Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

I am bothered by a crippling phobia and would like to be free of it but fear some sort of confrontation with what I fear. Can you help?

Answer

A phobia is a specific debilitating fear, which can include panic, when exposed to the object of the fear. Phobias can include the fear reaction and panic even when anticipating that which is feared. Thus, persons can be afraid of a specific animal, a specific type of construction such as bridges or tall buildings, or specific types of individuals. People can also be afraid of specific activities such as flying, being in water, etc. Phobias can often go undetected until a confrontation with the feared object or situation exposes it. Phobias may also be at the root of such compulsive behaviors as hand-washing (fear of germs).

The most effective treatments available do not require going back into an extensive uncovering process such as what one might experience in psychoanalysis. The current treatments of choice are behavioral or cognitive- behavioral. One approach called flooding does involve exposure to the feared object. A very effective therapy, however, is systematic desensitization. This involves first of all learning deep muscle relaxation, then developing visual images which gradually approach the feared object in stages.

The idea is to pair imagining feared situations with being deeply relaxed. If, for example, you feared bridges, a firsts step after becoming relaxed might be to picture yourself looking at a magazine with pictures of bridges in it. The approach is gradual and very much under the control of the patient.

I would certainly encourage you to explore your phobia with a therapist and to discuss with the therapist his/her approach until you find one that gives you hope without causing you more panic.

07/24/98

Richard B. Patterson is a clinical psychologist in private practice in El Paso, TX. He is the author of three books on psychology and spirituality.