One of the most common psychological disorders is specific phobia; however, it is not necessarily disabling because people who suffer from it tend to avoid what frightens them, or it is difficult for them to find it in their usual environment. However, not all phobic stimuli can be easily avoided.

In this article we will analyze the fear of water, also known as hydrophobia or aquaphobia . We will explain what it is, what its causes are and how to apply live exposure, the most effective treatment for specific phobias, in the case of hydrophobia.

What is hydrophobia?

Hydrophobia or aquaphobia is a specific type of phobia , that is, an anxiety disorder in which exposure to a specific stimulus causes intense fear and discomfort that induces the person to avoid and escape from the situation. In this case, the object of the fear is water.

Within the specific phobias we find the environmental or natural subtype ; hydrophobia can be included within this category, together with fear of heights (acrophobia), of darkness (nictophobia) or of storms (astraphobia).

People with hydrophobia have different symptoms related to water avoidance. Most commonly, they are afraid of drowning while swimming , but they may also avoid drinking fluids or showering and bathing to avoid water, especially if the phobia is very irrational.

Thus, fear of water can interfere in the lives of those who suffer from it in many ways. For example, people with hydrophobia who do not shower may have hygiene and social problems, and those who avoid drinking water may suffer from dehydration, which causes tiredness, pain and heart failure.

Most commonly, fear of water appears in childhood and recedes spontaneously as the child grows older. However, if the fear is very intense or persistent (and therefore meets the diagnostic criteria of the specific phobia) it is advisable to consult a specialist, since phobias tend to worsen over time.

Causes of fear of water

Psychology has offered many hypotheses about the causes of specific phobias. Currently, behavioural and cognitive-behavioural models predominate, although the evolutionary perspective has also made relevant contributions in this field.

Seligman’s theory of preparation states that, as our species evolved, humans consolidated through inheritance biological predispositions to associate certain stimuli and responses because these favoured our survival.

In the case of hydrophobia, fear of water could have prevented deaths mainly from drowning. Today many people would retain this “prepared association” to a greater or lesser extent, which would partly explain the different degrees of hydrophobia.

Whether there is a biological preparation or not, during our life we can associate by means of classical conditioning fear with any stimulus through anxious experiences. Moreover, if exposure does not occur, these fears are intensified by negative reinforcement, as stated in Mowrer’s two-factor model.

However, it is also possible to acquire a phobia without a direct negative experience, but rather through observation or transmission of information . For example, a girl or boy might start to be afraid of water after seeing a person drowning in a movie or hearing a similar story.

Rabies and hydrophobia

It is very common for fear of water to appear in the advanced stages of rabies because the pharyngeal spasms characteristic of this disease cause pain when swallowing. In fact, the word “hydrophobia” is sometimes used as an alternative name for this disease.

Rabies is a viral disease that affects all mammals. It causes an inflammation of the brain (encephalitis) that eventually kills the affected animal or person. Vaccines are now available to prevent and eliminate the rabies virus.

In this case hydrophobia arises as a natural consequence of the physical symptoms of the disease, and therefore has different characteristics from those of psychogenic hydrophobia. The same applies to the fear of water produced by other organic causes.

Treatment of aquaphobia: live exposure

When hydrophobia is due to medical causes, correcting the condition usually makes the symptoms go away. However, if the fear is explained by psychological factors, treatments for specific phobia would be applied, based mainly on the technique of live exposure.

Live exposure consists of staying close to the phobic stimulus (the object of the fear) until the anxiety is reduced. Through this procedure, you learn to manage your anxiety and see that your fears are not fulfilled.

Generally many exposure sessions are necessary : practice by the patient is one of the best predictors of the success of this treatment. Most often, hierarchies of phobic situations are made and progress is made from those that cause a slight fear to those that caused real panic at the beginning of the therapy.

Since most people with hydrophobia are afraid of falling into the water and drowning , the feared situations they should be exposed to are usually related to staying close to the water and swimming, or learning to do so. In cases where the fear is different, such as drowning, the exposure situations may vary.

Those with this phobia are also likely to interpret normal swimming sensations, such as shortness of breath, as signs that their life is in danger. In these cases it may be advisable to use interoceptive exposure to physical sensations to facilitate cognitive restructuring.