The sight of a person running away from water, refusing to enter a lift, or mortally afraid of going near an innocuous pet dog may appear ridiculous or even childish, yet to that person the fear is real and terrifying, causing severe anxiety often amounting to panic. The person may recognise the fear to be irrational and unwarranted yet feels totally powerless to overcome it. His mind is taxed in working out strategies to avoid the feared situation or object, movements become restricted. There could be an abnormal need for a constant companion and thus life can turn into a torturous nightmare for those afflicted with phobia.
Everybody has irrational fear of something or other, severe enough to be even called a phobic anxiety, but it is the degree and the object of fear that makes phobia a problem. Phobia is that in which the individual is clearly distressed and whose life is affected to some degree by his or her abnormal fears. For example, a pathological fear of snakes can be lived with easily as snakes are uncommon to come across, whereas a phobia for travelling or driving can seriously interfere with normal daily living.
'Why me?' This question is posed by every phobic person but is difficult to answer. It is generally believed traumatic experiences in childhood or dramatic situations in the past coupled with certain personality traits that many anxious people have may predispose someone to suffer from phobias. However, individuals become phobic because of different mechanisms, including modelling (seeing someone close being phobic to a situation or having anxiety in a life-threatening situation which gets generalised).
PHOBIAS CAN BE BROADLY DIVIDED AS:
- Fears of specific objects (simple phobia), such as mice, cats, snakes, spiders etc.
- Fears of specific situation, such as being on the top of a high building, in a confined space
(agoraphobia and claustrophobia), for going to school etc.
- Fears of illness (nosophobia) or dying (necrophobia).
- Fears of social situations (social phobia).
SOME COMMON PHOBIAS
ZOOPHOBIA is a fear of animals, especially of cats, dogs, rats, cockroaches, snakes, insects etc. Here the fear may be of the animal itself or a fear of being contaminated by it. The fear may be based on actual unpleasant experience or a symbolic significance attached to it.
AGORAPHOBIA in which the person feels threatened in open, public places like markets, crowds, buses, theatres etc to an extent they become totally housebound.
CLAUSTROPHOBIA is present in those who cannot bear to be in closed, confined, small spaces such as crowds, lifts, tunnels, planes or even bathrooms.
SOCIAL PHOBIA is a relatively common phobia in which the sufferer has intense fear of being in public gaze, or of meeting people, especially of the opposite sex, anxieties about looking foolish, ugly or simply getting noticed.
The list can go on endlessly as there can be many phobias or feared objects or situations, some fairly common and others quite rare. The earlier it is recognised as a problem and treated the better, before it becomes a fully entrenched behavior pattern.
MANAGEMENT
The ideal treatment approach is a combination of anti-anxiety medication which helps to control the acute anxiety and panic, along with a long term psychotherapy - specifically what is known as 'behaviour modification techniques'. This involves initial training in relaxation methods followed by a gradual exposure to the feared object or situation in a guided, systematic manner, under the supervision of a trained behaviour therapist.
Mild symptoms may be handled without medication, sometimes by the person alone or with the help of a close friend or relative. It is important that the family and friends encourage the person for the efforts and success without trivializing the matter or ridiculing the person. The journey is rough and arduous and requires discipline and commitment by all concerned but the reward is a life, free from crippling fear which is well worth all that and more.
—Dr. Avdesh Sharma is a celebrated mental health expert and Heads ‘Media and Public Education Committee’ of ‘Psychiatry in Developing Countries Section’ of World Psychiatric Association.
|
