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Monday, June 4, 2001

Phobia is an irrational fear triggered by close encounter

By ALYCE KLEIN | News-Journal Correspondent

DAYTONA BEACH — Navigating daily life can become virtually impossible for people with irrational fears, or phobias.

"Jane," as we will call her, dreaded the start of every school day. From the time she got on the school bus in the morning, her heart would pound and she felt like she was going to be sick. For the first few hours of classes, she barely talked to anyone.

Phobias are defined as a specific fear that is excessive or unreasonable and one cued by the presence or anticipation of a specific object or situation (e.g., snakes, flying, heights, spiders, public speaking). And they are much more common than many people realize.

Jane, for example, is one of more than 50 million Americans who have suffered from school phobia (scolionophobia). It began in her teens and became so severe that she temporarily dropped out. When she was finally diagnosed, it took several months of therapy and a few trials of different psychiatric medications before she was able to return to school.

"A phobia is an irrational fear, and most people can name their main fear," explained licensed marriage and family therapist, Diane Zeidwig of Daytona Beach. "You usually know when a fear is irrationally based, and when it seriously interferes in your life."

For a person with a phobia, the exposure to an object or situation causes a reaction that goes beyond simple fear or rationality. The phobic person usually experiences a panic attack and the fear of imminent death when exposed to a certain object or situation. Children often react to their specific phobias by crying, throwing a tantrum, freezing or clinging.

Studies have shown that a phobia can be generalized to other objects and situations. A snake phobia may progress to a morbid fear of all objects remotely resembling the shape of a snake, such as ropes or garden hoses.

If the phobic situation cannot be avoided, it is typically endured with great distress and anxiety. It may render a person helpless and housebound.

"Joe," a writer, became so agoraphobic (fear of being placed in social situations from which escape might be hard or in which he may suffer a panic attack), that he did not leave his home for over a year.

"I ordered my food in, read a lot, watched television and wrote," he explained. "I was so afraid of leaving my house that it took more than a year before I sought help."

After moving to California and enduring a serious earthquake, Joe's sister, "Ann," likewise was afraid to leave her house.

"My doctor prescribed an antidepressant. Within a month of taking the medication and undergoing therapy, I began going out again -- for short amounts of time at first -- and, after a few months, I felt free."

A true phobic reaction involves the body's fight-or-flight response. Sweating, a racing heart, and difficulty breathing along with an overwhelming need to flee may occur in the face of the feared object.

The origin of the phobic reaction may be traced back to its ancient programming. The instincts that once helped us survive among animals, places, and things that were dangerous trigger reflexive impulses that tell us to run. These instincts are still in place in the paralimbic region (which controls primal responses such as anger and sexual arousal) of our brains. These instincts are there to help us survive.

Phobias are not always instinctual, however. Experts agree that they can be learned. When parents consistently express a grave fear of heights or flying, it is not uncommon for children to have the same fear.

"We can develop phobias from other peoples phobias," explained Karen Weiss, a psychologist who practices in DeLand.

Some scientists claim that there is a genetic or inherited component to phobias, and that this is how the predisposition is passed on. Others claim that it is a combination of genetics and learning that sets a person up for irrational fear. Either way, it is estimated that 40 percent of people suffering from a phobia have at least one phobic parerom avoidance.

In order to conquer the phobia, therefore, she recommends exposure or desensitization therapy. This can be done through virtual reality, visualization, and an actual physical experience. Sometimes medications, used in combination with therapy, are prescribed by the physician.

"The worst thing you can do with a phobia is avoid it," Zeidwig said. "One way to reverse it is to go back and try to make a new association. Begin by placing a positive pleasant experience along with the phobic object or situation."

Weiss and Zeidwig first teach their patients a relaxation procedure, in order to help them regain control over their heart rate, breathing, their body and mind. They have the patient visualize the phobia while in a relaxed state. The patient imagines touching it, being near it, and, while awake, looks at and possibly holds a picture of the phobic object.

Therapists monitor how severe their patient's anxiety is while the person is going through the desensitization process. The person uses a 0 for no anxiety to 10 for the worst possible anxiety. Without professional guidance through this process, it can be traumatic and there is there is less of a chance for success.

Education is another important part of desensitization, said Weiss. If the person fears spiders and snakes, it is good to learn more about them to dispel any irrational beliefs. She helps the patient learn what is dangerous and what is not. For a person with a phobia of dogs, Weiss said, she teaches them how dogs are trained, how to communicate with a dog, and how to recognize if the dog is going to be aggressive.

Experts agree that by educating people, they feel more in control, thereby helping them to feel less out of control when exposed to their phobia.

"Phobias are usually one of the easiest anxiety disorders to correct, depending on the severity," Zeidwig said. "I have seen a lot of success with a short duration of therapy. You cannot always determine what the original trauma was, so the therapy is based on the here and now."

For further information about phobias and available treatments, visit the Anxiety disorders Association of America online at www.adaa.org or call (301) 231-9350. For a current list of all types of phobias, visit phobialist.com.

Check symptoms - Not sure if you have an actual phobia?

Here's a list of common symptoms experienced when a person encounters the source of his or her phobia:

-- The body's fight-or-flight response kicks in.
-- Heavy sweating.
-- A racing heart.
-- Difficulty breathing.
-- An overwhelming need to flee may occur.

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