A patient mentions avoiding certain situations out of fear. Before revealing the answer, decide how you would explore whether this is a phobia.

Establish whether the fear is consistently and specifically triggered by a particular object, activity, or situation, since this specificity is central to the concept. Ask directly whether the patient recognises the fear as excessive or irrational relative to the actual danger posed, even though she cannot control it, since this preserved insight is a key distinguishing feature from a delusional fear. Explore the extent of avoidance behaviour and how much it restricts day-to-day activity, since this depends heavily on how common the trigger is in everyday life. Ask about the degree of disproportion between the fear and the actual danger, since a phobic fear is by definition out of keeping with the real risk involved.