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Stop your Phobia in its tracks!

September 8, 2009


Phobia I

Originally uploaded by Daffnet

If you frequently feel intense irrational amounts of panic or anxiety in “seemingly harmless situations” and the need to escape to alleviate the physical symptoms you may be developing a phobia. Usually this leads to a strong desire to avoid these situations and a laundry list of behaviors that may look something like any combination of these:

• You may find yourself making excuses to skip out on taking the elevator or subway. You may suddenly find you prefer to take the local bus rather than the express train.

• You may find yourself preferring not to fly on long flights or during the evening. You may start avoiding visiting friends who live on high floors or work above a certain level.

• You may find yourself feeling angrier in traffic, even avoiding tunnel or bridge routes or particular highways.

• You may find that you don’t enjoy sporting events or music concerts as you once did. Or now when you attend the theater, your first job is to notice all of the exit signs. You may opt to sit in the aisle or purposely arrive late at meetings so you can sit close to the door.

• You may avoid one-on-one meetings or limit dates to specific situations or places where you feel comfortable. You may find yourself “feeling unsafe” outside of your home or neighborhood.

• You may find yourself leaving parties early or being able to cope with making small talk only after consuming a few alcoholic beverages. You may find yourself becoming less verbal in group-settings where you know a smaller percentage of the people, or making fewer requests for simple things as your anxiety worsens.

Your Body Has Memory!
Phobias can develop for a number of reasons such as modeled behavior from a parent, the result of a traumatic event or a biological predisposition, but commonly it is a conditioned response that maintains and worsens the problem.

A conditioned response is a learned automatic (physiological) response that is connected to the situation. So your body activates a knee jerk reaction ticking off an automatic nervous system response, which acts as an alarm warning you of danger.

The alarm response is neurological sympathetic arousal and looks something like this: increased heart rate, constriction of muscles, sweaty palms, shortness of breath, pins and needs in the fingers or toes, butterflies in the stomach, headache or clenched jaws or fists.

FALSE ALARM!
Only, in the phobic scenario, the danger is not real so the alarm is a false alarm and one THAT YOU SHOULD COME TO EXPECT.

This is an important point to grasp, and the essence of the cognitive therapy work I do with clients who experience phobias.

As one of my clients writes me shortly after flying to Africa after 3 weeks of hard work with me:

“While walking down the aisle and entering the plane, I had doubts about being able to do it. But the concept that you told me about it being my body lying to me, kept me going with minimal problems, just a few tears. Once seated the nervousness went away almost entirely, and there was rarely bad feelings. Other than that I was perfectly fine, and about 45 minutes into the flight I slept. When I woke up there was an hour left in the flight.

I now have no worries about making the flight back, worrying about the boat ride, etc. It all seems to have disappeared upon takeoff. I feel (at the moment, like I could fly anywhere).

Thanks a million. You’re a lifesaver.-DR”

RELAXATION

On the behavior side, practice shutting down the alarm response (sympathetic arousal) by practicing getting into the neurologically opposite position- parasympathetic arousal or simply put a true relaxation response.

Some great techniques to practice are deep diaphragmatic breathing, cardiovascular exercise, transcendental meditation, yoga and incorporating biofeedback.

My clinical specialty relies on a combination of breathing and meditation exercises that include biofeedback training to facilitate the clients’ ability to become neurologically and emotionally relaxed in challenging situations.

FACE YOUR FEAR
Then figure out ways to slowly challenge yourself rather than avoiding situations. Start with small incremental exposures. Staying in the situation will not only give your body an opportunity to learn a new response to the situation, but it will also stop validating to your body that the alarm was a real indication of danger.

REWARD  FOR STAYING NOT ESCAPING
If you are used to leaving a situation to obtain symptom termination, you have been rewarding the behavior with the sense of relief. Learn to reward yourself for staying in the situation so that your body learns to relieve itself and you feel good for challenging your self.

YOU ARE NOT SOLO
Although most people don’t generally talk openly about their phobias, the fact is that they are a very common condition.  It is estimated that over 20 million Americans suffer from a Phobia and more than 40 million Americans suffer from an Anxiety disorder.

So the next time you are putting yourself down for having such a condition, calling yourself “weak”, or feeling embarrassed by potential judgments from on-lookers, do your self a favor, pause for a moment to look around the situation

1. Odds are, you are probably NOT alone in your state of anxiety and others are feeling the same way!

2. Realize most people are too busy dealing with their own lives to
pay attention to your anxiety behavior that closely or really care.

3. Remember that Anxiety disorders are the most common mental problems and that your problem doesn’t need to be faced alone.

More Help

If you are feeling overwhelmed by challenging your anxiety elicit the aid of a professional cognitive behavioral specialist such as myself who can help you with the process.

For more information on the treatment, contact me at DrJayme@ASKtheCBT.com or 212-631-1133.

You can also read more about my methods of   treatment for phobias  and about a study I conducted demonstrating the effective use of Biofeedback and Virtual Reality Therapy in helping people overcome their Fear of Flying.

Treating Fear of Flying Using Biofeedback & Virtual Reality

Treating Fear of Flying Using Biofeedback & Virtual Reality

http://tiny.cc/AsktheCBTFOF

The important thing to realize is that you can work against your phobias and live anxiety free!

Best,
Dr. Jayme 

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5 Comments leave one →
  1. September 8, 2009 12:32 pm

    Hi Jayme,

    Tnx for the article. The People mind and behavior is worth while studying.
    I once noticed 1990´s as an entrepreneur that the sales life have gone while.
    And more wild it game when I noticed that the stress was so enourmously
    that my speaking left some words out from the normal sentence. That was
    the last wake up call – to slow down. And I did that. Change my life path.
    In Finland is not common to see “shrinker” so I did not. But study from the
    medical books what manic and paranoid behaviors are. And with or without
    little drama I felt that can fit in every depress illness in book which I read.

    The human bean is a unique wholeness and universe too. Personally I have
    challenged my mind and body to extream and uncomfortable areas many
    times and I have over come the obstacles every time more humble and learned
    person. The saying: The healthy mind lives in the healthy body . . . is very
    much a icon to me. I try to do health exercise almost daily and I´m eating more
    salad, berries, turkey meat and so on fruits to mention . . . In today´s world it is so easy to be addicted to almost everything . . . friends, coffee, internet, blogging, sex, depending other peoples and so on the list goes on . . .

    Jayme, thanks for the post – all positive to Your daily life : )

    Markku, Finnish Entrepreneur
    but writing English at . . .
    http://idea500.blogspot.com

  2. Jennifer permalink
    September 8, 2009 10:34 pm

    I had my first MRI and though I’d had a sedative, panicked at first but after being pulled out of the machine once due to my anxiety, was able to talk myself through it by thinking of colors and then naming fruits and vegetables that could be found in that color. I’d start to panic a little and I’d simply up my efforts in talking my way through it. I left feeling proud and wondered if I could do it without a sedative (I think it was the sedative talking). I went into the second MRI confident that with the sedative all would be well and that even if the sedative hadn’t kicked in, I’d be able to tolerate the MRI for the time until it did. The moment was in the machine, my heart rate sped up, and as it built and built, I wondered if I was going to cause myself a panic attack (which I’ve never had) by delaying asking to get out. I thought if I stalled that it would be like before, and I’d be able to start to tolerate it. It built and built, though, and finally I yelled out, “I”m panicking” after they’d just tested the speaker. You’d have to know how cooperative I am to know that yelling out was uncharacteristic. They didn’t hear me and started the MRI. My right arm started jumping around on it’s own, like it had a motor in it, which distracted me – I couldn’t control it. All the way through the MRI my arm would start and stop jumping around on its own, for about 5 or 10 minutes at a time. I couldn’t think of words to play any games, though I tried, and the entire time I was in the machine it was hard. There was no triumph getting through it the second time. Now I’m scared to death, and I have an illness that means I’ll be spending a lot of time in MRI machines over my lifetime. Next year alone I’ll be getting 4 MRIs that will last between 2 and 3 hours each. I’d like to get more comfortable in the machine, but my body takes over – even with my eyes covered, my body seems to know I’m in a small space – maybe from the soundproof room(?). Logically it shouldn’t matter because I have no need to get up, but to my body, I feel like I’ve been buried alive. Do you know of anyone who has a method for helping people with MRI’s? or should I just get a better sedative next time? I have no choice as far as a closed MRI. Thanks so much for any help!

    Jennifer

  3. September 9, 2009 9:00 am

    Jennifer your description of your anxiety is MORE ACCURATE than you know

    “but my body takes over – even with my eyes covered, my body seems to know I’m in a small space – maybe from the soundproof room(?). Logically it shouldn’t matter because I have no need to get up, but to my body, I feel like I’ve been buried alive”..

    Yes your body does take over, that is why its not about rational intelligence (there is no need to get up). Your body perceive that its a TRAPPED and its only “thought” is to get you out! THIS IS AN EXAMPLE OF A FALSE ALARM response.

    What you need to do it is follow the advice in the article. Practice PROPER deep diaphragmatic breathing for 15 min a day (See my article on Breathing), focus mentally on the fact that its a “False Alarm” and then practice being in small, closed in spaces, I suggest under your bed. Start with 5 minute intervals and then build from there. Have someone sit with you in the beginning to make it easier. Breath from your diaphragm when you are under there.

    If you need more assistance I would def consult with a mental health professional and/or breathing coach. The key to this is learning how to breath properly and then teaching your body a new response to the situation. Only experience btw your body and the machine can provide that. I am available for consultation appointments in NYC or LA in person or via teleconferences.
    DrJayme@AsktheCbt.com

  4. September 22, 2009 11:48 am

    Jayme – I have shared principles from this article with a number of executive coaching clients – particularly the notion that at times anxiety is your body telling you a lie. They love it. Some have used it to help anxious children as well. My thought – The stories we tell ourselves about our lives BECOME the story of our life. Sometimes you just have to tell yourself a different and more helpful story.

    Anne Perschel, Psychological Advisor to Leaders
    and Business Consultant to Psychologists
    http://www.germaneconsulting.com
    http://www.shrinkbiz.com

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