Spiders, planes, crowds how to overcome your phobias

Spiders, planes, crowds... how to overcome your phobias

Phobias are limitless but can be treated, provided they are taken care of early enough. The explanations of Dr Nicolas Belleux, psychiatrist in Lausanne and former vice-president of the Association of Vaud psychiatrists and psychotherapists.

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Phobia is a fairly widespread illness, which is part of anxiety disorders. It is an excessive and irrational fear that can lead to panic fear that makes us lose all our means. The phobia can apply to anything: the fear of the dark, of blood, of crowds, of insects, of cats, of dogs, the fear of vomiting, of eating in public, of losing your mobile phone… When 'one is confronted with the object of his phobia, it is all the thoughts, the emotions and the body which are put on alert, until the loss of control. We have trouble breathing, we have the impression that we are going to collapse, that we are going to die.

• How to explain this disorder? Phobias are in fact a protective mechanism. It is an avoidance strategy so as not to be confronted with a situation which one considers dangerous, so as not to be destroyed. A phobia can develop as a result of a traumatic event. The fear of water can for example find its origin in a drowning accident in the past, which we have directly or indirectly been confronted with. But the phobia can also exist without being correlated to a previous event. The triggering event is not always easy to identify.

• What treatments for treatment? Cognitive and behavioral therapies (CBT) are undoubtedly the most appropriate for treating phobias. And for good reason, it's a very pragmatic approach, as psychiatrist Nicolas Belleux explains: “CBTs make the link between thought (or cognition) and behavior. They are interested in how one and the other influence each other.” They generally begin with a work of comprehension, during which one tries to apprehend the phobia under an intellectual light.

Is the phobia related to a traumatic event? Does it have a predominantly symbolic component? These are questions that need to be answered. The therapy consists of gradually exposing the patient to the object of his anxieties with a view to desensitization. The goal being that he can face it without triggering a whole alarm system in his body and that he manages to manage his anxiety. An arachnophobic patient is cured when he can go into his basement, attic or laundry room without fear of coming across a spider. And that he is able to see her simply for what she is, in a neutral way, without any particular emotion or physical reaction.

• Should medication be used? Not necessarily, but medications of the anxiolytic or antidepressant type can be used as reinforcement, to promote relaxation, especially in people with strong anxiety.

• Are there alternatives to cognitive and behavioral therapies? New technologies are of great help in desensitizing the object of a phobia. Thanks to virtual reality, the patient can, in complete safety, be confronted with what frightens him excessively. “Virtual reality is an enabler. It makes it possible to develop various and more complex scenarios. The patient can for example virtually get on a plane, next to his therapist, undergo the turbulence of a capricious weather, without any risk for his person, and without having to go to the airport”, illustrates Nicolas Belleux.

Other therapies can also help the patient modify his experience as a phobic person. EMDR (“eye movement desensitization and reprocessing”) is especially indicated when the phobia is linked to a traumatic event. Its chances of success would even be higher than those of TCCs.

Hypnosis also allows you to work on the unconscious. “This approach is particularly useful when you don't understand the origin of the phobia and you want to bypass the mind,” comments Nicolas Belleux.

• Can it be easily cured? If you tackle a phobia early, you have a better chance of stopping it. But the more it is rooted in habits, the more difficult it will be to get rid of it. It is then necessary to show courage to consult a specialist. Because a phobia, and the avoidance behaviors that accompany it, can significantly reduce the quality of life, or at least complicate daily life, for example when one no longer dares to go out for fear of being in a crowd or meet a dog...

If overcoming a phobia is possible, certain situations are sometimes complex. Especially when there is a life problem that goes beyond the anxious relationship to the object of all fears. Sometimes the fear of spiders is resolved, but this fear transforms and the patient develops a new phobia. This happens when the first phobia has a symbolic component and is not related to trauma.

* Written in collaboration with Planète Santé

new phobia

New phobia. This neologism was invented to describe a phobia specific to our time: the excessive fear of being separated from your mobile phone! This anglicism (“nomo” for “no mobile” in English, associated with the term “phobia”) is not listed in the American classification manual of mental illnesses (DSM), but certainly speaks to many of us!

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