Phobia therapy onlineStop building your life around a fear.

The NHS describes a phobia as an overwhelming and debilitating fear of an object, place, situation, feeling or animal, more pronounced than ordinary fear and often leading people to organise their lives around avoiding what they fear¹. Common specific phobias include:

• Animals: dogs, spiders, snakes, insects, birds.
• The natural environment: heights, water, storms, the dark.
• Blood, injections and medical procedures, sometimes with fainting.
• Situations: flying, lifts, tunnels, bridges, driving, enclosed spaces.
• Others: vomiting, choking, loud noises.

Social anxiety, the fear of being judged by others, and agoraphobia, fear of situations where escape might be difficult, are more complex phobias that usually need broader work. See our social anxiety therapy page.

Phobias are very common. According to US national survey data, an estimated 9.1% of adults experienced a specific phobia in the past year and 12.5% at some point in their lives². Cross-national data from the World Mental Health Surveys confirm that specific phobia is common worldwide, typically begins early in life, and that only a minority of people with it receive any treatment⁵.

Phobias can follow a frightening experience, but they can also be learned by watching others or by hearing repeatedly that something is dangerous. Research on childhood fears shows that threatening verbal information alone can increase fear of something⁶. Many people cannot remember how their phobia started, and that is fine; treatment does not depend on finding the origin.

What keeps a phobia going is avoidance. Every time you avoid or escape, anxiety drops and your brain records this as proof that the situation was dangerous. Because you never stay long enough to discover that the feared outcome does not happen, or that you can cope even if you feel very anxious, the fear stays intact.

Exposure-based therapy, meaning a planned and gradual approach to the feared situation, is the preferred treatment for specific phobia. A 2022 meta-analysis of exposure studies including 1,758 participants found large effects for both single-session and multi-session exposure, with no significant difference between them at post-treatment or follow-up³. Contemporary research focuses on inhibitory learning: designing exposure so that your expectations are tested and updated, rather than simply waiting for anxiety to fade⁴. Virtual reality exposure has also been studied as an alternative to real-life exposure for some phobias⁷.

Our therapists work in an integrative, evidence-informed way. For phobias, sessions usually include:

• Understanding your fear: what exactly you expect to happen, and what you do to stay safe.
• Building a ladder of steps from least to most frightening, agreed together.
• Gradual exposure, starting with imagination, pictures or videos during online sessions and moving to real-life practice between sessions.
• Testing predictions, using techniques from cognitive behavioural therapy where helpful: what did you expect, and what actually happened?
• Dropping safety behaviours step by step, so that confidence belongs to you rather than to the crutch.
• Specific skills where needed, for example applied tension for people who faint at the sight of blood or needles.

You always decide the pace. Good exposure is challenging but never forced.

Consider therapy if a fear:

• has lasted for months and feels out of proportion;
• leads you to avoid travel, medical care, work opportunities or social events;
• causes intense distress or panic;
• is affecting the people around you, for example family holidays.

If avoiding medical procedures, such as blood tests or vaccinations, is putting your health at risk, it is worth seeking help sooner. We are happy to work alongside your doctor where that helps.