Why are psychological treatments for phobias often so effective?

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Exam number: y2272309

Why are psychological treatments for phobic anxiety often so effective?

With over 275 types of specific phobia, between 8-12% of us clinically diagnosable and some level of phobic anxiety affecting more than 60% of us at some point in our lives (Goodwin, 1983; Ollendick & King, 1994; Robins & Regier, 1991), effective treatments, unsurprisingly, are highly sought after. Varying interventions claim extraordinary success rates, from one-hour behavioural cures to prolonged drug therapy.  This essay focuses on psychological treatments for phobic anxiety, and examines possible reasons for their apparent success. Investigating the differences between psychological and pharmalogical treatments, and distinguishing phobias from other mental disorders can provide useful insights into the effectiveness of psychological treatments.

Fear is an everyday response. From walking home alone at night to public speaking, almost all of us experience it. Phobic anxiety, however, differs from fear in that it is irrational and disproportional to the level of actual danger in terms of “duration, degree of avoidance or subjective distress” (Davey, 1997). The DSM-IV criteria state that fear must be excessive or unreasonable, provoked by an object or situation; exposure to this object/situation immediately produces anxiety, and avoidance of this fear interferes with the sufferer’s life. It defines five types of specific phobia: animal, natural environment (heights, storms, water), blood-injection, situational (flying, driving, lifts), and other (choking, vomiting, sound), as well as social phobia and agoraphobia. The former, specific phobias differ in a number of ways, and of particular interest for this essay, in treatment success rates (Beck, 1985).

Phobias and their treatments have been an area of interest for centuries; Freud’s (1909) Little Hans and Watson and Rayner’s (1920) Little Albert are two of the most cited examples. The latter case study was a nine-month old boy who showed no fear towards animals, but did to loud noises. Watson & Rayner (1920) would produce a loud noise whenever Albert touched a rat. Albert showed a fear response to the noise, and after several pairings, showed the fear response to the rat alone, even generalising his fear to other animals such as rabbits. Not only did he learn the association between rat and noise; he also learnt that avoiding the rat meant avoiding the noise – an important aspect of the development and maintenance of phobias. This early research was the first in a wealth of studies supporting the theory of conditioning as cause for phobic anxiety. Because of the simplicity of conditioning, treatment options based on reversing the psychological pairings in phobias are some of the most common.  

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Goodwin (1983) states: ‘Anything that is learned can be unlearned’; this view forms the basis of many psychological treatments for phobias. Generally assumed is that the sufferer has, at some point, learnt the association of fear with their feared stimulus through childhood trauma, observational learning or projected fear associations (like Albert’s fear of rabbits). Whether the aim is uncovering subconscious conflicts or challenging illogical thought processes, almost all psychological treatments for phobias have something in common: unlearning through the method of exposure. The first major widely used behavioural treatment was developed by Wolpe (1958). It involved; ‘flooding’ – exposure to ...

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