Phobia

jft said:

All I read says exposure is the key. Exposure never has worked for my dr, and that is why i question whether the dr makes this phobia a little tougher to bring down. Whatever you do, I would do it now before it expands on you. please let me know how you do. It is funny becasue I used to be a companion/helper for agoraphobics when they were doing exposure. I would fly with them and ride elevators with them all day. No problem. Grab a friend if do exposure. Makes it nicer.
jft

Click to expand...

I couldn't agree more with this -- re: keep facing the phobia or it will feed on itself, grow, and become more debilitating. I know with myself, like anxiety and even DP/DR, these become conditioned and generalized to more and more situations. Then one avoids, and life becomes smaller and smaller.

I don't have any phobias, but my DP/DR/anxiety has limited me more and more, as I avoid situations where it has escalated in the past. In my current group therapy I'm getting another stern dose of what I already know, but am putting into action -- get out, do stuff, regardless. And that is NOT easy. Believe me I know this.

The only thing that bugs me is getting in a plane, but I think it's because of some strange superstition I have that because I traveled so much as a young girl and have been on planes a lot since then that "my number is up", LOL. I'll get on a plane, but I just have to take it on faith that the plane has been serviced and the pilot knows what he/she is doing.

My cousin has a fear of heights and of freeways. For 40 years she has driven to work the LONG way to avoid a freeway. She will NOT drive on a freeway.

Again, exposure, and as early as possible once the phobia appears, seems to be the most effective treatment. It is like with some folks with OCD ... through behavioral therapy we do have the means to conquer some limitations.

My biggest limitation is my fear of my DP/DR/anxiety spiking. And that is my conditioned response. I must force myself to do things. And also, again I learn today -- NO CAFFEINE. ERRRRRR.

sc, I'm astonished that you made it to the 80th floor of the Empire State Building! Wowzer. :shock: Damned impressive!

[quote name="Janine Baker said]A phobia is usually the following: Person A has no real nervous or depressive symptoms...functions very well, seems really normal. EXCEPT - put Person A in a plane (or in high places, or near a spider, etc.) and Person A flips out. THAT is a phobia. The meaning is usually reserved to imply that the overall psychic functioning is strong and sound - but that the person does have some anxiety-based "area" that is expressed in a single way (or one or two ways)...i.e., the phobia.
[/quote]

I agree that the word phobia is dicey and can be misused and miscontstrued, but wanted to respond to the above, taking the example of my cousin again.

Firstly I looked up phobia in the dictionary, LOL. "an irrational persistent fear or dread."

When we get down to semantics, defining this, it is confusing. When I think of a phobia, I think very specifically of say a person who can't go within ten feet of a spider, but then I could also say that sc's walking up 67 flights of stairs to avoid an elevator is a phobia, but is also part of... yes, a constellation of stuff. He has a number of problems, and some phobias are included in that mish mash? I'm not sure.

OK, my cousin though. She is grossly obsese, has always been depressed, but is not anxious. She was in an extremely abusive marriage. She hasn't missed a day of work in I don't know how many years, and has only recently had to take paid sick leave due to her obesity.

However she literally has this ONE funky phobia that seems to have no "source" -- and I can only say it is a phobia, ON TOP of, or ADDED onto her depression and eating disorder. She can't explain it, and says she always had it, since she can recall.

When she visited me in L.A. I drove her over a number of "interchanges", one called "The Four Level" downtown. It is a mighty daunting thing... four levels of freeways stacked one on top of the other. They give me pause when a minor "temblor" strikes.

Anytime we got on any freeway (flat or leveled), she was hyperventilating and anxious and clinging to the car door as though she might fall out and plummet to her death -- I think that's the fear as far as she can express it. When we got off the freeway onto the (more dangerous!) side streets she calmed down. The Porches and Lambourghinis sp? crash every 10 minutes at all the intersections in Beverly Hills... seriously.

When we got to that "Four Level" she let out a scream -- nearly caused me to run into somebody. There are also a number of HUGE overpasses that curve ... cloverleaf things ... near the airport. They go WAAAAAY up into the sky... say as tall as a building -- 30 stories or more? She'd start screaming.

Well, after a few of those episodes, I found myself avoiding every freeway in L.A., which isn't easy to do. It's a helluva thing. But it was too upsetting to my cousin, and two nerve-wracking for me to deal with the screaming... more of a yelling on a roller coaster type thing.

So in that case, I can say that my cousin has this ONE phobia, very specific, of dying? by falling from a height and/or dying on a freeway -- in no particular fashion. She doesn't even talk about dying in a crash.

Then I with 8 million problems, I have no phobias. Really none.

The biggest word that gets confused here I think is agoraphobia. Our DP/DR is horrifying and it keeps us indoors. We avoid shopping malls, or just going outside because the symptoms of the DP/DR are so miserable. We would go outdoors, etc. if we weren't DP/DR.

The agoraphobic doesn't have DP/DR necessarily. (I suppose they could) But let's say he/she doesn't. They literally fear a crowd. Agoraphobia is very specific. It means "Fear of the marketplace."

I don't know what I'm carrying on about, but I seem to find that again, we are all amazingly unique. I have DP/DR, GAD, some Borderline Traits, and have NO PHOBIAS. Go figure.

It's true, we have to separate out the wheat from the chaff ... what our key problems are and work on those -- with therapy, meds, CBT, whatever works.

The point, I've lost it. I have come to believe from my current work in DBT, that many illnesses .... the severity can be LESSENED... suffering can be lessened ... by using every coping skill at your command.

This doesn't eliminate therapy, meds, dealing with issues, etc.

Simple phobias.... I think one either lives with them, or faces them head on. Or makes due. My cousin has NEVER driven the freeway in 40 years, and only got on it the few times I took her on it in L.A. And that's the end of it.

Go figure.
We're all unique.
Forgive the ramble. :shock:

Oh my, RESEARCH ATTACK, but I wanted to understand this better. In a way we're all correct, but there are various types of phobias which are more or less severe, and all fall under the category of anxiety disorders.

http://www.merck.com/mrkshared/CVMH...om&word=phobia&domain=www.merck.com#hl_anchor

"The Merck Manual of Diagnosis and Therapy
Section 15. Psychiatric Disorders
Chapter 187. Anxiety Disorders
Topics
[General]
Panic Attacks And Panic Disorder
Phobic Disorders
Obsessive-Compulsive Disorder
Posttraumatic Stress Disorder
Acute Stress Disorder
Generalized Anxiety Disorder
Anxiety Due To A Physical Disorder Or A Substance

Phobic Disorders -- General Description

Disorders involving persistent, unrealistic, yet intense anxiety
that, unlike the free-floating anxiety of panic disorder, is
attached to external situations or stimuli.
Persons who have a phobia avoid such situations or stimuli or
endure them only with great distress. But they retain insight and
recognize the excessiveness of their anxiety."

IT IS NOTED THERE ARE THREE MAIN TYPES OF PHOBIC DISORDERS

1. Agoraphobia
2. Specific Phobias
3. Social Phobia

And you need to read the whole section of the Merck Manual to understand the specific, sometimes subtle differences. CBT/exposure seem to be the most effective treatment in some. Meds are recommended in other cases, etc. I only put in portions of the text.

"AGORAPHOBIA
Anxiety about or avoidance of being trapped in situations or places
with no way to escape easily if panic develops.
Agoraphobia is more common than panic disorder. It affects 3.8% of
women and 1.8% of men during any 6-mo period. Peak age of onset is
the early 20s; first appearance after age 40 is unusual..........

SPECIFIC PHOBIAS
Clinically significant anxiety induced by exposure to a specific
situation or object, often resulting in avoidance.
Specific phobias are the most common anxiety disorders but are
often less troubling than other anxiety disorders. They affect 7%
of women and 4.3% of men during any 6-mo period.

Symptoms and Signs
Some specific phobias cause little inconvenience--eg, fear of
snakes in a city dweller, unless he is asked to hike in an area
where snakes live. However, some phobias interfere severely with
functioning--eg, fear of closed places, such as elevators, in a
person who must work on an upper floor of a skyscraper.
Some specific phobias (eg, of animals, the dark, or strangers)
begin early in life, and many disappear later without treatment.

Others (eg, of storms, water, heights, flying, or enclosed places)
typically develop later in life. Phobia of blood, injections, or
injury occurs to some degree in at least 5% of the population.
Persons with this phobia, unlike those with other phobias or
anxiety disorders, can actually faint, because an excessive
vasovagal reflex produces bradycardia and orthostatic hypotension.
Many persons with anxiety disorders hyperventilate and feel faint
because of changes in their blood gas levels, but those who
hyperventilate virtually never faint............

SOCIAL PHOBIA
Clinically significant anxiety induced by exposure to certain
social or performance situations, often resulting in avoidance.

Humans are social animals, and their ability to relate comfortably
in social situations affects many important aspects of their lives,
including family, education, work, leisure, dating, and mating.

Social phobias affect 1.7% of women and 1.3% of men during any 6-mo
period. However, more recent epidemiologic studies suggest a
substantially higher lifetime prevalence of about 13%. Men are more
likely than women to have the most severe form of social anxiety,
avoidant personality disorder (see Ch. 191)........."