Confronting the Demon-so-Called Phobias!



``Man is distressed, not by events, but by his view of these events.`` Epictetus (Greek Philosopher)

INTRODUCTION:

Phobias, from the original Greek word φοβος(fovos) is described by many authors to be ``a fear of any specified type of object, stimulus or situation.`` Other resources also add ``an unreasonable persistent fear of a particular thing`` or ill excessive fear of objects, ideas, behaviour expressed through neurotics manifestations``or simply ``anxious fears``.

The following characteristics: ill, compulsive, non reasonable, neurotic and lack of courage stresses,in my opinion, a strongly bias and negative interpretation of and individual's fear.

Anxiety is a low self-esteem related illness. Phobias can be described to be the sisters of anxiety.

TRADITIONAL VISIONS OR INTERPRETATIONS OF PHOBIAS:

A better understanding of society’s attitude towards fears through time and history will help us position ourselves for a better understanding of its triggers, signs and symptoms.

Back in history, phobias were interpretated as supernatural manifestations – they were considered tested evil possessions by a divinity or an illness similar to generalized anxiety disorder and panic disorder.

Generalized Anxiety Disorder

In the XIX century Psychology Science evolved … so did the understanding of phobias. Some psychiatrists explained phobias to be repressed sexual conflicts and phobias was the subconscious defensive mechanism. The excessive fear was considered the means by which an individual – unconsciously – avoided the problem and protected his personal ego. It was not until the mid-twentieth century before we recognized that there could be biological and environmental factors responsible for those strong emotional feelings.

An individual suffering of phobias develops a hypersensitive reaction to his surrounding environment. For example, any sounds, critics, odours or objects can awake the inner alarming reaction and trigger the individual to search for the source of danger.

Emotional stress experimented by the pregnant mother, for example, could also be felt by the foetus. For that reason, some fears such as, animal fears can be genetic.

Whether biological or environmental, the fear is excessive and no matter the efforts to confront them, the individual senses the feeling of paralysis, of shame and humiliation replacing his feeling of serenity. The greater the source of fear, the greater his overwhelming feeling of losing control.

Ex.; If you suffer of agoraphobia (public places) or social phobia (surrounded by crowds) the impact of this fear will be much greater on your life than the fear of arachnophobia or snakes.

We all experienced fear in our life, at one time or another. As a child, anything from approaching farm animals, strangers or sleeping in the dark where a few examples of fear. I still vividly remember a nightmare I use to have – as a child – not long after I first started grade school – in kindergarten. In my dream, I vividly remember the fear of rejection - when at the end of the class – I was left alone in the school yard – waiting for my parents to come and pick me up as promised. What stroked me was the isolated desert into which was build the school; there was no traffic, no houses…only a school in the desert and myself – desperately waiting for my parents to come and the feeling of rejection. Not only did this nightmare illustrate the emotional shock and repressed anxiety felt from having to leave home (from an overprotecting mother)to meet total estranged individuals (such as my first teacher and classmates) for the first time. As a matter of fact, my mother used to share with me that for a whole week, I would escape from school to return home; she had to walk me back to school – until my father got upset and insisted that I would return to school - on my own...that was the end of my escapes!

If you pay attention to your own irrational fears and try to unravel the source of them, you might discover similar roots in your own life. The purpose of this exercise consists not of accusing guardians and educators – they did the best that they could – but to pinpoint the origin (whenever possible) of our fears – whether the cause might be upbringing, environmental or of genetic sources.

Understanding helps us to acknowledge – and acknowledgement of our fears is the first step towards healing. I mentioned it in our first encounters and I mention it again…! No, I haven’t forgotten... this is the primordial therapeutic attitude we must develop in order to instigate renewal into any mid-life concerns … acknowledgement and positive thinking.

How do I explain my persisting fear?

I know it’s excessive, yet no matter my efforts, I give in; am I weak or coward? I feel like there’s something wrong with me…

Depending on the severity of your phobia and the impact it has on your life, these fears affect your perception or self as well as your trust in your abilities.

The difficult challenges surrounding phobias are the instigating reasons that trigger them; these reasons are rational and logical to you but might not be the case for others. That is when the feeling of shame, humiliation or the feeling of lack of courage may take place…

Example: If you suffer of claustrophobia, the fear of dark, narrow spaces, the fear of being locked in with no way out or of suffocating …not being heard or seen in your distress is logical to you. If you have lived such an experience in the pass, this makes it worse. The less control you feel you have over the situation, the higher the anxiety. Picture this scene in a small restroom on a plane at 5000 feet of altitude! Your imagination begins to go wild!

Confronting such fears requires good will and courage. The last thing you need to do is to be self-judgemental and hard on your self as those fears are not immaterial or in your mind! There are biological triggers to this… You are not responsible for those fears – so don’t blame yourself and more over, don’t let anyone judge you in any kind of way. Have your friends, family or siblings respect you for who you are – which includes your limits!

We all have fears, so who are we to pinpoint and judge? I have an uncle, for example who is afraid of spiders... as for my father, he feared snakes. My mother feared mice, rats and cold blooded animals and so do I…. I present these examples to illustrate that some phobias are genetically transmitted. Genetics and environmental factors explain the origin of our phobias and impact the emotional, psychological and behavioural elements of our human nature.

Any situation of fear will create an emotional oppressive sensation in our body; psychologically we experiment the fearing situation as being a dangerous or menacing one; consequently, we feel unable to do anything else other than checking for a possibility of flight as we want nothing else but to escape the dangerous situation.

In therapy, we learn to confront these situations progressively, in order to control it. We will elaborate this a little further in our therapeutic approaches to phobias. For now let’s pursue our understanding of fear as we will discover the progressive categories of fears identified below:

  • timidity
  • performance
  • phobias

    These fears can range from simple shyness to panic attacks. They fear other people’s look or judgements (…about themselves as a person or about their behaviour). The focus of their attention is on themselves as an individual rather than on the social situation per say. This type of anxiety will mostly be felt in:

    i) Situations of performance – where the individual has to make conferential presentations, read a text in public etc…

    ii) Situations of observation - in a case where the candidate is observed for the purpose of professional evaluation or any other time he is doing something. The candidate will also feel anxiety when feeling observed.

    iii) Situations of self-affirmation – where the individual needs to defend his/her rights, give an opinion, express personal needs, and/or negotiate prices.

    iv) Situations of personal revelation – where the candidate must reveal himself more intimately in individual get-to-know presentations. For some people this might be intimidating – particularly if they experiment unemployment, an illness such as depression or simply because they are single.

    v) Interactive situations – around a coffee machine for example, where the conversations are superficial; the individuals fear being judged or evaluated on whatever they say or do and how they say and do. Silence periods can be a source of anxiety particularly when you fear your subject of conversation to be boring or you fear not giving a positive self-impression. Sometimes the person doesn’t feel like being a non-interesting person and has nothing interesting to communicate. The feeling of shame can influence our social interactions particularly when we felt unable to confront our challenges.

    Ex.: Finishing a presentation…The person fears being blamed or intimidated.

    In many of those identified case-scenarios one big issue involved here is low self-esteem; the individual as the impression of losing credibility and value in front of others and therefore as a consequence he chooses to withdraw… if he doesn’t do it, he feels like doing so in order to isolate himself.

    Such situations are common and normal… we all went through this at one time or another… just remember our first classroom oral presentations we had to prepare as a student. Another example is the job interview… When anxiety emotionally paralyses – unabling you to perform duties, we must than consider this anxiety as a serious issue your must confront…

    b) Performance - stage-freight

    It is common for artists to feel anxiety before going on stage (stage-freight) but this anxiety falls not long after they begin their artistic performance. I quote Nana Mouskouri from her Farewell French book:``Mémoires: La fille de la Chauve-souris`` published in 2007 and offered by her as a gift of gratitude to her fans. I translate her descriptive stage-freight agony when she performed at the Olympia in 1967 and earned her artistic recognition in France:

    ``I would like to describe this moment of agony – I cannot find any other word – this moment of agony just before my appearance on stage, on this first Olympia - October 26, 1967 performance!

    I am in my dressing room, and… by moments, I believe my heart feels like it’s going to break - so much it’s pounding! I look in the mirror instinctively – my brown hair, my square glasses; I look at this lady dressed in this red caftan…I feel anaesthetic. What are we doing here, both of us,(Nana is six months pregnant.) in this room of disorder? Am I still alive or am I dead? In a fraction of second, this important performance re-appears before my eyes, like the sensation of a fist punching my chest I am back to reality again!

    In an hour…in 45 minutes… Oh! no, never, will I have the strength….Sometimes the seconds fly rapidly…``My God``..., I whisper silently to myself, it isn’t possible … five minutes have passed by already, is the clock to fast by any chance…sometimes I feel the time is never ending…Serge Lama confessed to me one day: ``When I saw you heading towards the stage the director of the Olympia at your side, I had the impression of seeing a lamb heading towards the slaughter – that was how much you looked anxious! ``The author continues…``than we appear on stage… music finally I hear the music pulling me out of this stage-freight making me forget all these preceding painful hours I just lived…and like the heavens opening their gates to send me wings of support, I begin to sing Adieu Angelina.`` (Farewell Angelina written by Bob Dylan and translated in French)

    According to Christophe André the author of ``Psychologie de la peur – craintes, angoisses et phobies`` timidity is another social fear. Timidity is another form of social fear related to low self-esteem concerns. The individual lacks self-appreciation and therefore judges himself negatively. Consequently, he compares himself negatively in front of others and fears situations of failure, of criticism. This timidity limits his ability to risk any challenge therefore limits his ability to socially change and grow. Individuals feeling timidity must take initiatives to overcome their issues and must learn to self-affirm with calm. The first times overcoming this issue is challenging. Whether you want to meet new people or simply express your desires or feelings assertively and clearly, the fear to look foolish or incompetent is strong but the more the individual confronts the social challenge, eventually the fear decreases. This was a big challenge for me! Whether it was at school surrounded by youths, in social gatherings or even in staff room – trying to maintain a conversation was a concern... It still is a times, but I can appreciate the efforts and the positive outcome of these challenges and so will you if you learn to believe in yourself and in your potential. One element that comes in all these fear-related concerns is the individual’s stress in regards to what he interpretates to be the challenging danger situation. All his attention is focused on this situation creating the physical, emotional, psychological and behavioural reactions we are all familiar with:

  • Racing heart beats
  • Freight or flight reaction
  • Hyperventilation and perspiration
  • Panic
  • Redness in the face
  • These reactions become serious and signs of phobia when these signs are accompanied by the inability to confront them, by the attitude of isolation and depression, by shame and a feeling of failure.

    Phobias

    Phobias are fears you feel unable to confront or control. Any fears whether inmate or experienced are comparable to our body`s allergenic reactions. Our immune system protects us from biological organisms that could be a nuisance to our physical health. Sometimes the system develops a hypersensitive attitude when in contact with an organism (environmental in the most cases) most generally very well tolerated by the general population. For some reason, the body rejects this organism and creates an over-exaggerating pathological reaction against this organism and as an outcome develops the familiar symptoms of hitching, rashes, runny nose and eyes we are all too familiar with…(and also identified to be hypersensitivities).

    Our nervous system also as its respective defensive``immune system`` to protect us from potentially dangerous situations and just like our body towards allergies, our brain will develop similar reactions to biological, upbringing or environmental situations; he will activate emergency alarm signals of fight or flight warnings to us. When over-activated this system reacts like a faulty alarm system sending faulty warnings. Just like allergies, phobias could be numerous. Here’s a list of some of the most popular ones; you might recognize some of yours and at the same time learn a little bit of Greek:

  • Agoraphobia (αγοραφοβια) (fear of open spaces)

    Agora phobia

    We can describe the agora phobia in four words: ``fear of being afraid``. For someone who does not experiment this fear, it might sound a little strange but would it help you if I tell you that agora phobia are, in the most cases, directly or indirectly implicated with the fear or anxiety of having panic attacks in public places where they cannot escape? They prefer not to leave their homes. Statistics demonstrates that 22% of Americans may be suffering of this type of phobia.

    This fear often develops itself with a first-time unexpected panic attack – either in a mall, driving over a bridge or in a tunnel. The effect of this panic attack is such that you simply want to avoid any possibility of panic attack re-occurrence and to feel safe you simply avoid that particular area or situation. In a long term basis, this withdrawal becomes a vicious circle and eventually you reach a point where you feel unable to leave the house - the isolation eventually becomes part of your everyday life. The more you nourish this vicious circle behavioural response it becomes more and more a challenge to socialize and this is where low self-esteem comes in as you begin to depreciate yourself for feeling unable to confront these fears and you fear other peoples reactions. In most extreme scenarios people become depressed. The more you fear, the more you avoid and the more you avoid, the harder it becomes to confront it.

    Fear of Flying

  • aerodromophobia fear of flights
  • Acarophobia – fear of insect stings
  • Acluophobia – fear of the dark
  • Acrophobia – fear of heights
  • Algilophobia - fear of pain
  • Arachnophobia – fear of spiders
  • Benelophobia – fear of pins and needles

  • Bronte phobia - fear of thunder
  • Claustrophobia – fear of enclosed or confined places
  • Cremnophobia – fear of abyss
  • Cynophobia - fear of dogs
  • Hematophobia - fear of blood
  • Keno phobia – fear of deep empty spaces
  • Koniphobia – fear of dust
  • Nosophobia – fear of being sick
  • Ornithophobia – fear of birds
  • Pontikophobia – fear of mice
  • Thalassaphobia – fear of the sea
  • Xenophobia – fear of strangers
  • Zoophobia – fear of animals

    If reading this list you developed a fear of Greek words than chances are you need helenophobic therapy!

    In our last presentation we mentioned the strong emotionally-social effects of panic disorder…agora phobia was identified to be one of the symptoms. Let us now discover more fully the signs and symptoms of this anxiety related illness.

  • Social phobia – fear of crowds

    Social phobia

    Social phobia is agora phobia’s twin sister. As you might have seen in the first description, agora phobia and social phobia are public-related types of fears. The symptoms are similar to shyness or timidity but the level of anxiety does not reach the extent of isolation or withdrawal to avoid the conflicting issue. Individuals with social phobias ``might not be shy at all; they may feel completely at ease with people most of the time, but particular situations, such as walking down an aisle in public or making a speech can give them intense anxiety. Social phobia disrupts normal life, interfering with career or social relationships.``

    An individual with social phobia will feel intimated by his vulnerability to:

  • blush
  • to shake
  • to perspirate
  • by not presenting himself intelligent and cultivated

    Depression and alcoholism are also social-phobia related concerns…individuals can no longer bear the pain of shame, isolation and social failure. You can now begin to understand how these phobias have a much more devastating impact on your life than any genetic or environmental fears – without underestimating the impact of these last phobias. How to confront those atrocious fears?

    Phobic pathological reactions

    Behavioural compulsive faulty alarm signal type of behaviour instigated by people with high phobias. These pathological reactions are not will-intended and drain the victims energies leaving the person with a false impression of relief and extends the the fear:

  • Avoiding the feelings, the thoughts and the environmental source of fear creates a momentarily feeling of peace but does not eliminate the fear itself – it only postpones it until the next moment.

  • You reinforce the fear and this cycle continues in a vicious circle.

  • You develop a dependency over the need of avoidance

  • You loose your sense of freedom

  • You no longer observe, admire or contemplate your world environment you inspect it.

  • Fear in case of doubt as it better to fear for nothing rather than fearing too late.

  • They often anticipate the worse and amplify it to protect themselves

  • They drown themselves in sensations of freight

    Therapeutic approaches

    Healing phobias means:

  • Regaining freedom in your thoughts, your emotions and in your movements

  • Learning to confront your fears for the future sake.

  • Taking into consideration the biological dimension of our phobias (Ex.: Do we need medical therapy for a period of time to strengthen our neurological system?)

  • Decrease the emotional symptoms of shame and fear or avoid) Bring the level of fear to a level intensity much more socially acceptable

  • Getting implicated physically, emotionally and intellectually in the cognitive and exposition therapies. The individual must be willing and ready to actively participate fully.

    types of therapy

  • cognitive behavioural therapy
  • exposition therapy
  • medical therapy

    Cognitive therapy

    Cognition means automatic thoughts that come to mind. The purpose of cognitive therapy consists of working on those thoughts: Ex.: If I blush in public, everyone will notice and I will look like a fool. The therapist will help the client to:

  • identify the thought
  • help the client reflect upon the rationality of his thought
  • replace or modify with a positive thought

    The therapist will also depict rationalising avoidance thoughts.For example an individual suffering of claustrophobia says:

    ``I no longer take the lift because it is more healthy-friendly to use the stairs.``The therapist will invite the client to analyse his thoughts and to face the hidden message of fear.

  • behavioural therapy

    This therapeutic approach accentuates the need to work on symptoms and re-educates the client by helping him adapt to his world environment again. To do so the need to establish a confiding relationship with the therapist is a must for positive achievement. The therapists suggest cognitive and behavioural suggestions as well as practical exercises to complete during and in between appointments. The purpose of the therapy is to help the client confront is world of fear with assistance and on his own.

  • exposition therapy

    This therapeutic approach recommends the client to confront his phobic world environment in t a progressive rate of phobic intensity approach.

    (in vivo approach)

    The individual will confront his fears through stages.

  • imagination (thoughts)
  • looking at pictures or virtual presentations.
  • Manipulation
  • Going out into the world and confronting the source of fear with the help of a therapist as well as to evaluate the client’s behaviour.

    The purpose of the exposition therapy is to activate the physical as well as emotional sensations and invite the client to confront to tolerate the anxiety and to learn to control it.

    Ex.: hyperventilation

    The therapist will serve as model to the client and will accomplish whatever requested task expected on behalf of his client. Ex.: practice hyperventilation by climbing stairs - four by four – to develop sensations of heart palpitations, heavy breathing. The client must tolerate symptoms long enough (minimum an hour) or until the anxiety decreases significantly. The therapist evaluates the client’s behaviour and his ability to focus on the source of fear; the client must avoid strategies of distraction – for example: thinking about something else or looking at n something else other than the phobic source.

  • medication

    The success of your therapy depends on your active participation in good will. The more you are implicated in your therapy the sooner the recovery. Medication should not be used as a healing therapy. Tranquilizers may temporarily decrease the fear, the symptoms and its intensity but does not help you to confront them, nor control them – not to mention the dependence you may develop in regards to those medications. The end of the medical therapy will instigate anxiety. Medication will be an obstacle when interfering in the confronting process of exposure therapy. It only helps you to survive on a day to day basis. If you depend on medical treatment, it can become a crutch in your healing process.

    Other therapeutic approaches

    Physical exercises

  • improves the well-being and instigates a favourable emotional effect as it increases the moral level
  • it reproduces the physical symptoms and effects link to fear : heart palpitation, sweating in a healthy- friendly living context helping the client to confront and tame those symptoms rather than avoid them. When they present themselves in phobic environment the client is less to feel anxious.Example of exercises: skipping rope jumping;Climbing stairs 4 by 4;Jogging or rapid walking

    Good nutritional diet

  • Avoid toxic food (high carbohydrates, caffeine)
  • Avoid smoking and alcohol
  • Add vitamin B to your diet

    Learn to relax and to meditate

  • Mid-life-inner-journeyhttp://www.mid-life-renewal.com/Mid-life-and-self-esteem.html
  • good night sleep
  • breathing techniques (from the abdomen)
  • Stress management

    Conclusion

    Fear as always been part of humanity as a defensive reaction towards danger therefore the purpose of any therapy consists not of eliminating all fears. We must learn not to let fear interfere into our life and let it control us.

    The exposition therapeutic approach appears to be harsh on the client when you think of it…but the client needs to learn to sense the symptoms related to his fear, and to discover that they are not as dangerous as he may believe them to be. As the client learns to confront the phobic environment, as he learns to approach it with courage, he progressively reaches the evidence – with the help of his therapist - he learns to restructure these automatic thoughts - the situation is not as dangerous as he thinks it is – in time he will enjoy inner peace and freedom and self control again.

    In our introduction I stressed the descriptive characteristics of phobias some authors have stressed in their definition of phobias. As we approach the end of this encounter, I hope to help you see how society needs to journey further in the better understanding of mental health concerns.

    To judge an individual suffering of agora or social phobia as ill or weak because of lack of courage is not only an example of misunderstanding but also a sign of lack of education; this lack of education about this low self-esteem related illness is of no therapeutic support to clients.

    More public education about mental health related illnesses is needed to overcome this misunderstanding and build a society that will help our clients to better reintegrate and feel safe and cared. As members of our society we all contribute in this matter.

    If this website helps you to better understand yourself or the one you care – victimized by any of these low self-esteem related illnesses, I feel my efforts to be rewarded.


    The Sources:

    Websites

    Hypnose ericksonienne http://hypnose-ericksonienne.e-monsite.con

    Mental Help.Net http://www.mentalhelp.net

    http://www.mid-life-renewal.com/Mid-life-and-self-esteem.html

    Wikipedia.org http://en.wikipedia.org/wiki/Phobia

    Books

    Abrégé du Dictionnaire Grec-Français A. Bailly, Éditions Hachette, 43 Quai de Grenelle, Paris 75905 Copyright 1901 – definition of Phobia

    AMERICAN PSYCHIATRIC ASSOCIATION (1994)4th Edition APA Washington, DC. U.S.A.

    ANXIETY, PHOBIAS & PANIC – A step by step Program for Requiring Control of your Life, by Reneau Z. Peurifoy, M.A, M.F.T. Warnes Books, 1271 Avenue of Amercias New York, NY 10020

    FUNK & WAGNALLS STANDARD DESK DICTIONARY – Deluxe Edition Copyright 1980 by Lippincott & Crowell, Publishers 1977 definition of Phobia

    MÉMOIRES – La fille de la Chauve-souris, Nana Mouskouri, Éditions XO © 2007 p. 235-237

    PETIT ROBERT 1 – Éditions Firmin-Didot S.A.Copyright © France 1981 – definition of Phobia

    Psychologie de la peur – craintes, angoisses et phobies – Éditions Odile Jacob, 15 rue Soufflot, 75005 Paris August 2004

    Psychologie – science de l`homme by Robert J. Trotter & James V. McConnell, Les Éditions HRW Ltée, Montreal, Quebec Copyright © 1980