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BANISH YOUR PHOBIAS

Phobias are obsessive, inadequate emotional experienes o! spei!i !ears !elt b" the

sub#et in a de!inite $phobi% situation and aompanied b" dis!untions&

Phobias are observed in neuroses, ps"hoses and or'ani brain diseases&

In neuroti Phobias, patients are 'enerall" a(are that their !ears are un!ounded, and

ta)e them !or morbid and sub#etivel" tormentin' experienes the" are unable to

ontrol&

Ps"holo'ists distin'uish nosophobia $!ear o! ontratin' some disease, sa" aner,

heart disease, and so on%, soiphobia $!ear or appearin' in publi, !ear o! blushin'

et&%, !ear o! spae, laustrophobia $!ear o! losed premises%, a'rophobia $!ear o! open

spae%, and so on&

I! a patient !ails to sho( distintl" ritial understandin' that his !ears are un!ounded

and unreasonable, then all the above*mentioned states (ould more o!ten not be

phobias but doubts&

Phobias involve spei!i behavioural mani!estations desi'ned to avoid their ob#et, or

to redue !ear b" per!ormin' obsessive, ritualised ations&

Neuroti phobias, in (hih the neuroti (ould unonsiousl" +hide !rom some

insoluble on!lit, usuall" arise in people (ith ima'inable thin)in' and, at the same

time, some(hat inert and unstable& In most ases, the" are overome a!ter expert

ps"hotherapeuti treatment&

A phobia is an irrational !ear& It ma" mani!est as !ear o! spei!i animate or inanimate

ob#et, suh as !ear o! sna)es- !ear o! a de!ined 'roup or lass o! people $xenophobia%

impendin' or antiipated ourrenes astrophobia or a !ear o! virtuall" an"thin' else

that one an ima'ine&

Ob#etive assessment o! an" !ear is open to debate& But t(o riteria, di!!erentiate

phobias !rom rational, non*neuroti !ears& .irst, phobias have an obsessive nature& A

phobi individual is o!ten ompelled to d(ell on the !eared thin' !or more than is

neessar" under the ob#etive irumstanes&

Phobia thin)in' ma" ta)e the !orm o! !antasies, suh as one !antasi/in' about his or

her !uneral or ima'inin' over and over (hat the d"in' moment (ill be li)e&

0harateristiall", these t"pes o! phobi !antasies ombine !ear (ith a sense o!

!asination, almost pleasure, as ima'es o! the ob#et or senarios o! the event ause a

trepidation and tremblin' muh as one mi'ht experiene on a sar" amusement ride&1he !antas" itsel! ma" produe a sense o! +relie! in that it allo(s momentar" master"

over the !ear!ulness&

A seond harateristi that di!!erentiates a phobia !rom a realisti !ear the (a" in

(hih anxiet" is handled& A phobia produes so hi'h level o! anxiet" that it is

immobili/in', preventin' the person !rom ation in a (a" that ould prove e!!etive in

reduin' the anxiet"&

2hereas, rational !ear (ill !requentl" preipitate behaviours desi'ned to protet one

!rom a dan'er, phobias o!ten plae their vitims in more dan'er, either b" temporaril"

paral"sin' them in a a(e*stru) inativit", or b" ompellin' them to on!ront the

dan'er in an unprodutive manner&

.or example, a person (ith a normal !ear o! s(immin' in the oean mi'ht learn to

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beome 'ood s(immer as a protetion a'ainst the surprises o! tides and under*

urrents&

A person (ith a phobi !ear, on the other hand, mi'ht not learn to s(im at all and, in a

dan'erous situation near (ater, mi'ht pani and dro(n, immobili/ed b" anxiet"&

1here is o!ten a mar'inal line bet(een a rational !ear, anxiet", and a phobia& A person

su!!erin' !rom 'eneral anxiet" and malaise ma" be unable to do an"thin', ma" be

listless, lethar'i, unable to at or ma)e deisions (ithout exhibitin' a spei!i phobia&

One ma", in other (ords, be phobi to(ard li!e itsel!, dreadin' ever"thin' !rom the

mundane to the unusual&

Althou'h this is more ommonl" re!erred to as anxiet" h"steria, in man" (a"s it

parallels the phobi reation& 2hat delineates the dia'nosti riterion bet(een a phobi

!ear and 'enerali/ed anxiet" is not al(a"s a'reed upon, but seems to depend on the

onreteness o! the !eared ob#et or event&

1here is no sin'le explanation o! phobias& It is 'enerall" a'reed, ho(ever, that somephobias ma" have diret events preedin' their onset and others ma" not& .or

example, a person au'ht in a terrible hotel !ire ma" develop o! ase o! $p"rophobia%

!ear o! !ire, but o! the hundreds o! people trapped in the hotel at the same time, the

ma#orit" (ill not beome phobi&

1his is alled the traumati event, and ma" or ma" not be vie(ed as the diret ause

o! the phobia&

1hree hie! models o! phobia are the ps"hoanal"ti, the behavioural, and the

o'nitive&

.reud3s !amous ase o! 4ittle Hans $5657% o!!ers his most detailed disussion o! phobia&

Hans had developed a !ear o! lar'e animals, espeiall" horses, soon a!ter (itnessin' a

lar'e horse !allin'& Anal"sis o! the hild3s unonsious, b" .reud and the bo"3s !ather,

revealed the auses o! the phobia involved astration anxiet", Oedipal (ishes a'ainst

his !ather, and a''ressive*eroti !antasies about his parents&

1hese !ears (ere ountered b" the de!enes o! repression, displaement, and

pro#etion8(hereb" Hans !or'ot his traumati memories, sa( the horse as his !ather

$displaement% and ima'ined that the horse (anted to hurt him&

1his spetrum o! linial insi'hts8!rom ps"hoanal"sis, lassial onditionin',

modellin', and operand onditionin' theor"8eluidates throu'h a behavioural lens the

question o! (hat auses a phobia in the person3s o'nitions (ith learnin' paradi'ms&

1he o'nitive behavioural explanation vie(s thin)in' as a mediatin' proess bet(een

stimulus and response& A phobia develops (hen the individual3s thin)in' results indistortions, that ause ertain t"pes o! inappropriate responses $ombinin' anxiet" and

!ear (ith avoidane behaviour% to (hat are reall" non*dan'erous stimuli&

1he o'nitive*d"nami vie( o! phobia, represented b" Albert 9llis3 Rational*9motive

1herap" $R91%, extends this !urther b" dissetin' and lari!"in' the thin)in' proesses

involved in the distortion& In 'ro(in' up, 9llis su''ests, (e are tau'ht to thin) and !eel

ertain onnetions about oursel!, others and thin's in the (orld& 0onnetions that are

assoiated (ith the idea o! +1his is 'ood ar'ues 9llis, beome positive human

emotions, suh as love or #o", (hile those assoiated (ith the idea that +1his is bad

beome ne'ative emotions, oloured (ith pain!ul, an'r", or depressive !eelin's&

1hrou'h a atharsis8a sudden emotionall" har'ed !reein' o! the repressed8thepatient an overome the phobia and reover& .reud also su''ested that patients

su!!erin' !rom phobia should be exposed diretl" to the !eared ob#et, somethin' that

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is entral to ontemporar" behaviour therapies&

Solutions

:e*sensitisation is a !orm o! onditionin' in (hih anxiet"*evo)in' stimuli are paired

(ith inhibitor" response either throu'h ima'ination or in real*li!e situations&

1his method as)s the patient to disuss in details the omponents o! his or her !ear,

(ith the 'oal o! onstrutin' a list o! anxiet"*evo)in' !ators in order o! intensit"&

1hese stimuli are then dealt (ith one at a time, in order, until the one that evo)es the

most anxiet" is no lon'er apable o! 'eneratin' anxiet"&

.or example, let us sa" a patient has a !ear o! drivin' a ar& A hierarh" ma" be

onstruted o! $5% 'ettin' into the ar, $;% startin' the en'ine, $% pullin' out o! the par)in' spot, and so on&

9ver" time the patient thin)s o! the urrent item in the hierarh", he or she is related

and made to !eel om!ortable b" the therapist& 1hen, the next item, more anxiet"*

evo)in', an be introdued and desensitised& Ultimatel", the stimulus $the phobi*

related thou'ht% (ill !ail to eliit the anxiet" it one did&

+.loodin' is a modi!ied !orm o! onditionin'& .loodin' +is a method o! treatin'

phobias b" rapid exposure in real li!e to the !eared ob#et or situation, maintainin'

maximum tolerable anxiet" until it be'ins to diminish, then ontinuin' loser and

loser exposure until the patient or lient is om!ortable in the situation (hih (as

previousl" !eared&

2hile it is onsidered a rapid method, and e!!etive, at least in the short term, it does

expose the patient to hi'h levels o! anxiet", levels that some onsider too hi'h,

possibl" dan'erous&

1he proess o! rational*emotive therap" is harateri/ed b" the therapist3s

ommuniation $o!ten hi'hl" dramati% to the patient o! the distortions in his or her

thin)in'& 1his is muh li)e a teahin' tehnique and is, in !at, 'eared to(ard helpin'

the patient learn about ho( illo'ial thin)in' leads to illo'ial and phobi behaviour

patterns&

All !our methods8ps"hoanal"sis, s"stemati desensitisation, implosive therap", and

rational, emotive therap"8laim hi'h rates o! ure& 9mpirial evidene tends to

support this, at least inso!ar as omparison (ith disorders suh as depression and

shi/ophrenia are onerned&