Is fear of Trump the phobia of phobias?

I don’t like heights. I’m okay on ladders but as soon as the visible distance between me and terra firma exceeds 150 feet or so, anxiety kicks in. Infamously, Mrs H was obliged to climb the Eiffel Tower on her own, as I literally froze, knuckles white with fear, clenching the ironwork of the Parisian landmark.

A phobia of stairs is referred to as either climacophobia or bathmophobia. When President Trump held Theresa May's hand as they walked down a ramp during their first White House meeting, Downing Street officials claimed the president's phobia of stairs and slopes led him to grab the prime minister's hand.

Last year we witnessed a "Killer Clowns" epidemic. Pranksters dressed as terrifying clowns would jump out from behind bushes, startling passersby and occasionally giving chase as those with a specific fear of clowns triggered a primitive fight or flight response. Johnny Depp is one such coulrophobia sufferer. "It's impossible, thanks to their painted-on smiles, to distinguish if they are happy or if they are about to bite your face off," he has said of his intense fear of clowns.

Specific phobias

Specific phobias such as my fear of heights are quite common. Arachnophobia stalks chez Houston, with all female family members afflicted to some degree. At its worst, even images of spiders trigger anxiety while the sight of an actual spider walking rapidly along a wall or ceiling is shriek-inducing.

Specific phobias are an overwhelming and unreasonable fear of objects or situations that pose little real danger but provoke anxiety and avoidance. Unlike the brief anxiety you may feel when giving a speech or sitting an examination, specific phobias are long lasting, cause intense physical and psychological reactions, and may affect your ability to function normally at work or in social settings.

Phobias are among the most common anxiety disorders. Claustrophobia, for example, affects 5-7 per cent of people.

Despite an awareness that your fears are unreasonable or exaggerated, you feel powerless to control them. The anxiety worsens as the situation or object gets closer to you in time or physical proximity. It causes you difficulty in functioning normally as physical reactions such as sweating, rapid heartbeat, tight chest or difficulty breathing kick in. You may feel nauseated and may even faint.

Genetic link

There is considerable scientific debate about the cause of phobias. Could there be a genetic link between your own specific phobia and the phobia or anxiety of your parents? Is it triggered by the environment or a learned behaviour?

Twin studies allow researchers to find out how genes affect behaviour. One study looked at the responses of twins to “fear-relevant” images (spiders, snakes) compared with benign images. Statistical analysis of the results revealed that genetic influences were “substantial”, which suggests arachnophobia is inheritable. So you need not necessarily experience spiders to be fearful of them.

Treatment

The best treatments for specific phobias are exposure therapy and cognitive behavioural therapy (CBT). Understanding the cause of a phobia is less important than focusing on how to treat the avoidance behaviour that has developed over time. The principal goal of treatment is to improve quality of life so that you’re no longer limited by your phobia.

Exposure therapy focuses on changing your response to the object or situation that you fear. For example, if you’re afraid of lifts, your therapist will get you to progress from simply thinking about getting into a lift, to looking at pictures of lifts, to going near a lift, to stepping into one. Next, you’ll take a one-floor trip, then several floors, before progressing to a trip in a crowded lift.

CBT involves exposure combined with learning to develop a sense of mastery and confidence with your thoughts and feelings rather than feeling overwhelmed by them.

Meanwhile, could a bathmophobic and xenophobic US president trigger a worldwide epidemic of Trump-phobia? As an acrophobic I wouldn’t bet against it.