Fears and Phobias

Fear and phobias are a common problem. In the United States, 7%-9% of the population struggles with a specific phobia including 5% of children and 16% of 13-17-year-olds. Phobias sometimes develop following a traumatic event, such as, being attacked by an animal, or stuck in an elevator, or a swimming accident. If you are experiencing any of the symptoms below, you are not alone, and there are effective evidence-based treatments available at Brain Health Northwest.

These symptoms include:

  • A marked fear or anxiety about a specific object or situation
  • The phobic object or situation almost always provokes immediate fear or anxiety
  • The phobic object or situation is actively avoided or endured with intense fear or anxiety
  • The fear or anxiety is out of proportion to the actual danger posed by the object or situation
  • The symptoms last 6 months or longer
  • The symptoms cause distress or impairment in social, occupational, or other important areas


The artwork conveys the horror felt when confronted with a number of common phobias: social anxiety, arachnophobia, fear of flying, fear of enclosed spaces, and panic experienced when scuba diving.

The limbic system in our brain is wired to react to fearful situations so we can protect ourself and survive. Our body responds to threats with sympathetic arousal, such as fainting, or panic with accelerated heart rate and breathing rate. Individuals with phobias, however, experience a heightened physiological arousal in anticipation of exposure to the object or situation – not just in the face of an actual threat. They find themselves trapped in a never-ending cycle where their thoughts provoke the fearful physiological response in their body, and then these signals in the body reinforce their fearful thoughts. They find themselves constantly scanning their environment for danger, a state known as hypervigilance.

Fortunately, there are evidence-based treatments that work very well by combining cognitive-behavioral psychotherapy, biofeedback, and Virtual Reality immersion therapy. Virtual Reality Therapy (VRT) is a highly effective form of exposure therapy that immerses the patient into a virtual environment from the safety of our office. It creates a visual, auditory and sensory environment that psychologically exposes the patient to the feared object or activity (e.g. flying in an airplane or speaking in front of a large group of people). The therapist maintains control of the entire experience, gradually increasing exposure to the portions of the experience that create the most anxiety.

Some common phobias treated by VRT include:

  • Flying
  • Social situations
  • Animals and insects
  • Heights
  • Public speaking
  • Bridges or open spaces
  • Closed spaces

Biofeedback, concurrent with the VR session, allows the patient to see how they are physiologically responding to stress by monitoring heart rate, blood pressure, muscle tension, blood flow and even brainwaves. This real-time feedback helps patients to become aware of their reactions during the virtual exposure and ultimately teaches them how to control their responses.

If you are experiencing intense fears and/or phobias, come visit us for a comprehensive assessment and treatment plan.