Picture this. An employment offer that will see the world becoming your office, where you spend most of your time jetting off to exotic destinations for important meetings. Sound like a dream offer?

While many people would jump at the proposition, a sizeable group would do everything in their power to avoid landing this lucrative deal.

The fact is that while many South Africans can cope with most situations, creatures or animals, a staggering 21% of the population is estimated to be suffering from some form of intense, irrational or real fear, better know as a phobia -and in this scenario, aerophobia (fear of flying).

Although the subject of many jokes and nasty pranks, there is help for those suffereing from various phobias. The Mental Health Information Centre attached to the Psychiatry Department at the University of Stellenbosch spends considerable time researching phobias as well as treating those suffering from these irrational fears.

“The extent of the feeling is out of proportion and out of control. It usually manifests physically in the form of sweating, heart palpitations and the person breathing faster,” explains Charmaine Hugo, Project Director at the centre.

“The person will go out of their way to avoid whatever brings about this fear. But it is important to note that it is normal to have fear, it is a healthy reaction.

“For example when confronted by a lion, your fear will protect you and not allow you to stroke its head, but in the case of a phobia the person’s fear can also be intense, and irrational,” Hugo explains. Researchers divide phobias into three categories:

Specific phobias or simple phobias (such as aerophobia). Agoraphobia (meaning fear of the marketplace in Greek), which translates into a fear of open, crowded places. The person fears a panic attack in an open, crowded place and is afraid that help will not be available or that he/she will not be able to escape. This creates a situation where many isolate themselves from places such as shopping malls, which in turn impacts on their functioning. Social phobia or Social Anxiety Disorder. Here it is important to differentiate between shyness and social phobia. Social phobia is a fear of performing in a public situation. This could include speaking, eating, drinking and even urinating in a public toilet. The person is fearful that he/she will do something to humiliate themselves in front of others. There is also a fear of being criticised or negatively evaluated. Hugo defines specific or simple phobias as a marked, persistent fear of a clearly identifiable object or situation.

This would basically involve:

• Fear or animals such as dogs, mice and cats.
• Fear or situations such as fear of flying or closed spaces.
• Fear of blood, needles or injury. This could include seeing blood or working with it.
• Fear of the natural environment such as the weather, wind, storms, thunder or heights.

According to Hugo up to 12% of the population could be suffering from some form of phobia at some point in their lives while up to 21% of people would be able to relate to one of the specific phobias.

Social phobias are common among both genders, while more women suffer from agoraphobia than their male counterparts who, according to Hugo, are well ahead when it comes to fear of blood, needles or injury.

While the causes of phobia are still being researched, Hugo says that it is accepted that they are brought on by a combination of biological factors and life events.

Genetics also plays a role. Some 40% of the specific phobias are hereditory.

Hugo says there is a definite difference in certain areas of the brain which govern functioning, between those who have a phobia and those who don’t.

“Interestingly the area of the brain involved with bringing on these phobias, is the same area involved with other anxiety disorders,” Hugo notes.

This discovery has spurred researchers to test some of the treatment regimes that have been found to be successful when treating other disorders such as obsessive compulsive disorders.

Some of the new generation anti-depressants have been found to work well for anxiety disorders as the drugs can correct the differences in brain chemistry and functioning (imbalance) in the brain.

Treatment also involves psychotherapy. Patients undergoing behavioural therapy could be exposed to systematic desensitisation or flooding.

Systematic desensitisation involves a process whereby a person is gradually exposed to the feared object. Flooding is much more dramatic – the person is immediately and fully exposed to the object.

Cognitive therapy aims to correct the person’s dysfunctional thought patterns. The person is taught to distinguish between what is rational and what is irrational. The person is taught that it is acceptable to harbour fear, but to distinguish whether they are in danger.

Cognitive behavioural therapy would involve a combination of the two.

“People see phobias as a light-hearted thing. That is fine, but it is important to acknowledge when to treat or not.

“When it starts impacting on the person’s work or social functioning it becomes problematic and then you have to start looking at treatment.

“For example a person who has ailurophobia (fear of cats) cannot work at the SPCA. Or a person suffering from aerophobia would find it problematic working in a place where he/she has to travel by plane,” says Hugo.

A potentially life-threatening example is where an ill person who has a fear of needles refuses to have blood drawn.

If you do not yet suffer from a phobia, chances are that it could rear its head when you least expect it.

Some phobias characteristically start at specific times, social anxiety disorder for example, begins in adolescence. Some also start after a traumatic event.

“With some people it starts in childhood and often it disappears with age. In other cases it arrives out of the blue,” says Hugo.

Anyone wanting more information can contact the Mental Health Information Centre of SA at 0800-600-411.