or being carried in Daddy's arms up close to a horse's nose is enough to emotionally undo many young children. The suddenness or novelty of the experience seems to cause fright. If the animal were to move more slowly and if the child could choose its own pace for getting acquainted, he would feel much less afraid.

        The intensity of these three kinds of fear generally declines over time, primarily because of repeated exposure to them and because of the help of caring adults who reassure the child. However, fears that have been increased by painful events (such as being afraid of a dog and then being bitten by it) may require a longer, more careful, repeated exposure and more emotional support if they are to decrease.

        As a child becomes a toddler, he can experience a more serious fear called separation anxiety. This is an unreasoning fear of being separated from his parents, and it is often disguised as a fear of going to school, of being afraid to have his parents go out for an evening or weekend, or persistent worries about his parents dying. The child may develop headaches, become nauseous and vomit, or in other ways seem unable to stay in the situation in which he or she is separated from the parent. Parents can help the child deal with the fear in three ways: First, it is important that the parent be unafraid of the child's alarm. This will do much to help the child feel that the problem can be overcome. Second, it is important that the child be reexposed to the feared situation with encouragement and support. Sometimes it is necessary to build the exposure gradually, with increasing amounts of time spent before the parent returns. In each case the parent and others should continue to express confidence in the child's ability to overcome the fear. Finally, parents should look for opportunities to spend time with the child when the fear is not an issue. Reassured that he or she is loved and that his parents will not leave permanently— either physically or emotionally—the child's fear will diminish.

        From middle childhood, children can become self-conscious. At this stage their fears revolve around people— family, friends, classmates, and even strangers. They fear criticism, rejection, being laughed at, and feeling foolish or inadequate. Such social fears may be expressed in a fear of public speaking or of schoolwork.

        Like other normal fears, many people overcome these social difficulties by practice, by repeated exposure to the situation, and by learning confidence in their abilities. Others, believing that their fears have been confirmed by disastrous experience, choose to avoid the necessary events that would dispel their feelings. They may still lead healthy, fulfilled lives, but they will not enter certain social arenas.

        Nearly all of us have experienced unreasonable fears. At different stages of life, our levels of intellectual and emotional development are associated with the kinds of fears to which we might have been susceptible. For most of us, the fear-arousing situations become more manageable and important as we grow through the influence of repeated exposure, support of family members, and our expanding capabilities. For some, however, childhood fears (especially those that have been increased by trauma) become excessive and persistent, limiting activities and opportunities. Such fears are classified as phobias.

        Standing in front of the class, my knees actually shook so hard I had to hold on to the piano to make sure I wouldn't fall down. I felt that my face must be completely drained of any color, and yet I was sweating. As I began, I already had so much air in my lungs from breathing hard that I could hardly inhale any more. My heart must have sounded louder than my shaky voice.

        I don't know how I ever made it through the song. I was exhausted for the rest of the day. And now, even months later, I can get tense just watching someone else sing and thinking of my doing it. As much as I love singing, I don't think I'll ever be able to perform a solo. I don't ever want to have that feeling again. I know that it's silly, too, but that's how I feel.

        This is a description of what might be called a singing phobia. Often a person experiencing such anxiety feels nauseous, dizzy, or weak and may have a sense of choking or suffocation. The heart beats rapidly, the skin perspires, the pupils are dilated, and the muscles tremble excessively. The extremes of such feelings are known as panic, and they may occur in a feared situation, real or imagined. Panic sometimes occurs without warning or apparent cause.

What are the differences between normal and abnormal fears? How do fears that many people experience and overcome become phobias for others?

        One cause may be the intensity of the initial frightening experience. More important, however, are the reactions of the person to the experience. The person anticipates other such frightening encounters with increasing anxiety. For example, a person who fears flying may know that he needs to make a plane trip in several days. He begins to think about it and becomes nervous. The more concerned he becomes about his anxiety, the more the emotion increases. The closer he comes to the time for the flight, the more anxious he is. Then the final stage comes into focus—an actual decision to avoid flying. Having done so, the fear diminishes. The person has learned a means of escape, and the phobia is reinforced. This is what it means to be phobic. The person seems governed by emotions not appropriate to the real situation but which seem to be caused by the situation.

        Such feelings may even be extended to additional settings, restricting the person's life and increasing his feelings of desperation about his situation.

        Phobic behavior can be expressed in a variety of ways. Some people face the fearful situation over and over again, and the fear continues to grow. Also, some people who have animal phobias do not experience "anxiety in advance" as does the man who must fly or the woman who must sing. They may not anticipate the appearance of a snake in a park. So their emotions do not deter them from walking in the park.

        Another illustration of a phobia is described as spontaneous panic. Victims of such panic attacks often report that they are feeling fine, occupied in normal tasks, when suddenly they feel heart palpitations, difficulty in breathing, nausea, sometimes an urge to urinate or defecate, and a sense of imminent death. Without clues to its cause, victims of panic attacks begin to avoid situations where they might have a reoccurrence. These people are more afraid of the panic itself than they are of the setting, although the setting becomes associated with fear and becomes a place to avoid.

        The first category is animal phobias. Professionals have categorized phobias by the nature of the symptoms. These fears are usually of one species of animal, although occasionally a person will express a fear of many kinds of animals. The most common are fears of snakes certain insects, spiders, dogs, cats, and birds. Animal phobias often do not interfere with the lives of their victims as much as other categories because the victims can live away from the feared species. Of course, that is not always the case. One woman had such a fear of crickets that she would not leave her house during the warm months when she might encounter a cricket.

        The second category is social phobias, where the fears are related to circumstances involving other people. As mentioned earlier, the person usually fears appearing foolish. Social phobias also range from being highly specific to general, from stage fright to being afraid to eat with or even talk with people.

        Specific phobias constitute the third category. Usually these are fears of certain circumstances or settings: fear of high places (acrophobia), fear of closed places (claustrophobia), fear of flying, or fear of driving. About 20 percent of the people seeking phobia treatment have this kind of fear.

        The fourth category of phobic symptom is agoraphobia. Agoraphobia literally means a fear of the marketplace. The symptoms are fears of being away from a safe person or a safe place. For example, an agoraphobic traveling away from home may eventually fear any kind of travel. A fear of driving on the highway leads to fear of driving in town, and then of driving at all. Being afraid of large department stores gradually spreads to any store, and so on. Being in the company of a loved one may lessen the fear dramatically, however. Some people who will not leave their homes alone can go anywhere if a family member or close friend accompanies them. This is interesting evidence that the situation itself does not cause the phobia, but this is a point agoraphobias rarely see. If they were to see it, they wouldn't be phobic anymore. Agoraphobics comprise the most frequently treated group (60 percent to 75 percent of the total) because their symptoms so severely limit their opportunities.

        Over the past fifteen years, a great deal of clinical and research attention has been focused on fears and phobias. Several authors have described much of the apparent fear involved in phobias, especially among agoraphobias, as a fear of fear. People are accustomed to understanding themselves and having a greater or lesser degree of control of their feelings. When they encounter a situation in which they experience extreme fear, one of the most frightening aspects of that experience is the sense of not being able to control their own feelings. As you might guess, that is especially the case with those who experience panic, which seems to "come out of the blue." Thus, what people are really afraid of is having those uncontrollable feelings again. In addition, many people are afraid of breaking down in front of other people. Their nervousness about making fools of themselves increases their anxiety as well as their attempts to avoid the feared circumstances. A study of fear and its effects in World War II bomber crews found that the most intense fear occurred on the first mission. The men reported that they were not so much afraid of dying as they were of being so frightened that they might behave like cowards! They were more anxious about controlling themselves than they were about the object of fear. Once they found that they could perform adequately under the stress, their fears dropped markedly.

        Recently, therapists have noted that panic seems to occur when the person is in very unpleasant interpersonal interactions in which the person who panics has strange feelings that he has been unable to express or resolve. Women who felt trapped in marriages in which they were not happy but which they were afraid to leave were particularly prone to panic. Most often, they had not connected the stress in their life situations to the panic attack. In a small percentage of the cases, panic had been experienced following severe physical stress such as childbirth, adverse reaction to drugs, hypoglycemia, or a major illness. Therapists soon found that victims of the physical stress were more rapidly and successfully treated than those of more chronic, long-term, psychological stress.

        In some of the programs, the therapist sets up a progression from less fearful situations to more highly feared circumstances. A program developed by Bandura and his associates at Stanford University uses the additional benefit of what is called modeling. Here, the therapist shows the client how to enter the situation without fear. In the case of a snake phobia, for instance, the therapist approaches a snake inside a cage. Then he talks to the client and comes back.

        Then the client approaches the snake and talks to the therapist. Next, the therapist will walk closer to the snake, talking to the client. Then the client will walk closer to the snake, and so on, until the client can actually stand to allow the snake to sit on his lap.

        In some cases, the therapist finds that the initial fear is too severe for the person to approach the situation directly. As a preparatory step, the therapist may teach the client to imagine the events as though he were living through them. As the client becomes capable of imagining facing the feared situation and does so without excessive anxiety, then the therapist moves into live practice.

        Often, in combination with such rehearsal or exposure, therapists will teach clients to talk to themselves, giving themselves encouragement and instruction. One woman with a severe snake phobia felt that the picture of a snake on a page began to come alive and move. The therapist helped her by having her say to herself as she looked at the picture, "Picture on page, picture on page." This statement helped the client maintain her sense of reality—the snake is only a picture. Similarly, when a client might be apt to say, "I could only climb three steps up the ladder today without becoming terribly frightened. This is terrible! I'll never be able to overcome my fear," the therapist might help the client to learn to say, "I climbed three steps up the ladder today. That's better than I've done for a long time. This is a slow process, but I'm going to make it." Or, instead of thinking, "Well, I really did well today, but what's going to happen tomorrow? Am I going to be able to continue my growth?" the client may learn to say, "Today was great. I really did well, and while I might do better or worse tomorrow, I'm on my way to overcoming this fear."

        Another technique, called flooding, is used less frequently today, but it is simple to attempt. In this technique, the lay counselor instructs the person to imagine the feared situation, and then the counselor deliberately describes the situation in its most fearful terms. The worst possible events that could take place are described until the client has experienced the fear and its gradual dissipation. Although live exposure has proven to be more effective, where that is impractical this process can be helpful.

        With complex phobias like agoraphobia, therapists have sometimes found it useful to refer clients to psychotherapy or marital counseling. Clinicians have noted that agoraphobics often experience panic as an eruption of emotional tension felt but not expressed. Spouses and sometimes other members of the family are asked to participate in the training to learn to understand the problem, to learn how they can help, and to learn what doesn't help. Occasionally the couple begins working on deeper relationship problems in the marriage.

        The treatment of fears may be linked with a deeper understanding of our own spiritual beliefs. After all, fearfulness is a topic discussed in the scriptures. Most of those references suggest that the unrighteous and the wicked have every reason to fear God and his judgment; that each of us should prudently fear God in the sense of being aware of him and desiring in a reverent manner to live his commandments; and that the Lord has said that as we live his commandments we have no need to fear other people. Since many people fear rejection and criticism, the Lord's counsel helps provide comfort: "Fear not to do good, my sons, for whatsoever ye sow, that shall ye also reap; therefore if ye sow good ye shall also reap good for your reward. Therefore, fear not, little flock; do good; let earth and hell combine against you, for if ye are built upon my rock, they cannot prevail. . . . Look unto me in every thought; doubt not, fear not." (D&C 6:33-34, 35.) Drawing near to the Lord has its own calming effect—we are given greater perspective in which to understand what is really important and what is not. As we live God's commandments and look toward him and his kingdom, our fear of the responses of others will diminish. We will become less concerned about criticism and more confident about the rightness of our acts.

        Perhaps, in a sense, some phobias are a crisis of faith after all. Perhaps God's admonition to look unto him in every thought has even more specific applicability. As a person approaches a feared situation, holding the image of a loving God in mind could be very beneficial. Similarly, understanding that we are God's children and that he wants us to succeed can give us confidence. Many of us have accomplished very difficult tasks beyond our ordinary skill because we have done it for God. We wouldn't even have attempted it for ourselves.

        Each of us can choose to exercise faith and hope. Indeed, God has commanded us to hope; therefore it must be within our abilities to choose to see things hopefully and to exert the energy and faith to overcome our problems and fears in spite of apparently insurmountable difficulties.

Suggested Readings

Bandura, A., R. W. Jeffery, and E. Gajdos. "Generalizing Change through Participant Modeling with Self-Directed Mastery." Behavior Research and Therapy, 1975, 13: 1 41 -52.

DuPont, R. L. Phobia: A Comprehensive Summary of Modern Treatments. New York: Brunner/Mazel, 1982.

Mavissakalian, M., and D. H. Barlow. Phobia: Psychological and Pharmacological Treatment. New York: Guildford Press, 1981.

Rachman, S. J. Fear and Courage. San Francisco: W. H. Freeman and Company, 1978.

About the Author

M. Gawain Wells, a native of St. George, Utah, is an associate professor of psychology and serves in the Comprehensive Clinic at Brigham Young University. He has published articles on children's feelings and has done research on religion and mental health. He has designed a diagnostic system for crisis intervention. He and his wife Gayle, are rearing six children. Brother Wells has served in the Church as a high councilor, as a bishop, and in many teaching and administrative assignments.