Phobia's: (Ir)Rational?

Ever since I can remember, I have dreaded going to the doctor’s. Every year during my annual physicals, I would wait anxiously for the nurse to look through my papers and say, “Oh look! You’re due for some shots.” For some, this news is an inconvenience; for me, this news starts an episode of sweaty palms, nausea, severe anxiety, and usually fainting. 

• Phobia:  “a persistent and unreasonable fear of a particular object, activity, or situation.” [Comer 2022]
• Blood Injection Injury (BII) Phobia: “a condition in which people are likely to faint at the sight of blood, the anticipation of physical injury, or the anticipation of an injection, characterized by avoidance behavior and intense, irrational fear in response to seeing blood, injections, injuries, disability, or exposure to these or other similar medical procedures.” [Wani 2014]

This definition of phobia, and the common understanding of phobias, paints phobias as causing an irrational reaction to something that is not necessarily life threatening… So why do phobias exist? 

Behavioral-Evolutionary Perspective

In the year 2018, about 3,150 people died and 254,484 were injured in car accidents in the state of Florida [Holliday 2021]. On the other hand, a study done by the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (WONDER),, showed that between the years 2008-2015, approximately 6 people died from spider bites in the US per year [Pest 2019]. These studies show that motor vehicles are much more dangerous to human life, yet spider phobia is considered very common, while a motor vehicle phobia is not. Other common phobias include the fear of snakes, heights, and darkness, all of which are less fatal than cars. 

The behavioral-evolutionary perspective on phobias theorizes that these common phobias are passed down to us from our ancient ancestors. While cars may be more dangerous to humans now, our ancestors were more at risk of dying from venomous snakes and spiders, falling from tall heights, and being attacked by an animal that is hiding in the dark. Humans that had phobias of these dangerous objects and situations were more likely to avoid them, leading them to live longer. These humans that survived reproduced and passed  their phobias on to their offspring. This led to their offspring having a higher chance of survival, who could then reproduce and pass on the phobia to their offspring, and so on and so forth. This concept of being more likely to develop a phobia due to genes is considered preparedness.

• Preparedness: “A predisposition to develop certain fears”[Comer 2022]

When it comes to my phobia, blood injection injury phobia, the behavioral-evolutionary perspective may still be relevant. One of the main symptoms of BII phobia is fainting. Fainting is due to a sudden drop in blood pressure during exposure or the anticipation of exposure to blood, injury or injection [Nebel-Schwalm 2022]. When blood pressure decreases, it means the heart is sending less blood to the body. For me, this reaction causes an embarrassing scene at the blood bank, but for my ancestors, this reaction may have been a life-saver. For example, if a person without BII phobia were to get a deep cut, they may die due to losing a fatal amount of blood. A person with BII phobia will experience a drop in blood pressure and faint when seeing the injury or blood. This means that less blood will be sent to the wound, conserving more blood, and saving their lives. 

Treatment

Although many phobias may be caused by genetics, this does not mean you are doomed. 

• Exposure Treatment: “treatments in which persons are exposed to the objects or situations they dread.”[Comer 2022]

For me personally, exposure treatment has been really useful in reducing my anxiety about injections and blood. For about a year, I have had to get my blood drawn every 2 months, and I have noticed a decrease in anxiety and even a decrease in fainting episodes. Although I was more or less forced into exposure treatment, professional exposure treatment given by a psychologist can be very effective.

Works Cited

Comer, Ronald J. (2022). Abnormal Psychology . Worth Publishers. 

Holliday, J. (2021, November 15). Florida car accident facts and statistics: Car accident lawyer . Holliday Karatinos Law Firm, PLLC. Retrieved October 2, 2022, from https://www.helpinginjuredpeople.com/personal-injury-attorney/motor-vehicle-collisions/car-accident-lawyer/car-accident-facts-and-statistics/  

Nebel-Schwalm. (n.d.). Comprehensive clinical psychology . ScienceDirect. Retrieved October 2, 2022, from https://www.sciencedirect.com/science/referenceworks/9780128222324  

Pest, P. (2019, April 18). How many people die each year from Spider Bites? the answer may shock you. Pest Control Everything. Retrieved October 2, 2022, from https://pestcontroleverything.com/blogs/everything-pest-control-resource-guide/how-many-people-die-each-year-from-spider-bites-the-answer-may-shock-you Links to an external site.

Wani, A. L., Ara, A., & Bhat, S. A. (2014). Blood injury and injection phobia: the neglected one. Behavioural neurology , 2014 , 471340. https://doi.org/10.1155/2014/471340