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Mental wellness

December 23, 2013

Facing down your fear: New ways to treat phobias

The heart-pounding fear of a phobia can have a severe impact on your life. But new treatment approaches may cure you in as little as one visit.

Do you keep putting off having your blood tested? Or avoid travelling to countries with large, hairy spiders? If so, you're in good company. It's estimated that between 6.2% and 8% of Canadians suffer from specific phobias, such as a fear of blood, flying or small spaces.

Vancouver-based therapist Megan Sutherland is one of the lucky ones; her phobia is quite manageable. "I've had a phobia about chickens since childhood but being a city girl, I never run into them," she says. "I don't feel compelled to do anything about it."

But Sutherland's patients aren't in the same position. For many people who are exposed daily to situations or animals that trigger their fears, day-to-day living can be anxiety-filled and challenging. They need techniques and treatments to help them cope.

Phobias are a form of anxiety

According to the Canadian Mental Health Association, phobias are irrational, severe reactions to situations or things that usually aren't harmful. A type of anxiety, they can cause:

  • A racing, pounding heart
  • A sensation of shortness of breath
  • Dizziness
  • Nausea
  • Trembling
  • Feeling faint

"For most phobias, people have a panic reaction," says Dr. Martin Antony, a professor of psychology at Ryerson University in Toronto and author of The Anti-Anxiety Workbook. "The individual interprets the situation as dangerous," he says.

Generally, if the phobia-triggering event can be avoided, symptoms can usually be managed. But in more serious cases, phobic people may begin to avoid situations where they may encounter the object they fear, have increasing episodes of anxiety, become more isolated and be unable to travel or work.

Antony says blood and needle phobias are quite common. Other prevalent phobias include:

  • Animal phobias, such as a fear of snakes, spiders or birds
  • Flying
  • Being in a small space (claustrophobia)
  • Driving
  • Heights
  • Being in public places (agoraphobia)

Although these phobias are the most common, it's actually possible to have a phobia about almost anything, such as a fear of children, bare feet or vomiting.

Phobias are very curable

"Phobias are very treatable, particularly if the person is motivated to receive help and to follow the recommended therapy," says Sutherland.  "Even though this is very doable, this is no small feat as there is typically homework involved which needs to be applied on a consistent basis, for best results."

Sutherland treats her phobic patients with exposure therapy conducted in a controlled setting and performed by a psychologist trained in cognitive behavioural therapy, coupled with relaxation therapy. Their homework involves gradual exposure to books and images of the feared object, "For example, if the person has a fear of dogs, the first step might be looking a cartoon pictures of dogs which are obviously not as realistic, moving to photographs of dogs, looking at a dog from across the street and after perhaps many more steps in between, petting a dog," she says.

While people can try to desensitize themselves using Sutherland's technique, the most effect therapeutic treatment helps the person to understand how thoughts and behaviours influence negative emotions such as fear, says Antony.

"Once-a-day exposure works better than once-a-week exposure," says Antony, with gradually longer sessions being optimal. The idea is that the person becomes more and more familiar and comfortable with the object or situation triggering the phobia, until fear has decreased to a manageable level. "There are hundreds of evidence-based studies on [the effectiveness of] exposure," he says.

He says that some phobias can be treated in as little as one session. "A single session of two to three hours can treat an animal phobia in some circumstances," he says. For driving phobias, five to 10 sessions can be curative.

As for the many websites that promise to treat phobias effectively through hypnosis downloads, there are "zero" clinical studies proving their effectiveness in curing phobias, says Antony.

Three tips for dealing with a phobia:

  • Sometimes, you can just leave it alone. “If the phobia is not life-interfering, it may never need to be treated,” says Sutherland.
  • Yoga and meditation can help lower anxiety and reduce the severity of a phobia.
  • Daily exercises, such as staring at a picture of the animal that causes your phobia, can desensitize you over time.

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