Phobia Treatment | Carolina Anxiety and OCD Therapy

Therapy for Specific Fears with Julia Markovich, LCSW – Raleigh, NC

Phobias are intense fears of specific things or situations that feel out of proportion to the actual threat. Most people have fears, but a phobia tends to cause avoidance, physical symptoms (like racing heart, nausea, or dizziness), and distress that interferes with everyday life.

These fears can feel irrational—but your nervous system doesn’t see it that way. It’s reacting as if you're in real danger, even when you're not. That’s where therapy can help: by retraining those responses and helping you face fear in a more manageable way.

Phobias can focus on just about anything, but here are a few I see most often in therapy:

• Fear of Flying (aviophobia): Avoiding air travel due to fear of crashing, loss of control, or panic mid-flight.
• Animal Phobias: Dogs, spiders, snakes, or insects—these fears often start early but can persist into adulthood.
• Medical or Needle Phobia: Strong fear around shots, blood draws, or medical settings, often triggering fainting or panic.
• Claustrophobia: Fear of enclosed spaces like elevators, tunnels, or small rooms.
• Social Phobia: Fear of being judged or embarrassed in public. This might look like avoiding speaking up, eating in front of others, or attending social events.
• Agoraphobia: Fear of being in situations where escape might feel difficult—like crowds, open spaces, or leaving home.
• Emetophobia: Intense fear of vomiting (yourself or others), which can lead to food avoidance or health anxiety.

Phobias may seem specific, but they often show up with similar physical and emotional symptoms, like panic, sweating, shaking, or a strong urge to flee.

In therapy, we’ll work together to reduce the power these fears have over your life. I use a mix of approaches depending on your needs and comfort level, including:

• Cognitive Behavioral Therapy (CBT) – to understand and reframe fear-based thoughts.
• Exposure Therapy – done slowly and collaboratively, so you can face fears without being overwhelmed.
• Mindfulness & ACT (Acceptance and Commitment Therapy) – to help you respond more flexibly to anxiety and discomfort.
• DBT Skills – when emotional regulation or distress tolerance need extra support.

It’s not about “just getting over it.” It’s about helping your brain and body learn that you’re safe—through real experience, not force or pressure.