Phobia and its treatment. How to reduce fear and anxiety?

Fear is a natural and safe experience, but sometimes it turns into fear. Fortunately, therapists have techniques to tame fear.

Fear and anxiety – what are these feelings?

Psychology distinguishes between the concepts of fear and anxiety used interchangeably in everyday language. Fear is an indispensable feeling for a developed living organism, it enables it to survive and appears only in situations of real danger, so it is a rational experience. Fear is not rational, and it is aroused by something that does not pose a threat. A phobia, then, is a strong, paralyzing fear of a situation or object that should not cause fear.

What causes fear and anxiety?

The list of phobias is virtually endless and browsing through it can be quite fun. There are points such as fear of spiders, dancing, clowns, swallowing, rain, and finally, as the culmination of all fears, the fear of having a phobia … who is afraid of getting wet is no longer a reason to laugh. It should also be remembered that the fear of a specific and specific thing or situation is the so-called specific phobia, but phobic anxiety disorders also include more complex agoraphobia and sociophobia. The former means fear of open space, leaving the house, being among people in public places, and traveling by public transport. Sociophobia, or social phobia, is a huge stress caused by interactions with other people, public speeches and situations in which the sociophobic is exposed to other people’s views or evaluation. Panic that takes hold of a man every time he finds himself in any of the above situations, which, after all, constitute a significant percentage of everyday life, is a problem of a completely different caliber than the fear of a clown. How to deal with it?

Therapy helps tame fear and anxiety

The methods of therapy, especially of specific phobias, can be divided into two main groups. The first consists of behavioral techniques that focus on teaching the patient to cope with the anxiety triggering factor and to eliminate the feeling of fear. Psychoanalysis is in the second group. It also presupposes finding the cause of a strong fear. In other words, it will be important for a psychoanalyst that when his patient was three years old, while on vacation in Darłówek, he was chased by an aggressive ratler from the manager of the holiday center and from now on he is afraid of dogs, for a therapist – a behaviorist it will be important that the same patient who thirty years later, he had just returned from a vacation in Crete, he didn’t panic every time he saw a dog.

Desensitization and Immersion – Behavioral Techniques

The main behavioral techniques are desensitization (desensitization), flooding and implosive therapy.

Desensitization is a gradual and adapted to the patient’s ability to confront him with an object that causes fear. The patient can only imagine an object that scares him, e.g. a spider, if he suffers from fear of a spider – arachnophobia, observe him in photos or in films, and during therapy, also associate with a live spider.

The condition for carrying out flooding, i.e. immersion, is the use of a real object. This is a higher level of initiation and imagination is not enough. Doctor Alicja Rutkowska-Suchorska, a specialist psychiatrist and certified psychotherapist, stipulates that flooding requires the patient’s trust in the therapist and compliance with his recommendations, assuming, of course, that the phobia concerns such objects or situations that do not pose a threat.

Implosive therapy

Compared to immersion, implosive therapy is throwing the patient into deep water: confronting the patient with a panic-inducing situation and maintaining a constant feeling of anxiety in order to reduce the anxiety and ultimately eliminate it. This is according to the reinforcement theory: ignored behavior disappears, which in practice means that if a spider walks around the patient during the entire treatment session, but otherwise nothing is wrong, the phobic comes to the conclusion that there is nothing to be afraid of.

Doctor Alicja Rutkowska-Suchorska, who considers behavioral methods the most effective in the treatment of phobias, explains:

– In therapy, I prefer gradual desensitization, which, admittedly, takes longer and requires patience from both the patient and the therapist, but at the same time allows me to achieve tiny successes in each session, which strengthens motivation. However, for example, with a patient who is afraid of dirt and bacteria, I flooding and rummaging together in my office waste bin. An implosive version of this therapy would be to drop him from a helicopter right in the middle of a garbage dump.

Avoidance, Breathing – How to Stop Fear and Anxiety?

In addition to all these methods, which are to lead the patient to believe that he himself decides about making a harmless situation scary, relaxation techniques are also used, e.g. breathing control or developing behaviors that facilitate survival in a stressful situation, e.g. not looking down on a mountain trip ( in fear of heights) or avoiding the view of the audience by choosing a fulcrum for the sight above the heads of the audience (in fear of public speaking).

In the case of sociophobia, behavioral techniques primarily reduce the fear of social exposure, Master the ways of dealing with anxiety (e.g., distract from it) and teach the patient that other people are not as interested in it as he or she imagines. With complex and severe phobias, especially social phobia, apart from psychotherapy, pharmacological treatment is also used.

In the optimistic version, desensitizing a simple specific phobia, e.g. fear of elevator driving, takes from a few to a dozen or so sessions and leads to the complete elimination of fear symptoms. A success in the treatment of complex phobias, e.g. social phobias, is the mere improvement of the patient’s quality of life, and the therapy may take several months or even years.

According to what criteria is the therapy selected for a specific case?

Doctor Alicja Rutkowska – Suchorska says:

– I think that apart from the type of phobia and the patient’s individual characteristics, the type of therapy also depends on the nature of the therapist. Some people prefer to heal slowly and gently, others quickly and radically. Regardless of the method, both succeed and fail.

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