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Anxiety: Part II - Treating (arachno)phobia

Can you remember the first time that you flew in an airplane? How about the first time that you drove a car? Or what about the first day of your job? These events all have at least two things in common. By using the word “first” in my descriptions, I have hinted that they were once novel experiences, things that you had never done before. And the other commonality is that they provoked at least some degree of anxiety. As I mentioned last week, anxiety is a perfectly normal response to situations that make you feel vulnerable or lacking in control over your environment. Your personal experience with these situations can either increase (or perpetuate) your level of anxiety or, conversely, reduce your discomfort when confronted with the same or similar situations in the future. I should hope that your second day on the job was less anxiety-provoking than your first day, your second month less anxiety-provoking than your first month, and so on and so forth. As we learn what to expect and how to minimize the possible risks, mistakes, and disruptions that could occur in our environment, that knowledge instills in us a sense of mastery and control.

While most people report having a fear or multiple fears (e.g. spiders, enclosed spaces, flying in an airplane), those fears do not usually turn into true phobias. Phobias are accompanied by severe symptoms of anxiety that interfere with a person’s normal life. Furthermore, someone who has a phobia realizes that his or her fear is excessive or unreasonable, but will avoid that situation/object/creature nonetheless. For instance, someone who has a fear of spiders (i.e. arachnophobia) may avoid visiting parks or nature preserves with his or her children, refuse to enter the home of a close relative who has cobwebs in the corners, or experience tunnel vision if he or she spots a daddy longlegs from across the room. It is possible that this person has never even suffered from a serious spider bite! Yet somehow, the association between a spider and this intense fear response was still learned. And guess what? It can be unlearned too.

There are effective ways to treat phobias but, just like it took you anywhere from a few lessons to a few months to feel comfortable behind the wheel of a car, it will take multiple sessions with a psychotherapist to reduce or eliminate your phobia as well. So rather than speaking in generalizations, I will walk you through a typical intervention plan- CliffsNotes version. The first step involves learning and practicing breathing and muscle relaxation techniques that will help you rein in your body’s natural fight-or-flight reaction. We’d then create what is known as a fear hierarchy, which involves your personal ranking of situations that trigger mild feelings of anxiety all the way up to debilitating fear or panic. For example: You might start by viewing a magnified photo of a spider, to watching a film about spiders, to studying a spider from a distance, to touching a spider-less web, and, finally, to sitting next to a web with a spider in it. Each of these situations is ultimately paired with an assignment to be discussed in further detail during your sessions. Know that you would be taking each step towards overcoming your phobia gradually, and with assistance through the breathing and relaxation techniques that were previously learned. Last, any thoughts and beliefs that might arise to stand in the way of your progress are explored and, if needed, other strategies (e.g. distraction techniques, consideration of medication) are employed.

It sounds simple, right? Well, probably not so simple if you happen to be someone with a phobia. The idea of exposing yourself to the very thing that terrifies you the most probably makes you want to turn tail and run. This technique does, indeed, require a good amount of courage and perseverance. However, exposure therapy (imagined and/or in real life) has been proven to be quite effective! No matter how nervous you were during your first flight, I bet that most of you reading this now barely break a sweat when boarding a plane to travel home for the holidays. That is, unless you associate your home with heated political debates at the dinner table, flying glassware, and one or more people storming out in tears. But that’s another issue…

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