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About Anxiety Disorders
Phobias
A phobia is an extreme, irrational fear of a particular thing or situation. People with phobias realize the fear is irrational. However, because even the thought of facing the feared object or situation brings on severe anxiety, the feared stimulus is avoided. Avoiding only intensifies the fear, since the way to get over fears is to face them down. Thus, the more it is avoided, the more fearful the stimulus becomes.
No one knows just what causes phobias, but more than 1 in 10 people are known to have a phobia. Psychodynamic theories hold that phobias are the manifestation of an unconscious conflict ????? Behavior theories posit that the feared stimulus is paired with a traumatic event, and conditioning occurs???? Phobias seem to run in families. They often first appear in adolescence or adulthood. About 20 percent of adult phobias vanish on their own. Childhood phobias usually, but not always, disappear over time. Specific Phobias
Typically, people develop specific phobias about heights, flying, closed-in places, elevators, dogs, going over bridges, blood, or water. A phobia can subtly or dramatically alter one’s life.
“I can’t bring myself to drive over a bridge. When I have tried, it was a dreadful feeling. I felt panicked. My heart was pounding, my mind closed down… I only wanted to get off that bridge. I couldn’t distract myself or have a conversation. Now, I won’t try at all. I just won’t do it. I can’t tell you exactly what frightens me about going over a bridge… nothing realistic… and I know it’s silly to be afraid… But I just can’t do it. When I drove to New York from Maine, I got out a map and found all the bridges on the route. I plotted alternate routes that avoided bridges, even though it took hours longer to get to my destination.”
If the feared stimulus is avoidable, it may not seem necessary to seek treatment for the fear. Instead, an individual may make adjustments in her or his life, such as in the preceding case example of bridge phobia; and the phobia may cause little, or only occasional impairment in quality of life. Likewise, someone with an elevator phobia may simply take the stairs. Sometimes, important career or personal decisions are made to avoid a phobic situation. For example, a bridge phobic may not move to San Francisco; an elevator phobic would not work in the Empire State Building. An agoraphobic may find excuses not to leave home.
In some cases, a feared object or situation is not so easy to plan a life around, and in fact, makes exceedingly difficult what for most of us are only mildly anxiety-producing situations. An example would be social phobia, which is discussed later.
Treatment
Approximately 3 out of 4 people with a specific phobia can be helped with a kind of cognitive-behavioral therapy called desensitization therapy, in which patients are exposed to the frightening stimulus in very gradual phases, until it can be tolerated. Relaxation techniques are also helpful in reducing anxiety symptoms.
There is no proven drug treatment to cure phobias. Medication is sometimes prescribed to help an individual face a feared stimulus, such as flying. |
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Contact Dr. Barton: |
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Geraldine T. Barton, Ph.D. Phone: 845-338-3250 159 Green Street Email: drgmbarton@drgmbarton.com Kingston, NY 12401 |
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Clinical Psychologist |
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Geraldine Merola Barton, Ph.D. |