Treatment of Phobias (Including Agoraphobia)
Practicing cognitive behavioral therapy in NYC for more than 30 years, I have had the opportunity to see many patients who have rational and irrational fears. Phobias are quite simply irrational fears. They tend to increase your anxiety and to be an interference in your life. If you have one phobia, you probably have more than one. People who develop phobias are already anxious and of course the phobias add to it.
What are some causes of phobias?
- Anxiety, when it is high, often just attaches itself to situations or objects. Examples: being in a crowd, crossing bridges or going in tunnels, elevators, planes, etc. High anxiety can also create a fear of illness or death, often causes anxiety in older adults.
- A traumatic experience, such as being bitten by a dog, being stuck in an elevator or having a car accident can cause a phobia.
- Hearing about or seeing a traumatic situation such as a car accident or someone fainting in the street, can result in a person developing a phobia.
- Simply worrying about something, such as germs, leaving the gas on, failing to lock the door or your health can cause a phobia and sometimes an obsessive behavior as well.
- Panic attacks increase anxiety and often result in fear of going outside, fear of being alone, fear of crowds, and fear of being in small spaces, among other phobias.
What are the symptoms of phobias?
- Fear of an object or situation that is overwhelming to the point of wanting to avoid or escape it.
- Often the fear is severe enough to cause physical symptoms such as heart palpitations, perspiration, and rapid breathing.
- In extreme cases, the fear of the object or situation persists even in its absence. Example: being afraid of crossing paths with a dog on the street or seeing a bug in the house.
- People who have phobias usually realize that they are not being rational about their fear, but are unable to control their feelings.
- The fear usually decreases quickly and significantly as soon as the feared object or situation is gone.
How will Dr. Schwartz help me to overcome my phobias, including agoraphobia?
No matter which of the several cognitive behavioral therapy techniques works on your phobias, the goal of treatment is the same. You need to experience the object or situation while remaining calm and relatively anxiety free. You probably can’t imagine being at a party, getting on a plane, leaving your house by yourself or getting on an escalator, etc. You will learn how to confront your particular phobia, without being very fearful. My challenge is to, with your cooperation, develop a plan that will reduce your fear enough so that you can get on an elevator or go to the supermarket.
Often you will be given positive sentences to say instead of the anxiety producing sentences you have been saying. If you are obsessing I will teach you “thought stopping”. In some cases systematic desensitization is used. This is a method of having you imagine the feared object or situation at the same time that you are practicing to be calm. Learning to overcome a phobia takes much less time than you would expect and the time it takes is the same whether you have had the phobia for a long time or not.
Dr. Merny Schwartz is a dedicated and caring licensed clinical psychologist and certified school psychologist serving patients in Brooklyn, NY for more than 35 years.
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Dr. Merny Schwartz, PhD