Once the fear has been triggered the physical reaction can lead to a cycle of distress. The body responds to any naturally stressful situation by tensing up. This helps the person perform better. However if the reaction is misinterpreted and excessive this can lead to unnecessarily high levels of tension and symptoms of phobia are often evident..

Although a sufferer may realise that the muscular pain and breathing difficulties they are experiencing are merely a response to stress; if the bodily reaction is extreme enough it may give rise to a fear of the symptoms of phobia: a fear of the fear. Anticipation of this discomfort, the fear of chest pain or hyperventilation can produce the stress that triggers these symptoms.

Some of the physical symptoms of phobia include:

• shaking/trembling
• sweating excessively
• nausea
• dizziness
• hyperventilation
• chest pain
• freezing

As fear levels increase, the mental processes intensify and distort and symptoms of phobia also incresase. A phobic person will overestimate the danger they are in and underestimate their ability to cope. For example someone with a fear of driving will overestimate the dangers of road travel while underestimating their own driving ability. In this way they may lose all sense of perspective. They expect disaster to be the only outcome. This is called catastrophising.

Some of the common mental processes associated with phobia include:

• catastrophising
• ignoring the positive
• exaggerating
• over generalizing
• looking for disaster
• thinking in all or nothing terms