A Practical Guide to Overcoming Phobias E-Book

Patricia Furness-Smith

• Herausgeber: Icon Books
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 209

Veröffentlichungsjahr: 2014

Beschreibung

Whether you suffer from panic attacks or feelings of crippling dread, Introducing Overcoming Phobias offers proven techniques to help you break down your fears into manageable parts. Psychologist Patricia Furness-Smith teaches the reader to understand their phobias and remove the anxiety surrounding them. STAND UP TO FEAR and increase your self-confidence. UNDERSTAND PANIC ATTACKS so that the symptoms no longer frighten you. CONTROL THE FIGHT OR FLIGHT RESPONSE and free yourself from avoidance behaviours.

Leseprobe

First published in the UK and USA in 2014

by Icon Books Ltd,

Omnibus Business Centre, 39–41 North Road, London N7 9DP

email: [email protected]

www.iconbooks.net

This electronic edition published in the UK in 2014 by Icon Books Ltd

ISBN: 978-184831-725-3 (ePub format)

Text copyright © 2013 Patricia Furness-Smith

The author has asserted her moral rights.

No part of this book may be reproduced in any form, or by any means, without prior permission in writing from the publisher.

Typeset by Marie Doherty

About the Author

Patricia Furness-Smith is an international phobia specialist with a particular interest in Hodophobia, the fear of travelling. For over ten years she has worked as a consultant on British Airways’ ‘Flying with Confidence’ courses where she has helped thousands of sufferers overcome their fear of flying and has recently had published a book on this subject. She is often quoted in the media and has appeared in national newspapers and magazines and on social media sites, radio and television.

Her career includes over twenty years’ experience in lecturing and training in psychology, psychopathology and psychotherapy in further and higher education across a variety of institutions, including prisons and financial establishments. She is a fellow of the Institute for Learning and a Fellow of the Chartered Institute of Educational Assessors. She is also a member of a validation panel for a leading supervision training provider.

Her other specialisms are working with eating disorders and relationship therapy, having been involved in these fields for almost 25 years with leading national and local providers.

She is a Fellow of the National Counselling Society and runs her own practice in Buckinghamshire where she offers individual therapy for all mental health issues, couple therapy and workplace therapeutic services.

Author’s Note

I have changed the names of all the people I have described in case studies. In order to respect privacy and anonymity, I have scrambled some of the personal details and have formed composite characters.

Dedication

I would like to dedicate this book to my extraordinary mother-in-law, Joan Barbara Gilbert (née Rapsey), a veritable legend in her own lifetime, and my dear father-in-law, John Gerald Furness-Smith. I thank them for all the wonderful times we have shared over the past 40 years, their unstinting support, amazing generosity and singular brand of humour. But most of all I am eternally grateful to them for producing their son, Charles, the love of my life.

Contents

Title page

Copyright information

About the Author

Author’s Note

Dedication

Preface

Introduction

SECTION A: Understanding Phobias

1. Phobias and Fear

2. Types of Phobia

3. Social Phobias

4. Agoraphobia

5. Phobias – History, Targets and Causes

6. Phobias – Risk Factors

7. The Brain and Fear

8. Anxiety and Panic Attacks

9. Symptoms of Anxiety/Panic Attack

SECTION B: Overcoming Phobias

10. How to Get Help and the Types of Treatment Available

11. Exposure Therapies

12. Types of Exposure, Flooding and Implosion

13. Cognitive Behavioural Therapy (CBT)

14. Cognitive Distortions

15. My Preferred Approach

16. The 4Rs Paradigm

17. Final Word

Useful Contacts

Acknowledgements

Appendix

Index

Preface

Difficulties are things that show a person what they are.

Epictetus

From as far back as I can remember I have always been intrigued by the human mind. That curiosity has led me into a career where I have been privileged to gain access to the personal experiences of thousands of people. My clients and students, over the past 25 years, have generously and courageously shared with me the deepest and darkest recesses of their minds.

Throughout these many years of exploration I have come to realize that each of us possesses huge reservoirs of untapped resources. One of the joys I experience in my work is that I am able to alert my clients and students to the fact that they all have amazing potential if only they choose to recognize this fact.

In this book I hope to convince you that overcoming life-long limiting phobias is readily achievable, providing you have an open mind, a willingness to learn and the courage to try new ways of thinking and behaving.

Very little of what we think about ourselves is actually based on indisputable solid concrete evidence; so why not elect to have positive and constructive thoughts rather than limiting and debilitating ones. After all, beyond the certainty that everyone reading this book has been born and one day will die – all else is mere speculation.

As we embark upon this adventure into the world of phobias I want you to keep these pre-requisites to change in the forefront of your mind.

In many ways a book entitled Overcoming Phobias might imply that the objective is to return the reader to the status quo, which existed before they became afflicted with the phobia. From my experience, in this field, I can categorically say that this is only half the story. History records endless examples of individuals who have overcome serious personal challenges and afflictions to emerge as stronger, more resilient and resourceful versions of their former selves. Winston Churchill, Helen Keller and Bob Champion are just a few who, through conquering adversity, went on to accomplish incredible achievements.

The wonderful by-product of overcoming a phobia is that it not only releases you from your ‘imprisonment’ but it will imbue you with tremendous inner confidence which will enable you to soar to even higher levels of personal achievement and satisfaction.

In the following chapters I will provide you with the knowledge and information you need to work towards defeating a phobia; but only you can provide the attitudes of determination and openness to put this learning into action. I hope that you accept this invitation to work together to enable you to discover how truly amazing you are.

Introduction

Fear is a tyrant and a despot, more terrible than the rack, more potent than a snake.

Edgar Wallace

A phobia is an intense fear of ‘something’, such as an object or situation, which would not normally worry others. The person with the phobia knows that they are being irrational and that their response is entirely out of proportion to the threat, but feels powerless and unable to control their negative thoughts and bodily sensations.

A phobia is a type of anxiety disorder, which causes people to adjust their lives in order to avoid encountering the feared ‘something’. Phobias range from mild to strong but all are annoying, limiting and frustrating, and some are downright exhausting, debilitating and overwhelmingly terrifying.

Welcome reader to the land of phobias. This terrain is populated with the most diverse range of characters in the mental health field. Phobias are very common in the western world and affect many millions of people. The Royal College of Psychiatrists tells us that as many as one in ten people will suffer from a phobia at some point in their lives.

The actual figure is believed to be significantly higher than this with some sources suggesting that as many as 16 million people suffer from phobias in the UK alone. The reason why we have such a huge discrepancy in these figures is because mental health issues in general are victims of under-reporting, due to the perceived stigma which they attract.

Added to this, phobias by their very nature are irrational fears, therefore frequently cause the sufferer acute shame and embarrassment as well as anxiety and distress. For this reason many people with a phobia do not seek medical help.

Worryingly, evidence shows that the vast majority of people who do eventually seek help for their phobia have endured symptoms for over ten years. Sadly, some sufferers do not even disclose their problems to close family or friends out of fear of being ridiculed or teased, thus rendering them isolated from all avenues of support. The examples below illustrate this point.

Coulrophobia (Fear of Clowns)

Imagine how you would feel if your wife informed you that your young daughter had chosen a visit to the circus, with several of her friends, for her seventh birthday treat. How easy would it be to come clean and tell your family that you can’t accompany them because you have a terror of clowns?

The chances are that you would probably come up with some elaborate excuse to save you from the embarrassment. But as the saying goes ‘liars have to have good memories’ so this ‘white lie’ not only has an energy cost but will also make you feel uncomfortable for not being straight with your loved ones.

Being incongruent, that is, projecting an image which does not tally with how we really feel, becomes an ongoing stressor in our life and inevitably leads to greater anxiety.

Eremikophobia (Fear of Sand)

Your fiancé meets you in the restaurant and presents you with some airline tickets and hotel reservations. He excitedly informs you that he has booked a luxury two-week holiday in the Maldives for your honeymoon in six weeks’ time.

In the flush of romance you ‘omitted’ to mention that you have a phobia of sand! Now what are you going to do? You will have to confront the problem since I am sure that you of all people will not resort to ‘burying your head in the sand’!

A phobia is a type of fear and it can literally be a fear of anything. The key aspect of this type of fear is that the threat is actually non-existent or greatly exaggerated.

Phobias are not always taken seriously by others

Many of us are familiar with people having a fear of spiders, heights or enclosed spaces. But how many people have you met who have a fear of uneven seams or a fear of swallowing? In my work I have met these people, whose lives have not only been blighted by such fears but have also encountered contempt, dismissal or disbelief when they have confided in others about their difficulties.

Those of us with physical illnesses are offered understanding and sympathy, but sadly there is still a long distance to be travelled before mental health problems are afforded the same level of comprehension and compassion. In this book I hope to address this imbalance.

Having a phobia is not your fault and it doesn’t mean you are weak; however, being prepared to challenge your phobia and reclaim your autonomy does mean that you are courageous.

People do not go out and freely acquire a phobia any more than we would expect them to willingly become afflicted with heart problems, skin complaints and other physical illnesses. In this book you won’t find any trite dismissive phrases like ‘it’s just a case of mind over matter’, ‘you’ll be okay’, ‘pull yourself together’, and so forth as a response to how to deal with your phobia.

Who will benefit from reading this book?

You may have picked this book up out of pure curiosity or because you are a general practitioner or therapist and wish to know what treatments are available, in order to help your patients or clients. There is a strong possibility that you yourself may have a phobia or know someone close who is suffering from one. Whoever you are, I am both delighted and excited at the prospect of accompanying you on your journey through this little book.

It is my hope that, by sharing my enthusiasm and experience, you will be empowered to help liberate yourself or others from the stranglehold of phobias. If this book provides you with the information and motivation to decide to address your fears, then I will be hugely gratified.

It should be noted that for some people this book alone might provide sufficient guidance for them to be able to address their phobia and free themselves from its grip. For others it may be advisable to seek the help of a professional to support you through your treatment, in the same way that you would turn to a doctor for help with a physical ailment.

There is no doubt whatsoever that phobias take a great toll on your happiness and limit what you can comfortably do in life but also, and even more damagingly, they can rob you of self-confidence and self-respect. My message to anyone with a phobia is that it must always be challenged. This not only emancipates you from its limitations but more importantly it promotes a sense of autonomy and personal agency which is essential for healthy living.

Always remember that a phobia is a parasite gorging off your life.

For many years I have specialized in phobias and without hesitation I can own to the fact that it is my favourite line of work within my practice. This is for two reasons. Firstly, the sheer diversity of phobias makes them a compelling and fascinating subject for study. But by far and away, the main reason why I love this field of mental health is because of the amazing job satisfaction I derive from working with clients who successfully defeat their phobias.

Phobias are very responsive to treatment

Unlike many other mental health problems, phobias can be brought under manageable control or even totally destroyed, sometimes within hours. This is a far cry from some of the medium- to long-term work which is required for other mental health issues. So the good news is that phobias are relatively easy to deal with, providing you have the correct knowledge, support and treatment plan, along with a determined and proactive attitude.

In life there are many REAL problems, which we all have to contend with, so my view is that we should conserve our energy to tackle those by ridding ourselves of the UNREAL threats, which are the hallmarks of a phobia.

Conquering a phobia not only stems the senseless drain on personal resources but will also create a tremendous confidence boost, by you having faced your fear and emerging triumphant.

Introducing the gremlin

Throughout this book I will be referring to your phobia as the gremlin, which is an imaginary mischievous creature. It seems to be a suitable nickname, since the threat, which causes your phobia, is imaginary too.

Pity the person who acquiesces to domination by the gremlin – is the dog wagging the tail or the tail wagging the dog? I urge you to take the risk to ensure that it is the former and not the latter.

Taking the RISK to change the status quo involves mobilizing the following:

Resilience – be determined and don’t give up until you get there

Initiative – be prepared to try something new

Skills – develop the skills needed to take back control

Knowledge – acquisition of the theory to defeat your anxiety

I am on a mission to purge the population of phobias, as they are cruel fraudsters and imposters that cripple our lives and curtail our freedom to live in accordance with our choices.

What we will cover in the book

In Section A, I will be covering how a phobia is diagnosed and classified, along with the history of phobias, their causes and why some people are more susceptible to developing and maintaining them. We will then explore fear, anxiety, panic attacks and stress, which are all key components of a phobia.

In Section B, I will discuss the various available treatments for phobias and in particular I will look at Exposure Therapy, Cognitive Behavioural Therapy and the 4Rs Paradigm.

SECTION A: Understanding Phobias

1. Phobias and Fear

What is a phobia?

A phobia is a type of fear based on a misdiagnosis of the threat

A phobia is a persistent irrational aversion to something, known as the phobic stimulus or trigger, which the sufferer feels compelled to try to avoid at all costs to prevent them from experiencing an intense anxiety response.

When unpacking this statement we can see that a phobia is an intense fear, which possesses the following characteristics:

It is specific to an object (e.g. statue), creature (e.g. moth), person (e.g. genius), situation (e.g. a job interview), concept (e.g. a number) or action (e.g. dancing)It is irrational, excessive and unreasonable, since the feared ‘something’ does not pose an actual threat to the extent calculated by the sufferer; the adult sufferer is aware of this (some children are not)It is usually a learned response, although some phobias may be hard-wired genetically (e.g. fear of falling or fear of loud noises)Avoidance behaviour is sought by the sufferer, in that they will go to great lengths to contrive ways to not encounter the phobic stimulus, despite it hugely inconveniencing the way that they live their lifeThe fear is persistent – in children this must be for at least six months before it can be diagnosed as a phobiaIf the phobic stimulus is encountered the sufferer will endure intense distress.

However, avoidance is not in the long run a viable option in that it is positively injurious to the sufferer.

Avoidance is like oxygen to a phobia: it is essential to keep it alive and flourishing – while at the same time it will inevitably create a void in your life as you are prevented from following your own wishes and desires. The only way to be liberated to live your life fully is to confront and defeat your phobia.

A phobia is a:

Persistent

Hang Upor

Obstruction that

Blocks an

Individual’sability to enjoy

Autonomy

Below I have listed a dozen very common phobias, which are classified as specific phobias.

12 Common Specific Phobias

Arachnophobia

Fear of spiders

Ophidiophobia

Fear of snakes

Claustrophobia

Fear of confined spaces

Acrophobia

Fear of heights

Brontophobia

Fear of thunder

Aviaphobia

Fear of flying

Trypanophobia

Fear of injections

Mysophobia

Fear of germs

Musophobia

Fear of rats and mice

Cynophobia

Fear of dogs

Glossophobia

Fear of public speaking

Atychiphobia

Fear of failure

The oldest and strongest emotion of mankind is fear.

Anonymous

Fear is a very powerful, unpleasant and distressing emotion, which we experience when we believe that we are at risk of serious harm, threat or impending danger.

We have this emotion for survival purposes since it will steer us away from situations that could potentially harm us. People who do not possess the ability to experience this emotion are seriously handicapped and their chances of survival are significantly diminished.

How does fear help us to survive?

Fear will activate our fight or flight response mechanism, making us instantly as alert and powerful as possible so that we can face the threat and fight, or run away from it. In this context fear is a protective emotion and helps to keep us safe.

Fear is activated by our beliefs

False fear and its close associate, anxiety, squeeze the life-blood out of your existence. Sadly this powerful emotion is activated by our beliefs, whichalas are not always founded on reality. It is this false fear that we must learn to eradicate since it curtails our freedom to live our lives fully.

Fear and imagination

As a small child I recall inventing some terrifying creatures called E-cats to entertain my little brother, who adored my made-up bedtime stories. These fierce creatures lurked under the bed and could sever your arm or leg with one swift bite. Such were the powers of my imagination that I would lie immobilized and terrified in my bed in the dark, totally convinced of their existence and silently willing my parents to come up to say goodnight long after my little brother was fast asleep, he being of a more grounded constitution.

The point to be gleaned from this personal anecdote is that it did not matter if I was in real or imagined danger. My fear, based on my own overly active imagination, felt very real indeed, despite the fact that it was self-induced, and brought about the same symptoms as if the threat was genuine.

Perhaps you can remember times in the past when you have put yourself through agony due to incorrect beliefs and assumptions. Have you ever thought that you were being followed at night and in terror turned round to confront your assailant, only to discover that the noise you had heard was merely a crisp packet rustling in the wind? Though in no real danger, your body would have prepared itself just as thoroughly as if the danger were real. In chapter 7 we will look in detail at this phenomenon known as the activation of the fight or flight response.

2. Types of Phobia

Classification of phobias

DSM-IV

Phobias are divided into various categories depending on the level of sophistication and complexity of the classification system. The most commonly used classification system is taken from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, commonly referred to as the DSM-IV. In this system, phobias are allocated to three groups, namely social phobias, specific phobias and Agoraphobia. The specific phobia group is further broken down into five groups these being, animal, blood-injection-injury, situational, natural environment and other. For our purpose in this practical guide, we will follow the DSM-IV classification system on the whole. However, we will break down the category referred to as ‘other’into people and objects. We will alsorefer to the‘blood-injection-injury’ category asmedical/body-basedphobias. The specific phobias will be referred to as simple phobias and Agoraphobia and social phobias will be termed complex phobias:

Simple phobias (equivalent to the DSM-IV specific phobias)

Simple phobias are grouped together under the following category headings, and in each category you will find a brief case study to illustrate a particular phobia.

1. Animal phobias e.g. fear of bees, rats, jellyfish, sharks, eels, birds, wasps, lice, rabbits, cows, spiders, snakes, lizards, crabs, bats, frogs, horses, dogs, monkeys, pigs, slugs, crocodiles, hamsters or cats.

Sciurophobia

Fear of Squirrels

Darcy developed a fear of squirrels when, aged ten, a glis glis, which is an edible dormouse, had managed to get inside of his bedroom. The glis glis knocked over an ornament on his bedside locker, which startled Darcy. The glis glis did not seem to know how to find its way out of the room and ran amok whilst Darcy sat frozen to the spot in terror. Darcy, unsurprisingly, developed a fear of glis glis, which also extended to a fear of squirrels due to their similarity in appearance.

As a result of this experience Darcy would not go into the garden unless his dog went out first, reasoning that the dog’s presence would deter either of these creatures. He also flatly refused to go on any school trips which involved walking in the woods, parks or anywhere he felt might be a habitat for a squirrel or a glis glis.

2. Medical/body-based phobias e.g. fear of sleep, death, suffocating, choking, being cold or hot, being diseased, being anaesthetized, being injured, being sick, receiving stitches, going to hospital, giving birth, having an x-ray or operation, inoculation, blood transfusion.

Tokophobia

Fear of Giving Birth

Sunita developed a fear of giving birth when as a small child she watched a film in which the heroine went through considerable agonies before succumbing to death in childbirth. The fear was further compounded when in her early teens she heard her elder sister scream out in pain whilst giving birth to her first child.

Sunita felt both ashamed and embarrassed by her fear and did not disclose this to her family. Having sabotaged all her romantic relationships as a young adult, Sunita eventually met a partner with whom she wanted to share the rest of her life. Recognizing that her boyfriend wanted a family she eventually decided that she needed to address this fear and sought help.

3. Situational/action phobias e.g. fear of travelling through a tunnel, crossing a bridge, driving on a motorway, flying in turbulence, climbing a ladder, travelling on the Underground, sailing on the sea, diving off a board, skiing down a mountain or walking by a canal.

Subterrenus-Siderodromophobia

Fear of travelling on the Underground

Harry had recently broken up with his girlfriend, whom he had been dating for three years, whilst they were at university together. She had decided to take a job abroad and felt that they should end their relationship. Harry had struggled through his finals due to suffering from glandular fever, which was not diagnosed until he visited his doctor at the end of his exams. Harry had not done as well as expected in his exams on account of feeling too exhausted to study.

One day, whilst recovering from his illness, he returned home from a hospital check-up by tube train. The train stopped in a tunnel for a considerable amount of time as a consequence of a signal problem. During this time Harry started to panic and felt that he must get off the train since he felt he was unable to catch his breath. He became increasingly distressed and was convinced that he was going to suffocate. People around him were very kind and supportive but Harry felt absolutely desperate.