Success in treating a phobia depends on the person's level of courage in confronting it, writes EDEL MORGAN
PHOBIAS DON’T necessarily stem from childhood or as a result of repeated terrifying experiences – they can strike at any time, says hypnotherapist Katie Jane Goldin.
“Sometimes they happen after one bad experience. For example, a person could develop a fear of flying after experiencing turbulence on a flight or a fear of dogs after a dog jumping out at them.”
Goldin has come across some unusual phobias, including a patient who was afraid of a pub in Limerick where he’d been mugged – “he couldn't drive past it, so he would choose a longer route”.
She has seen a mother and daughter with a dread of earrings – “If they saw someone touching earrings they’d want to vomit” – and an eight-year-old child with a fear of buttons. “We can’t wear any clothing with buttons when she comes in. Her parents think when she was getting an injection at age two, the doctor was wearing a jacket with big buttons.”
One of the most debilitating phobias she has come across is atychiphobia – a fear of failing. “People with it often don’t want to get into a relationship or go to work, it’s really serious.
“Sometimes people don’t know why they have a phobia, but it doesn’t really matter how it arose, it’s an irrational fear,” says Goldin, who practises from the south Dublin clinic set up by her late father, Paul Goldin.
Psychotherapist Áine Tubridy, author of When Panic Attacks, says journalists are always fascinated with unusual phobias.
She once had a patient with alektorophobia, a fear of chickens, “not just chickens running around, it was the shape of a chicken, the smell of a chicken, even the idea of a chicken. She got it into her head that chickens are harmful.”
For the most part, however, the phobias she treats are the more common ones including spiders, flying, public speaking, lifts, injections and hospitals, and social phobia.
Tubridy says that after a terrifying experience, the unconscious mind can interpret a trigger as being frightening. “For phobics, avoidance is their only best guarantee even though it is not harming them.”
The symptoms of phobias include feelings of terror and impending doom, sweating, palpitations, muscle tension, panic attacks and nausea. People can even experience severe anxiety when anticipating a phobic trigger.
Ann McHugh says she only had to set foot in the airport terminal to feel panicky. She isn’t sure how her fear of flying started, “but it could have something to do with the fact my mother was very protective. She was always afraid something was going to happens to us . . .”
McHugh took the occasional short- haul flight, “but hated it. I’d always have a few drinks or take a pill.”
Her phobia meant she missed out on family trips to Cuba and San Francisco. “My husband and son went instead, I hated connecting flights – it meant I’d have to take off and land twice.”
In 2008 when the chance of a trip of a lifetime to Australia arose she decided to try hypnotherapy and went for six sessions over three months.
“A lot of it was about learning to relax, about not having to be in control all the time. I had to tell myself the pilot is flying the plane, not me. It’s the same in the car – I like driving but not being the passenger.”
She got through the flights using relaxation exercises. “Coming back from Sydney at Singapore there was turbulence, but I got through it. I’m never not going to be nervous, but I was able to deal with it without panicking.”
Katie Jane Goldin says hypnosis works by inducing a state of deep relaxation and infiltrating the subconscious to change habit patterns because the mind “doesn’t like to change. If you tell the conscious mind we’re going into an aeroplane now, don’t be frightened, of course the person is going to be frightened.”
Áine Tubridy says when a phobic is in the grip of fear, what they are relating to is a memory. “They are interfacing with the past and they are catastrophising.”
How treatable a phobia is can depend on a person’s level of courage, says Tubridy. “I’ve had people who can’t get the courage to face their fears because the feeling inside their body is so strong. Thoughts dictate, and if there is a fear thought it gathers molecules and becomes quite a big sensation.”
Fifty-nine-year-old James Fogarty has being battling a fear of heights – and bridges – for years and has tried several forms of therapy.
He says it doesn’t affect him too much in Ireland because we don’t have as many high rise buildings and intimidating bridges.
“It’s only when I go abroad that I find the phobia comes to the fore. I love driving yet when I go to England I lose all my bravado,” he says.
His son lives in Leeds and the most direct route involves a drive across the M62 motorway, which rises more than 1,400ft above sea level at its highest point. He has driven over it by focusing on the middle distance, but is more inclined to avoid doing it as he gets older.
“I would love to be able to go to whatever country and just drive without that nagging fear and having to research the roads so I can avoid any heights.
“To avoid the M62 adds an hour and 15 minutes on to my journey,” he says.
He thinks his fear of heights might stem from an experience in Thurles “50 odd years ago” when he was crossing a metal bridge over the railway.
“There were holes in the bridge. I could see down through the holes and had an awful feeling in my stomach like I was going to be physically sick.”
When he and his wife visit his brother-in-law, who lives an hour’s drive outside New York, they hire a car to take them because he can’t face driving over George Washington Bridge.
He avoids hotels in New York after an experience in the late 1990s on the 11th floor of thebuilding where was staying when he was afraid to approach the window to close the blinds. “Logically it’s terrible silly, I know there’s a glass window there to stop me falling out.”
The key to overcoming a phobia is breathing, relaxation and talking your mind around, says Áine Tubridy.
“This involves sensation exposure but if, for example, a person is terrified of dogs you don’t put the person in a room with a German Shepherd. They will even react to a video of a dog.
“You have to show and tell yourself. So if you’re in the garden and the dog is on a lead, you have to show yourself every minute the dog isn’t going to bite you.
“As you feel calmer you move a bit closer, let the dog off the lead and finally get nearer.”
She says the success of treatment often depends on the timing. “Sometimes people go off, slide back, and it can be in fits and starts until they reach the point where the price of not sticking to it is too high,” she says.
REALITY CHECK: TACKLING YOUR FEAR IN 3D
Psychologist Susannah Healy runs a 3D virtual reality clinic for phobias in Dundrum Town Centre.
She says she has seen business people who’ve delivered speeches and presentations for years suddenly develop a fear of public speaking after one bad experience.
“They might be tired or unprepared or their stress levels high when they’re giving the presentation. They might be thinking, ‘If this feels awful, the presentation must be awful’ , which isnt necessarily true. It’s a fear of being judged by other people.”
While the clinic, called AccessPsychology, offers a range of 3D therapies – including fear of flying, heights, lifts and storms – I tried the public speaking programme.
With Healy at the helm controlling the programme from her computer, I stand at a podium and am immersed through earphones and 3D goggles into a simulated room full of virtual strangers.
Healy says before she sends people to confront their greatest fear, she prepares them first and assesses the severity of their phobia. She says for some affected by glossophobia, the sight of the podium is enough to induce panic.
I’m daunted by the prospect of public speaking, but I don’t know if it’s a phobia. A phobia is the avoidance of something you fear and I’m not required to give presentations in my job. The last time I did one was at college as part of an exam and while I got through it I was sure my heart was about to explode.
I start to deliver my speech to three rows of very real looking people – all actors who have been pre-recorded – and while at the beginning they listen intently, some start to fidget and get distracted.
Healy can adjust the levels of inattentiveness and at one point a very bored looking woman in the front row writes something on her notepad and shows it to the person beside her. At intervals, audience members stand up to ask questions and then I have to pick up the thread of my speech.
While I think this is a great way of preparing for a presentation, I didn’t feel overly anxious because I knew they weren’t real people and weren’t really judging my performance.
Healy reckons if I was truly phobic there would be enough triggers in the simulated situation to provoke fear. She says where virtual reality comes into its own is in providing a controlled environment for people to confront their fears.
With something like lifts and underground car parks you can get away with avoiding them for many years, but avoidance only confirms your fear and strengthens it.
“For the treatment to work you have to feel the fear, then realise those feelings are not going to hurt you. The fear subsides and so do the sweaty palms and palpitations.”
