A life without fear sounds idyllic but it would be no paradise. Fear protects us from present danger, alerts us to future threat, sharpens our minds and blunts our selfishness. Friedrich Nietzsche once said that fear is the mother of morals, and people who lack it do indeed tend to be nasty, brutish and short-lived.
While useful to a point, people often suffer from an excess of fear. Although many of us are afraid of snakes, spiders, heights and blood, when these normal fears are taken to extremes they become phobias.
To qualify as a phobia, a fear must be lasting, intense and seen by the sufferer as excessive and irrational. It must also be a source of distress or impairment in the person’s occupational life and social relationships.
Phobias affect about 10% of the general population at some point in their lives, with women affected twice as commonly as men.
What are we afraid of?
Phobias commonly involve objects and situations that were realistic dangers for our distant ancestors: poisonous or vicious animals and invitations to injury. As a result, many people are terrified of things that no longer pose a contemporary threat.
Ancestral fears are learnt with remarkable ease. One study found that young rhesus monkeys acquired a fear of snakes when they viewed a film of older monkeys acting terrified in the presence of a snake, but did not come to fear flowers when they viewed monkeys going ape in the presence of a blossom. Fears related to things that were threats to our forebears are more easily acquired than others.

Although many common phobias are of this ancient or “prepared” kind, the spectrum of human fears is astonishingly broad. The clinical literature records phobias of rubber bands, dolls, clowns, balloons, onions, being laughed at, dictation, sneezing, swings, chocolate and the wicked, beady eyes of potatoes. Unusual fears are particularly common among people with autism, who have been known to dread hair dryers, egg-beaters, toilets, black television screens, buttons, hairs in the bathtub and facial moles.
It is hard to see the evolutionary threat posed by these innocuous things. As Stanley Rachman, the psychologist who treated the chocophobe wrote, “it is difficult to imagine our pre-technological ancestors fleeing into the bushes at the sight of a well-made truffle”.
How do phobias develop?
Given that many modern phobias make little logical sense, it is interesting to explore how they emerge. There are three main identified ways that phobias come about: a terrifying personal encounter, witnessing another person’s fright, and receiving threatening information. A person might acquire a spider phobia after a close encounter in the shower, after seeing a sibling run screaming from an infested room or after being told that spider bites cause you to turn purple and die.
Only a small minority of people will develop phobias after common experiences such as these. Those who had inhibited temperaments in childhood and neurotic personalities in adulthood are more vulnerable, and this vulnerability has a substantial genetic component.
A study that followed a sample of young women over a 17-month period found that those who developed phobias tended to have more pre-existing psychological problems, poorer coping skills and a more pessimistic mindset than their peers.
Let’s consider one odd but surprisingly common aversion, the fear of frogs.
One published case documented a woman who developed ranidaphobia, as it is known, after running over a knot of frogs with a lawn-mower. Paralysed by fear and tormented by amphibian dreams, she was persecuted every evening by an accusing chorus of survivors on a nearby riverbank.
In another case, a Ghanaian schoolboy developed his phobia when he stepped on a frog while touching itchy leaves. After his brother told him that frog urine could cause itching and a painful death, the boy became paralysed with the fear that frogs were hiding in his bed.
This fear was put to productive use elsewhere in west Africa, with one anthropologist reporting that bed-wetting children were frightened into bladder control by having a live frog attached to their waists.

What gives these puny creatures – with big eyes and scrawny, hairless bodies – their power to inspire fear and trembling? They pose no realistic threat to life: phobic individuals understand that in an encounter with a frog they are unlikely to be the one to croak.
The fear of frogs is viscerally unreasonable. To many people it reflects the frog’s slimy, skin-crawling ickyness. To others, it is the creature’s propensity for sudden movement, a trait it shares with another tiny source of terror, the mouse.
Treatment
Luckily for phobia sufferers, treatment is generally quick and effective. Cognitive-behaviour therapists have an assortment of techniques for confronting fears and challenging the avoidance and thinking biases that sustain them. Usually these methods involve progressive exposure to the feared object or situation up the steps of a “fear hierarchy”, from relatively nonthreatening encounters to the most terrifying.
These “behavioural experiments” are often supplemented by relaxation techniques, modelling of exposure by the therapist and correction of catastrophic thoughts.
In another case of ranidaphobia, a young nursing student, fainted in a biology class when her laboratory partner severed a frog’s spinal cord (“pithing”). A course of therapy was commenced in which she repeatedly viewed a videotape of the operation and practised relaxation techniques.
Such was the success of the treatment that in a single sitting immediately afterwards she was able to deliver electric shocks to one frog, pith another and cut open the abdomen of an anaesthetised rat, remaining calm even when one frog hopped loose, bleeding profusely from its injuries.
By facing what we dread, under the guidance of a psychologist, we can find freedom from irrational fear.
Eric Glare
HIV public speaker and volunteer
The nursing student's therapy may be described as successful but "remaining calm even when one frog hopped loose, bleeding profusely from its injuries" sounds like a lack of empathy somewhere along the line such as how some readers might respond to the description and query the necessity of it all. I hope she calmly gave it prompt care.
Peter Lang
Retired geologist and engineer
I’d like to ask about what seems to be a society level equivalent of an individual’s phobia.
Is the fear of nuclear energy a phobia?
“To qualify as a phobia, a fear must be lasting, intense and seen by the sufferer as excessive and irrational.”
I am surprised the definition says “it must be seen by the sufferer as excessive and irrational”.
On that basis nuclear phobia (or radiation phobia) would not be considered a phobia.
However, if we consider society as a whole, then society…
Read moreRobert Peers
General Practitioner
The vulnerability to phobia development is anxiety disorder, and does not have a substantial genetic component at all. It has NO genetic basis whatsoever: anxiety disorder is now known to be caused by 1] fatty maternal diet, and 2] maternal liquorice consumption during pregnancy. Both factors allow maternal stress hormones to reach the foetal brain, therein to programme lifelong anxiety, by means of a unique epigenetic mechanism that leaves the stress axis permanently switched on. Although anxiety has no genetic cause, phobias may possible involve some particular predisposing gene. Only genome-wide association studies can find such genes, if they exist. Like any anxiety disorder, phobias should respond quickly to high-inositol diet [whole grains, nuts, legumes, citrus]: inositol is a simple glucose derivative that reverses anxiety, by inhibiting serotonin 2A receptors--which reverses stress axis activation within days.
Eric Glare
HIV public speaker and volunteer
The idea of anxiety having an "epigenetic mechanism" and/or a "predisposing gene" is not compatible with "no genetic cause" as 1) both mechanisms are subsets of 'genetic cause' by definition 2) any genetics like a SNP at or influencing the site of epigenetics or the expression of such gene/gene sequence targeted by epigenetics will lead to a phenotype that is the sum of the two mechanisms plus that of any other mechanisms acting on that transcription and translation. Gene expression in situ is a…
Read moreRobert Peers
General Practitioner
I do most earnestly advise Mr Glare to look up the difference between genetic and epigenetic. I explained quite clearly the chain of causation, starting with fatty maternal diet, proceeding through maternal cortisol crossing an inflamed placenta, resulting in a cortisol-induced epigenetic [not genetic] change in the unborn baby's brain, that causes lifelong anxiety. Without the fatty maternal diet, there is no such epigenetic effect. Butter, cream, chocolate, cheese, cakes and pastries are not, to my knowledge, subsumed under the rubric "genetic".
Eric Glare
HIV public speaker and volunteer
You are trying to obfuscate and dismiss my post by addressing only a quarter of it and I think the key problem is that you want to use complex genetics but you are still thinking of "genetic cause" (your term) in simple Mendelian terms with a limited number of loci.
Clearly, genome-wide association scans are looking for causative genes, mutations and haplotypes (ie genetic causes) that are in linkage disequilibrium with a particular phenotype such as anxiety. Genome-wide scans are not the only…
Read moreTom Hennessy
Retired
"Polycythaemia and agoraphobia"
http://www.sciencedirect.com/science/article/pii/0005791696000067