Treatment of Fears and Phobias

I have used fear of cicadas (cicada phobia) as an example phobia for this article.  Generally speaking, the treatment of phobias are addressed in much the same manner regardless of what you might be afraid of.


Explanation of Phobias

A phobia is an irrational, overblown fear that causes the person to go to ridiculous lengths to avoid the fear and may cause them to think about the topic incessantly.

How Phobias Originate in People’s Minds

A phobia originates when something scary happens around an event and the person’s brain assigns undue importance to making sure it does not happen again.  An example we might all understand would be a phobia of getting in a car after a severe auto accident.  A phobia of something less rational (like fear of cicadas) is more likely to start in childhood when a child’s flawed perspective is used to decide how much of a threat something is.  It’s pretty easy to see a five-year-old being startled by a huge buzzing cicada diving right at them!  Children also learn from their parents – so if mom or dad is unduly scared of cicadas (or anything else) the child may accept their assessment that such should be feared.

Fears can also generalize – that is, if someone is already afraid of something similar (say spiders or hummingbirds), it becomes easier to fear similar (like cicadas).

Fears can also grow with time for multiple reasons.  So say someone starts with a mild fear of cicadas.  Every time they have a bad experience with a cicada this just reinforces how bad cicadas are.  After a time they are only looking for bad experiences.  Without the phobia it’s possible they might have had a good experience with cicadas – like noticing how neat they look or developing a sense of awe and wonder at the swarm outside their window.  With a phobia, everything is filtered through the fear, and the person is just going to keep having more and more bad experiences that deepen the phobia.

Anxiety is about the future.  One strategy for preventing bad future occurrences is to work out ahead of time how to avoid them.  But that which you focus on becomes your reality and your habit.  So if you spend too much time rehearsing all the bad cicada events that could happen to you, you can get in the habit of thinking of little else, and even deepen your fear in advance of any cicadas even being around yet.

This growing level of fear can result in more and more fear for less and less reason.  For example, I am writing this article in the Spring of 2013.  This year cicadas are expected in parts of Washington DC, Virginia, and southern Maryland.  Very few are expected near Baltimore.  But interest in (and fear of) cicadas is higher than it might be in Baltimore right now due to the mere mention of them being nearby.

How it’s treated

(Some of this is copied from my blog)

Usually through exposure therapy and systematic desensitization.  In exposure therapy the client is first taught a method of relaxation or controlling their fear (breathing, a visualization, etc.) and then they are exposed to the fear.  This could be through “flooding” if the client is ready/able to face the full fear.  I usually utilize systematic Desensitization — This involves very gradual exposure to forms of the phobia starting with the less severe and working up to the more severe.  The therapist and client together develop a rating scale from 1 (least severe) to 10 (most severe) of scary events.  So — for cicadas — a 1 might be talking about them, a 3 might be seeing a black and white photo of a cicada, a 5 might be hearing a tape recording or YouTube recording of their buzzing, a 7 might be watching them swarm outside from the safety of a window, and a 10 might be walking through crunching bodies and having them land on you.  If the therapist proceeds too quickly up this scale the client is of course going to head for the door… so communication is key.  Coupled with this scale is a form of relaxation — usually meditation or guided visualization.  So you might learn a relaxation technique, look at the black and white picture, then relax again.  This would be repeated until looking at the picture is sufficiently not scary to be able to move a notch up the scale.

I also utilize NLP & hypnosis techniques — A number of Neuro-Linguistic Programming (NLP) and hypnotic methods can be helpful.  One technique I utilize is to relax the client, “distance” them from the experience (like watching themselves sitting in a theatre watching a fuzzy black and white movie), and then do things to the feared image in the “movie” to mess-up its ability to be scary.  We can also go back in time in a light hypnotic trance to a scary memory — but this time go in confident as an empowered adult, and say aloud or do things you wish you could have done originally.  A new understanding of the memory and its meaning can be found.  Another is an “anchoring” technique – the client practices going back to a useful time – say when they felt strong and fearless.  They practice an “anchor” that reminds them of this fearless strong feeling (a word, a visualization, a rock in their pocket to squeeze, etc.).  When facing the phobia, they invoke this anchor to bring in the fearless strong feeling to help cancel the fear.

Other techniques are possible, such as looking at how irrational thoughts (“The cicadas will suffocate me!”) might lead to overblow fear (Cognitive Behavioral Therapy).  General regular use of relaxation skills might also be a good strategy.